Complementary and alternative therapy

Complementary therapies can be used alongside medical treatment. They aim to help someone feel better. But they do not claim to treat or cure the condition.

Examples of complementary therapy include:

• Massage or aromatherapy to relax or to ease sore muscles.
• Cool baths and showers to help with itching.
• Mindfulness and meditation to help with anxiety.

Alternative therapies claim to treat or cure a condition. Alternative therapists often say that their treatment is better or safer than treatment from a doctor. They might suggest stopping the treatment a doctor has recommended. Some alternative therapists genuinely believe that they can help. Others try to take advantage of people who are worried, confused and looking for help.

Some medicines can fall into either of these groups. For example herbal remedies, traditional Chinese medicine, homeopathy, natural remedies, and naturopathic medicines. These might all be sold to help with symptoms or to actually treat a condition. Whatever they are being sold for, they can sometimes be dangerous for people with a liver condition.

Complementary therapies like massage and aromatherapy are usually safe. But this can be different for everyone. For example, it might not be safe for people with bleeding or clotting problems to have a massage. Always check with the liver medical team first.

Medicines and other alternative therapies can be more risky. The liver has many jobs. One of these is breaking down (metabolising) medicines. If the liver is not working properly, it might not be able to do this. When this happens, medicines can build up in the body. This can be serious and can cause more damage to the liver. You can find out more about this here.

Some alternative and complementary medicines can change the way other medicines work. This can mean important medicines do not work properly. Or it can increase the risk of serious side effects.

You might not know how strong the medicine is (the dose).

Licenced medicines must be made in a very controlled way. This makes sure that every time someone takes the medicine they get the exact same amount of the active ingredient in it. This amount must be written on the package.

This is not always possible for complementary and alternative medicines. For example, plants grow differently at different times of the year. So the amount of active ingredient in a herbal medicine might depend on when the plants were collected. This means that the medicine might not have enough of the active ingredient to work. Or it could have so much that it is dangerous.

Most complementary and alternative therapies are not available on the NHS. This is because they do not have the evidence to back them up. You can read more about some specific therapies on the NHS website.

Complementary therapies like massage or aromatherapy work well for some people and not for others. There is not usually strong evidence for them. But they do not replace medical treatment so if you can afford to pay for them and find them helpful this might not be a problem.

Alternative therapies seek to replace medical treatment. But there is not good evidence that they work or that they are safe.

Medicines that you get from the doctor go through a lot of tests before they can be prescribed. These tests check:

• The medicine is safe
• The medicine works
• What the side effects of the medicine are
• If it is safe to take the medicine when someone has other conditions or takes other medicines

Alternative therapies are not tested in the same way. So it is possible that some work. But there is no strong evidence that they do, or that they are safe.

If you have cirrhosis you may have trouble absorbing all of the vitamins and minerals in your diet. Your liver medical team should be able to tell you if any supplements are needed and which are the best ones to try.

Babies and children with liver disease sometimes need special formula or supplements from the medical team.

However, a wide variety of other dietary supplements may cause damage to the liver. For example, supplements containing vitamin A, green tea extract, kava (often taken for anxiety or insomnia), conjugated linoleic acid supplements (sometimes used for slimming), noni juice have all been reported as causing liver damage.

It is therefore important to discuss with a doctor or registered dietitian before taking any dietary supplements.

You can find out more about supplements and vitamins here.

If you or someone you care for has a liver condition, always talk to a doctor before trying alternative and complementary medicines. They will have information on medical history and other medicines. They will be able to help you decide if it is safe to try a treatment.

This is important even if the medicine was given to you by someone working as an expert in that type of medicine.

Some types of healthcare professional are carefully regulated. This includes doctors, nurses and dietitians. And some other types of healthcare professional that you find in the NHS. They must have done a lot of training. They are also registered.

Complementary and alternative medicine practitioners are not regulated. Anyone can call themselves an expert. For example, a naturopath, nutritionist, nutritional therapist, homeopath, herbalist, or Chinese herbalist. There are also no regulations about how much training they must have done or how good this training is.

This means that they are unlikely to fully understand your liver condition. Or how different conditions and medicines can affect each other.

If your liver is working normally, always check with a pharmacist before taking a new medicine. They can tell you if it is known to affect any other medicines.

There is a huge amount of information online about alternative and complementary therapies. People selling or promoting a particular treatment can be very convincing. They might list lots of evidence that they say proves the treatment works. Or they might have lots of quotes from happy customers.

It is always a good idea to be cautious about this sort of information. Especially if it comes from someone who is trying to sell you something.

They might be showing you evidence from one very small study that said something works. But ignoring many more much better studies that show it does not.

You also cannot be sure that quotes from happy customers or online ratings are real. And unfortunately, even if something has worked for someone else, that does not mean it will work for you. It might not even be safe.

More about finding health information online

Online forums and groups can be a great way to meet people with similar experiences. You can find out more about The British Liver Trust forum here .

Suggestions for complementary and alternative treatments are usually well meant. But you should never take medical advice from strangers on the internet.

Friends and family often make suggestions for treatments. This might be based on something they read. Or on something that has worked for someone they know. This advice is well meant but it is important to be careful about it.

As with online information, the suggested treatment might not work or be safe for you. Having a liver condition means you need to be even more careful about which medicines you take. The person making the suggestion might not understand this.

Occasionally someone can be very persistent in sending you unwanted advice. If this happens it might help to share this page with them.