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Wikipedia defines alternative medicine as a set of products, practices, and theories believed or perceived by their users to have the healing effects of medicine but whose effectiveness has not been established using scientific methods, whose theory and practice are not part of biomedicine, and directly contradicted by scientific evidence.
The term "snake oil" implies something ineffective or useless and is often used by people as a derogatory term for alternative medicine. Sometimes, the term fits, and sometimes, it doesn't.
Science-based advocates
Many scientists and physicians identify themselves as "science-based" and advocate for only traditional medical methods. The most extreme consider alternative, holistic, complementary, and integrative medicine to be the same. So, for this article, when I use the term "alternative medicine," I'm including holistic, complementary, and integrative medicine.
However, I want to clarify that “complementary” and “integrative” imply using holistic or alternative practices to augment traditional medical care.
The main concern that "science-based" advocates have is that everything in medicine must have scientific studies to prove it works. "Proving it works" is easier said than done regarding the human body since drugs and procedures often seem to be effective, and then, when another clinical trial comes along, it turns out not to be so.
Or after the United States (U.S.) Food and Drug Administration (FDA) approves a treatment, and it has been on the market for a while; it turns out to be dangerous and even deadly. In addition, people living in glass houses shouldn't throw stones, which I will expand on later in this article.
Quackery
The most rigid of these "science-based" advocates think the following are quackery: Acupuncture, Traditional Chinese Medicine (TCM), Ayurveda, Homeopathy, Naturopathy, Osteopathic Medicine, Chiropractic, and Functional Medicine.
There are over 9,300 licensed acupuncturists, 8,500 licensed naturopathic doctors, and over 70,000 licensed chiropractors in the U.S., with chiropractors treating over 35 million people annually. In addition, 7,705 osteopathic medical students and prior osteopathic graduates matched into medical residency programs in 2024.
That's a lot of licensed quacks practicing in the U.S.!
In addition, by labeling TCM and Ayurveda as quackery, these "science-based" advocates are arrogantly dismissing thousands of years of cultural and medical traditions that have helped millions of people in China, Taiwan, India, and Nepal.
According to the British Medical Journal, TCM accounts for 40% of all healthcare delivered in China. According to the National Center for Complementary and Integrative Health, Ayurvedic medicine is one of the world's oldest medical systems and remains one of India's traditional healthcare systems.
My bias
I'm biased because my parents brought me to the family chiropractor when I was an infant to treat my "floppy neck" and "lazy eye," which he corrected. In addition, my favorite uncle, a chiropractor, adjusted us cousins as children well into adulthood.
Not only that, but my training through The Institute for Functional Medicine has helped fill in many of the blanks that medical school left out. Functional medicine taught me that our lifestyles, diets, environments, and social structures interact with our genome and epigenome to influence our health outcomes.
Gene-environment interaction is a central feature in establishing an individual's function.
Interaction among organ systems regulates the function of the individual.
Signals from the diet, environment, lifestyle, and social experiences translate into clinical phenotypes.
Assessment of the patient focuses on understanding their antecedents, triggers, and mediators and their relationship to their signs and symptoms.
Managing systems dysfunction requires multimodal treatment programs.
Each patient is unique and, therefore, represents an N-of-1 experience.
Perspectives of time and relationships help contextualize an individual's health issues.
The core concepts of functional medicine encourage a root-cause analysis of disease, which should be in the curriculum of traditional medical schools. Functional medicine has become mainstream to the extent that Cleveland Clinic has established a Center for Functional Medicine.
Medical reversals
"Science-based" advocates use derogatory terms for alternative medicine like "pseudoscience" and say you should only practice medicine proven through the scientific method. Ironically, they advocate for the same scientific methods that have resulted in many medical reversals.
Vinay Prasad, M.D., in his book Ending Medical Reversal, Improving Outcomes, Saving Lives, says, "[Medical] reversal occurs when a currently accepted therapy is overturned, found to be no better than the therapy it replaced. This often occurs when a practice - a diagnostic tool, medicine, a procedure, or a surgical technique - is adopted without a robust evidence base."
What follows is a list of therapies that were once considered the standard of care but eventually found to be useless or dangerous:
Estrogen replacement in postmenopausal women to prevent heart disease does not prevent it and may even exacerbate it early on in treatment.
