(Complementary & Alternative Medicine Sourcebook) Amy L. Sutton - Complementary and Alternative Medicine Sourcebook-Omnigraphics Inc (2010)
(Complementary & Alternative Medicine Sourcebook) Amy L. Sutton - Complementary and Alternative Medicine Sourcebook-Omnigraphics Inc (2010)
(Complementary & Alternative Medicine Sourcebook) Amy L. Sutton - Complementary and Alternative Medicine Sourcebook-Omnigraphics Inc (2010)
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and Alternative Medicine reports that in the United States, about four in _________________________________________________________________________________________________________________ ___
10 adults and about one in nine children use some form of CAM, such as _____________________________________________________________________________________________________________________
deep breathing, dietary supplements, massage, meditation, or yoga. CAM, _____________________________________________________________________________________________________________________
alone or in conjunction with mainstream medicine, is often used to treat an
increasing variety of diseases and conditions, such as arthritis, anxiety, back
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general well-being or specific health conditions. It discusses how to select a
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Reference _____________________________________________________________________________________________________________________
and Vitamin Supplements, Homeopathy, Hypnosis, Massage,
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evaluate information on the internet, and pay for CAM therapies. It describes Series _____________________________________________________________________________________________________________________
Meditation, Naturopathy, Pilates, Reflexology, Reiki, Shiatsu,
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whole medical systems, such as Ayurveda, traditional Chinese medicine, Na-
tive American medicine, acupuncture, homeopathy, and naturopathy. It also
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talks about the safe use of dietary supplements, including vitamins, minerals, Complementary and Alternative Medical Therapies
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and herbs. Information on biologically based therapies, mind-body medicine,
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manipulative and body-based therapies, and energy-based therapies is also Along with Statistics, Tips for Selecting a Practitioner,
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included. A glossary of related terms and a directory of additional resources _____________________________________________________________________________________________________________________
provide additional help and information.
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Phone: 800-234-1340
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Bibliographic Note
Because this page cannot legibly accommodate all the copyright notices, the Bibliographic
Note portion of the Preface constitutes an extension of the copyright notice.
Edited by Amy L. Sutton
Health Reference Series
Karen Bellenir, Managing Editor
David A. Cooke, MD, FACP, Medical Consultant
Elizabeth Collins, Research and Permissions Coordinator
Cherry Edwards, Permissions Assistant
EdIndex, Services for Publishers, Indexers
***
Omnigraphics, Inc.
Matthew P. Barbour, Senior Vice President
Kevin M. Hayes, Operations Manager
***
Peter E. Ruffner, Publisher
Copyright © 2010 Omnigraphics, Inc.
ISBN 978-0-7808-1082-2
This book is printed on acid-free paper meeting the ANSI Z39.48 Standard. The infinity
symbol that appears above indicates that the paper in this book meets that standard.
Preface ............................................................................................ xi
v
Part II: Alternative Medicine Systems
Chapter 10—What Are Whole Medical Systems? ....................... 59
Chapter 11—Ayurvedic Medicine ................................................ 65
Chapter 12—Other Indigenous Medical Systems ....................... 73
Section 12.1—Traditional Chinese
Medicine...................................... 74
Section 12.2—Native American Medicine ........ 78
Chapter 13—Acupuncture............................................................ 81
Chapter 14—Homeopathy ............................................................ 85
Chapter 15—Naturopathy............................................................ 91
vi
Section 30.2—Glucosamine/Chondroitin
Supplements and Joint
Health ....................................... 201
Chapter 31—Immune System Support Supplements............... 205
Section 31.1—Echinacea.................................. 206
Section 31.2—Zinc............................................ 208
Chapter 32—Mood and Brain Health Supplements ................. 213
Section 32.1—Ginkgo Biloba ........................... 214
Section 32.2—St. John’s Wort.......................... 216
Chapter 33—Probiotics: Supplements for
Gastrointestinal Health ....................................... 219
Chapter 34—Sports and Energy Supplements ......................... 225
Section 34.1—Sports Supplements ................. 226
Section 34.2—Energy Drinks .......................... 231
Chapter 35—Supplements Used for Weight Loss ..................... 235
Section 35.1—Green Tea.................................. 236
Section 35.2—Hoodia ....................................... 238
vii
Chapter 43—Biofeedback ........................................................... 303
Chapter 44—Deep Breathing Exercises .................................... 311
Chapter 45—Feng Shui .............................................................. 317
Chapter 46—Guided Imagery and Hypnosis............................. 321
Section 46.1—Guided Imagery........................ 322
Section 46.2—Hypnosis ................................... 324
Chapter 47—Meditation ............................................................. 329
Chapter 48—Music Therapy ...................................................... 335
Chapter 49—Prayer and Spirituality ........................................ 341
Chapter 50—Relaxation Training.............................................. 345
Chapter 51—Tai Chi ................................................................... 349
Chapter 52—Yoga ....................................................................... 353
Chapter 53—Other Mind-Body Medicine
Therapies............................................................... 357
Section 53.1—Color Therapy ........................... 358
Section 53.2—Dance Therapy.......................... 359
viii
Chapter 61—Pilates.................................................................... 423
Chapter 62—Qigong ................................................................... 427
Chapter 63—Reflexology ............................................................ 431
Chapter 64—Structural Integration Techniques ...................... 435
Section 64.1—Hellerwork Structural
Integration................................ 436
Section 64.2—Rolfing....................................... 438
Chapter 65—Other Manipulative and Body-Based
Therapies............................................................... 447
Section 65.1—Applied Kinesiology.................. 448
Section 65.2—Bowen Technique...................... 449
Section 65.3—Trager Approach....................... 450
ix
Chapter 78—Fibromyalgia and CAM ........................................ 529
Chapter 79—Headache and CAM .............................................. 533
Chapter 80—Heart Disease and Chelation Therapy ................ 537
Chapter 81—Hepatitis C and CAM ........................................... 541
Chapter 82—Hormones, CAM, and Aging ................................. 547
Chapter 83—Infertility and CAM .............................................. 559
Section 83.1—Herbal Remedies for
Infertility .................................. 560
Section 83.2—Infertility and CAM.................. 561
Chapter 84—Low Back Pain and CAM...................................... 563
Chapter 85—Menopausal Symptoms and CAM........................ 567
Chapter 86—Mental Health Care and CAM ............................. 573
Section 86.1—Overview of CAM Used in
Mental Health Care ................. 574
Section 86.2—Alcohol Addiction and
Electroacupuncture .................. 579
Section 86.3—Attention Deficit
Hyperactivity Disorder
(ADHD) and CAM .................... 580
Section 86.4—Anxiety and Self-Hypnosis ...... 582
Section 86.5—Posttraumatic Stress Disorder
and Acupuncture ...................... 583
Chapter 87—Sleep Disorders and CAM .................................... 585
x
Preface
xi
How to Use This Book
This book is divided into parts and chapters. Parts focus on broad
areas of interest. Chapters are devoted to single topics within a part.
Part I: An Overview of Complementary and Alternative Medicine (CAM)
defines CAM, identifies common therapies, and answers questions
consumers often have about choosing a CAM practitioner and pay-
ing for treatments. Information and statistics on CAM use in specific
populations, including children and the elderly, is also included, along
with tips on avoiding health fraud and spotting internet scams.
Part II: Alternative Medicine Systems describes whole medical systems
practiced in cultures throughout the world that evolved separately
from conventional medicine as it is practiced in the United States.
These include Ayurvedic medicine, traditional Chinese medicine, Na-
tive American medicine, acupuncture, homeopathy, and naturopathy.
Part III: Dietary Supplements identifies vitamins, minerals, herbs and
botanicals, and other food and dietary substances taken to improve
health or nutrition. Readers will also find tips on ensuring supple-
ment safety and selecting specific products to support bone and joint
health, immune system functioning, mood regulation, and weight loss
efforts.
Part IV: Biologically Based Therapies discusses CAM practices that
strive to enhance or improve health using substances found in nature.
This part highlights biologically based techniques including apitherapy,
aromatherapy and essential oils, and diet-based therapies such as de-
toxification diets, fasting, macrobiotics, and vegetarianism.
Part V: Mind-Body Medicine describes CAM techniques that focus on
using the mind to improve health or reduce unwanted symptoms, such
as biofeedback, deep breathing, guided imagery and hypnosis, medi-
tation, prayer and spirituality, relaxation training, tai chi, and yoga.
In addition, readers will find information about practices focused on
healing via creative expression in art, music, and dance.
Part VI: Manipulative and Body-Based Therapies offers information
about massage therapy, chiropractic care and osteopathic manipula-
tion, hydrotherapy, Pilates, reflexology, qigong, and other CAM thera-
pies that involve movement or manipulation of one or more parts of
the body.
Part VII: Energy-Based Therapies discusses CAM therapies that encour-
age healing through the manipulation of energy fields. CAM practitioners
xii
of reiki, shiatsu, polarity therapy, and therapeutic touch use pressure
and touch to manipulate the energy fields in and around a person’s
body. With magnet and bioresonance therapies, practitioners influence
electromagnetic fields, which purports to increase energy and vitality
in the patient.
Part VIII: Alternative Treatments for Specific Diseases and Conditions
highlights scientific research of CAM therapies for treating arthritis,
asthma and allergies, cancer, dementia, diabetes, fibromyalgia, head-
ache, heart disease, hepatitis, and sleep disorders. The use of CAM for
treating mental health problems, including anxiety and addiction, is
also discussed.
Part IX: Additional Help and Information provides a glossary of im-
portant terms related to complementary and alternative medicine. A
directory of organizations that provide information to consumers about
complementary and alternative therapies is also included.
Bibliographic Note
This volume contains documents and excerpts from publications is-
sued by the following U.S. government agencies: Agency for Healthcare
Research and Quality (AHRQ); National Cancer Institute (NCI); Na-
tional Center for Complementary and Alternative Medicine (NCCAM);
National Institute of Arthritis and Musculoskeletal and Skin Diseases
(NIAMS); National Institute of Neurological Disorders and Stroke
(NINDS); National Institute on Aging (NIA); National Institutes of
Health (NIH); Office of Dietary Supplements (ODS); Substance Abuse
and Mental Health Services Administration (SAMHSA); and the U.S.
Food and Drug Administration (FDA).
In addition, this volume contains copyrighted documents from the
following organizations: A.D.A.M., Inc.; American Apitherapy Society;
American Art Therapy Association; American Dance Therapy Associa-
tion; American Music Therapy Association; American Polarity Therapy
Association; American Pregnancy Association; American Psychological
Association; American Reflexology Certification Board; American Soci-
ety for the Alexander Technique; Association for Applied Psychophysi-
ology and Biofeedback; Asthma and Allergy Foundation of America;
Center for Integrative Health and Healing; ChiEnergy; Feldenkrais
Educational Foundation of North America; Gannett Company, Inc.;
Hellerwork International; National Center on Physical Activity and
Disability; National Headache Foundation; National Qigong Associa-
tion; Natural Medicines Comprehensive Database; Natural Standard;
xiii
The Nemours Foundation; Rolf Institute of Structural Integration;
Trager International; University of California–San Diego; Vegetarian
Resource Group; and the Zero Balancing Health Association.
Full citation information is provided on the first page of each chap-
ter or section. Every effort has been made to secure all necessary rights
to reprint the copyrighted material. If any omissions have been made,
please contact Omnigraphics to make corrections for future editions.
Acknowledgements
Thanks go to the many organizations, agencies, and individuals
who have contributed materials for this Sourcebook and to medical
consultant Dr. David Cooke and document engineer Bruce Bellenir.
Special thanks go to managing editor Karen Bellenir and research and
permissions coordinator Liz Collins for their help and support.
xiv
following the terms specified by each document’s producer. This some-
times means that information in different chapters or sections may
follow other guidelines and alternate spelling authorities. For example,
occasionally a copyright holder may require that eponymous terms be
shown in possessive forms (Crohn’s disease vs. Crohn disease) or that
British spelling norms be retained (leukaemia vs. leukemia).
