Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Science and Society
  • Published:

Complementary and alternative medicine: assessing the evidence for immunological benefits

Nature Reviews Immunology volume 4, pages 912–921 (2004)Cite this article

Abstract

With words such as AIDS, allergy and autoimmunity embedded in the popular lexicon, we often equate health with the precision and the tenor of responses to allergens and microorganisms. This leads many people to seek their own solutions to sustain, restore or even boost their immune competence, hoping to live more comfortably and longer. Here, we consider the social and clinical contexts in which these promises of enhanced immunity are pursued through popular practices known as complementary and alternative medicine and the evidence that supports these.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: CAM domains and some of the most common examples.
Figure 2: Hierarchy of evidence.

References

  1. National Center for Complementary and Alternative Medicine. Expanding Horizons of Healthcare: Five-Year Strategic Plan 2001–2005 (National Institutes of Health, Bethesda, 2000).

  2. Ernst, E. Prevalence of use of complementary/alternative medicine: a systematic review. Bull. World Health Organ. 78, 252–257 (2000).

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Barnes, P. M., Powell-Griner, E., McFann, K. & Nahin, R. L. Complementary and alternative medicine use among adults: United States, 2002. Adv. Data 343, 1–19 (2004).

    Google Scholar 

  4. Eisenberg, D. M. et al. Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA 280, 1569–1575 (1998).

    CAS  PubMed  Google Scholar 

  5. Ni, H., Simile, C. & Hardy, A. M. Utilization of complementary and alternative medicine by United States adults: results from the 1999 National Health Interview Survey. Med. Care 40, 353–358 (2002).

    PubMed  Google Scholar 

  6. Harris Interactive. Widespread ignorance of regulation and labeling of vitamins, minerals and food supplements, according to a National Harris Interactive Survey. Harris Interactive Health Care News (Dec 2002). Harris Interactive [online], http://www.harrisinteractive.com/news/allnewsbydate.asp?NewsID=560

  7. Zeisel, S. H. Regulation of 'nutraceuticals'. Science 285, 1853–1855 (1999).

    CAS  PubMed  Google Scholar 

  8. World Health Organization. Regulatory Situation of Herbal Medicines: A Worldwide Review (World Health Organization, Geneva, 1998).

  9. European Parliament and the Council of the European Union. The approximation of the laws of the member states relating to food supplements directive (2002/46/EC). Official J. Eur. Communities L183/51 (10 Jun 2002).

  10. Astin, J. A. Why patients use alternative medicine: results of a national study. JAMA 279, 1548–1553 (1998).

    CAS  PubMed  Google Scholar 

  11. Nortier, J. L. et al. Urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi). N. Engl. J. Med. 342, 1686–1692 (2000).

    CAS  PubMed  Google Scholar 

  12. Teschke, R. Kava, kavapyrones and toxic liver injury. Z. Gastroenterol. 41, 395–404 (2003) (in German).

    CAS  PubMed  Google Scholar 

  13. Chen, C., Biller, J., Willing, S. J. & Lopez, A. M. Ischemic stroke after using over the counter products containing ephedra. J. Neurol. Sci. 217, 55–60 (2004).

    PubMed  Google Scholar 

  14. Markowitz, J. S. et al. Effect of St John's wort on drug metabolism by induction of cytochrome P450 3A4 enzyme. JAMA 290, 1500–1504 (2003).

    CAS  PubMed  Google Scholar 

  15. Piscitelli, S. C., Burstein, A. H., Chaitt, D., Alfaro, R. M. & Falloon, J. Indinavir concentrations and St John's wort. Lancet 355, 547–548 (2000).

    CAS  PubMed  Google Scholar 

  16. Mathijssen, R. H., Verweij, J., de Bruijn, P., Loos, W. J. & Sparreboom, A. Effects of St. John's wort on irinotecan metabolism. J. Natl Cancer Inst. 94, 1247–1249 (2002).

    CAS  Google Scholar 

  17. Mansky, P. J. & Straus, S. E. St. John's Wort: more implications for cancer patients. J. Natl Cancer Inst. 94, 1187–1188 (2002).

