Nov. 27, 1999 (Atlanta) -- Of the 43 million Americans suffering from arthritis, two-thirds have tried alternative therapies, according to the Arthritis Foundation. To avoid adverse reactions with prescription drugs, rheumatologists say they need to know when patients are taking vitamins, herbs, or dietary supplements.
This widespread use of alternative therapies recently led the Arthritis Foundation to publish a comprehensive consumer guide. The subject matter, ranging from exercise and massage to copper bracelets and bee venom, is intended to represent the full scope of alternative approaches. John Klippel, MD, the medical director of the Arthritis Foundation, tells WebMD, "We don't recommend or advocate any of these therapies, but we do recommend that patients use these therapies with their doctor's knowledge."
Klippel says that "vitamins, herbs, and dietary supplements are of special concern because they are biologically active and may interact with prescription drugs. This can alter the effectiveness of medications and cause serious side effects. To help sort these problems out, doctors need to know everything patients are taking."
This position is strongly supported by rheumatologists in clinical practice. Steven Edworthy, MD, associate professor of medicine at the University of Calgary, tells WebMD, "it's not always easy for patients to discuss alternative therapies with physicians, but it's terribly important. Doctors need to create a kind of comfort zone to encourage such disclosure. Being open, accepting, and neutral is a big part of that."
Similarly, Roy Fleischmann, MD, the division chief of rheumatology at St. Paul Medical Center in Dallas, tells WebMD, "Even though patients may be reluctant, I encourage them to list everything they are taking by mouth, no matter how they learned about it or where they got it. That way, they are less likely to get into trouble with potential side effects. Besides, it's OK for physicians and patients to agree to disagree on some issues. Of course, I would prefer that patients opt for treatments that have been shown to be effective."
Many alternative therapies have not been thoroughly studied, although Klippel says this is changing. Recently, the National Institutes of Health (NIH) launched a clinical trial to evaluate glucosamine and chondroitin sulfate in treating osteoarthritis of the knee. In its announcement to the press, the NIH cited an "urgent need to test these drugs in a rigorous way due to rising public interest and conflicting results in the past."
Until the data are in, "consumers should be wary of claims and testimonials about alternative therapies," says Klippel. "They should look for the scientific evidence supporting each and every claim."