Medical Consultant
Medical consultation services are provided to the Health Reference
Series editors by David A. Cooke, MD, FACP. Dr. Cooke is a graduate of
Brandeis University, and he received his M.D. degree from the Univer-
sity of Michigan. He completed residency training at the University of
Wisconsin Hospital and Clinics. He is board-certified in Internal Medi-
cine. Dr. Cooke currently works as part of the University of Michigan
Health System and practices in Ann Arbor, MI. In his free time, he
enjoys writing, science fiction, and spending time with his family.
xv
s +AREN )MARISIO "LOOMlELD 4OWNSHIP 0UBLIC ,IBRARY
Bloomfield Township, MI
s +AREN -ORGAN -ARDIGIAN ,IBRARY 5NIVERSITY OF -ICHIGAN
Dearborn, Dearborn, MI
s 2OSEMARY /RLANDO 3T #LAIR 3HORES 0UBLIC ,IBRARY
St. Clair Shores, MI
xvi
Part One
An Overview of
Complementary and
Alternative Medicine (CAM)
Chapter 1
What is CAM?
CAM is a group of diverse medical and health care systems, practices,
and products that are not generally considered to be part of conventional
medicine. While scientific evidence exists regarding some CAM therapies,
for most there are key questions that are yet to be answered through well-
designed scientific studies—questions such as whether these therapies are
safe and whether they work for the purposes for which they are used.
3
Complementary and Alternative Medicine Sourcebook, Fourth Edition
4
What Is Complementary and Alternative Medicine (CAM)?
5
Chapter 2
What is CAM?
CAM is a group of diverse medical and health care systems, prac-
tices, and products that are not generally considered part of conven-
tional medicine. Conventional medicine is medicine as practiced by
holders of MD (medical doctor) or DO (doctor of osteopathy) degrees
and by their allied health professionals, such as physical therapists,
psychologists, and registered nurses. Integrative medicine combines
conventional and CAM treatments for which there is evidence of safety
and effectiveness.
7
Complementary and Alternative Medicine Sourcebook, Fourth Edition
8
Common Questions and Answers about CAM
9
Complementary and Alternative Medicine Sourcebook, Fourth Edition
10
Common Questions and Answers about CAM
11
Chapter 3
About CAM
CAM is a group of diverse medical and health care systems, practic-
es, and products that are not generally considered part of conventional
medicine. Complementary medicine is used together with conventional
medicine, and alternative medicine is used in place of conventional
medicine. Integrative medicine combines conventional and CAM treat-
ments for which there is evidence of safety and effectiveness. While
scientific evidence exists regarding some CAM therapies, for most there
are key questions that are yet to be answered through well-designed
Excerpted from “The Use of Complementary and Alternative Medicine in
the United States,” by the National Center for Complementary and Alternative
Medicine (NCCAM, nccam.nih.gov), December 2008.
13
Complementary and Alternative Medicine Sourcebook, Fourth Edition
14
The Use of CAM in the United States
15
Complementary and Alternative Medicine Sourcebook, Fourth Edition
s 4RADITIONAL HEALERS
s "OTANICA s #URANDERO s %SPIRITISTA
s (IERBERO OR 9ERBERA s .ATIVE !MERICAN HEALER-EDICINE MAN
s 3HAMAN s 3OBADOR
s 9OGA
.OTE !N ASTERISK INDICATES A PRACTITIONER BASED THERAPY
16
Chapter 4
From “CAM Use and Children,” by the National Center for Complementary
and Alternative Medicine (NCCAM, nccam.nih.gov), part of the National Insti-
tutes of Health, February 2009.
17
Complementary and Alternative Medicine Sourcebook, Fourth Edition
18
CAM Use and Children
19
Chapter 5
What is CAM?
Today, many people use complementary and alternative medicine,
or CAM, for a wide variety of diseases or conditions, and use of CAM
has increased in recent years. But what exactly is CAM, and how is it
different from standard medical care?
Definition of CAM
Complementary medicine is used together with standard medical
care. An example is using acupuncture to help with side effects of
cancer treatment.
Alternative medicine is used in place of standard medical care. An
example is treating heart disease with chelation therapy (which seeks
to remove excess metals from the blood) instead of using a standard
approach.
A related concept, “integrative medicine,” is a total approach to care
that involves the patient’s mind, body, and spirit. It combines standard
medical treatments with CAM practices that have shown the most
promise. An example is taking an omega-3 fatty acid supplement in
addition to a prescription statin medication to reduce cholesterol.
Experts group CAM practices into four major categories. These
include the following:
Excerpted from “Complementary and Alternative Medicine (CAM),” by the
National Institute on Aging (NIA, nihseniorhealth.gov), part of the National In-
stitutes of Health, December 2008.
21
Complementary and Alternative Medicine Sourcebook, Fourth Edition
CAM Practices
The four major categories of complementary and alternative medi-
cine include biologically based practices, energy medicine, manipulative
and body-based practices, and mind-body medicine. These categories
sometimes overlap.
Energy Medicine
Energy medicine uses energy fields with the intent to affect health.
Some fields, such as magnetic fields, have been measured. Others,
such as biofields, have not. Therapies involving biofields are based on
the idea that people have a subtle form of energy; energy medicine
practitioners believe that illness results from disturbances of these
subtle energies.
Examples of energy medicine include magnet therapy, healing
touch, and Reiki.
Magnet therapy uses magnets or magnetic devices to treat or ease
the symptoms of various diseases and conditions, including pain.
Healing touch practitioners pass their hands over or gently touch a
person’s body to try to identify imbalances in the body’s energy field.
22
CAM Use in Older Adults
Reiki is based on the idea that there is a universal (or source) en-
ergy that supports the body’s innate healing abilities. Practitioners
seek to access the energy and allow it to flow to the body to help with
healing. In a Reiki session, the practitioner’s hands are placed lightly
on or just above the client’s body.
Mind-Body Medicine
Mind-body medicine, which focuses on how the mind and body in-
teract, uses a variety of techniques designed to enhance the mind’s
capacity to affect bodily function and symptoms.
23
Complementary and Alternative Medicine Sourcebook, Fourth Edition
24
CAM Use in Older Adults
Ayurvedic Medicine
Ayurveda, which means “the science of life” in Sanskrit, originated
in India and evolved there over thousands of years. Its goal is to prevent
and treat disease by bringing the body, mind, and spirit into balance.
Ayurveda also proposes treatments for specific health problems.
Three qualities called doshas are believed to form important charac-
teristics of each person’s body constitution and to control bodily activities.
Imbalances in the doshas, which can be caused by an unhealthy lifestyle,
diet, stress, the weather, chemicals, or germs, can lead to illness.
Ayurvedic medicine relies on therapies such as diet, exercise, medi-
tation, herbs, massage, exposure to sunlight, and controlled breathing.
The goals of treatment are to eliminate impurities, reduce symptoms,
reduce worry, increase harmony in a person’s life, and help resolve
both physical and psychological problems.
Homeopathy
Homeopathy originated in Europe and has been practiced in the
United States since the early 19th century. Its goal is to help the body
heal itself by using very small doses of highly diluted substances that
in larger doses would produce illness or symptoms. Most homeopathic
remedies are derived from natural substances that come from plants,
minerals, or animals.
A homeopathic practitioner will select treatments based upon a
total picture of a person’s symptoms, not solely upon the symptoms of
a disease. Homeopaths evaluate not only a person’s physical symptoms
but emotions, psychological state, lifestyle, nutrition, and other aspects.
In homeopathy, different people with the same symptoms may receive
different homeopathic remedies.
25
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Naturopathy
Like homeopathy, naturopathy originated in Europe, but it also
includes ancient and modern therapies from other traditions. Natur-
opathy attempts to help the body heal itself, and naturopaths consider
a person’s physical, emotional, genetic, environmental, and social cir-
cumstances when evaluating treatment. The emphasis is on supporting
health rather than fighting disease.
Practitioners of naturopathy prefer to use treatment approaches
that they consider to be the most natural and least invasive, relying
on methods other than standard medications and surgery. They focus
on changes in diet and lifestyle and on preventing disease, together
with CAM therapies such as herbs and massage.
26
CAM Use in Older Adults
27
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Be an Informed Consumer
Take charge of your health by being an informed consumer.
Talk with your health care providers when making any decisions
about using complementary and alternative medicine (CAM). Your health
care providers can give you advice based on your medical needs.
If you are thinking about using a CAM therapy, learn the facts. Is
it safe? Does it work?
Find out what scientific studies have been done. It is not a good
idea to use a CAM therapy simply because you have seen it in an
advertisement or on a website or because people have told you that it
worked for them.
+EEP IN MIND THAT THE NUMBER OF WEBSITES OFFERING HEALTH RELATED
resources grows every day. Many sites provide valuable information,
while others may have information that is unreliable or misleading.
To evaluate the quality of a website, take a look at who runs the site,
who pays for it, and the purpose of the site. Also, check out where the
information comes from, how it is selected, and how current it is.
Scientific research on many CAM therapies is relatively new, so
information about safety and effectiveness may not be available for
every therapy. However, many studies of CAM treatments are under-
way, and researchers are always learning more about CAM.
You can find reliable information on CAM through the National
Institutes of Health’s National Center for Complementary and Alterna-
tive Medicine (NCCAM). The NCCAM website (nccam.nih.gov) provides
a variety of useful information as well as links to other trustworthy
SOURCES 9OU CAN ALSO CONTACT THE .##!- #LEARINGHOUSE STAFF ;CALL
toll-free at: 888-644-6226 or e-mail info@nccam.nih.gov] for help).
Your health care providers and pharmacist are also good resources
for learning about CAM. If you are considering a new CAM therapy,
28
CAM Use in Older Adults
ask them about its safety, effectiveness, and possible interactions with
medications (both prescription and over-the-counter). Your health care
team can find the latest scientific studies or help you to understand
the results of studies you have found.
Dietary supplements—such as vitamins, minerals, and herbs and
other botanicals—can be a form of CAM. Some dietary supplements
can interact with your prescription medicines. Supplements may also
have side effects if not used correctly, if taken in large amounts, or
sometimes even if taken according to the instructions on the label.
While many supplements come from natural sources, “natural” does
not always mean “safe.” Natural supplements may have active ingredi-
ents that cause strong biological effects in the body. Some supplements
will affect how your medicines work.
Also, if you are considering or using dietary supplements, it is
important to know that they are not regulated in the same way as
drugs. The federal government does not review supplements for safety
and effectiveness before they are sold. However, in 2007 the U.S.
Food and Drug Administration (FDA) established a rule requiring
current good manufacturing practices for dietary supplements. The
rule will help ensure that dietary supplements are produced in a
quality manner, do not contain contaminants or impurities, and are
accurately labeled.
For CAM therapies provided by a practitioner, such as acupuncture
or chiropractic treatments, choose a practitioner with care.
29
Complementary and Alternative Medicine Sourcebook, Fourth Edition
30
Chapter 6
Health Care
Providers and CAM
Chapter Contents
Section 6.1—Selecting a CAM Practitioner ................................. 32
Section 6.2—Tips for Talking with Your Health
Care Providers about CAM..................................... 37
31
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 6.1
What is CAM?
CAM is a group of diverse medical and health care systems, prac-
tices, and products that are not presently considered to be part of
conventional medicine. Complementary medicine is used together with
conventional medicine, and alternative medicine is used in place of
conventional medicine. Some health care providers practice both CAM
and conventional medicine. The list of what is considered to be CAM
changes continually as those therapies that are proven to be safe and
effective become adopted into conventional health care and as new
approaches to health care emerge.
32
Health Care Providers and CAM
33
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Once you have gathered the information, assess the answers and
determine which practitioner was best able to respond to your ques-
tions and best suits your needs.