    CAS  Google Scholar 

  18. Bauer, S. et al. Alterations in cyclosporin A pharmacokinetics and metabolism during treatment with St John's wort in renal transplant patients. Br. J. Clin. Pharmacol. 55, 203–211 (2003).

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Ernst, E. St John's wort supplements endanger the success of organ transplantation. Arch. Surg. 137, 316–319 (2002).

    CAS  PubMed  Google Scholar 

  20. Hall, S. D. et al. The interaction between St John's wort and an oral contraceptive. Clin. Pharmacol. Ther. 74, 525–535 (2003).

    CAS  PubMed  Google Scholar 

  21. Pfrunder, A. et al. Interaction of St John's wort with low-dose oral contraceptive therapy: a randomized controlled trial. Br. J. Clin. Pharmacol. 56, 683–690 (2003).

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Nahin, R. L. & Straus, S. E. Research into complementary and alternative medicine: problems and potential. BMJ 322, 161–164 (2001).

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Hughes, D. A. Dietary carotenoids and human immune function. Nutrition 17, 823–827 (2001).

    CAS  PubMed  Google Scholar 

  24. De la Fuente, M. Effects of antioxidants on immune system ageing. Eur. J. Clin. Nutr. 56 (Suppl. 3), S5–S8 (2002).

    CAS  PubMed  Google Scholar 

  25. Stephensen, C. B. Vitamin A, infection, and immune function. Annu. Rev. Nutr. 21, 167–192 (2001).

    CAS  PubMed  Google Scholar 

  26. Moriguchi, S. & Muraga, M. Vitamin E and immunity. Vitam. Horm. 59, 305–336 (2000).

    CAS  Google Scholar 

  27. Beharka, A., Redican, S., Leka, L. & Meydani, S. N. Vitamin E status and immune function. Methods Enzymol. 282, 247–263 (1997).

    CAS  PubMed  Google Scholar 

  28. Serafini, M. Dietary vitamin E and T cell-mediated function in the elderly: effectiveness and mechanism of action. Int. J. Dev. Neurosci. 18, 401–410 (2000).

    CAS  PubMed  Google Scholar 

  29. Langweiler, M., Schultz, R. D. & Sheffy, B. E. Effect of vitamin E deficiency on the proliferative response of canine lymphocytes. Am. J. Vet. Res. 42, 1681–1685 (1981).

    CAS  PubMed  Google Scholar 

  30. Meeker, H. C., Eskew, M. L., Scheuchenzuber, W., Scholz, R. W. & Zarkower, A. Antioxidant effects on cell-mediated immunity. J. Leukoc. Biol. 38, 451–458 (1985).

    CAS  PubMed  Google Scholar 

  31. Bendich, A., Gabriel, E. & Machlin, L. J. Dietary vitamin E requirement for optimum immune responses in the rat. J. Nutr. 116, 675–681 (1986).

    CAS  PubMed  Google Scholar 

  32. Moriguchi, S., Kobayashi, N. & Kishino, Y. High dietary intakes of vitamin E and cellular immune functions in rats. J. Nutr. 120, 1096–1102 (1990).

    CAS  PubMed  Google Scholar 

  33. Yasunaga, T., Kato, H., Ohgaki, K., Inamoto, T. & Hikasa, Y. Effect of vitamin E as an immunopotentiation agent for mice at optimal dosage and its toxicity at high dosage. J. Nutr. 112, 1075–1084 (1982).

    CAS  PubMed  Google Scholar 

  34. Tengerdy, R. P., Henzerling, R. H., Brown, G. L. & Mathias, M. M. Enhancement of the humoral immune response by vitamin E. Int. Arch. Allergy Appl. Immunol. 44, 221–232 (1973).

    CAS  PubMed  Google Scholar 

  35. High, K. P. Nutritional strategies to boost immunity and prevent infection in elderly individuals. Clin. Infect. Dis. 33, 1892–1900 (2001).

    CAS  PubMed  Google Scholar 

  36. Meydani, S. N. et al. Vitamin E supplementation and in vivo immune response in healthy elderly subjects. A randomized controlled trial. JAMA 277, 1380–1386 (1997).

