Many people use medicines or remedies that their healthcare professionals did not prescribe. These remedies can include herbal medicines, medical marijuana, vitamins, supplements, and folk remedies.

These remedies can be part of:

• Alternative medicine, which is not mainstream medicine, that replaces conventional medicine.
• Complementary medicine, which is not mainstream medicine but is used along with conventional medicine. This is much more common in the United States compared to alternative medicine.
• Integrative medicine, which is using mainstream and complementary medicine in a coordinated way. This is ideal for health care.

Evidence about the effectiveness of these types of medicine is growing, although more research is needed in older adults.

Evidence about the effectiveness of complementary and integrative medicine is growing. For example:

• Osteoarthritis. Some healthcare professionals recommend glucosamine and chondroitin for people with arthritis. These supplements are building blocks of cartilage. Research has found reduced pain, less loss of space between joints, and improved function. Use of curcumin, which is found in the spice turmeric, can reduce pain and use of pain relievers.
• Depression. Use of St. John’s Wort and SAM-e (made in the body from methionine, which is an amino acid found in foods) have shown some benefit in treating depression.
• Cognition (thinking and memory). Green tea has shown small improvement in cognition in mild dementia.
• Pain. Medical marijuana can reduce chronic pain and nerve pain in some patients.

Cautions About Complementary Remedies

However, there are cautions about use of other alternative and complementary medicines. 

• Herbal products can affect the body just like prescription drugs. They can:
  • Add to or work against the effects of regular medications (drug interaction is common)
  • Cause side effects that can be hard to predict, especially for older adults
• Large doses of vitamins, minerals or supplements can be harmful. For example, large doses of vitamin A can worsen bone health. And large doses of vitamin B6 can cause nerve pain. Do not take extra vitamins unless your healthcare professional recommends it.
• Medical marijuana can have dangerous side effects, especially for frail older adults. It can cause dizziness, disorientation, confusion, loss of balance, fatigue, drowsiness, and hallucinations.

Regulation of Complementary Remedies

The US Food and Drug Administration (FDA) does not regulate herbal products, vitamins or supplements the same way it does prescription and OTC medicines. The FDA regulations only help assure that a natural product has good production practices and can be removed from the market if it is unsafe.

• FDA rules do not make sure that herbal remedies are safe for everyone to use. Companies that make these products are not regulated in the U.S. So, products with the same name may not have the same type or amount of ingredients.
• Some companies produce high-quality products, but others may have poor quality control or unclean conditions. This increases the chances of side effects.
• Supplements do not cure or prevent most disease.

Always tell your healthcare providers about all medicines you are using, including those that are alternative or complementary. This is important because these medicines may cause harmful interactions with other drugs and side effects sometimes can be life-threatening.

If you choose to try complementary therapies, work with your healthcare professionals before you start. They can help you use them safely. Your pharmacist can help ensure you are buying a product from a reputable company and check on drug interactions and side effects to prevent harm. For example:

• Ginkgo biloba, St. John’s wort, and fish oil all interact with blood thinning (anticoagulant) medications to increase bleeding risks.
• Echinacea interacts with medications that suppress the immune system.

Your healthcare professionals can help you decide which complementary treatments are best for you.

Last Updated March 2023