34
Health Care Providers and CAM
35
Complementary and Alternative Medicine Sourcebook, Fourth Edition
36
Health Care Providers and CAM
Section 6.2
About CAM
CAM refers to health-related products and practices that are not pres-
ently considered part of conventional medicine. Examples include herbal
supplements, acupuncture, chiropractic manipulation, and many others.
Tips for Talking with Your Health Care Providers about CAM
s $ONT WAIT FOR YOUR HEALTH CARE PROVIDERS TO ASK ABOUT YOUR #!-
use. Be proactive—start the conversation.
37
Complementary and Alternative Medicine Sourcebook, Fourth Edition
38
Chapter 7
If you are using (or thinking about using) complementary and al-
ternative medicine (CAM), you may have financial questions about
paying for treatment.
Excerpted from “Paying for CAM Treatment,” by the National Center for
Complementary and Alternative Medicine (NCCAM, nccam.nih.gov), part of the
National Institutes of Health, August 2008.
39
Complementary and Alternative Medicine Sourcebook, Fourth Edition
If it would be difficult for you to pay the full fee at each visit, you
can ask these questions:
s #OULD YOU ARRANGE A PAYMENT PLAN OVER TIME
s $O YOU OFFER A SLIDING SCALE FEE 3LIDING SCALE FEES ARE DETER-
mined by people’s income and ability to pay.)
40
Insurance Issues and Paying for CAM Treatment
It is a good idea to keep detailed records about all contacts you have
with the insurance company, including notes on calls and copies of bills,
claims, and letters. This will help you if a dispute arises about a claim.
41
Complementary and Alternative Medicine Sourcebook, Fourth Edition
What are FSAs and HSAs, and can they help me with CAM
expenses?
An FSA (short for flexible spending arrangement or flexible spend-
ing account) is a benefit offered by some employers. An FSA allows you
to set aside pretax dollars each pay period for health-related expenses
(some employers also make contributions). You submit receipts for
yourself, your spouse, and/or your dependents to the FSA administra-
tor for health-related expenses that were not covered some other way
(for example, by insurance). You are then reimbursed for qualifying
expenses (check your plan’s language on this), such as deductibles,
medical appointments, tests, and medicines.
42
Insurance Issues and Paying for CAM Treatment
43
Complementary and Alternative Medicine Sourcebook, Fourth Edition
44
Chapter 8
From “FDA 101: Health Fraud Awareness,” by the U.S. Food and Drug Ad-
ministration (FDA, www.fda.gov), May 2009.
45
Complementary and Alternative Medicine Sourcebook, Fourth Edition
46
Health Fraud Awareness
It’s rare that the use of only one of these tests can provide a meaning-
FUL DIAGNOSIS 9OU CAN BUY )6$ TESTS IN STORES THROUGH THE MAIL OR ON-
line. Many of these tests are regulated by FDA and sold legally. However,
many others are marketed illegally and do not meet FDA’s regulatory
requirements. These tests may not work or may be harmful.
4O lND OUT WHETHER &$! HAS CLEARED OR APPROVED AN )6$ TEST FOR A
particular purpose, call FDA at 888-463-6332, or your local FDA dis-
trict office www.fda.gov/Safety/ReportaProblem/ConsumerComplaint-
Coordinators/default.htm.
Weight loss fraud: Since 2003, FDA has worked with national and
international partners to take hundreds of compliance actions against
companies pushing bogus and misleading weight loss schemes.
FDA has recently enhanced efforts to stop sales and importation of—
and to warn consumers about—weight loss products that contain dan-
gerous prescription drug ingredients that are not listed on the label.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Don’t Be a Victim
It’s ultimately up to the buyer to beware of potential health fraud.
+NOW OF THE POTENTIAL FOR HEALTH FRAUD AND LEARN ABOUT THE COMMON
techniques and gimmicks that fraudulent marketers use to gain your
attention and trust.
For instance, testimonials from people who say they have used the
product may sound convincing, but these can easily be made up. These
“testimonials” are not a substitute for scientific proof.
Also, never diagnose or treat yourself with questionable products.
Always check with your health care professional before using new
medical products.
Be wary of these red flags:
s #LAIMS THAT A PRODUCT IS A QUICK EFFECTIVE CURE ALL OR A DIAGNOSTIC
tool for a wide variety of ailments
s 3UGGESTIONS THAT A PRODUCT CAN TREAT OR CURE DISEASES
s 0ROMOTIONS USING WORDS SUCH AS hSCIENTIlC BREAKTHROUGH v
“miraculous cure,” “secret ingredient,” and “ancient remedy”
s 4EXT WITH IMPRESSIVE SOUNDING TERMS SUCH AS hHUNGER STIMULA-
tion point” and “thermogenesis” for a weight loss product
s 5NDOCUMENTED CASE HISTORIES BY CONSUMERS OR DOCTORS CLAIMING
amazing results
s ,IMITED AVAILABILITY AND ADVANCE PAYMENT REQUIREMENTS
s 0ROMISES OF NO RISK MONEY BACK GUARANTEES
s 0ROMISES OF AN hEASYv lX
s #LAIMS THAT THE PRODUCT IS hNATURALv OR hNON TOXICv WHICH DOESNT
necessarily mean safe)
48
Health Fraud Awareness
Report Problems
If you find a person or company that you think is illegally selling
human drugs, animal drugs, medical devices, biological products, foods,
dietary supplements, or cosmetics, report it to FDA.
To report problems with FDA-regulated products, visit www.fda
.gov/opacom/backgrounders/complain.html.
To report unlawful sales of medical products on the internet, visit
www.fda.gov/oc/buyonline/buyonlineform.htm.
49
Chapter 9
Excerpted from “Use Caution Buying Medical Products Online,” by the U.S.
Food and Drug Administration (FDA, www.fda.gov), May 1, 2009.
51
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Dietary Supplements
Dietary supplements are products taken as a supplement to the
diet. Examples are vitamins, minerals, herbs, botanicals, and amino
acids, the individual building blocks of proteins needed for all life.
Dietary supplements are classified as foods and not drugs.
52
Use Caution Buying Medical Products Online
53
Complementary and Alternative Medicine Sourcebook, Fourth Edition
54
Use Caution Buying Medical Products Online
The FDA recommends that consumers contact their health care pro-
viders before using dietary supplements. This is especially important for
people who are pregnant or breast-feeding, chronically ill, older, younger
than 18, or taking prescription or over-the-counter medicines.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Reporting Problems
To report a problem with a website selling human drugs, animal
drugs, medical devices, biological products, foods, dietary supplements,
or cosmetics, see the following:
s )F THE PROBLEM INVOLVES A SERIOUS OR LIFE THREATENING SITUATION
call your health care professional immediately for medical ad-
vice. To report the situation to the FDA, call 301-443-1240.
s )F THE PROBLEM INVOLVES A SERIOUS REACTION OR PROBLEM CONTACT
your health care professional for advice. To fill out the FDA’s
MedWatch reporting form, go to www.fda.gov/medwatch.
s &OR PROBLEMS THAT DO NOT INVOLVE A SERIOUS OR LIFE THREATENING
reaction, fill out the form at www.fda.gov/oc/buyonline/
buyonlineform.htm.
s 4O REPORT E MAILS OR WEBSITES PROMOTING MEDICAL PRODUCTS
that might be illegal, forward the material to webcomplaints
@ora.fda.gov.
s 4O REPORT FALSE CLAIMS TO THE &EDERAL 4RADE #OMMISSION CALL
877-382-4357. If you lose your money, contact the credit card
company, your state attorney general’s office, or the Better
Business Bureau.
56
Part Two
Alternative
Medicine Systems
Chapter 10
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Acupuncture
The report from a Consensus Development Conference on Acupunc-
ture held at the National Institutes of Health (NIH) in 1997 states that
acupuncture is being “widely” practiced—by thousands of acupuncturists,
physicians, dentists, and other practitioners—for relief or prevention of
pain and for various other health conditions. In terms of the evidence at
that time, acupuncture was considered to have potential clinical value for
nausea/vomiting and dental pain, and limited evidence suggested its po-
tential in the treatment of other pain disorders, paralysis and numbness,
movement disorders, depression, insomnia, breathlessness, and asthma.
Preclinical studies have documented acupuncture’s effects, but they
have not been able to fully explain how acupuncture works within the
framework of the Western system of medicine.
It is proposed that acupuncture produces its effects by the conduction
of electromagnetic signals at a greater-than-normal rate, thus aiding the
activity of pain-killing biochemicals, such as endorphins and immune
system cells at specific sites in the body. In addition, studies have shown
that acupuncture may alter brain chemistry by changing the release of
neurotransmitters and neurohormones and affecting the parts of the
central nervous system related to sensation and involuntary body func-
tions, such as immune reactions and processes whereby a person’s blood
pressure, blood flow, and body temperature are regulated.
60
What Are Whole Medical Systems?
Ayurvedic Medicine
Ayurveda, which literally means “the science of life,” is a natural
healing system developed in India. Ayurvedic texts claim that the
sages who developed India’s original systems of meditation and yoga
developed the foundations of this medical system. It is a comprehen-
sive system of medicine that places equal emphasis on the body, mind,
and spirit, and strives to restore the innate harmony of the individual.
Some of the primary Ayurvedic treatments include diet, exercise, medi-
tation, herbs, massage, exposure to sunlight, and controlled breathing. In
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Naturopathy
Naturopathy is a system of healing, originating from Europe, that
views disease as a manifestation of alterations in the processes by
which the body naturally heals itself. It emphasizes health restora-
tion as well as disease treatment. The term “naturopathy” literally
translates as “nature disease.” Today naturopathy, or naturopathic
medicine, is practiced throughout Europe, Australia, New Zealand,
Canada, and the United States. There are six principles that form the
basis of naturopathic practice in North America (not all are unique
to naturopathy):
1. The healing power of nature
2. Identification and treatment of the cause of disease
3. The concept of “first do no harm”
4. The doctor as teacher
5. Treatment of the whole person
6. Prevention
62
What Are Whole Medical Systems?
Homeopathy
Homeopathy is a complete system of medical theory and practice. Its
founder, German physician Samuel Christian Hahnemann (1755–1843),
hypothesized that one can select therapies on the basis of how closely
symptoms produced by a remedy match the symptoms of the patient’s
disease. He called this the “principle of similars.” Hahnemann proceeded
to give repeated doses of many common remedies to healthy volunteers
and carefully record the symptoms they produced. This procedure is
called a “proving” or, in modern homeopathy, a “human pathogenic trial.”
As a result of this experience, Hahnemann developed his treatments for
sick patients by matching the symptoms produced by a drug to symptoms
in sick patients. Hahnemann emphasized from the beginning carefully
examining all aspects of a person’s health status, including emotional
and mental states, and tiny idiosyncratic characteristics.
Since homeopathy is administered in minute or potentially nonex-
istent material dosages, there is an a priori skepticism in the scientific
community about its efficacy. Nonetheless, the medical literature pro-
vides evidence of ongoing research in the field. Studies of homeopathy’s
effectiveness involve three areas of research:
1. Comparisons of homeopathic remedies and placebos
2. Studies of homeopathy’s effectiveness for particular clinical
conditions
3. Studies of the biological effects of potencies, especially ultra-
high dilutions
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Summary
While whole medical systems differ in their philosophical approach-
es to the prevention and treatment of disease, they share a number
of common elements. These systems are based on the belief that one’s
body has the power to heal itself. Healing often involves marshalling
multiple techniques that involve the mind, body, and spirit. Treatment
is often individualized and dependent on the presenting symptoms. To
date, NCCAM’s research efforts have focused on individual therapies
with adequate experimental rationale and not on evaluating whole
systems of medicine as they are commonly practiced.
64
Chapter 11
Ayurvedic Medicine
Background
Ayurvedic medicine, also called Ayurveda, originated in India sev-
eral thousand years ago. The term “Ayurveda” combines the Sanskrit
words ayur (life) and veda (science or knowledge). Thus, Ayurveda
means “the science of life.”
In the United States, Ayurvedic medicine is considered a type of
CAM and a whole medical system. As with other such systems, it is
based on theories of health and illness and on ways to prevent, man-
age, or treat health problems.
