Complementary medicine for the allergist

The objective of this article is to provide a historical overview of the pr esent state of complementary and alternative medicine (CAM) in the treatmen t of atopic disorders. The evolution of medicine in the united States has b een in flux: with the advent of newer technologies, new designs in managed care, and integrating the cultural differences into a complex multidiscipli nary health care delivery process. There have been several herbal modalitie s that contain various anti-allergy and asthma components with effects on b ronchodilation, congestion, pulmonary function tests, and antagonism of ast hma mediators such as histamine and PAF, corticosteroid levels, and clearan ce of mucus. In the field of allergy, asthma, and immunology, the popularit y of CAM is more widespread than other common chronic medical problems. Ove rall, CAM use has created a $15-billion-a-year industry in dietary suppleme nts alone. This has been especially fueled by the deregulation of the the " herbal" industry by the congressional passage of the Dietary Supplement Hea lth and Education Act of 1994. It would appear that our specialty would cle arly benefit from expanding its knowledge base about these entities because "allergies" are high on the list of patients seeking CAM. This will prepar e us to better coordinate the future possibilities and to "doctor" (i.e., t each) our patients about the risks and benefits of these modalities.