    CAS  PubMed  Google Scholar 

  37. Meydani, S. N. et al. Vitamin E and respiratory tract infections in elderly nursing home residents: a randomized controlled trial. JAMA 292, 828–836 (2004).

    CAS  PubMed  PubMed Central  Google Scholar 

  38. Martorell, R., Yarbrough, C., Yarbrough, S. & Klein, R. E. The impact of ordinary illnesses on the dietary intakes of malnourished children. Am. J. Clin. Nutr. 33, 345–350 (1980).

    CAS  PubMed  Google Scholar 

  39. Solomons, N. W. Pathways to the impairment of human nutritional status by gastrointestinal pathogens. Parasitology 107, S19–S35 (1993).

    PubMed  Google Scholar 

  40. Stephensen, C. B. et al. Vitamin A is excreted in the urine during acute infection. Am. J. Clin. Nutr. 60, 388–392 (1994).

    CAS  PubMed  Google Scholar 

  41. Wiedermann, U. et al. Vitamin A deficiency predisposes to Staphylococcus aureus infection. Infect. Immun. 64, 209–214 (1996).

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Dawson, H. D., Li, N. Q., DeCicco, K. L., Nibert, J. A. & Ross, A. C. Chronic marginal vitamin A status reduces natural killer cell number and function in aging Lewis rats. J. Nutr. 129, 1510–1517 (1999).

    CAS  PubMed  Google Scholar 

  43. Carman, J. A., Pond, L., Nashold, F., Wassom, D. L. & Hayes, C. E. Immunity to Trichinella spiralis infection in vitamin A-deficient mice. J. Exp. Med. 175, 111–120 (1992).

    CAS  PubMed  Google Scholar 

  44. Glasziou, P. P. & Mackerras, D. E. Vitamin A supplementation in infectious diseases: a meta-analysis. BMJ 306, 366–370 (1993).

    CAS  PubMed  PubMed Central  Google Scholar 

  45. Fawzi, W. W., Chalmers, T. C., Herrera, M. G. & Mosteller, F. Vitamin A supplementation and child mortality. A meta-analysis. JAMA 269, 898–903 (1993).

    CAS  PubMed  Google Scholar 

  46. American Academy of Pediatrics Committee on Infectious Diseases. Vitamin A treatment of measles. Pediatrics 91, 1014–1015 (1993).

  47. Stephensen, C. B. et al. Adverse effects of high-dose vitamin A supplements in children hospitalized with pneumonia. Pediatrics [online], 101, E3 (1998).

    CAS  PubMed  Google Scholar 

  48. Aukrust, P. et al. Decreased vitamin A levels in common variable immunodeficiency: vitamin A supplementation in vivo enhances immunoglobulin production and downregulates inflammatory responses. Eur. J. Clin. Invest. 30, 252–259 (2000).

    CAS  PubMed  Google Scholar 

  49. Semba, R. D. Vitamin A and human immunodeficiency virus infection. Proc. Nutr. Soc. 56, 459–469 (1997).

    CAS  PubMed  Google Scholar 

  50. Coutsoudis, A., Pillay, K., Spooner, E., Kuhn, L. & Coovadia, H. M. Randomized trial testing the effect of vitamin A supplementation on pregnancy outcomes and early mother-to-child HIV-1 transmission in Durban, South Africa. South African Vitamin A Study Group. AIDS 13, 1517–1524 (1999).

    CAS  PubMed  Google Scholar 

  51. Fawzi, W. W. et al. Effect of providing vitamin supplements to human immunodeficiency virus-infected, lactating mothers on the child's morbidity and CD4+ cell counts. Clin. Infect. Dis. 36, 1053–1062 (2003).

    CAS  PubMed  Google Scholar 

  52. Barnes, P. M. & Moynahan, E. J. Zinc deficiency in acrodermatitis enteropathica: multiple dietary intolerance treated with synthetic diet. Proc. R. Soc. Med. 66, 327–329 (1973).