Ayurvedic medicine aims to integrate and balance the body, mind,
and spirit; thus, some view it as “holistic.” This balance is believed to lead
to happiness and health, and to help prevent illness. Ayurvedic medicine
also treats specific physical and mental health problems. A chief aim of
From “Ayurvedic Medicine: An Introduction,” by the National Center for
Complementary and Alternative Medicine (NCCAM, nccam.nih.gov), part of the
National Institutes of Health, July 2009.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Underlying Concepts
Ayurvedic medicine has several key foundations that pertain to
health and disease. These concepts have to do with universal intercon-
nectedness, the body’s constitution (prakriti), and life forces (doshas).
66
Ayurvedic Medicine
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
The doshas are known by their original Sanskrit names: vata, pitta,
and kapha.
The vata dosha combines the elements ether and air. It is considered
the most powerful dosha because it controls very basic body processes
such as cell division, the heart, breathing, discharge of waste, and
the mind. Vata can be aggravated by, for example, fear, grief, staying
up late at night, eating dry fruit, or eating before the previous meal
is digested. People with vata as their main dosha are thought to be
especially susceptible to skin and neurological conditions, rheumatoid
arthritis, heart disease, anxiety, and insomnia.
The pitta dosha represents the elements fire and water. Pitta controls
hormones and the digestive system. A person with a pitta imbalance
may experience negative emotions such as anger and may have physi-
cal symptoms such as heartburn within 2 or 3 hours of eating. Pitta is
upset by, for example, eating spicy or sour food, fatigue, or spending too
much time in the sun. People with a predominantly pitta constitution
are thought to be susceptible to hypertension, heart disease, infectious
diseases, and digestive conditions such as Crohn disease.
The kapha dosha combines the elements water and earth. Kapha
helps to maintain strength and immunity and to control growth. An
imbalance of the kapha dosha may cause nausea immediately after
eating. Kapha is aggravated by, for example, greed, sleeping during
the daytime, eating too many sweet foods, eating after one is full, and
eating and drinking foods and beverages with too much salt and water
(especially in the springtime). Those with a predominant kapha dosha
are thought to be vulnerable to diabetes, cancer, obesity, and respira-
tory illnesses such as asthma.
Treatment
Ayurvedic treatment is tailored to each person’s constitution.
Practitioners expect patients to be active participants because many
Ayurvedic treatments require changes in diet, lifestyle, and habits.
The patient’s dosha balance: Ayurvedic practitioners first de-
termine the patient’s primary dosha and the balance among the three
doshas by doing the following:
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Ayurvedic Medicine
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
70
Ayurvedic Medicine
71
Chapter 12
Other Indigenous
Medical Systems
Chapter Contents
Section 12.1—Traditional Chinese Medicine .............................. 74
Section 12.2—Native American Medicine ................................... 78
73
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 12.1
Background
Traditional Chinese medicine, which encompasses many different
practices, is rooted in the ancient philosophy of Taoism and dates
back more than 5,000 years. Today, TCM is practiced side by side with
Western medicine in many of China’s hospitals and clinics.
TCM is widely used in the United States. Although the exact num-
ber of people who use TCM in the United States is unknown, it was
estimated in 1997 that some 10,000 practitioners served more than
1 million patients each year. According to the 2007 National Health
Interview Survey, which included questions on the use of various CAM
therapies, an estimated 3.1 million U.S. adults had used acupuncture
in the previous year. In addition, according to this same survey, ap-
proximately 17 percent of adults use natural products, including herbs,
making it the most commonly used therapy. In another survey, more
than one third of the patients at six large acupuncture clinics said they
also received Chinese herbal treatments at the clinics.
Underlying Concepts
Underlying the practice of TCM is a unique view of the world and
the human body that is different from Western medicine concepts.
This view is based on the ancient Chinese perception of humans as
microcosms of the larger, surrounding universe—interconnected with
nature and subject to its forces. The human body is regarded as an
74
Other Indigenous Medical Systems
organic entity in which the various organs, tissues, and other parts
have distinct functions but are all interdependent. In this view, health
and disease relate to balance of the functions.
The theoretical framework of TCM has a number of key compo-
nents:
s 9IN YANG THEORYTHE CONCEPT OF TWO OPPOSING YET COMPLEMEN-
tary, forces that shape the world and all life—is central to TCM.
s )N THE 4#- VIEW A VITAL ENERGY OR LIFE FORCE CALLED QI CIRCULATES
in the body through a system of pathways called meridians.
Health is an ongoing process of maintaining balance and har-
mony in the circulation of qi.
s 4HE 4#- APPROACH USES EIGHT PRINCIPLES TO ANALYZE SYMPTOMS
and categorize conditions: cold/heat, interior/exterior, excess/
deficiency, and yin/yang (the chief principles). TCM also uses the
theory of five elements—fire, earth, metal, water, and wood—to
explain how the body works; these elements correspond to par-
ticular organs and tissues in the body.
Treatment
TCM emphasizes individualized treatment. Practitioners tradition-
ally used four methods to evaluate a patient’s condition: observing
(especially the tongue), hearing/smelling, asking/interviewing, and
touching/palpating (especially the pulse).
TCM practitioners use a variety of therapies in an effort to promote
health and treat disease. The most commonly used are Chinese herbal
medicine and acupuncture.
s Chinese herbal medicine: The Chinese materia medica (a
pharmacological reference book used by TCM practitioners) con-
tains hundreds of medicinal substances—primarily plants, but also
some minerals and animal products—classified by their perceived
action in the body. Different parts of plants such as the leaves,
roots, stems, flowers, and seeds are used. Usually, herbs are com-
bined in formulas and given as teas, capsules, tinctures, or powders.
s Acupuncture: By stimulating specific points on the body, most
often by inserting thin metal needles through the skin, practitio-
ners seek to remove blockages in the flow of qi.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Safety
The U.S. Food and Drug Administration (FDA) regulations for di-
etary supplements (including manufactured herbal products) are not
the same as those for prescription or over-the-counter drugs; in general,
the regulations for dietary supplements are less strict. Some Chinese
76
Other Indigenous Medical Systems
herbal treatments may be safe, but others may not. There have been
reports of products being contaminated with drugs, toxins, or heavy
metals or not containing the listed ingredients. Some of the herbs are
very powerful, can interact with drugs, and may have serious side
effects. For example, the Chinese herb ephedra (ma huang) has been
linked to serious health complications, including heart attack and
stroke. In 2004, the FDA banned the sale of ephedra-containing dietary
supplements used for weight loss and performance enhancement, but
the ban does not apply to TCM remedies or to herbal teas.
Acupuncture is considered safe when performed by an experienced
practitioner using sterile needles.
77
Complementary and Alternative Medicine Sourcebook, Fourth Edition
s 4ELL ALL YOUR HEALTH CARE PROVIDERS ABOUT ANY COMPLEMENTARY AND
alternative practices you use. Give them a full picture of what
you do to manage your health. This will help ensure coordinated
and safe care.
NCCAM-Funded Research
2ECENT .##!- SUPPORTED STUDIES HAVE BEEN INVESTIGATING THE FOL-
lowing:
s 4#- FOR ENDOMETRIOSIS RELATED PELVIC PAIN IRRITABLE BOWEL SYN-
drome, and temporomandibular (jaw) disorders
s #HINESE HERBAL MEDICINES FOR FOOD ALLERGIES AND FOR OSTEOARTHRITIS
of the knee
s #ONSISTENCY OF 4#- PRACTITIONERS DIAGNOSIS AND HERBAL PRESCRIP-
tions for rheumatoid arthritis patients
Section 12.2
78
Other Indigenous Medical Systems
79
Complementary and Alternative Medicine Sourcebook, Fourth Edition
80
Chapter 13
Acupuncture
About Acupuncture
The term “acupuncture” describes a family of procedures involving
the stimulation of anatomical points on the body using a variety of tech-
niques. The acupuncture technique that has been most often studied sci-
entifically involves penetrating the skin with thin, solid, metallic needles
that are manipulated by the hands or by electrical stimulation.
Practiced in China and other Asian countries for thousands of years,
acupuncture is one of the key components of traditional Chinese medi-
cine. In TCM, the body is seen as a delicate balance of two opposing
and inseparable forces: yin and yang. Yin represents the cold, slow, or
passive principle, while yang represents the hot, excited, or active prin-
ciple. According to TCM, health is achieved by maintaining the body in
a “balanced state”; disease is due to an internal imbalance of yin and
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
82
Acupuncture
83
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Treatment Costs
Ask the practitioner about the estimated number of treatments need-
ed and how much each treatment will cost. Some insurance companies
may cover the costs of acupuncture, while others may not. It is important
to check with your insurer before you start treatment to see whether
acupuncture is covered for your condition and, if so, to what extent.
84
Chapter 14
Homeopathy
Overview
The term homeopathy comes from the Greek words homeo, meaning
similar, and pathos, meaning suffering or disease. Homeopathy seeks
to stimulate the body’s ability to heal itself by giving very small doses
of highly diluted substances. This therapeutic method was developed
by German physician Samuel Christian Hahnemann at the end of the
18th century. Hahnemann articulated two main principles:
s The principle of similars (or “like cures like”) states that a dis-
ease can be cured by a substance that produces similar symptoms in
healthy people. This idea, which can be traced back to Hippocrates,
was further developed by Hahnemann after he repeatedly ingested
cinchona bark, a popular treatment for malaria, and found that he
developed the symptoms of the disease. Hahnemann theorized that
if a substance could cause disease symptoms in a healthy person,
small amounts could cure a sick person who had similar symptoms.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
86
Homeopathy
Research Challenges
Homeopathy is difficult to study using current scientific methods
because highly diluted substances (known as ultra-high dilutions or
UHDs) cannot be readily measured, making it difficult to design or
replicate studies. In addition, homeopathic treatments are highly in-
dividualized and there is no uniform prescribing standard for homeo-
paths. There are hundreds of different homeopathic remedies, which
can be prescribed in a variety of different dilutions to treat thousands
of symptoms. On the other hand, many aspects of the interactions
between the homeopathic practitioner and his or her patients may be
quite beneficial, and can be studied more easily.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
88
Homeopathy
Tell your health care providers about any complementary and al-
ternative practices you use. Give them a full picture of all you do to
manage your health. This will ensure coordinated and safe care.
NCCAM-Funded Research
NCCAM-supported exploratory grants have sought to understand
patient and provider perspectives on homeopathic treatment and have
explored the effectiveness of homeopathic remedies with various suc-
cussions (vigorous shaking) and dilutions.
89
Chapter 15
Naturopathy
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
92
Naturopathy
Key Principles
The practice of naturopathy is based on six key principles:
1. Promote the healing power of nature.
2. First do no harm. Naturopathic practitioners choose therapies
with the intent to keep harmful side effects to a minimum and
not suppress symptoms.
3. Treat the whole person. Practitioners believe a person’s
health is affected by many factors, such as physical, mental,
emotional, genetic, environmental, and social ones. Practitio-
ners consider all these factors when choosing therapies and
tailor treatment to each patient.
4. Treat the cause. Practitioners seek to identify and treat the
causes of a disease or condition, rather than its symptoms.
They believe that symptoms are signs that the body is trying
to fight disease, adapt to it, or recover from it.
5. Prevention is the best cure. Practitioners teach ways of living that
they consider most healthy and most likely to prevent illness.
6. The physician is a teacher. Practitioners consider it impor-
tant to educate their patients in taking responsibility for
their own health.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Naturopathic Physicians
Naturopathic physicians are educated and trained in a 4-year,
graduate-level program at one of the four U.S. naturopathic medical
schools accredited by the Council on Naturopathic Medical Education.
Admission requirements include a bachelor’s degree and standard
premedical courses. The study program includes basic sciences, natur-
opathic therapies and techniques, diagnostic techniques and tests,
specialty courses, clinical sciences, and clinical training. Graduates
receive the degree of N.D. (Doctor of Naturopathic Medicine). Post-
doctoral training is not required, but graduates may pursue it.
