Since last century, traditional medicine has been playing a major role in providing healthcare to mankind. Traditional and complementary medicine (T&CM) is getting more popular in Malaysia's community for the purpose of healing diseases and healthcare. Once relegated to mythology and folklore, T&CM is now increasingly accepted globally as a form of health care alongside mainstream health services.

What is T&CM?

According to the World Health Organization (WHO) Traditional Medicine Strategy 2014 - 2023, T&CM are defined as follow:

Traditional Medicine (TM)

Traditional medicine has a long history. It is the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness. 

Complementary Medicine (CM)

The terms “complementary medicine” or “alternative medicine” refer to a broad set of health care practices that are not part of that country’s own tradition or conventional medicine and are not fully integrated into the dominant health-care system. They are used interchangeably with traditional medicine in some countries.

Traditional and complementary medicine (T&CM)

T&CM merges the terms TM and CM, encompassing products, practices and practitioners.

T&CM in Malaysia

Image credit:https://www.hmetro.com.my/hati/2018/09/380684/urutan-malaysia

Since Malaysia is a multicultural society, we have a wide variety of T&CM practices in the country. The recognized practice areas (i.e. those are recognized under T&CM Order 2017) in Malaysia are:

1. Traditional Malay Medicine, such as Malay post-natal massage

2. Traditional Chinese Medicine, such as acupuncture and cupping

3. Traditional Indian Medicine, such as ayurveda 

4. Homeopathy

5. Chiropractic

6. Osteopathy

7. Islamic Medical Practice

Latest update: June 2019

Source: http://tcm.moh.gov.my/ms/

Image credit: https://www.nst.com.my/news/exclusive/2017/04/235051/traditional-and-complementary-medicine-practitioners-be-regulated

Things to consider before using T&CM

1. Do your own research and homework

This doesn’t mean that you should believe everything you have Googled. You should look for high-quality studies that involve large, controlled and randomized controlled trials that are published in peer-reviewed scientific journals. Although scientific studies are the best way to evaluate whether a treatment is safe and effective, it isn't always possible to find good studies about nonconventional therapies. A lack of evidence doesn't necessarily mean a treatment doesn't work — but it does make it harder to evaluate whether it's safe and effective. 

If you think you lack the scientific knowledge to discern these information, or they are just simply too overwhelming for you, you should always talk to a healthcare professional. Do not take any information you see online or hearsay from people you know as a guide to your decision.

2. Talk to your healthcare professionals about options

Before deciding on a T&CM therapy or product, tell your healthcare professionals about the therapy or products you are considering and ask any questions you may have. They may know about the therapy and be able to advise you on its general safety, use, and effectiveness. Ideally, they should be able to provide guidance about whether it is safe and likely to provide benefits in your particular situation. Be very cautious about using a T&CM therapy as a replacement for any proven treatment or as a reason to postpone seeing your doctor about a medical problem.

3. Beware of scams and false claims

Scammers have perfected ways to convince you that their products are the best. They often target people who have serious and chronic medical problems. Remember, if something sounds too good to be true, it probably is. The ‘red flags’ of scams are:

• Big promises. Ads may call the product a "miracle cure," "scientific breakthrough," "secret ingredient" or "ancient remedy." Be skeptical of exaggerated claims.

• Cure-alls. The product claims to treat a wide range of symptoms or cure or prevent a number of diseases. No single product can do all of this.

• Testimonials. Stories from people who have used the product are not the same as scientific proof. If a product's claims were backed up by clinical studies, the manufacturer would say so.

• Limited-time offers and guarantees. These pitches are intended to get you to buy before you can evaluate the product's claims.

The Malaysia’s Medicines (Advertisement and Sale) Act 1956 has specified certain rules to be applied to T&CM practitioners. The following are examples of advertisements with false claims.

If you have seen similar ads like these, you should make a complaint to the authority and stop using their services. This is because any T&CM treatment that claims to treat chronic diseases such as diabetes and asthma are not backed up by substantial scientific evidence yet. 

4. Check if T&CM product is registered with Ministry of Health

All pharmaceutical and T&CM products sold in Malaysia including health supplements are regulated by the Ministry of Health (MOH) under the Control of Drugs and Cosmetics Regulations 1984. This is to ensure they are of high quality and safe for consumption by the public. 

