Complementary medicine for the allergist.

The objective of this article is to provide a historical overview of the present state of complementary and alternative medicine (CAM) in the treatment of atopic disorders. The evolution of medicine in the United States has been in flux with the advent of newer technologies, new designs in managed care, and integrating the cultural differences into a complex multidisciplinary health care delivery process. There have been several herbal modalities that contain various anti-allergy and asthma components with effects on bronchodilation, congestion, pulmonary function tests, and antagonism of asthma mediators such as histamine and PAF, corticosteroid levels, and clearance of mucus. In the field of allergy, asthma, and immunology, the popularity of CAM is more widespread than other common chronic medical problems. Overall, CAM use has created a $15-billion-a-year industry in dietary supplements alone. This has been especially fueled by the deregulation of the "herbal" industry by the congressional passage of the Dietary Supplement Health and Education Act of 1994. It would appear that our specialty would clearly benefit from expanding its knowledge base about these entities because "allergies" are high on the list of patients seeking CAM. This will prepare us to better coordinate the future possibilities and to "doctor" (i.e., teach) our patients about the risks and benefits of these modalities.