Depending on where they wish to practice, naturopathic physicians
may also need to be licensed. A number of states, the District of Colum-
bia, and two U.S. territories have such licensing requirements, most of-
ten consisting of graduation from a 4-year naturopathic medical college
and passing the national standardized board examination (known as the
.0,%8 ;.ATUROPATHIC 0HYSICIANS ,ICENSING %XAMINATIONS= 4HE SCOPE OF
practice varies by state and jurisdiction. For example, some states allow
naturopathic physicians with special training to prescribe drugs, perform
minor surgery, practice acupuncture, and/or assist in childbirth.
Traditional Naturopaths
The second major group of practitioners are traditional naturopaths,
or simply naturopaths. They emphasize education in naturopathic ap-
proaches to a healthy lifestyle, strengthening and cleansing the body,
and noninvasive treatments. Prescription drugs, x-rays, and surgery
are several of the practices that traditional naturopaths do not use.
Education and training for these practitioners typically consists of
correspondence courses, an apprenticeship, and/or self-teaching. Ad-
mission requirements for schools can range from none, to a high school
diploma, to specific degrees and coursework. Programs vary in length
and content. They are not accredited by agencies recognized for ac-
creditation purposes by the U.S. Department of Education. Traditional
naturopaths are not subject to licensing.
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Naturopathy
97
Part Three
Dietary Supplements
Chapter 16
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102
Questions and Answers about Dietary Supplements
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Questions and Answers about Dietary Supplements
105
Chapter 17
Botanical Dietary
Supplements
What is a botanical?
A botanical is a plant or plant part valued for its medicinal or
therapeutic properties, flavor, and/or scent. Herbs are a subset of bo-
tanicals. Products made from botanicals that are used to maintain or
improve health may be called herbal products, botanical products, or
phytomedicines.
In naming botanicals, botanists use a Latin name made up of the
genus and species of the plant. Under this system the botanical black
cohosh is known as Actaea racemosa L., where “L” stands for Linneaus,
who first described the type of plant specimen. In this text, we do not
include such initials because they do not appear on most products
used by consumers.
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108
Botanical Dietary Supplements
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110
Chapter 18
Using Dietary
Supplements Wisely
Excerpted from text by the National Center for Complementary and Alter-
native Medicine (NCCAM, nccam.nih.gov), part of the National Institutes of
Health, February 2009.
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Using Dietary Supplements Wisely
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Safety Considerations
If you are thinking about or are using a dietary supplement, here
are some points to keep in mind.
Tell your health care providers about any complementary and al-
ternative practices you use, including dietary supplements. Give them
a full picture of what you do to manage your health. This will help
ensure coordinated and safe care. It is especially important to talk to
your health care provider if you are considering the following:
s 4ALK TO YOUR PROVIDER IF YOU ARE THINKING ABOUT REPLACING YOUR
regular medication with one or more dietary supplements.
s 4ALK TO YOUR PROVIDER IF YOU ARE THINKING ABOUT TAKING ANY MEDI-
cations (whether prescription or over-the-counter), as some di-
etary supplements have been found to interact with medications.
s 4ALK TO YOUR PROVIDER IF YOU ARE PLANNING TO HAVE SURGERY #ER-
tain dietary supplements may increase the risk of bleeding or
affect the response to anesthesia.
s 4ALK TO YOUR PROVIDER IF YOU ARE PREGNANT OR NURSING A BABY OR
are considering giving a child a dietary supplement. Most dietary
supplements have not been tested in pregnant women, nursing
mothers, or children.
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Using Dietary Supplements Wisely
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Chapter 19
Adolescents and
Supplement Use
Wide Variety
Vitamins and minerals may be the most familiar dietary supple-
ments. However, they include many other substances such as herbals,
BOTANICALS AMINO ACIDS AND ENZYMES $IETARY AND NUTRITIONAL SUPPLE-
ments also come in many forms such as tablets, capsules, powders,
energy bars, or drinks.
Sports and bodybuilding supplements promise more power, im-
proved performance, and better health. While your teen may know
better than to take steroids, which are illegal, he may think it is okay to
use other legal substances. However, most supplements have not been
studied thoroughly, especially for the effects on teenage athletes.
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Little Control
The U.S. Food and Drug Administration (FDA) does not approve
dietary supplements as safe and effective. Manufacturers and dis-
tributors are responsible for making sure that their products are
safe and that claims about them are correct. The FDA acts only
when it finds that a dietary supplement product carries a high risk
of illness or injury. Some problems become clear over time through
reports of tragedies or through the results of studies that often take
years to conduct.
In 2004, the FDA banned the supplement ephedra, also known
as ephedrine or ma huang. Ephedra was labeled as a fat burner
because it acts as a stimulant, speeding up the nervous system
and increasing metabolism. The FDA found that ephedra is risky,
especially for people suffering from heart disease and high blood
pressure.
Ephedra had been controversial before the FDA declared it illegal.
"EGINNING IN THE S SEVERAL ORGANIZATIONS GOVERNING SPORTS BANNED
the drug. The United States military banned ephedra from commis-
saries and military exchanges in 2002 after the deaths of military
personnel who were taking the drug. Ephedra drew added attention
when the drug was linked to the death of 23-year-old Baltimore Orioles
pitcher Steve Bechler in 2003.
Uncertain Effects
Because many supplements have not been studied scientifically, we
cannot be sure how well they work or if they are dangerous. Supple-
ments that are safe for most people who use them may be risky for
others. Groups at increased risk include women who are pregnant or
nursing a baby and people who have medical conditions such as dia-
betes, hypertension, or heart disease.
Likewise, a supplement that is safe when taken by itself may cause
problems if combined with other medications. Even well-known prod-
ucts such as vitamin supplements, which are widely used and generally
considered safe for teens and children, can cause problems under cer-
tain conditions. For example, combining supplements and medications
that thin the blood can increase the potential for internal bleeding.
In addition, vitamins, minerals, herbals, or other supplements can be
dangerous for people having surgery. To avoid harmful drug reactions,
doctors may ask patients to stop taking these substances 2 or 3 weeks
before surgery.
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Adolescents and Supplement Use
119
Chapter 20
Excerpted from text by the U.S. Food and Drug Administration (FDA, www.fda
.gov), May 7, 2009.
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Tips for Older Dietary Supplement Users
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Tips for Older Dietary Supplement Users
Remember: Safety first. Resist the pressure to decide “on the spot”
about trying an untested product or treatment. Ask for more information
and consult your doctor, nurse, dietitian, pharmacist, and/or caregiver
about whether the product is right for you and safe for you to use.
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Ask yourself the following questions and talk to your doctor, nurse,
dietitian, pharmacist, and/or caregiver about dietary supplements.
s )S TAKING A DIETARY SUPPLEMENT AN IMPORTANT PART OF MY TOTAL DIET
s !RE THERE ANY PRECAUTIONS OR WARNINGS ) SHOULD KNOW ABOUT EG
is there an amount or “upper limit” I should not go above)?
s !RE THERE ANY KNOWN SIDE EFFECTS EG LOSS OF APPETITE NAUSEA
headaches, etc.)? Do they apply to me?
s !RE THERE ANY FOODS MEDICINES PRESCRIPTION OR OVER THE COUNTER
or other supplements I should avoid while taking this product?
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Tips for Older Dietary Supplement Users
127
Chapter 21
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130
Vitamin A and Carotenoids
Levels (UL). The RDA recommends the average daily dietary intake
level that is sufficient to meet the nutrient requirements of nearly
all (97% to 98%) healthy individuals in each age and gender group.
An AI is set when there are insufficient scientific data to establish an
RDA. AIs meet or exceed the amount needed to maintain nutritional
adequacy in nearly all people. The UL, on the other hand, is the maxi-
mum daily intake unlikely to result in adverse health effects.
The NHANES III survey (1988–1994) found that most Americans
consume recommended amounts of vitamin A. More recent NHANES
data (1999–2000) show average adult intakes to be about 3,300 IU per
day, which also suggests that most Americans get enough vitamin A.
There is no RDA for beta-carotene or other provitamin A carote-
noids. The IOM states that consuming 3 mg to 6 mg of beta-carotene
daily (equivalent to 833 IU to 1,667 IU vitamin A) will maintain blood
levels of beta-carotene in the range associated with a lower risk of
chronic diseases. A diet that provides five or more servings of fruits and
vegetables per day and includes some dark green and leafy vegetables
and deep yellow or orange fruits should provide sufficient beta-carotene
and other carotenoids.
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Vitamin A and Carotenoids
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The IOM has established Tolerable Upper Intake Levels (ULs) for
vitamin A that apply to healthy populations. The UL was established
to help prevent the risk of vitamin A toxicity. The risk of adverse health
effects increases at intakes greater than the UL. The UL does not apply
to malnourished individuals receiving vitamin A either periodically or
through fortification programs as a means of preventing vitamin A de-
ficiency. It also does not apply to individuals being treated with vitamin
A by medical doctors for diseases such as retinitis pigmentosa.
Retinoids are compounds that are chemically similar to vitamin A.
Over the past 15 years, synthetic retinoids have been prescribed for
acne, psoriasis, and other skin disorders. Isotretinoin (Roaccutane®
or Accutane®) is considered an effective anti-acne therapy. At very
high doses, however, it can be toxic, which is why this medication is
usually saved for the most severe forms of acne. The most serious con-
sequence of this medication is birth defects. It is extremely important
for sexually active females who may become pregnant and who take
these medications to use an effective method of birth control. Women
of childbearing age who take these medications are advised to undergo
monthly pregnancy tests to make sure they are not pregnant.
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Vitamin A and Carotenoids
The IOM did not set ULs for carotene or other carotenoids. Instead,
it concluded that beta-carotene supplements are not advisable for the
general population. As stated earlier, however, they may be appropriate
as a provitamin A source for the prevention of vitamin A deficiency in
specific populations.
135
Chapter 22
Vitamin B6
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Vitamin B6
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Vitamin B6
141
Chapter 23
Vitamin B12
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Dietary Supplements
In dietary supplements, vitamin B12 is usually present as cyano-
cobalamin, a form that the body readily converts to the active forms
methylcobalamin and 5-deoxyadenosylcobalamin. Dietary supplements
can also contain methylcobalamin and other forms of vitamin B12.
Existing evidence does not suggest any differences among forms
with respect to absorption or bioavailability. However the body’s abil-
ity to absorb vitamin B12 from dietary supplements is largely limited
by the capacity of intrinsic factor. For example, only about 10 mcg of a
500 mcg oral supplement is actually absorbed in healthy people.
In addition to oral dietary supplements, vitamin B12 is available in
SUBLINGUAL PREPARATIONS AS TABLETS OR LOZENGES 4HESE PREPARATIONS ARE
frequently marketed as having superior bioavailability, although evidence
suggests no difference in efficacy between oral and sublingual forms.
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dementia. Low vitamin B12 status has also been positively associated
with cognitive decline.
Despite evidence that vitamin B12 lowers homocysteine levels and cor-
relations between low vitamin B12 levels and cognitive decline, research
has not shown that vitamin B12 has an independent effect on cognition.
)N ONE RANDOMIZED DOUBLE BLIND PLACEBO CONTROLLED TRIAL SUBJECTS
aged 70 years or older with no or moderate cognitive impairment received
1,000 mcg vitamin B12, 1,000 mcg vitamin B12 plus 400 mcg folic acid, or
placebo for 24 weeks. Treatment with vitamin B12 plus folic acid reduced
homocysteine concentrations by 36%, but neither vitamin B12 treatment
nor vitamin B12 plus folic acid treatment improved cognitive function.
