Millions of Americans use complementary health approaches. Like any decision concerning your health, decisions about whether to use complementary approaches are important. The National Center for Complementary and Integrative Health (NCCIH) has developed this fact sheet to assist you in your decisionmaking about complementary health products and practices.

• Be an informed consumer. Find out and consider what scientific studies have been done on the safety and effectiveness of any health approach that is recommended to or interests you.
• Discuss the information and your interests with your health care providers before making a decision.
• Choose a complementary health practitioner, such as an acupuncturist, as carefully as you would choose a conventional health care provider.
• Before using any or herbal product, make sure you find out about potential side effects or interactions with medications you may be taking.
• Only use treatments for your condition that have been proven safe. Do not use a product or practice that has not been proven to be effective to postpone seeing your health care provider for your condition.
• Tell all your health care providers—complementary and conventional—about all the health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

“Complementary and alternative medicine,” “complementary medicine,” “alternative medicine,” “”—you may have seen these terms on the Internet and in marketing, but what do they really mean? While the terms are often used to mean the array of health care approaches with a history of use or origins outside of , they are actually hard to define and may mean different things to different people.

The terms complementary and integrative refer to the use of non-mainstream approaches together with conventional medical approaches.

Alternative health approaches refer to the use of non-mainstream products or practices in place of . NCCIH advises against using any product or practice that has not been proven safe and effective as a substitute for conventional medical treatment or as a reason to postpone seeing your health care provider about any health problem. In some instances, stopping—or not starting—conventional treatment can have serious consequences. Before making a decision not to use a proven conventional treatment, talk to your health care providers.

It's important to learn what scientific studies have discovered about the complementary health approach you're considering. Evidence from research studies is stronger and more reliable than something you've seen in an advertisement or on a Web site, or something someone told you about that worked for them. (For tips on how to evaluate Web site information, see the NCCIH fact sheet Finding and Evaluating Online Resources on Complementary Health Approaches.)

Understanding a product's or practice's potential benefits, risks, and scientific evidence is critical to your health and safety. Scientific research on many complementary health approaches is relatively new, so this kind of information may not be available for each one. However, many studies are under way, including those that NCCIH supports, and knowledge and understanding of complementary approaches are increasing all the time. Here are some ways to find reliable information:

• Talk with your health care providers. Tell them about the complementary health approach you're considering and ask any questions you may have about safety, effectiveness, or interactions with medications (prescription or nonprescription) or dietary supplements.
• Visit the NCCIH Web site (nccih.nih.gov). The “Health Information” page has an A-Z list of complementary health products and practices, which describes what the science says about them, and links to other objective sources of online information. The Web site also has contact information for the NCCIH Clearinghouse, where information specialists are available to assist you in searching the scientific literature and to suggest useful NCCIH publications. You can also find information from NCCIH on Facebook (www.facebook.com/nih.nccih), Twitter (www.twitter.com/nih_nccih), YouTube (www.youtube.com/c/nih_nccih), and Pinterest (www.pinterest.com/nccih).
• Visit your local library or a medical library. Ask the reference librarian to help you find scientific journals and trustworthy books with information on the product or practice that interests you.

As with any medical product or treatment, there can be risks with complementary approaches. These risks depend on the specific product or practice. Each needs to be considered on its own. However, if you're considering a specific product or practice, the following general suggestions can help you think about safety and minimize risks.

• Be aware that individuals respond differently to health products and practices, whether conventional or complementary. How you might respond to one depends on many things, including your state of health, how you use it, or your belief in it.
• Keep in mind that “natural” does not necessarily mean “safe.” (Think of mushrooms that grow in the wild: some are safe to eat, while others are not.)
• Learn about factors that affect safety. For a practice that is administered by a practitioner, such as , these factors include the training, skill, and experience of the practitioner. For a product such as a dietary supplement, the specific ingredients and the quality of the manufacturing process are important factors.
• If you decide to use a practice provided by a complementary health practitioner, choose the practitioner as carefully as you would your primary health care provider. (To learn more, see NCCIH's 6 Things To Know When Selecting a Complementary Health Practitioner.)
• If you decide to use a dietary supplement, such as an herbal product, be aware that some products may interact in harmful ways with medications (prescription or over-the-counter) or other dietary supplements, and some may have side effects on their own. (To learn more, see the NCCIH fact sheet Using Dietary Supplements Wisely.)
• Tell all your health care providers about any complementary or integrative health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

As with any treatment, it is important to consider safety before using complementary health products and practices. Safety depends on the specific therapy, and each complementary product or practice should be considered on its own.

Mind and body practices such as meditation and yoga, for example, are generally considered to be safe in healthy people when practiced appropriately. Natural products such as herbal medicines or botanicals are often sold as dietary supplements and are readily available to consumers; however, there is a lot we don’t know about the safety of many of these products, in part because a manufacturer does not have to prove the safety and effectiveness of a dietary supplement before it is available to the public.

