Complimentary and Alternative Medicine
Alternative or complementary medicine include among others, herbal and vitamin supplements. Today, more than 40% of the general public 1, especially patients suffering from cancer, chronic and cardiovascular diseases treat themselves with these techniques. Unfortunately, some of these therapies have not been subjected to clinical trials to validate their effectiveness, and more importantly their safety profile. While some of these supplements may potentially provide benefit, others may actually prove deadly.
We reported the case of a 47 year old patient who presented with syncope and polymorphic ventricular tachycardia, a life threatening rhythm disorder of the heart2. Among a multitude of dietary and vitamin supplements, she had been taking Cesium pills as a strategy to prevent breast cancer. The proposed mechanism of this antineoplastic effect of Cesium is that it is preferentially taken up by tumor cells and changes the intracellular environment (by increasing the pH) shortening thus the tumor life span.
It is well known however that Cesium has been used in experimental and animal models to induce ventricular arrhythmia (an abnormal heart rhythm). By blocking potassium channels, it prolongs the repolarization time of the heart muscle cells, which in turn predispose to the development of a specific form of ventricular tachycardia called Torsade de Pointes. Moreover, some of these supplements can interact with each other and may create a more suitable environment for adverse events.
Our patient was also ingesting "green tea" which contains licorice. This can lead to a decrease in serum potassium, which in turn facilitates the occurrence of the ventricular arrhythmia. It is concerning that most of these supplements are commercially available on an unregulated basis.
Almost three fourths of patients using alternative medicine do not inform their doctors of such practice3 and without such information, doctors cannot provide an adequate advice and safe treatment.
What is needed are controlled clinical trials as well as further physician education about these supplements, before they can be used in a safe and effective manner. Until then, patients should be warned.
Walid Saliba, MD
References
- Eisenberg DM, Davis RB, Ettner SL et al. Trends in Alternative Medicine Use in The United States. 1990-1997: results of a follow-up national survey. JAMA 1998; 280:1569-75
- Saliba WI, Erdogan O, Neibauer M. Polymorphic Ventricular Tachycardia in a Patient Taking Cesium Chloride. PACE 2001; 24: 515-17.
- Eisenberg DM, Kessler RC, Foster C et al. Unconventional Medicine in the United States. Prevalence, costs and patterns of use. NEJM 1993; 328: 246-52
If you need more information,
We would be happy to help you.
Know someone who could use this information?... Send them this link.
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
© Copyright 2001-2009 Cleveland Clinic. All rights reserved. rev. 5/09