Women at high risk of cardiovascular disease who participated in the
Women’s Antioxidant and Folic Acid Cardiovascular Study were ran-
domly assigned to receive daily supplements containing 1 mg vitamin
B12, 2.5 mg folic acid and 50 mg vitamin B6, or placebo. After a mean
of 1.2 years, B-vitamin supplementation did not affect mean cognitive
change from baseline compared with placebo. However, in a subset of
women with low baseline dietary intake of B vitamins, supplementation
significantly slowed the rate of cognitive decline. In a trial conducted
BY THE !LZHEIMERS $ISEASE #OOPERATIVE 3TUDY CONSORTIUM THAT INCLUDED
INDIVIDUALS WITH MILD TO MODERATE !LZHEIMER DISEASE DAILY SUPPLEMENTS
of 1 mg vitamin B12, 5 mg folic acid, and 25 mg vitamin B6 for 18 months
did not slow cognitive decline compared with placebo. Another study
found similar results in 142 individuals at risk of dementia who received
supplements of 2 mg folic acid and 1 mg vitamin B12 for 12 weeks.
The authors of two Cochrane reviews and a systematic review of
RANDOMIZED TRIALS OF THE EFFECTS OF " VITAMINS ON COGNITIVE FUNCTION CON-
cluded that insufficient evidence is available to show whether vitamin
B12 alone or in combination with vitamin B6 or folic acid has an effect
on cognitive function or dementia. Additional large clinical trials of
vitamin B12 supplementation are needed to assess whether vitamin
B12 has a direct effect on cognitive function and dementia.
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Chapter 24
Vitamin D
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Dietary Supplements
In supplements and fortified foods, vitamin D is available in two
forms, D2 (ergocalciferol) and D3 (cholecalciferol). Vitamin D2 is manu-
factured by the UV irradiation of ergosterol in yeast, and vitamin D3 is
manufactured by the irradiation of 7-dehydrocholesterol from lanolin
and the chemical conversion of cholesterol. The two forms have tradition-
ally been regarded as equivalent based on their ability to cure rickets,
BUT EVIDENCE HAS BEEN OFFERED THAT THEY ARE METABOLIZED DIFFERENTLY
Vitamin D3 could be more than three times as effective as vitamin D2
in raising serum 25(OH)D concentrations and maintaining those levels
for a longer time, and its metabolites have superior affinity for vitamin
D-binding proteins in plasma. Because metabolite receptor affinity is not
a functional assessment, as the earlier results for the healing of rickets
were, further research is needed on the comparative physiological effects
of both forms. Many supplements are being reformulated to contain
vitamin D3 instead of vitamin D2. Both forms (as well as vitamin D in
foods and from cutaneous synthesis) effectively raise serum 25(OH)D
levels. According to NHANES (National Health and Nutrition Survey)
data from 2005-2006, only 29% of adult men and 17% of adult women
(ages 19 and older) had intakes of vitamin D from food alone that ex-
ceeded their AIs. Overall in the U.S. population, only about one third
of individuals 1 year of age and older had vitamin D intakes from food
exceeding their respective AIs. However, dietary supplements as well as
foods contribute vitamin D, so both sources must be included to obtain a
true picture of total intakes. In 2005–2006, 37% of people in the United
States reported the use of a dietary supplement containing vitamin D.
Total intake estimates of vitamin D from both food and supplements are
currently being tabulated by the Office of Dietary Supplements.
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Vitamin D
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
their more efficient calcium economy, and have a lower risk of fracture
even when they have the same bone density as Caucasians. They also
have a higher prevalence of obesity, and the resulting higher estrogen
levels in obese women might protect them from bone loss. Further
reducing the risk of osteoporosis in African Americans are their lower
levels of bone-turnover markers, shorter hip-axis length, and superior
renal calcium conservation. However, despite this advantage in bone
density, osteoporosis is a significant health problem among African
Americans as they age.
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Vitamin D
151
Chapter 25
Vitamin E
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154
Vitamin E
90,000 nurses found that the incidence of heart disease was 30% to
40% lower in those with the highest intakes of vitamin E, primarily
from supplements. Among a group of 5,133 Finnish men and women
followed for a mean of 14 years, higher vitamin E intakes from food
were associated with decreased mortality from CHD.
(OWEVER RANDOMIZED CLINICAL TRIALS CAST DOUBT ON THE EFlCACY OF VITA-
min E supplements to prevent CHD. For example, the Heart Outcomes
Prevention Evaluation (HOPE) study, which followed almost 10,000
patients at high risk of heart attack or stroke for 4.5 years, found
that participants taking 400 IU/day of natural vitamin E experienced
NO FEWER CARDIOVASCULAR EVENTS OR HOSPITALIZATIONS FOR HEART FAILURE
or chest pain than participants taking a placebo. In the HOPE-TOO
followup study, almost 4,000 of the original participants continued
to take vitamin E or placebo for an additional 2.5 years. HOPE-TOO
found that vitamin E provided no significant protection against heart
attacks, strokes, unstable angina, or deaths from cardiovascular dis-
ease or other causes after 7 years of treatment. Participants taking
vitamin E, however, were 13% more likely to experience, and 21% more
LIKELY TO BE HOSPITALIZED FOR HEART FAILURE A STATISTICALLY SIGNIlCANT BUT
unexpected finding not reported in other large studies.
The HOPE and HOPE-TOO trials provide compelling evidence that
moderately high doses of vitamin E supplements do not reduce the risk
of serious cardiovascular events among men and women >50 years of
age with established heart disease or diabetes. These findings are sup-
ported by evidence from the Women’s Angiographic Vitamin and Estrogen
study, in which 423 postmenopausal women with some degree of coronary
stenosis took supplements with 400 IU vitamin E (type not specified) and
500 mg vitamin C twice a day or placebo for >4 years. Not only did the
supplements provide no cardiovascular benefits, but all-cause mortality
was significantly higher in the women taking the supplements.
The latest published clinical trial of vitamin E’s effects on the heart
and blood vessels of women included almost 40,000 healthy women
greater than or equal to 45 years of age who were randomly assigned
to receive either 600 IU of natural vitamin E on alternate days or pla-
cebo and who were followed for an average of 10 years. The investiga-
tors found no significant differences in rates of overall cardiovascular
events (combined nonfatal heart attacks, strokes, and cardiovascular
deaths) or all-cause mortality between the groups. However, the study
did find two positive and significant results for women taking vitamin
E: they had a 24% reduction in cardiovascular death rates, and those
greater than or equal to 65 years of age had a 26% decrease in nonfatal
heart attack and a 49% decrease in cardiovascular death rates.
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The most recent published clinical trial of vitamin E and men’s car-
diovascular health included almost 15,000 healthy physicians greater
than or equal to 50 years of age who were randomly assigned to receive
400 IU synthetic alpha-tocopherol every other day, 500 mg vitamin C
daily, both vitamins, or placebo. During a mean followup period of 8
years, intake of vitamin E (and/or vitamin C) had no effect on the inci-
dence of major cardiovascular events, myocardial infarction, stroke, or
cardiovascular morality. Furthermore, use of vitamin E was associated
with a significantly increased risk of hemorrhagic stroke.
In general, clinical trials have not provided evidence that routine
use of vitamin E supplements prevents cardiovascular disease or
reduces its morbidity and mortality. However, participants in these
studies have been largely middle-aged or elderly individuals with
demonstrated heart disease or risk factors for heart disease. Some
researchers have suggested that understanding the potential utility of
vitamin E in preventing CHD might require longer studies in younger
participants taking higher doses of the supplement. Further research is
needed to determine whether supplemental vitamin E has any protec-
tive value for younger, healthier people at no obvious risk of CHD.
Cancer
Antioxidant nutrients like vitamin E protect cell constituents from
the damaging effects of free radicals that, if unchecked, might contrib-
ute to cancer development. Vitamin E might also block the formation
of carcinogenic nitrosamines formed in the stomach from nitrites in
foods and protect against cancer by enhancing immune function. Hu-
man trials and surveys that attempted to associate vitamin E intake
with cancer incidence have generally been inconclusive.
Some research links higher intakes of vitamin E with a decreased
incidence of breast and prostate cancers, but the evidence is incon-
sistent. For example, an examination of the impact of dietary factors,
including vitamin E, on the incidence of postmenopausal breast can-
cer in >18,000 women found no benefit from the vitamin. Similarly, a
prospective cohort study of >29,000 men found no association between
dietary or supplemental vitamin E intake and prostate cancer risk,
with one exception: among current smokers and men who had quit,
vitamin E intakes of more than 400 IU/day were associated with a
statistically significant 71% reduction in the risk of advanced prostate
CANCER ! LARGE RANDOMIZED CLINICAL TRIAL BEGAN IN TO DETERMINE
whether 7–12 years of daily supplementation with synthetic vitamin
E (400 IU), with or without selenium (200 mcg), reduces the number
of new prostate cancers in healthy men. The trial was discontinued
156
Vitamin E
Eye Disorders
Age-related macular degeneration (AMD) and cataracts are among
the most common causes of significant vision loss in older people. Their
etiologies are usually unknown, but the cumulative effects of oxida-
tive stress have been postulated to play a role. If so, nutrients with
antioxidant functions, such as vitamin E, could be used to prevent or
treat these conditions.
Prospective cohort studies have found that people with relatively high
dietary intakes of vitamin E (e.g., 30 IU/day) have an approximately 20%
lower risk of developing AMD than people with low intakes (e.g., <15 IU/
DAY (OWEVER TWO RANDOMIZED CONTROLLED TRIALS IN WHICH PARTICIPANTS TOOK
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Cognitive Decline
The brain has a high oxygen consumption rate and abundant poly-
unsaturated fatty acids in the neuronal cell membranes. Researchers
HYPOTHESIZE THAT IF CUMULATIVE FREE RADICAL DAMAGE TO NEURONS OVER
time contributes to cognitive decline and neurodegenerative diseases,
SUCH AS !LZHEIMER DISEASE THEN INGESTION OF SUFlCIENT OR SUPPLEMEN-
tal antioxidants (such as vitamin E) might provide some protection.
This hypothesis was supported by the results of a clinical trial in 341
PATIENTS WITH !LZHEIMER DISEASE OF MODERATE SEVERITY WHO WERE RAN-
domly assigned to receive a placebo, vitamin E (2,000 IU/day dl-alpha-
tocopherol), a monoamine oxidase inhibitor (selegiline), or vitamin E
and selegiline. Over 2 years, treatment with vitamin E and selegiline,
separately or together, significantly delayed functional deterioration
AND THE NEED FOR INSTITUTIONALIZATION COMPARED TO PLACEBO (OWEVER
participants taking vitamin E experienced significantly more falls.
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Vitamin E
159
Chapter 26
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Note: 1 DFE = 1 mcg food folate = 0.6 mcg folic acid from supplements and
fortified foods.
162
Folate (Folic Acid)
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164
Folate (Folic Acid)
Folic acid and cancer: Some evidence associates low blood levels
of folate with a greater risk of cancer. Folate is involved in the synthe-
sis, repair, and function of DNA, our genetic map, and there is some
evidence that a deficiency of folate can cause damage to DNA that may
lead to cancer. Several studies have associated diets low in folate with
increased risk of breast, pancreatic, and colon cancer.
Over 88,000 women enrolled in the Nurses’ Health Study who were
free of cancer in 1980 were followed from 1980 through 1994. Researchers
found that women ages 55 to 69 years in this study who took multivitamins
containing folic acid for more than 15 years had a markedly lower risk of
developing colon cancer. Findings from over 14,000 subjects followed for
20 years suggest that men who do not consume alcohol and whose diets
provide the recommended intake of folate are less likely to develop colon
cancer. However, associations between diet and disease do not indicate a
direct cause. Researchers are continuing to investigate whether enhanced
folate intake from foods or folic acid supplements may reduce the risk of
cancer. Until results from such clinical trials are available, folic acid supple-
ments should not be recommended to reduce the risk of cancer.
Folic acid and methotrexate for cancer: Folate is important for
cells and tissues that rapidly divide. Cancer cells divide rapidly, and
drugs that interfere with folate metabolism are used to treat cancer.
