Alternative medicine should be subject to scientific rigor, too

Nearly 20 percent of Americans have used 'natural' health products – an alternative treatment produced by a living organism – creating a huge market for complementary and alternative medicine. According to the FDA, in 2014 there were 85,000 natural health products on the market in the US, and this number is ever on the rise.

Unfortunately, it is frequently hard for laypeople – and sometimes even for scientists – to sort out which of these therapies are actually beneficial to our health and which ones are just pseudoscientific woo. This problem is further compounded by the wealth of misinformation regarding complementary and alternative medicine readily available to patients. This information gap can be relatively innocuous, in the case of multivitamin and other supplements. And it can be downright dangerous, as in the case of amygdalin (laetrile), a compound extracted from apricot kernels which is marketed as a cure for cancer but instead places consumers at risk of cyanide poisoning.

To undercut companies peddling such dubious products, their promises need to undergo scientific scrutiny – researchers need to work toward understanding what active compounds could be responsible (if indeed there are any present) for the medicinal effects allegedly seen by using natural products. Identifying active compounds would potentially allow scientists to improve their medicinal properties and – importantly – allow for quality-controlled mass production.

Honey and royal jelly are two great examples of how research on alternative treatments can benefit us all. Both substances have been marketed as a panacea - from treating wounds, to ameliorating cancer. A recently published scientific article shows how defensin-1, a well-known anti-bacterial protein in both honey and royal jelly, can help heal skin wounds. Furthermore, purified defensin-1 had the same effect on wound healing as an extract of royal jelly, demonstrating that it is one of the major components responsible for the effect of the natural substance. Bee defensin-1 thus appears to be a promising compound for treating diabetic wounds or other wounds which would require a long time to heal.

Similarly, Nobel Prize-winning research into a traditional Chinese medicinal preparation led to the discovery of artemisinin, today a best-selling anti-malarial drug. The discovery of such active compounds present in traditional medicinal preparations can play an important role towards discovering new compounds.

The FDA classifies most natural products as dietary supplements rather than drugs, making them subject to a much less stringent regime of proving safety and efficacy. Additionally, alternative medical preparations such as homeopathic medications are not required to show any proof of efficacy or safety, and this has led to a number of high profile cases such as the recall of products which were contaminated with belladonna. And such natural products are frequently plagued by other issues, such as high batch-to-batch variability and the presence of contaminants, including heavy metals. Research into discovering active compounds in such products could help solve these problems.

At the same time, it is crucial to understand that not all alternative medical systems are equal, and preparations which are found to be ineffective or even downright harmful should be definitively labelled as such by the scientific community for the benefit of the general public. Traditional medicines which do not show any promise in clinical trials should be clearly and widely labelled as such.

It is entirely possible that a wealth of medical knowledge, refined over decades and centuries of observation and experimentation, is hidden away in complementary and alternative medical systems such as ayurveda, traditional Chinese medicine, and herbalism. But in order to fully capitalize on this knowledge, it is crucial we make use of the in-depth understanding we now possess of biological systems to understand whether, and how, natural product preparations work.

Now is the time for researchers to carefully analyze which ones show promise and to convert them into potentially game-changing medications by distilling out active substances. Obtaining such an in-depth understanding of how natural products work would allow us to market these to the world in a safe and medically responsible manner.