Along with the popularity of massage therapy, the percentage of Americans who use complementary and alternative medicine (CAM) each year is growing. On the positive side of this trend, an increasing number of people are taking control of their health to live a better quality life. On the not so good side, many of those interested in CAM are mixing drugs and supplements without the guidance of a knowledgeable physician. Although bodyworkers don’t prescribe medications, they may be the first healthcare professional to recognize that their client is dabbling with a risky combination of substances.
The likelihood of a person taking supplements without the guidance of his/her physician is steadily rising. In December 2008, the National Center for Complementary and Alternative Medicine (NCCAM) and the National Center for Health Statistics (part of the Centers for Disease Control and Prevention) released new findings on Americans’ use of CAM. According to NCCAM, approximately 38 percent of American adults are using some form of CAM. The most commonly used CAM therapy among adults is reported to be non-vitamin, non-mineral natural products. In addition, America’s patronage of deep breathing exercises, meditation, massage therapy and yoga is progressively growing.
The popularization of CAM modalities has been a major player in improving the public’s quality of life. However, many mistakenly assume that its isolation outside of conventional medicine renders their therapy as completely safe. Extensively trained in the cautions and contraindications of their profession, massage therapists are well aware of this common misconception.
When it comes to non-vitamin, non-mineral supplementation (the most popular form of CAM), most Americans act without professional guidance. Published in a December 2008 edition of the Journal of the American Medical Association, a study conducted by the National Institutes of Health and University of Chicago found that at least two million older Americans are taking a combination of drugs or supplements that can be a risky mix. According to the researchers, older men are particularly prone, with one in ten taking potentially harmful combinations.
Based on analysis of nearly 3,000 interviews of Americans aged 57 to 85, the older population is especially vulnerable to potential drug and supplement interactions, because their medication use is higher than their younger counterparts:
- Encompassing over 50 million people, 91 percent of older Americans use at least one medication.
- More than half of older Americans use at least five remedies, including prescriptions, over-the-counter medicines or supplements.
Unfortunately, mixing substances without discussing it with a knowledgeable physician or pharmacist could result in disastrous consequences. As a CAM practitioner, massage therapists must be aware of this huge lack of guidance for the general public – especially with their older clientele.
What to Look Out For
As part of the initial history taking process, massage therapists traditionally ask their clients about the medications and supplements they take. Since medications influence massage, this information is crucial to maximizing the session’s safety and effectiveness. However, this also means that massage therapists may be the first practitioners to realize their client is dangerously mixing substances. Some common things to look out for include:
- Blood Thinners With Garlic – Warfarin is a potent prescription clot-fighting drug. Garlic supplements are often taken to benefit the heart and prevent blood clots. However, when taken together, the risk of bleeding is magnified. Excessive bleeding could include bruising easily, hard-to-stop bleeding from the gums or cuts or blood in the urine.
- Aspirin With Ginkgo – Aspirin also thins the blood and is commonly taken as a clot preventative. Ginkgo is usually taken to enhance memory but it also thins the blood. When taken together, the chance of excess bleeding is increased.
- ACE Inhibitor With Potassium – Potassium is often taken to compensate for the effects of some blood pressure drugs. Lisinopril, an ACE inhibitor used to lower blood pressure, can cause abnormal heart rhythms when combined with potassium.
- Statins With Niacin – Also known as niacin, Vitamin B3 is commonly taken to help lower cholesterol. When combined with the cholesterol lowering class of drugs known as statins, the risk for muscle damage is magnified.
- Diabetes Medications With Ginseng – Ginseng is a popular supplement for reducing stress and boosting energy. However, ginseng may lower blood sugar, which can be dangerous when combined with certain diabetes medications.
- St. John’s Wort – While this supplement is popular to relieve mild depression, it can interfere with the metabolism of prescription antidepressants, birth control pills and anticoagulants.
As confirmed by the recent National Institutes of Health and University of Chicago study, the potential for a risky combination is even greater in people over the age of 57. Keeping this in mind, all healthcare practitioners should pay closer attention to this age group’s medications.
By recognizing a potentially risky combination, massage therapists can voice their concerns and advise their clients to discuss their medication and supplement list with a physician or pharmacist. Some people may be aware of the potential for harm and are already being monitored by their doctor, but others may not know of the risks they are creating. As knowledgeable and trusted CAM practitioners, massage therapists are probably in the best position to uncover such risky combinations and make a potentially life-saving referral.