Methotrexate is a drug often used to treat cancer because it limits the
ACTIVITY OF ENZYMES THAT NEED FOLATE
Unfortunately, methotrexate can be toxic, producing side effects
such as inflammation in the digestive tract that may make it difficult
to eat normally. Leucovorin is a form of folate that can help “rescue”
or reverse the toxic effects of methotrexate. There are many studies
underway to determine if folic acid supplements can help control the
side effects of methotrexate without decreasing its effectiveness in
chemotherapy. It is important for anyone receiving methotrexate to
follow a medical doctor’s advice on the use of folic acid supplements.
Folic acid and methotrexate for non-cancerous diseases: Low
dose methotrexate is used to treat a wide variety of non-cancerous
diseases such as rheumatoid arthritis, lupus, psoriasis, asthma, sar-
coidosis, primary biliary cirrhosis, and inflammatory bowel disease.
Low doses of methotrexate can deplete folate stores and cause side
effects that are similar to folate deficiency. Both high folate diets and
supplemental folic acid may help reduce the toxic side effects of low
dose methotrexate without decreasing its effectiveness. Anyone taking
low dose methotrexate for the health problems listed should consult
with a physician about the need for a folic acid supplement.
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166
Folate (Folic Acid)
United States to consume the recommended 400 mcg of folic acid per day
from fortified foods and/or supplements. The large numbers of fortified
foods on the market, however, also raises the risk of exceeding the UL.
This is especially important for anyone at risk of vitamin B12 deficiency,
which can be triggered by too much folic acid. It is important for any-
one who is considering taking a folic acid supplement to first consider
whether their diet already includes adequate sources of dietary folate
and fortified food sources of folic acid.
167
Chapter 27
Magnesium
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Magnesium
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those with lower magnesium intake. This study also supports the di-
etary recommendation to increase consumption of major food sources of
magnesium, such as whole grains, nuts, and green leafy vegetables.
On the other hand, the Atherosclerosis Risk in Communities
(ARIC) study did not find any association between dietary magne-
sium intake and the risk for type 2 diabetes. During 6 years of follow-
up, ARIC researchers examined the risk for type 2 diabetes in over
12,000 middle-aged adults without diabetes at baseline examination.
In this study, there was no association between dietary magnesium
intake and incidence of type 2 diabetes in either black or white par-
ticipants. It can be confusing to read about studies that examine the
same issue but have different results. Before reaching a conclusion
on a health issue, scientists conduct and evaluate many studies. Over
time, they determine when results are consistent enough to suggest
a conclusion. They want to be sure they are providing correct recom-
mendations to the public.
Several clinical studies have examined the potential benefit of supple-
mental magnesium on control of type 2 diabetes. In one such study, 63
subjects with below normal serum magnesium levels received either
2.5 grams of oral magnesium chloride daily “in liquid form” (providing
300 mg elemental magnesium per day) or a placebo. At the end of the
16-week study period, those who received the magnesium supplement
had higher blood levels of magnesium and improved control of diabetes,
as suggested by lower hemoglobin A1C levels, than those who received
a placebo. Hemoglobin A1C is a test that measures overall control of
blood glucose over the previous 2 to 3 months, and is considered by many
doctors to be the single most important blood test for diabetics.
In another study, 128 patients with poorly controlled type 2 diabetes
WERE RANDOMIZED TO RECEIVE A PLACEBO OR A SUPPLEMENT WITH EITHER
mg or 1000 mg of magnesium oxide (MgO) for 30 days. All patients
were also treated with diet or diet plus oral medication to control blood
glucose levels. Magnesium levels increased in the group receiving 1000
mg magnesium oxide per day (equal to 600 mg elemental magnesium
per day) but did not significantly change in the placebo group or the
group receiving 500 mg of magnesium oxide per day (equal to 300 mg
elemental magnesium per day). However, neither level of magnesium
supplementation significantly improved blood glucose control.
These studies provide intriguing results but also suggest that ad-
ditional research is needed to better explain the association between
blood magnesium levels, dietary magnesium intake, and type 2 diabe-
tes. In 1999, the American Diabetes Association (ADA) issued nutri-
tion recommendations for diabetics stating that “routine evaluation of
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174
Chapter 28
Omega-3 Fatty
Acid Supplements
Chapter Contents
Section 28.1—Fish Oils............................................................... 176
Section 28.2—Flaxseed and Flaxseed Oils ................................ 190
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 28.1
Fish Oils
“Omega-3 Fatty Acids, Fish Oil, Alpha-Linolenic Acid” Copy-
right © 2009 Natural Standard (www.naturalstandard.com).
All rights reserved.
Background
Dietary sources of omega-3 fatty acids include fish oil and certain
plant/nut oils. Fish oil contains both docosahexaenoic acid (DHA) and
eicosapentaenoic acid (EPA), while some nuts (English walnuts) and
vegetable oils (canola, soybean, flaxseed/linseed, olive) contain alpha-
linolenic acid (ALA).
There is evidence from multiple studies supporting intake of recom-
mended amounts of DHA and EPA in the form of dietary fish or fish
oil supplements lowers triglycerides, reduces the risk of death, heart
attack, dangerous abnormal heart rhythms, and strokes in people
with known cardiovascular disease, slows the buildup of atheroscle-
rotic plaques (“hardening of the arteries”), and lowers blood pressure
slightly. However, high doses may have harmful effects, such as an
increased risk of bleeding. Although similar benefits are proposed for
alpha-linolenic acid, scientific evidence is less compelling, and benefi-
cial effects may be less pronounced.
Some species of fish carry a higher risk of environmental contami-
nation, such as with methylmercury.
Synonyms
Alpha-linolenic acid (ALA, C18:3n-3), cod liver oil, coldwater fish,
docosahexaenoic acid (DHA, C22:6n-3), eicosapentaenoic acid (EPA,
C20:5n-3), fish oil fatty acids, fish body oil, fish extract, fish liver oil,
halibut oil, long chain polyunsaturated fatty acids, mackerel oil, ma-
rine oil, menhaden oil, n-3 fatty acids, n-3 polyunsaturated fatty acids,
omega fatty acids, omega-3 oils, polyunsaturated fatty acids (PUFA),
salmon oil, shark liver oil, w-3 fatty acids.
Note: Should not be confused with omega-6 fatty acids.
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Evidence
These uses have been tested in humans or animals. Safety and ef-
fectiveness have not always been proven. Some of these conditions are
potentially serious, and should be evaluated by a qualified healthcare
PROVIDER +EY TO GRADES! 3TRONG SCIENTIlC EVIDENCE FOR THIS USE "
'OOD SCIENTIlC EVIDENCE FOR THIS USE # 5NCLEAR SCIENTIlC EVIDENCE
FOR THIS USE $ &AIR SCIENTIlC EVIDENCE AGAINST THIS USE & 3TRONG
scientific evidence against this use).
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Angina Pectoris
Preliminary studies report reductions in angina associated with
fish oil intake. Better research is necessary before a firm conclusion
can be drawn. Grade: C.
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Omega-3 Fatty Acid Supplements
Asthma
Several studies in this area do not provide enough reliable evidence
to form a clear conclusion, with some studies reporting no effects, and
others finding benefits. Because most studies have been small without
clear descriptions of design or results, the results cannot be considered
conclusive. Grade: C.
Atherosclerosis
Some research reports that regular intake of fish or fish oil supplements
reduces the risk of developing atherosclerotic plaques in the arteries of
the heart, while other research reports no effects. Additional evidence is
necessary before a firm conclusion can be drawn in this area. Grade: C.
Bipolar Disorder
Several studies in this area do not provide enough reliable evidence
to form a clear conclusion. Grade: C.
Cancer Prevention
Several population (epidemiologic) studies report that dietary omega-3
fatty acids or fish oil may reduce the risk of developing breast, colon,
OR PROSTATE CANCER 2ANDOMIZED CONTROLLED TRIALS ARE NECESSARY BEFORE
a clear conclusion can be drawn. Grade: C.
Colon Cancer
Omega-3 fatty acids are commonly taken by cancer patients. Al-
though preliminary studies report that growth of colon cancer cells
may be reduced by taking fish oil, effects on survival or remission have
not been measured adequately. Grade: C.
Crohn’s Disease
It has been suggested that effects of omega-3 fatty acids on inflam-
mation may be beneficial in patients with Crohn’s disease when added
to standard therapy, and several studies have been conducted in this
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Cystic Fibrosis
A small amount of research in this area does not provide enough
reliable evidence to form a clear conclusion. Grade: C.
Dementia
Well-designed clinical trials are needed before omega-3 fatty acids
can be recommended for the prevention of cognitive impairment or
dementia. Grade: C.
Depression
Several studies on the use of omega 3 fatty acids in depression, in-
cluding positive results in postpartum depression, do not provide enough
reliable evidence to form a clear conclusion or replace standard treat-
ments. However, based on one recent study, omega-3 fatty acids may have
therapeutic benefits in childhood depression. Promising initial evidence
requires confirmation with larger, well-designed trials. Grade: C.
Eczema
3EVERAL STUDIES OF %0! FOR ECZEMA DO NOT PROVIDE ENOUGH RELIABLE
evidence to form a clear conclusion. Grade: C.
IgA Nephropathy
There are conflicting results from several trials in this area. Grade: C.
Lupus Erythematosus
There is not enough reliable evidence to form a clear conclusion in
this area. Grade: C.
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Nephrotic Syndrome
There is not enough reliable evidence to form a clear conclusion in
this area. Grade: C.
Preeclampsia
Several studies of fish oil do not provide enough reliable evidence
to form a clear conclusion in this area. Grade: C.
Psoriasis
Several studies in this area do not provide enough reliable evidence
to form a clear conclusion. Grade: C.
Schizophrenia
4HERE IS PROMISING PRELIMINARY EVIDENCE FROM SEVERAL RANDOMIZED
controlled trials in this area. Additional research is necessary before
a firm conclusion can be reached. Grade: C.
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Stroke Prevention
Several large studies of populations (“epidemiologic” studies) have
examined the effects of omega-3 fatty acid intake on stroke risk. Some
studies suggest benefits, while others do not. Effects are likely on isch-
emic or thrombotic stroke risk, and very large intakes of omega-3 fatty
acids (“Eskimo” amounts) may actually increase the risk of hemor-
rhagic (bleeding) stroke. At this time, it is unclear if there are benefits
in people with or without a history of stroke, or if effects of fish oil are
comparable to other treatment strategies. Grade: C.
Ulcerative Colitis
It has been suggested that effects of omega-3 fatty acids on inflam-
mation may be beneficial in patients with ulcerative colitis when added
to standard therapy, and several studies have been conducted in this
area. Better research is necessary before a clear conclusion can be
drawn. Grade: C.
Diabetes
The available scientific evidence suggests that there are no signifi-
cant long-term effects of fish oil in patients with diabetes. Most studies
in this area are not well designed. Grade: D.
Hypercholesterolemia
Although fish oil is able to reduce triglycerides, beneficial effects on
blood cholesterol levels have not been demonstrated. Fish oil supple-
ments appear to cause small improvements in high-density lipoprotein
hGOOD CHOLESTEROLv HOWEVER INCREASES WORSENING IN LOW DENSITY
lipoprotein levels (“bad cholesterol”) are also observed. Fish oil does
not appear to affect C-reactive protein (CRP) levels. Grade: D.
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Omega-3 Fatty Acid Supplements
(high blood pressure) compared to patients not taking fish oil. However,
several recent studies report no benefits on kidney function, and no chang-
es have been found in rates of rejection or graft survival. Grade D.
Dosing
The below doses are based on scientific research, publications, tra-
ditional use, or expert opinion. Many herbs and supplements have
not been thoroughly tested, and safety and effectiveness may not be
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Safety
The U.S. Food and Drug Administration does not strictly regulate
herbs and supplements. There is no guarantee of strength, purity or
safety of products, and effects may vary. You should always read product
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Omega-3 Fatty Acid Supplements
labels. If you have a medical condition, or are taking other drugs, herbs,
or supplements, you should speak with a qualified healthcare provider
before starting a new therapy. Consult a healthcare provider immedi-
ately if you experience side effects.