    CAS  PubMed  PubMed Central  Google Scholar 

  53. Zinc therapy of depressed cellular immunity in acrodermatitis enteropathica. Nutr. Rev. 39, 168 (1981).

  54. Beck, F. W., Prasad, A. S., Kaplan, J., Fitzgerald, J. T. & Brewer, G. J. Changes in cytokine production and T cell subpopulations in experimentally induced zinc-deficient humans. Am. J. Physiol. 272, E1002–E1007 (1997).

    CAS  PubMed  Google Scholar 

  55. Roy, S. K. et al. Randomised controlled trial of zinc supplementation in malnourished Bangladeshi children with acute diarrhoea. Arch. Dis. Child. 77, 196–200 (1997).

    CAS  PubMed  PubMed Central  Google Scholar 

  56. Sazawal, S. et al. Zinc supplementation in young children with acute diarrhea in India. N. Engl. J. Med. 333, 839–844 (1995).

    CAS  PubMed  Google Scholar 

  57. Turner, R. B. & Cetnarowski, W. E. Effect of treatment with zinc gluconate or zinc acetate on experimental and natural colds. Clin. Infect. Dis. 31, 1202–1208 (2000).

    CAS  PubMed  Google Scholar 

  58. Prasad, A. S. et al. Zinc deficiency in elderly patients. Nutrition 9, 218–224 (1993).

    CAS  PubMed  Google Scholar 

  59. Girodon, F. et al. Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial. Ann. Nutr. Metab. 41, 98–107 (1997).

    CAS  PubMed  Google Scholar 

  60. Chandra, R. K. Excessive intake of zinc impairs immune responses. JAMA 252, 1443–1446 (1984).

    CAS  PubMed  Google Scholar 

  61. Failla, M. L. & Hopkins, R. G. Is low copper status immunosuppressive? Nutr. Rev. 56, S59–S64 (1998).

    CAS  PubMed  Google Scholar 

  62. Gibney, M. J. & Hunter, B. The effects of short- and long-term supplementation with fish oil on the incorporation of n-3 polyunsaturated fatty acids into cells of the immune system in healthy volunteers. Eur. J. Clin. Nutr. 47, 255–259 (1993).

    CAS  PubMed  Google Scholar 

  63. Yaqoob, P., Pala, H. S., Cortina-Borja, M., Newsholme, E. A. & Calder, P. C. Encapsulated fish oil enriched in α-tocopherol alters plasma phospholipid and mononuclear cell fatty acid compositions but not mononuclear cell functions. Eur. J. Clin. Invest. 30, 260–274 (2000).

    CAS  PubMed  Google Scholar 

  64. Blok, W. L. et al. Pro- and anti-inflammatory cytokines in healthy volunteers fed various doses of fish oil for 1 year. Eur. J. Clin. Invest. 27, 1003–1008 (1997).

    CAS  PubMed  Google Scholar 

  65. Meydani, S. N. et al. Oral (n-3) fatty acid supplementation suppresses cytokine production and lymphocyte proliferation: comparison between young and older women. J. Nutr. 121, 547–555 (1991).

    CAS  PubMed  Google Scholar 

  66. Kramer, T. R. et al. Increased vitamin E intake restores fish-oil-induced suppressed blastogenesis of mitogen-stimulated T lymphocytes. Am. J. Clin. Nutr. 54, 896–902 (1991).

    CAS  PubMed  Google Scholar 

  67. Wang, C. et al. Effects of Omega-3 Fatty Acids on Cardiovascular Disease Summary, Evidence report/technology assessment 94 (Agency for Healthcare Research and Quality, Rockville, 2004).

    Google Scholar 

  68. Marchioli, R. et al. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione. Circulation 105, 1897–1903 (2002).

    CAS  Google Scholar 

  69. Volker, D., Fitzgerald, P., Major, G. & Garg, M. Efficacy of fish oil concentrate in the treatment of rheumatoid arthritis. J. Rheumatol. 27, 2343–2346 (2000).

    CAS  PubMed  Google Scholar 

  70. Belluzzi, A. et al. Effect of an enteric-coated fish-oil preparation on relapses in Crohn's disease. N. Engl. J. Med. 334, 1557–1560 (1996).

