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Complementary and Alternative Medicine: Myths and Truths

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Complementary and Alternative Medicine: Myths and Truths

Background Information

The use of complementary and alternative medicine (CAM) are common in multi-racial and multi-cultural countries such as Singapore. A study conducted in Singapore showed that our prevalence of CAM use is as high as 76%, far exceeding what is reported in western countries.  The use of CAM in Singapore also differs significantly between the ethnic communities; Chinese (84%) are the most frequent users, followed by the Malays (69%), and Indians (69%).  Not surprisingly, Traditional Chinese Medicine (88%) was the most widely used, followed by traditional Malay medicine (Jamu) (8%) and traditional Indian (Ayuverdic) Medicine (3%).1


What is Complementary and Alternative Medicine (CAM)?  

Complementary therapy is when it is used concurrently with standard or conventional medical treatment which is commonly used to alleviate stress, reduce pain and anxiety, manage symptoms and promote a feeling of well-being.  Alternative therapy is when it is used in place of conventional medication and is built upon complete system of theory and practice e.g homeopathy or naturopathy.2,5


What are the differences between the types of popular CAM in Singapore?

Traditional Chinese Medicine:  Encompasses many different practices, including acupuncture, moxibustion (burning an herb above the skin to apply heat to acupuncture points), Chinese herbal medicine, tui na (Chinese therapeutic massage), dietary therapy, and tai chi and qi gong (practices that combine specific movements or postures, coordinated breathing, and mental focus). It is dated back to more than 2500 years.5

Traditional Malay medicine (Jamu): Indonesian traditional herbal medicine that has been practised for many centuries in the Indonesian community to maintain good health and to treat diseases.

Traditional Indian (Ayuverdic) Medicine: One of the world’s oldest medical systems which concepts promote the use of herbal compounds, special diets, and other unique health practices.5


Regulation of CAM (Traditional Chinese Medicine) Singapore

The importance of traditional medicine in the provision of health care is recognized by our health authorities and efforts have been made to promote and ensure the safe practice of traditional medicine. The popularity of the use of Traditional Chinese Medicine would mean that additional efforts needed to be made to safeguard the interests of the public seeking these services.  The Traditional Chinese Medicine Practitioners Act of 2000 was thus established; in addition from January 2004 onwards, all who practise TCM are required to be registered with the TCM Practitioners Board and possess a valid practising certificate.3,4


All Chinese Proprietary Medicines (CPM) i.e. products in the finished dosage forms (e.g. tablet, capsule, liquid) are regulated by the Health Sciences Authority (HSA) and are required to comply with a set of safety and quality criteria before they are allowed to be sold in Singapore. In addition, CPM dealers (importers, wholesale dealers and manufacturers) are also required to be licensed by HSA.4

To monitor the safety of CPM; HSA also implemented a post-marketing surveillance programme.  It has two components4:

  • A risk-based market surveillance programme to sample and test products found in the market.
  • An adverse reaction monitoring programme, which draws on HSA’s network of local healthcare professionals and international regulatory partners to pick up signals of any health products that may be causing adverse reactions. This system of checks and controls has enabled HSA to initiate timely recalls of harmful and inferior quality products.


Other traditional medicines (e.g. traditional Malay and Indian medicines) and homoeopathic medicines are currently not subject to pre-marketing approval and licensing for their import, manufacture and sale in Singapore. Therefore, the safety and quality of traditional medicines and homoeopathic medicines is dependent on the dealers (importers, manufacturers, wholesale dealers) and sellers.4


Consumers should be vigilant on the use of CPM and other complementary health products and are advised to only buy health products from reliable and reputable sources. For example consumers can search for the list approved CPM in Singapore at the following HSA webpage4


How safe is CAM?

As CAM often promotes the use of herbal or natural remedies, one of the common misconception is that it is safe. “Natural” does not necessarily translate into safety and there are concerns of the possibilities of side effects from the natural product or even drug interactions with conventional medicine which may affect the body’s absorption of either one of the medicines. In addition, product contamination is also possible if one is not careful as certain health supplements are not as strictly regulated as conventional medicine or CPM. Moreover, these may also be easily be obtained via online sources or makeshift stalls.


Thus the consumer must interpret claims made by manufacturers carefully and be wary of claims that are “too good to be true” such as a quick or painless cure.  Consumers should therefore consult their health care professionals prior to starting any CAM therapy so that an informed decision can be made. They should also only purchase their CAM products from reliable and reputable sources such as registered TCM clinics or pharmacies.


Where can I find reliable information on CAM?

The best course of action is to speak to your health care provider or pharmacist about your intention to use CAM especially if you are thinking about replacing your conventional medication with CAM.


However, there are some reliable resources where you can obtain evidence-based CAM information. These information should be interpreted carefully and discussed with your health care provider or pharmacist when in doubt.




References :

  1. Lim, M. K., et al. "Complementary and alternative medicine use in multiracial Singapore." Complementary therapies in medicine 13.1 (2005): 16-24.
  2. Public Education Initiative by National Cancer Center Singapore. Complementary and Alternative Medicine. A Guide for People with Cancer.
  3. Ministry Of Health (Singapore) TCM Practitioners. 21st August 2016, date last accessed) 
  4. Health Sciences Authority (HSA). Singapore : Health Products Regulation. ( 21st August 2016, date last accessed) 
  5. National Center for Complementary and Integrative Health.  Traditional Chinese Medicine, ( 21st August 2016, date last accessed) 


Written by Ms Lim Kae Shin 

Reviewed by Mr Franky (Pharmacists, PSS Public Education Chapter)