Two of the main safety concerns for dietary supplements are

• The possibilities of drug interactions—for example, research has shown that St. John’s wort interacts with drugs such as antidepressants in ways that can interfere with their intended effects
• The possibilities of product contamination—supplements have been found to contain hidden prescription drugs or other compounds, particularly in dietary supplements marketed for weight loss, sexual health including erectile dysfunction, and athletic performance or body-building.

Before you begin using a complementary health approach, it’s a good idea to ask the following questions:

• Is there scientific evidence (not just personal stories) to back up the statements?
• What is the source? Statements that manufacturers or other promoters of some complementary health approaches may make about effectiveness and benefits can sound reasonable and promising. However, the statements may be based on a biased view of the available scientific evidence.
• Does the Federal Government have anything to report about the product or practice?
  • Visit the NCCIH Web site or contact the NCCIH Clearinghouse to see if NCCIH has information about the product or practice.
  • Visit the U.S. Food and Drug Administration (FDA) online at www.fda.gov/ to see if there is any information available about the product or practice.
  • Information specifically about dietary supplements can be found on the FDA’s Web site at www.fda.gov/Food/DietarySupplements/ and on the Web site of the National Institutes of Health (NIH) Office of Dietary Supplements at ods.od.nih.gov/.
  • Visit the FDA's Web page on recalls and safety alerts at www.fda.gov/Safety/Recalls/. The FDA has a rapid public notification system to provide information about tainted dietary supplements. See www.fda.gov/AboutFDA/ContactFDA/StayInformed/RSSFeeds/TDS/rss.xml.
  • Check with the Federal Trade Commission at www.ftc.gov to see if there are any enforcement actions for deceptive advertising regarding the therapy. Also, visit the site’s Consumer Information section at www.consumer.ftc.gov.
• How does the provider or manufacturer describe the approach?
  • Beware of terms like “scientific breakthrough,” “miracle cure,” “secret ingredient,” or “ancient remedy.”
  • If you encounter claims of a “quick fix” that depart from previous research, keep in mind that science usually advances over time by small steps, slowly building an evidence base.
  • Remember: if it sounds too good to be true—for example, claims that a product or practice can cure a disease or works for a variety of ailments—it usually is.

Is That Health Web Site Trustworthy?

If you're visiting a health Web site for the first time, these five quick questions can help you decide whether the site is a helpful resource.

Who? Who runs the Web site? Can you trust them?

What? What does the site say? Do its claims seem too good to be true?

When? When was the information posted or reviewed? Is it up-to-date?

Where? Where did the information come from? Is it based on scientific research?

Why? Why does the site exist? Is it selling something?

Are You Reading Real Online News or Just Advertising?

In April 2011, the Federal Trade Commission warned the public about fake online news sites promoting an acai berry weight-loss product. For example, one described an investigation in which a reporter used the product for several weeks, with “dramatic” results. The site looked real, but it was actually an advertisement. Everything was fake: there was no reporter, no news organization, and no investigation. The only real things were the links to a sales site that appeared in the story and elsewhere on the Web page. Similar fake news sites have promoted other products, including work-at-home opportunities and debt reduction plans.

You should suspect that a news site may be fake if it:

• Endorses a product. Real news organizations generally don’t do this.
• Only quotes people who say good things about the product.
• Presents research findings that seem too good to be true or fail to point out any limitations in research. (If something seems too good to be true, it usually is.)
• Contains links to a sales site.
• Includes positive reader comments only, and you can’t add a comment of your own.

How To Protect Yourself

If you suspect that a news site might be fake, look for a disclaimer somewhere on the page (often in small print) that indicates that the site is an advertisement. Also, don't rely on Internet news reports when making important decisions about your health. If you're considering a health product described in the news, discuss it with your health care provider.

While scientific evidence now exists regarding the effectiveness and safety of some complementary health approaches, there remain many yet-to-be-answered questions about whether others are safe, whether they work for the diseases or medical conditions for which they are promoted, and how those approaches with health benefits may work. As the Federal Government’s lead agency for scientific research on health interventions, practices, products, and disciplines that originate from outside , NCCIH supports scientific research to answer these questions and determine who might benefit most from the use of specific approaches.

• Your primary health care provider or local hospital may be able to recommend a complementary health practitioner.
• The professional organization for the type of practitioner you’re seeking may have helpful information, such as licensing and training requirements. Many states have regulatory agencies or licensing boards for certain types of complementary health practitioners; they may be able to help you locate practitioners in your area.
• Make sure any practitioner you’re considering is willing to work in collaboration with your other health care providers.

NCCIH does not provide treatment or referrals to complementary health practitioners. NCCIH's mission is to define, through rigorous scientific investigation, the usefulness and safety of complementary health approaches and their roles in improving health and health care.

NCCIH supports clinical trials on complementary health approaches. These trials are taking place in many locations, and study participants are needed. To learn more or to find trials that are recruiting participants, visit NIH Clinical Research Trials and You. The site includes questions and answers about clinical trials, guidance on how to find clinical trials through ClinicalTrials.gov, and other resources and stories about the personal experiences of participants.