An article in The Star Online (Malysia) by Loh Foof Fong entitled 'Fusion of Old and New' provides a socioeconomic case for integrative medicine while cautioning that there is a need for adequate scientific evidence of clinical benefit, safety and risks before an endorsement of integrated medicine can be offered.
The article summarizes presentations at the recent 5th International Conference on Traditional and Complementary Medicine (TCM) held in Petaling Jaya, Selangor with several key points:
- Herbal medicine is rapidly growing in economic importance with sales for herbal medicines (including raw material) amounting to US$43 Billion.
- In some countries, traditional medicine practitioners care for at least 80% of the rural population.
- The Health Ministry (Malaysia) has not given total endorsement to all traditional/complementary medicine practices in Malaysia, taking an evidence-based approach such as introducing measures to ensure safety and quality through training of practitioners, and the requirement for clinical trials as products are inttroduced.
- Safety issues in TCM include contamination, adulteration, actions of herbs and herb-drug interactions.
Dr Alex Schauss, president and CEO of the AIBMR (American Institute for Biosocial and Medical Research Inc), noted that dietary supplement adverse events are rare, adulteration is a common problem. Speaking on the need for proper toxicology testing to substantiate safety, Dr Schauss also said that practitioners should be aware of contamination as a result of environmental pollution, citing cadmium as an example.
Dr. Schauss also stated, “My issue with the safety of dietary supplements is that if you change it from its traditional use in any way through any process, you have to prove it is safe,” he said. “If in a plant you find 10mg of kavalactone and by standardising it you provide 20mg, that's not a problem because in some plants you have 20mg. That's what you find through traditional use. But if I make a product with 100mg kavalactone, that's a problem because in nature you won't find 100mg in Kava kava. Then I need to know if it is safe.”
While discussing retaining biodiversity, presenters noted the surge in popularity of the jungle plant togkat ali, which is in danger (within seven years) at present harvesting rates, of being farmed out.