    CAS  PubMed  Google Scholar 

  71. Broughton, K. S., Johnson, C. S., Pace, B. K., Liebman, M. & Kleppinger, K. M. Reduced asthma symptoms with n-3 fatty acid ingestion are related to 5-series leukotriene production. Am. J. Clin. Nutr. 65, 1011–1017 (1997).

    CAS  PubMed  Google Scholar 

  72. Villani, F., Comazzi, R., De Maria, P. & Galimberti, M. Effect of dietary supplementation with polyunsaturated fatty acids on bronchial hyperreactivity in subjects with seasonal asthma. Respiration 65, 265–269 (1998).

    CAS  PubMed  Google Scholar 

  73. Donadio, J. V. Jr, Bergstralh, E. J., Offord, K. P., Spencer, D. C. & Holley, K. E. A controlled trial of fish oil in IgA nephropathy. Mayo Nephrology Collaborative Group. N. Engl. J. Med. 331, 1194–1199 (1994).

    PubMed  Google Scholar 

  74. Newman, D. J., Cragg, G. M. & Snader, K. M. Natural products as sources of new drugs over the period 1981–2002. J. Nat. Prod. 66, 1022–1037 (2003).

    CAS  PubMed  Google Scholar 

  75. Borchers, A. T., Keen, C. L., Stern, J. S. & Gershwin, M. E. Inflammation and Native American medicine: the role of botanicals. Am. J. Clin. Nutr. 72, 339–347 (2000).

    CAS  PubMed  Google Scholar 

  76. Perry, N. B., Burgess, E. J. & Glennie, V. L. Echinacea standardization: analytical methods for phenolic compounds and typical levels in medicinal species. J. Agric. Food Chem. 49, 1702–1706 (2001).

    CAS  PubMed  Google Scholar 

  77. Burger, R. A., Torres, A. R., Warren, R. P., Caldwell, V. D. & Hughes, B. G. Echinacea-induced cytokine production by human macrophages. Int. J. Immunopharmacol. 19, 371–379 (1997).

    CAS  PubMed  Google Scholar 

  78. Berman, J. D. & Straus, S. E. in Principles and Practices of Infectious Diseases (eds Mandell, G., Bennett, J. E. & Dolin, R.) (Elsevier, Philadelphia, in the press).

  79. Schulten, B., Bulitta, M., Ballering-Bruhl, B., Koster, U. & Schafer, M. Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Arzneimittelforschung 51, 563–568 (2001).

    CAS  PubMed  Google Scholar 

  80. Barrett, B. P. et al. Treatment of the common cold with unrefined Echinacea. A randomized, double-blind, placebo-controlled trial. Ann. Intern. Med. 137, 939–946 (2002).

    PubMed  Google Scholar 

  81. Tao, X. & Lipsky, P. E. The Chinese anti-inflammatory and immunosuppressive herbal remedy Tripterygium wilfordii Hook F. Rheum. Dis. Clin. North Am. 26, 29–50 (2000).

    CAS  PubMed  Google Scholar 

  82. Chen, B. J. Triptolide, a novel immunosuppressive and anti-inflammatory agent purified from a Chinese herb Tripterygium wilfordii Hook F. Leuk. Lymphoma 42, 253–265 (2001).

    CAS  PubMed  Google Scholar 

  83. Tao, X., Younger, J., Fan, F. Z., Wang, B. & Lipsky, P. E. Benefit of an extract of Tripterygium wilfordii Hook F. in patients with rheumatoid arthritis: a double-blind, placebo-controlled study. Arthritis Rheum. 46, 1735–1743 (2002).

    PubMed  Google Scholar 

  84. Alvarez-Olmos, M. I. & Oberhelman, R. A. Probiotic agents and infectious diseases: a modern perspective on a traditional therapy. Clin. Infect. Dis. 32, 1567–1576 (2001).

    CAS  PubMed  Google Scholar 

  85. Silva, M., Jacobus, N. V., Deneke, C. & Gorbach, S. L. Antimicrobial substance from a human Lactobacillus strain. Antimicrob. Agents Chemother. 31, 1231–1233 (1987).

