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Alternative Therapies

Dec 18, 2001

Doctor Aberg,

How many clinical trials have been funded/conducted to test the benefits of alternative therapies? Who has funded them/conducted them and for how long?

I would imagine that they are few and far between. If it is proven that Vitamin A, or NAC, or whatever is stopping or controlling HIV replication and disease progression, who the hell will profit from it, afterall you can't patent vitamins or herbs can you?

You should state this to your patients, that the clinical results of vitamin/herbal therapy alone are unknown.

Have a good day!

Response from Dr. Aberg

I don't know how many clinical trials have been done or are in development evaluating alternative therapies. One such trial just opened nationally by the AIDS Clinical Trials Group which is a pilot study of oral B vitamin therapy for asymptomatic or mildly symptomatic hyperlactatemia in patients on nucleosides. So there is an interest to do these trials. One of the problems with conducting actual clinical trials is that these therapies are not regulated by the FDA so therefore the content of "therapy" is not always known even between lots of the same brand name. You also bring up an excellent point regarding funding. No one wants to fund a generic drug let alone an over the counter herbal. Even the herbal companies do not want to fund studies. Why should they? This is a multi-million to billion dollar industry so why do testing if it is not required to sell your product?

I do discuss herbal and alternative therapies with my patients. It is important for everyone to understand that we do not know a lot about these products. I am cautious about their use in the absence of data and my specific concerns relate to side effects and potential drug interactions. Some of my patients take as many as 40 different products. There is no way I can know what the effects of these kind of mega doses of alternative therapy are. It is important for your doctor and pharmacist to know what they are in case there are side effects or drug interactions but as far as knowing whether any of these therapies have immunologic or virologic properties, this data is unknown. But also in the absence of data, everyone does have the right to make their own decisions regarding the use of alternative therapies. Just as I cannot say there is no data to support that it works, there is no data to say that it doesn't. The ultimate decision to try a product is up to that individual.

Thanks for bringing this to everyone's attention.

Federalway, WA

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