Alternative therapies have emerged out of the public's dissatisfaction with the limitations of conventional treatments.

The conventional medical system has boxed itself into only diagnosing and treating disease rather than focusing on prevention. Although attempts to correct public perception have been made with a push for early diagnosis of disease, conventional medicine is still unable to be of help to healthy people who are just looking for ways to stay healthy.

What conventional medicine considers prevention, PAP smears, mammographies, colonoscopies, cardiac stress tests, are actually methods of diagnosing diseases at early stages. Not one of these methods actually prevents diseases from occurring. Desperately aware of the need to prevent disease, the public has been searching for different avenues of true prevention. As our population lives longer and healthier lives, deferring the aging process has become a must for many people. In fact, a whole booming industry has developed in an attempt to satisfy this urgent need to stay young and healthy. Menopause and its attendant hormone imbalances have provided an enormous amount of fuel for the alternative health industry. Billions of dollars are spent every year by women in search of alternative help for symptoms of hormone imbalance, and millions of dollars are spent by the alternative industry in the development and promotion of alternative treatments.

While the alternative trend is booming, it behooves conventional doctors and patients to become vigilant, well informed and careful in making safe and effective choices in this new area. In the past many of my patients have come to me with questions on alternative therapies. As a conventional physician I had limited access to the alternative world, and I had to do my own research. In the end, I became somewhat of an expert. I've begun to use alternative therapies in my practice with varying results. This article offers an overview of the alternative medicine world I've been sharing with my patients and have had some success with.

But before you try any of these remedies, I strongly suggest you seek professional advice. Do not follow advice given by sales people in health food stores, or on-line advertising by marketers for the particular product they are selling. Do not fall prey to advertised specials for cure-all medications, you don't know what is in them, you don't know what their effects will be. Find a physician interested in alternative therapies, go to a health care provider with experience and get the most knowledgeable help available. Even if these products are available over-the-counter, they may not be as safe as you think they are. Remember, there is only one of you and every time you take a supplement or medication, you are affecting your body's balance.

Most supplements and herbs are not regulated by the Food and Drug Administration (F.D.A.). This is the single most important piece of information you must be aware of when making alternative therapy choices.

The Food and Drug Administration is the federal regulatory body that approves medication for usage by the public. The only medications approved by this agency are pharmaceuticals, medications with unique chemical formulations, patented and having undergone rigorous and expensive processes of testing for function and safety.

F.D.A. approval is a large part of the expense of bringing patented medications to market. Having obtained this approval drug companies can make certain claims that serve to differentiate between medications and allow them to charge higher prices for their products. Because the F.D.A. approval process is tedious and expensive, only pharmaceutical companies with unlimited funds can undergo it.

Even F.D.A. approval does not guarantee safety. F.D.A. approved medications are often taken off the market in a hurry when they prove dangerous to users. A few recent examples are: Duract-anti-inflammatory medication taken off the market because it caused liver failure, Rezulin - a drug used to treat type 2 diabetes that caused liver toxicity, Seldane - an antihistamine with cardiac and other untoward side-effects.

The F.D.A. does not evaluate the function and safety, or supervise the manufacturing of alternative therapies, herbs and supplements. As these are natural, unpatentable substances, there is no large company who serves to make a great deal of money from the F.D.A.'s approval and the public's wide usage of the products. Therefore, most alternative therapies, herbs, and supplements do not undergo the costly approval process from the FDA. Again, this does not mean that they are not safe or effective. Nonetheless this situation leaves us, the public in a precarious position. Whenever you go to a health food store, you are buying on faith. The information on the label is vague, contents are somewhat questionable and I am sure you noticed, indications for use are invariably missing. You may never know exactly what is in the pill you're taking. And that's a scary thought. We live in a society where the best marketer, the company that spends the most money on advertising, gets their product sold.

So how do you choose which supplement or herb to take?

Who is the product manufacturer?

When I started researching alternative treatments for symptoms of hormone imbalance, I learned something few people know. There are very few manufacturers of raw supplements, vitamins and herbs. The enormous variety of brands that fill the shelves of our health food stores, are often the same product packaged by different companies.

Let me explain a little further.