    CAS  PubMed  PubMed Central  Google Scholar 

  86. Mack, D. R., Michail, S., Wei, S., McDougall, L. & Hollingsworth, M. A. Probiotics inhibit enteropathogenic E. coli adherence in vitro by inducing intestinal mucin gene expression. Am. J. Physiol. 276, G941–G950 (1999).

    CAS  PubMed  Google Scholar 

  87. Christensen, H. R., Frokiaer, H. & Pestka, J. J. Lactobacilli differentially modulate expression of cytokines and maturation surface markers in murine dendritic cells. J. Immunol. 168, 171–178 (2002).

    CAS  PubMed  Google Scholar 

  88. Gill, H. S., Rutherfurd, K. J. & Cross, M. L. Dietary probiotic supplementation enhances natural killer cell activity in the elderly: an investigation of age-related immunological changes. J. Clin. Immunol. 21, 264–271 (2001).

    CAS  PubMed  Google Scholar 

  89. Kaila, M. et al. Enhancement of the circulating antibody secreting cell response in human diarrhea by a human Lactobacillus strain. Pediatr. Res. 32, 141–144 (1992).

    CAS  PubMed  Google Scholar 

  90. Guarino, A., Canani, R. B., Spagnuolo, M. I., Albano, F. & Di Benedetto, L. Oral bacterial therapy reduces the duration of symptoms and of viral excretion in children with mild diarrhea. J. Pediatr. Gastroenterol. Nutr. 25, 516–519 (1997).

    CAS  PubMed  Google Scholar 

  91. Van Niel, C. W., Feudtner, C., Garrison, M. M. & Christakis, D. A. Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis. Pediatrics 109, 678–684 (2002).

    PubMed  Google Scholar 

  92. Kalliomaki, M. et al. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet 357, 1076–1079 (2001).

    CAS  Google Scholar 

  93. Buydens, P. & Debeuckelaere, S. Efficacy of SF 68 in the treatment of acute diarrhea. A placebo-controlled trial. Scand. J. Gastroenterol. 31, 887–891 (1996).

    CAS  PubMed  Google Scholar 

  94. Oksanen, P. J. et al. Prevention of travellers' diarrhoea by Lactobacillus GG. Ann. Med. 22, 53–56 (1990).

    CAS  PubMed  Google Scholar 

  95. Fedorak, R. N. & Madsen, K. L. Probiotics and the management of inflammatory bowel disease. Inflamm. Bowel Dis. 10, 286–299 (2004).

    PubMed  Google Scholar 

  96. Reid, G. et al. Oral use of Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women. FEMS Immunol. Med. Microbiol. 20, 131–134 (2003).

    Google Scholar 

  97. Evans, P., Hucklebridge, F. & Chow, A. Mind, Immunity and Health: The Science of Psychoneuroimmunology (Free Association Books, London, 2000).

    Google Scholar 

  98. Kiecolt-Glaser, J. K., McGuire, L., Robles, T. F. & Glaser, R. Psychoneuroimmunology and psychosomatic medicine: back to the future. Psychosom. Med. 64, 15–28 (2002).

    PubMed  Google Scholar 

  99. Cohen, S., Tyrrell, D. A. & Smith, A. P. Psychological stress and susceptibility to the common cold. N. Engl. J. Med. 325, 606–612 (1991).

    CAS  PubMed  Google Scholar 

  100. Yang, E. V. & Glaser, R. Stress-associated immunomodulation and its implications for responses to vaccination. Expert Rev. Vaccines 1, 453–459 (2002).

    CAS  PubMed  Google Scholar 

  101. Eskandari, F. & Sternberg, E. M. Neural–immune interactions in health and disease. Ann. NY Acad. Sci. 966, 20–27 (2002).

    CAS  PubMed  Google Scholar 

  102. Elenkov, I. J., Papanicolaou, D. A., Wilder, R. L. & Chrousos, G. P. Modulatory effects of glucocorticoids and catecholamines on human interleukin-12 and interleukin-10 production: clinical implications. Proc. Assoc. Am. Physicians 108, 374–381 (1996).

