Be honest with your doctor about the alternative approaches you’re using. Perhaps afraid that their physicians will criticize them, many people don’t tell their doctors what alternatives they’re trying. And that’s a problem because conventional drugs and therapies can interact—sometimes dangerously—with herbs and other alternative approaches. The Journal of the American Medical Association (JAMA) study reports that only 40% of patients told their doctors about their use of alternative therapies. Approximately 15 million Americans use prescription drugs and herbal remedies at the same time, putting them at risk of potentially dangerous interactions. The best policy is to be honest with your doctors and with your alternative providers about every approach you’re using. Everybody benefits when all your practitioners are getting the full picture. Maybe you’ll even discover that your doctor is more open-minded, or at least tolerant, than you expected. And if not, you can ask yourself if you’d feel more comfortable with a doctor who is.

• Get diagnosed by a conventional physician to be sure you’re not missing anything. Conventional doctors generally have much more training in the use of diagnostic tests and high-tech equipment to diagnose serious illness. Make sure your fatigue, weight loss, or other potentially worrisome symptom is evaluated by a conventional doctor before embarking on an alternative approach. You don’t want to miss a cancer or other serious illness in the early stages when it may be more treatable. Getting diagnosed by a conventional doctor does not commit you to using conventional medicine or to using just conventional medicine. But it does allow you to make a more informed decision.

• Always weigh the risks and benefits of any approach. Just as you would do with conventional therapy it pays to evaluate the pros and cons of any alternative approach. This can sometimes be difficult because many alternative therapies have not been well studied. Things like acupuncture or herbal remedies, such as echinacea or St. John’s wort that have been used for thousands of years and which have some scientific backing, are very likely to be safe. Less is known about the newer alternatives.

• Approaches that are proven to work for one condition may not work for others. Aspirin can get rid of a headache but it won’t do a thing for constipation. Similarly, the herb St. John’s wort appears to be effective for mild to moderate depression but there’s no evidence it works for weight loss. Chiropractic can relieve acute low back pain but may do nothing for asthma. When you hear that a treatment is "clinically proven," be sure to ask, "For what?"

• Just because it’s "natural" doesn’t mean it’s safe. Arsenic and botulism toxin are 100% natural, but they happen to be deadly. That said, many natural approaches, such as herbal medicines, may indeed offer a less toxic way to treat certain conditions. And with the current prices of many prescription drugs, they may save you a lot of money, too.

• Be skeptical of claims on the bottle, in product brochures or those you read on the Internet. Remember the huge marketing behind dietary supplements and other alternative approaches. For many manufacturers this is not about a new age or greater patient autonomy, it’s about money. The supplement industry in this country was a $12 billion enterprise in 1997. With that kind of money at stake you can bet that both scrupulous and unscrupulous companies will be attracted to the market. Some of the information on Internet news-groups has its origin in people who are part of multi-level marketing schemes to sell supplements. Well-intentioned as they may be, clerks in health food stores may not be reliable sources of information either.

• If it sounds too good to be true, it probably is. Nothing cures all cancers or can help every condition. If the list of ailments a remedy is purported to help includes everything under the sun, be careful. Such claims almost always reflect marketing considerations more than good science. And people who aren’t honest about the effectiveness of their products may not tell you about their potential downsides either.

• Buy herbs and vitamin supplements only from reputable manufacturers. At the time of this writing, there are no federal regulations establishing purity criteria for dietary or herbal supplements. That means that you have no guarantee that you’ll get what you’re paying for. Investigations have found that some preparations of ginseng, for example, contain none of the product at all. Other times the dose may be more or less than listed. Your best bet is to buy from a company you trust. Also look for so-called "standardized" preparations which promise to deliver the amount of the substance listed on the label (though without regulations that claim is only as credible as the company that makes it). Be especially wary of patent medicines manufactured in Asia as they have been found on numerous occasions to be contaminated with heavy metals or to contain strong conventional medicines not listed on the label.

• Report any side effects. Since we’re still learning about the safety of many alternative therapies, be sure to tell both your alternative and conventional practitioners if you develop any unusual symptoms. You’ll be helping yourself and future patients. If you develop a side effect on a dietary supplement be sure to also report it to the government’s Food and Drug Administration (FDA). The toll-free number of the FDA’s Medwatch program is 1-800-FDA-1088.

• Whether effective or not, some alternative approaches are unlikely to cause harm. Many alternative therapies, such as massage, tai chi, yoga, meditation, and balanced vegetarian diets, have side effects—like stress reduction, improved balance and weight loss—which are almost all positive. Even if they don’t help your problem directly, they may make you feel better and are generally health-promoting. Other approaches, such as homeopathy and aromatherapy, are extremely unlikely to cause ill effects. Even if it turns out they don’t work, at the very worst you’ll have wasted a little money.

• Never forget that you’re the boss. Doctors and other health practitioners can offer advice, but ultimately what you do is your decision. Even though practitioners—both conventional and alternative—tend to be wedded to their particular system, it’s clear that most members of the general public simply want whatever will work best. And the evidence increasingly indicates that the best results may be obtained by a rational integration of alternative and conventional approaches. If your doctor tries to discourage your use of alternative approaches, listen to what he or she has to say—you might learn something that will help you make your decision. But doctors who categorically dismiss all alternative medicine (or alternative healers who have no use for conventional medicine) may simply be showing their insecurity or closed-mindedness. Never forget that as a competent adult, you are free to choose any therapy you wish—as long as it’s legal.