Let's take Dong Quai- an herbal supplement that presumably improves hot flashes. Dong Quai can be found in stores under as many as twenty different labels. Most Dong Quai is produced by a handful of manufacturing companies that package the raw Dong Quai under different labels. It is impossible to determine who the manufacturer is, and which product is better. Anybody can contract with a manufacturer, then get a packager, put their own label on a supplement, and then sell it to the public. It's that simple. But it leaves the public in an uncomfortable position. On the other hand, the industry has recognized the need for laboratory tested brands, and a few manufacturers with long standing solid track records have established themselves in the market. Their products are standardized. For the consumer this is an important fact. Standardized, means, that the dosing is the same from batch to batch of supplement. For instance- St. John's wort made by Pharmanex has the same amount of active ingredients in every bottle of St. John's wort bought under the Pharmanex label. Since there is no regulatory agency that requires standardization of dosing, the manufacturer decides whether to provide internal testing and quality control for their products.

I advise you to stick with standardized labeled products for your own safety. Some examples of standardized labeled products include: Pharmanex, Nature's Bounty, Solgar, and Twin Labs.

Assuming that you have chosen a reliable brand with a proven track record there still are no guarantees the therapy will work for you. A potential stumbling block to benefiting the most from your chosen herb, vitamin or supplement, is bioavailability.

A big word with big implications. Bioavailability represents the amount of active ingredient in the medication or supplement that gets into your blood stream and can be effectively used by your body. You could take pounds of supplements without visible improvement in your condition simply because your body is unable to extract its beneficial ingredients. A perfect example is yam in its natural forms. Although yams contain progesterone, the hormone our body needs, eating yams will never give you that progesterone. That is because our bodies cannot make yams bioavailable, meaning it cannot extract the progesterone from them. How the supplement gets into your system, what the body does with it once it's in your blood stream, how much of it gets to your cells and how they use it, are only parts of the bioavailability story. When medications are tested for effectiveness, the most important marker is their bioavailability. With supplements and food substances, that are not under FDA scrutiny, bioavailability is not even addressed.

Another example of variable bioavailability is calcium. Calcium is essential to good bone structure. But taking calcium supplements does not insure that more calcium gets into our system, let alone to our bone cells or into our bones. Let's follow the path of a calcium pill you take in the evening, three hours after your last meal. Your stomach is empty and the pill gets broken down into tiny components by gastric juices. If the components are small enough, the calcium supplement you took gets absorbed into your blood stream. If it isn't small enough, it goes through the stomach and into the intestine and out the other end- no calcium supplement for your body. If it gets absorbed into your blood stream it has a good chance of getting to your bone cells. But once there, there is no guarantee that the cells that need the calcium have the enzymes, substrates, and all other necessary environmental elements, to absorb the calcium molecules and use them to make strong bones.

The path I use to describe the fate of calcium in your body is similar to any other food or medication you take. There are lots of great supplements available with incredible potential benefits. The reason they don't live up to their promises is because they are not bioavailable. This is one of the key reasons many supplements just don't work. In an attempt to improve bioavailability, many manufacturers advise taking their supplements on an empty stomach. The reason behind this method of administration is that hypothetically, an empty stomach will be more inclined to digest and absorb a supplement than if mixed with other foods or medications. I stress hypothetically, because there are no studies to substantiate the bioavailability of most supplements on the market today.

Other methods of administration (besides pills and tablets) have better rates of absorption and bioavailability. Pharmaceutical companies have conducted numerous studies that reinforce the increased bioavailability of creams and gels. The reason is primarily that skin is a more predictable absorbent, it is the largest organ in the human body and the blood flow to the skin is high in warm areas, like chest, inner thighs, arms, and pulse points (wrists, ankles, armpits, groin).

From a clinical standpoint, degree of bioavailability of a substance is directly proportional to its expected effect. If you are taking a pill to get rid of a headache and the headache is gone in thirty minutes to an hour after you took the pill, clinically speaking, the pill was bioavailable enough to be effective. When we discuss the bioavailability of natural hormones or supplements we are referring to subjectively measurable effects (like elimination of hot flashes, or night sweats for instance).

Good luck on your journey!