    CAS  PubMed  Google Scholar 

  103. Irwin, M. R., Pike, J. L., Cole, J. C. & Oxman, M. N. Effects of a behavioral intervention, Tai Chi Chih, on varicella-zoster virus specific immunity and health functioning in older adults. Psychosom. Med. 65, 824–830 (2003).

    PubMed  Google Scholar 

  104. Gruzelier, J. H. A review of the impact of hypnosis, relaxation, guided imagery and individual differences on aspects of immunity and health. Stress 5, 147–163 (2002).

    CAS  PubMed  Google Scholar 

  105. Astin, J. A., Shapiro, S. L., Eisenberg, D. M. & Forys, K. L. Mind–body medicine: state of the science, implications for practice. J. Am. Board Fam. Pract. 16, 131–147 (2003).

    PubMed  Google Scholar 

  106. Miller, G. E. & Cohen, S. Psychological interventions and the immune system: a meta-analytic review and critique. Health Psychol. 20, 47–63 (2001).

    CAS  PubMed  Google Scholar 

  107. Anderson, J. W., Konz, E. C. & Jenkins, D. J. Health advantages and disadvantages of weight-reducing diets: a computer analysis and critical review. J. Am. Coll. Nutr. 19, 578–590 (2000).

    CAS  PubMed  Google Scholar 

  108. Foster, G. D. et al. A randomized trial of a low-carbohydrate diet for obesity. N. Engl. J. Med. 348, 2082–2090 (2003).

    CAS  Google Scholar 

  109. Ornish, D. Dr. Dean Ornish's Program for Reversing Heart Disease (Ballantine Books, New York, 2004).

    Google Scholar 

  110. Sheng, Y., Bryngelsson, C. & Pero, R. W. Enhanced DNA repair, immune function and reduced toxicity of C-MED-100, a novel aqueous extract from Uncaria tomentosa. J. Ethnopharmacol. 69, 115–126 (2000).

    CAS  PubMed  Google Scholar 

  111. Chan, M. M. Inhibition of tumor necrosis factor by curcumin, a phytochemical. Biochem. Pharmacol. 49, 1551–1556 (1995).

    CAS  PubMed  Google Scholar 

  112. Nakaya, T. A., Kita, M., Kuriyama, H., Iwakura, Y. & Imanishi, J. Panax ginseng induces production of proinflammatory cytokines via Toll-like receptor. J. Interferon Cytokine Res. 24, 93–100 (2004).

    CAS  PubMed  Google Scholar 

  113. McKallip, R. J., Lombard, C., Martin, B. R., Nagarkatti, M. & Nagarkatti, P. S. Δ9-tetrahydrocannabinol-induced apoptosis in the thymus and spleen as a mechanism of immunosuppression in vitro and in vivo. J. Pharmacol. Exp. Ther. 302, 451–465 (2002).

    CAS  PubMed  Google Scholar 

  114. United States Congress. Dietary Supplement Health and Education Act (Public Law 103-417; codified at US congress 287C-11) (25 Oct 1994). Food and Drug Administration [online], http://www.fda.gov/opacom/laws/dshea.html

Download references

Acknowledgements

We acknowledge the assistance of C. Pontzer for proof-reading the manuscript.

Author information

Authors and Affiliations

  1. the Office of Scientific Review, National Center for Complementary and Alternative Medicine, National Institutes of Health, Suite 401, 6707 Democracy Boulevard, Bethesda, 20817, Maryland, USA

    Martin H. Goldrosen

  2. the Office of the Director, National Center for Complementary and Alternative Medicine, National Institutes of Health, Building 31, Room 2B11, 31 Center Drive, Bethesda, 20892-2182, Maryland, USA

    Stephen E. Straus

Authors
  1. Martin H. Goldrosen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephen E. Straus
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stephen E. Straus.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Related links

Related links

DATABASES

Entrez Gene

C-reactive protein

IFN-γ

IL-1

IL-2

IL-4

IL-6

IL-8

IL-10

IL-12

TNF

FURTHER INFORMATION

National Center for Complementary and Alternative Medicine

Chronic Fatigue and Immune Dysfunction Syndrome Association of America

The Autism Autoimmunity Project

Glossary

AYURVEDA

The traditional Indian system of medicine. Ayurvedic (meaning 'science of life') medicine is a comprehensive system that places equal emphasis on the body, mind and spirit, and it strives to restore the innate harmony of the individual.