Image credit: https://www.thestar.com.my/news/nation/2018/11/27/traditional-medicine-lacks-stringent-regulations/

Products registered with the MOH have two main features, the registration number and genuine hologram sticker. The registration number starts with 'MAL', followed by eight numbers, and ending with an alphabet to indicate their registration category. For example, MAL20125467T. The categories of registered product are as follows:

A – Controlled medicines

X – Over the counter medicines (OTC)

T – Traditional medicines

N – Supplements

The list of registered products can be found at the official website of the National Pharmaceutical Regulatory Agency, http://www.npra.gov.my/. The authenticity of the hologram sticker can be determined using the Meditag hologram decoder which is available at any licensed pharmacies. 

Image credit: http://www.myhealth.gov.my/en/current-meditagtm-hologram-security-sticker/

You can read more about registration of medicines in Malaysia in our previous articles:

Can I buy medicines from the Internet?

Be Careful with Dangerous and Adulterated Cosmetics

5. Natural doesn’t mean it’s safe

Image credit:https://big.com.my/blog/b-i-g-raya-recipes-to-try-at-home/

Herbal remedies, vitamins and minerals, and dietary supplements are often marketed as natural products, but that doesn't guarantee that they're safe. These products can have serious side effects. For instance, they may interact with the other medications you’re taking, causing unwanted treatment failure or worsening side effects. Some of them may also increase your bleeding risk and it’s especially dangerous if you have scheduled surgery coming up.

Choose your T&CM practitioner wisely

• According to T&CM Act 2016, any practitioner who wishes to practise and provide T&CM services in Malaysia should register with T&CM Council. In order to be eligible for registration, the practitioners should meet the required criteria, which include having qualifications as specified by the T&CM Council. Those who meet all the requirements would be issued a registration certificate.

Source: https://www.npra.gov.my/images/Announcement/2015/NRC-2015-day2/TMHS08-P-Ms-TehLiYin-31-07-15.pdf

• You should also ensure the practitioner is willing to work together with your conventional health care providers. For safe, coordinated care, it’s important for all of the professionals involved in your health to communicate and cooperate.

• Remember to explain all of your health conditions to the practitioner, and find out about the practitioner’s training and experience in working with people who have your conditions. Choose a practitioner who understands how to work with people with your specific needs, even if general well-being is your goal. And, remember that health conditions can affect the safety of complementary approaches; for example, if you have glaucoma, some yoga poses may not be safe for you.

• Contact your health insurance provider and ask if your health insurance covers the practitioner’s service. Insurance plans differ greatly in what complementary health approaches they cover, and even if they cover a particular approach, restrictions may apply.

Feedback and Complaints Channels

You may provide any feedback or complaints regarding T&CM services in Malaysia through the following channels:

Source: Consumer Guideline - For proper use of traditional and complementary medicine services in Malaysia

List of Ministry of Health (MoH) Facilities Offering T&CM Services

Source: Consumer Guideline - For proper use of traditional and complementary medicine services in Malaysia

References:

1. Mayo Clinic - Integrative medicine: Find out what works. https://www.mayoclinic.org/tests-procedures/complementary-alternative-medicine/in-depth/alternative-medicine/art-20046087

2. NICM Australia - Complementary Medicine Research fact sheet. https://www.westernsydney.edu.au/__data/assets/pdf_file/0005/723245/Fact_sheet_choosing_3.pdf

3. NIH - Complementary and Alternative Medicine. https://www.cancer.gov/about-cancer/treatment/cam

4. NIH - 6 Things To Know When Selecting a Complementary Health Practitioner. https://www.nccih.nih.gov/health/tips/things-to-know-when-selecting-a-complementary-health-practitioner

5. Consumer Guideline - For proper use of traditional and complementary medicine services in Malaysia. http://tcm.moh.gov.my/ms/upload/garispanduan/consumer/BukuPanduan_BI.pdf

6. WHO Traditional Medicine Strategy 2014 - 2023. https://apps.who.int/iris/bitstream/handle/10665/92455/9789241506090_eng.pdf?sequence=1

Written by

Ms Joyce Toh