Alternative, complementary and integrative medicine: what each means and what the evidence says

In the kitchen drawer there are bottles of capsules, herbal tea bags and the pills you were prescribed. You did not mention any of it at your last appointment, because you were not sure it mattered or feared being scolded. Meanwhile a symptom has gone weeks without being evaluated and the new tea seems the easier option. The cost of staying as you are is that nobody sees the whole picture: not what you take, and not what is actually going on.

NCCIH groups these approaches by what they do: nutritional (diets, dietary supplements, herbs, probiotics), psychological (such as mindfulness), physical (such as massage or spinal manipulation) and combinations (such as yoga, tai chi or acupuncture, or mindful eating).

In a 2012 national survey cited by NCCIH, more than 30 percent of U.S. adults and about 12 percent of children used one or more of them. That figure is dated and from a national survey, but it shows how common this is. What matters is that your doctor knows.

Phrases like “alternative therapies” and “natural medicine” are used loosely. “Natural” describes where something comes from, not whether it is safe or whether it works.

There is no single answer to “does alternative medicine work?”, because every practice has its own evidence. What can be said:

Trying a tea or a supplement for a few weeks can seem harmless, but the cost of waiting is real when a symptom has not been evaluated. Fatigue that does not lift, pain that keeps returning, unexplained weight change, shortness of breath, bleeding or a new lump needs a medical evaluation and, sometimes, lab tests, not another product.

See a doctor soon if a symptom has lasted more than a couple of weeks, is getting worse, keeps coming back or gets in the way of normal life; if you are pregnant or have a chronic illness; or if you were told to take a treatment and want to change it.

With warning signs, do not wait: call 911 or go to the emergency room. See what counts as an emergency.

The Health Initiative (THI) is the nonprofit that runs this telehealth clinic. Dr. Diana Nieves Castro is a general practice physician licensed in Puerto Rico. Her visit is a medical visit: first an assessment of your history and symptoms, and then sleep, nutrition, movement, stress and a review of everything you take.

In a video visit she can evaluate, diagnose, treat, prescribe when appropriate and order labs at a nearby lab. She can review the medicines, supplements, herbs and teas you already use, look for interactions, tell you honestly what is known and help you coordinate with other practitioners.

This is a visit with a licensed physician. Therapies such as acupuncture or chiropractic are provided by separately licensed practitioners, and she can help you decide what to ask them.

Online visits are for people who are physically in Puerto Rico. For lab follow-up and non-controlled refills, see follow-up visits, lab orders and primary care.

Write down everything you take today, and request an online visit so the doctor can go through the list with you, alongside your history and symptoms. Have any lab results handy. For the cost, see the pricing page.

As related reading, THI also runs an in-person wellness retreat in Puerto Rico, held in English; it is wellness, not medical treatment and not a substitute for medical care.

This guide is general information. It is not a diagnosis and does not replace your doctor. Do not stop, change or delay medicines, vaccines or screenings without talking to a health professional.