BIOFEEDBACK

A process for monitoring a body function (such as breathing, heart rate or blood pressure) and altering the function through relaxation or imagery.

CHIROPRACTIC

A system of treatment that is based on the relationship between structure (mainly of the spine) and function, and how that relationship affects the preservation and restoration of health.

DIETARY SUPPLEMENTS

Products that contain one or more ingredients (such as vitamins, minerals and herbs) that are intended to supplement the diet, are intended for human use and are in the form of a tablet, capsule, powder or another preparation that is not a conventional food.

ELECTROMAGNETIC FIELDS

Magnetic fields can be used therapeutically to create a static force on the body for the purpose of relieving pain.

HERBAL MEDICINES

Individual herbs or mixtures of herbs that are used for therapeutic value.

HERBS

Plants or plant products that produce or contain chemicals that act on the body.

HOMEOPATHY

A Western system of medicine that is based on the principle that 'like cures like' — that is, the same substance that in large doses produces the symptoms of an illness cures it when administered in very small doses. Homeopathic physicians believe that the more dilute the remedy, the greater its potency. Therefore, homeopaths treat illness by using small doses of specially prepared plant extracts and minerals to stimulate the defence mechanisms and healing processes of the body.

HYPNOSIS

An alternative state of consciousness in which the attention of an individual is focused away from the present reality and towards particular images, thoughts, perceptions, feelings, motivations, sensations, behaviours or any combination of these.

MASSAGE

The manipulation of the soft tissues of the body to normalize them.

MEDITATION

A self-directed method for relaxing the body and calming the mind. The practitioner makes a concentrated effort to focus on a single thought to still the inclination of the mind to mull over the many demands and details of daily life.

NATUROPATHIC TREATMENT

A system of treatment that views disease as a manifestation of alterations in the processes by which the body naturally heals itself. It emphasizes restoration of health, as well as treatment of disease. Naturopathic physicians use an array of healing practices, including diet and clinical nutrition, homeopathy, acupuncture and herbal medicine.

QIGONG

A component of traditional Chinese medicine that combines movement, meditation and the regulation of breathing to enhance the flow of vital energy (qi, pronounced chi) in the body, to improve blood circulation and to enhance immune function.

REIKI

Means 'universal life energy' in Japanese. It is based on the belief that, by channelling spiritual energy through the practitioner, the spirit is healed, and the spirit, in turn, heals the physical body.

SPECIAL DIETS

Diet therapies that are believed to prevent and/or control illness and/or promote health, such as those proposed by Drs Atkins and Ornish.

SPIRITUALITY

An inner sense of something greater than oneself. Recognition of a meaning to existence that transcends one's immediate circumstances.

TRADITIONAL CHINESE MEDICINE

A system of treatment that emphasizes the proper balance or disturbances of qi (vital energy) in health and disease, respectively. Traditional Chinese medicine consists of a group of techniques and methods, including acupuncture, herbal medicine, oriental massage and qigong (a form of energy therapy).

VISUAL IMAGERY

A flow of thoughts that includes sensory qualities such as smell, touch, hearing, taste, motion and images.

VITAMINS

A general term for various unrelated organic substances that occur in many foods in small amounts and that are required for the normal metabolic functioning of the body.

YOGA

An ancient system of practices originating in India. It is aimed at integrating mind, body and spirit to enhance health and well-being. There are many different forms of yoga. Hatha yoga — the most widely practised form of yoga in the Western world — uses specific postures and breathing exercises.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Goldrosen, M., Straus, S. Complementary and alternative medicine: assessing the evidence for immunological benefits. Nat Rev Immunol 4, 912–921 (2004). https://doi.org/10.1038/nri1486

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nri1486

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing