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… medical and health care practices outside the realm of
CAM Domains CAM’s Popularity: Growth of Visits to CAM Practitioners CAM: The Evidence CAM Domains St. John’s Wort Medicinal herb Widely used $6 billion European sales (1998) $140 million U.S. sales (1998) Complex mixture of 2 dozen compounds Antidepressant constituent = hyperforin Drug interactions oral contraceptives indinavir cyclosporin Chemoprotection: Defense Against Toxins CYP3A Induction Causes Drug Interactions Nuclear Receptor Superfamily Human PXR Expression Pattern PXR Binds to CYP3A Promoter St. John’s Wort Activates PXR SJW Regulates Other PXR Target Genes Now, these are truly diverse areas and we aggregate them for work purposes at the National Center for Complementary and Alternative Medicine into five major domains. These are biologically based systems, including special diets and thousands of different kinds of herbal remedies. These include manipulative and body-based systems, such as massage, chiropractic, and osteopathic manipulation. Energy therapies, involving things that are truly based on energies with electromagnetic radiation, such as magnets and electro-acupuncture, and things that are purporting to work through energy, such as reiki and qi gong and other forms of Asian health care practices. There are mind-body approaches of which many are within the field of CAM, including yoga and meditation. And there are whole systems that exist as parallel health care universes we call alternative medical systems. Some of which are ancient -- ayurvedic medicine from India, traditional Chinese medicine -- as well as things in the past two centuries that evolved in Europe and the United States, such as naturopathic medicine and homeopathy. Now, these are enormously popularly practices, and while the specific data here might be questioned, the survey by David Eisenberg at Harvard published four years ago suggested that people in the United States are making more visits to CAM practitioners, and that those numbers -- that number of visits grew
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