The benefits of coronary artery stents for stable coronary artery disease are gone by thirty-six months.
The use of flecainide and similar drugs to stabilize premature ventricular contractions increases the patient's chance of dying.
The use of atenolol and metoprolol in hypertension to decrease people's risk of dying or having a heart attack is not valid.
Vertebroplasty for osteoporotic fractures of the spine works no better than a sham procedure.
Here is a list of FDA-approved medications studied by "the scientific method" and later yanked from the market after showing risk, harm, and death to patients:
Baycol (Cerivastatin) 1998 - 2001
Belviq, Belviq XR (Lorcaserin) 2012 - 2020
Bextra (Valdecoxib) 2001 - 2005
Cylert (Pemoline) 1975 - 2010
Darvon & Darvocet(Propoxyphene) 1955 - 2010
DBI (Phenformin) 1959 - 1978
DES (Diethylstibestrol) 1940 - 1971
Duract (Bromfenac) 1997 - 1998
Ergamisol (Levamisole) 1989 - 2000
Hismanal (Astemizole) 1988 - 1999
Lotronex (Alosetron) 2000
Meridia (Sibutramine) 1997 - 2010
Merital & Alival (Nomifensine) 1982 - 1985
Micturin (Terodiline) 1989 - 1991
Mylotarg (Gemtuzumab Ozogamicin) 2000 - 2010
Omniflox (Temafloxacin) 1992
Palladone (Hydromorphone hydrochloride, extended-release) 2005
Permax (Pergolide) 1988 - 2007
Pondimin (Fenfluramine) 1973 - 1997
Posicor (Mibefradil) 1997 - 1998
Propulsid (Cisapride) 1993 - 2000
PTZ & Metrazol (Pentylenetetrazol) 1934 - 1982
Quaalude (Methaqualone) 1962 - 1985
Raplon (Rapacuronium) 1999 - 2001
Raptiva (Efalizumab) 2003 - 2009
Raxar (Grepafloxacin) 1997 - 1999
Redux (Dexfenfluramine) 1996 - 1997
Rezulin (Troglitazone) 1997 - 2000
Selacryn (Tienilic acid) 1979 - 1982
Seldane (Terfenadine) 1985 - 1998 *Prescribed to more than 20 million people
Trasylol (Aprotinin) 1993 - 2008
Vioxx (Rofecoxib) 1999 - 2004
Xigris (Drotrecogin alfa activated) 2001 - 2011
Zelmid (Zimelidine) 1982
Zelnorm (Tegaserod maleate) 2002 - 2007
A couple of these drugs were on the market for thirty-five and forty-eight years! Sadly, I remember writing prescriptions for many of these drugs.
Why reversals happen
How do these reversals happen? Dr. Prasad says it's because:
Pharmaceutical companies manipulate data to get drugs and devices approved.
Physicians overtest and overtreat for fear of malpractice suits.
Hospitals and clinics market tests and treatments that offer little benefit because they believe they will attract well-insured patients.
Dr. Prasad and colleagues reviewed 2,044 articles published in the New England Journal of Medicine between 2001 and 2010. Of those, 363 articles reported the efficacy of an established practice, and reversals made up a whopping 40%!
Prasad concludes,
"If that much of medical practice is ineffective, it is pretty scary."
Dietary supplements
Another aspect of alternative medicine that these science-based" advocates like to attack is dietary supplements. It cracks me up when they scream to the rooftops about proof of how dangerous supplements are when the New England Journal of Medicine publishes articles like Emergency Visits for Adverse Events Related to Dietary Supplements. This article reports, "An estimated 23,000 emergency department visits in the United States every year are attributed to adverse events related to dietary supplements."
Prescription drugs
But you won't hear a peep from them when The Centers for Disease Control and Prevention reports an estimated 1.3 million emergency department visits in the United States every year are due to adverse events related to prescription drugs. And that 350,000 patients are hospitalized each year for further treatment because of these events.
People want options
In the end, people want options for their health concerns. While they need adequate education about alternative, complementary, and integrative healthcare to make informed decisions, they should also be aware of traditional medicine's risks, failings, and hypocrisy.
So, is alternative medicine snake oil? Sometimes it is, and sometimes it isn't.
The medical literature also shows that some standard-of-care traditional medical therapies studied by the scientific method are also snake oil.
Keith R. Holden, M.D.