Allergies
People with allergy or hypersensitivity to fish should avoid fish oil
or omega-3 fatty acid products derived from fish. Skin rash has been
reported rarely. People with allergy or hypersensitivity to nuts should
avoid alpha linolenic acid or omega-3 fatty acid products that are de-
rived from the types of nuts to which they react.
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Omega-3 Fatty Acid Supplements
Interactions
Most herbs and supplements have not been thoroughly tested for
interactions with other herbs, supplements, drugs, or foods. The inter-
actions listed in the following text are based on reports in scientific
publications, laboratory experiments, or traditional use. You should
always read product labels. If you have a medical condition, or are
taking other drugs, herbs, or supplements, you should speak with a
qualified healthcare provider before starting a new therapy.
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the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto.
Numerous other agents may theoretically increase the risk of bleeding,
although this has not been proven in most cases.
Based on human studies, omega-3 fatty acids may lower blood pres-
sure, and theoretically may add to the effects of agents that may also
affect blood pressure.
Fish oil supplements may lower blood sugar levels a small amount.
Caution is advised when using herbs or supplements that may also
lower blood sugar. Blood glucose levels may require monitoring, and
doses may need adjustment.
Omega-3 fatty acids lower triglyceride levels, but can actually in-
crease (worsen) low-density lipoprotein (LDL/”bad cholesterol”) levels
by a small amount. Therefore, omega-3 fatty acids may add to the
triglyceride-lowering effects of agents like niacin/nicotinic acid, but
may work against the potential LDL-lowering properties of agents like
barley, garlic, guggul, psyllium, soy, or sweet almond.
Fish oil taken for many months may cause a deficiency of vitamin
E, and therefore vitamin E is added to many commercial fish oil prod-
ucts. As a result, regular use of vitamin E-enriched products may lead
to elevated levels of this fat-soluble vitamin. Fish liver oil contains
the fat-soluble vitamins A and D, and therefore fish liver oil products
(such as cod liver oil) may increase the risk of vitamin A or D toxicity.
Since fat-soluble vitamins can build up in the body and cause toxicity,
patients taking multiple vitamins regularly or in high doses should
discuss this risk with their healthcare practitioners.
Methodology
This information is based on a professional level monograph edited
and peer-reviewed by contributors to the Natural Standard Research
Collaboration (www.naturalstandard.com).
Selected References
1. Berbert AA, Kondo CR, Almendra CL, et al. Supplementation
of fish oil and olive oil in patients with rheumatoid arthritis.
Nutrition n
2. Bittiner SB, Tucker WF, Cartwright I, et al. A double-blind,
randomised, placebo-controlled trial of fish oil in psoriasis.
Lancet n
3. Bjorneboe A, Smith AK, Bjorneboe GE, et al. Effect of dietary
supplementation with n-3 fatty acids on clinical manifesta-
tions of psoriasis. Br J Dermatol n
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Omega-3 Fatty Acid Supplements
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
14. Stoll AL, Severus WE, Freeman MP, et al. Omega 3 fatty acids
in bipolar disorder: a preliminary double-blind, placebo-controlled
trial. Arch Gen. Psychiatry n
15. Su KP, Huang SY, Chiu CC, et al. Omega-3 fatty acids in major
depressive disorder. A preliminary double-blind, placebo-controlled
trial. Eur. Neuropsychopharmacol. n
Section 28.2
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Omega-3 Fatty Acid Supplements
191
Chapter 29
Selenium
What is selenium?
Selenium is a trace mineral that is essential to good health but re-
quired only in small amounts. Selenium is incorporated into proteins
TO MAKE SELENOPROTEINS WHICH ARE IMPORTANT ANTIOXIDANT ENZYMES 4HE
antioxidant properties of selenoproteins help prevent cellular damage
from free radicals. Free radicals are natural by-products of oxygen me-
tabolism that may contribute to the development of chronic diseases
such as cancer and heart disease. Other selenoproteins help regulate
thyroid function and play a role in the immune system.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
but significantly reduced the occurrence and death from total cancers.
The incidence of prostate cancer, colorectal cancer, and lung cancer was
notably lower in the group given selenium supplements.
Research suggests that selenium affects cancer risk in two ways. As
an antioxidant, selenium can help protect the body from damaging ef-
fects of free radicals. Selenium may also prevent or slow tumor growth.
Certain breakdown products of selenium are believed to prevent tumor
growth by enhancing immune cell activity and suppressing develop-
ment of blood vessels to the tumor.
However, not all studies have shown a relationship between seleni-
um status and cancer. In 1982, over 60,000 participants of the Nurse’s
Health Study with no history of cancer submitted toenail clippings for
selenium analysis. Toenails are thought to reflect selenium status over
the previous year. After three and a half years of data collection, re-
searchers compared toenail selenium levels of nurses with and without
cancer. Those nurses with higher levels of selenium in their toenails
did not have a reduced risk of cancer.
Two long-term studies, the SU.VI.MAX study in France and the
Selenium and Vitamin E Cancer Prevention Trial (SELECT) in the
United States and Canada, investigated whether selenium combined
with at least one other dietary supplement could reduce the risk of
prostate cancer in men.
The SU.VI.MAX study examined the effects of a supplement pack-
age containing moderate doses of vitamins E and C, beta-carotene,
ZINC AND SELENIUM MCGDAY VERSUS PLACEBO ON THE RISK OF CHRONIC
diseases such as cancer and cardiovascular disease. Among the 5,141
MEN ENROLLED THOSE RANDOMIZED TO THE SUPPLEMENTS WHO BEGAN THE
study with a normal (<3 ng/ml) PSA (prostate specific antigen) level at
baseline had their risk of prostate cancer reduced by half. Among the
men whose PSA levels were elevated at baseline, however, use of the
supplements was associated with an increased incidence of prostate
cancer of borderline statistical significance compared to placebo.
The Selenium and Vitamin E Cancer Prevention Trial (SELECT)
WAS A VERY LARGE RANDOMIZED CLINICAL TRIAL BEGUN IN SPECIlCALLY
designed to determine whether 7–12 years of daily supplementation
with selenium (200 mcg), with or without synthetic vitamin E (400
IU), reduces the number of new prostate cancers in healthy men (PSA
less than or equal to 4 ng/ml at baseline). The trial, which had enrolled
>35,000 men, was discontinued in October 2008 when an analysis
found that the supplements, taken alone or together for an average of
5.5 years, did not prevent prostate cancer. Study staff members will
continue to monitor participants’ health for an additional 3 years.
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196
Chapter 30
Chapter Contents
Section 30.1—Calcium Supplements and Bone Health..................198
Section 30.2—Glucosamine/Chondroitin Supplements ..................201
and Joint Health
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Section 30.1
198
Bone and Joint Health Supplements
s #ALCIUM CARBONATE
s #ALCIUM PHOSPHATE
s #ALCIUM CITRATE
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Combination Products
Calcium supplements are available in a bewildering array of com-
binations with vitamins and other minerals. Calcium supplements
often come in combination with vitamin D, which is necessary for the
absorption of calcium. However, calcium and vitamin D do not need
to be taken together or in the same preparation to be absorbed by the
body. Minerals such as magnesium and phosphorus also are important
but usually are obtained through food or multivitamins. Most experts
recommend that nutrients come from a balanced diet, with multivita-
mins used to supplement dietary deficiencies.
Getting enough calcium—whether through your diet or with the help
of supplements—will help to protect the health of your bones. However,
this is only one of the steps you need to take for bone health. Exercise, a
healthy lifestyle, and, for some people, medication are also important.
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Bone and Joint Health Supplements
Section 30.2
Glucosamine/Chondroitin
Supplements and Joint Health
Excerpted from “Dietary Supplements Glucosamine and/or Chondroitin
Fare No Better than Placebo in Slowing Structural Damage of Knee Os-
teoarthritis,” by the National Institutes of Health (NIH, www.nih.gov),
September 29, 2008.
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Bone and Joint Health Supplements
References
3AWITZKE !$ 3HI ( &INCO -& ET AL 4HE %FFECT OF 'LUCOSAMINE
and/or Chondroitin Sulfate on the Progression of Knee Os-
teoarthritis: A Report from the Glucosamine/Chondroitin
Arthritis Intervention Trial. Arthritis & Rheumatism,
58(10):3183–3191.
2. Clegg D, Reda DJ, Harris CL, et al. Glucosamine, Chondroitin
Sulfate, and the Two in Combination for Painful Knee Osteoar-
thritis. New England Journal of Medicine, n
203
Chapter 31
Immune System
Support Supplements
Chapter Contents
Section 31.1—Echinacea............................................................. 206
3ECTION :INC....................................................................... 208
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Section 31.1
Echinacea
Excerpted from text by the National Center for Complementary and
Alternative Medicine (NCCAM, nccam.nih.gov), part of the National
Institutes of Health, March 2008.
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Section 31.2
Zinc
%XCERPTED FROM h:INC v BY THE /FlCE OF $IETARY 3UPPLEMENTS /$3
ods.od.nih.gov), part of the National Institutes of Health, June 30, 2009.
Immune Function
3EVERE ZINC DElCIENCY DEPRESSES IMMUNE FUNCTION AND EVEN MILD TO
MODERATE DEGREES OF ZINC DElCIENCY CAN IMPAIR MACROPHAGE AND NEUTRO-
phil functions, natural killer cell activity, and complement activity. The
BODY REQUIRES ZINC TO DEVELOP AND ACTIVATE 4 LYMPHOCYTES )NDIVIDUALS
WITH LOW ZINC LEVELS HAVE SHOWN REDUCED LYMPHOCYTE PROLIFERATION
response to mitogens and other adverse alterations in immunity that
CAN BE CORRECTED BY ZINC SUPPLEMENTATION 4HESE ALTERATIONS IN IMMUNE
FUNCTION MIGHT EXPLAIN WHY LOW ZINC STATUS HAS BEEN ASSOCIATED WITH
increased susceptibility to pneumonia and other infections in children
in developing countries and the elderly.
Wound Healing
:INC HELPS MAINTAIN THE INTEGRITY OF SKIN AND MUCOSAL MEMBRANES
0ATIENTS WITH CHRONIC LEG ULCERS HAVE ABNORMAL ZINC METABOLISM AND
LOW SERUM ZINC LEVELS AND CLINICIANS FREQUENTLY TREAT SKIN ULCERS WITH
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Immune System Support Supplements
Diarrhea
Acute diarrhea is associated with high rates of mortality among
CHILDREN IN DEVELOPING COUNTRIES :INC DElCIENCY CAUSES ALTERATIONS IN
immune response that probably contribute to increased susceptibility to
infections, such as those that cause diarrhea, especially in children.
Studies show that poor, malnourished children in India, Africa,
South America, and Southeast Asia experience shorter courses of in-
FECTIOUS DIARRHEA AFTER TAKING ZINC SUPPLEMENTS 4HE CHILDREN IN THESE
STUDIES RECEIVED n MG OF ZINC A DAY IN THE FORM OF ZINC ACETATE ZINC
GLUCONATE OR ZINC SULFATE
)N ADDITION RESULTS FROM A POOLED ANALYSIS OF RANDOMIZED CONTROLLED
TRIALS OF ZINC SUPPLEMENTATION IN DEVELOPING COUNTRIES SUGGEST THAT ZINC
HELPS REDUCE THE DURATION AND SEVERITY OF DIARRHEA IN ZINC DElCIENT OR
otherwise malnourished children. Similar findings were reported in
A META ANALYSIS PUBLISHED IN AND A REVIEW OF ZINC SUPPLE-
MENTATION FOR PREVENTING AND TREATING DIARRHEA 4HE EFFECTS OF ZINC
SUPPLEMENTATION ON DIARRHEA IN CHILDREN WITH ADEQUATE ZINC STATUS
such as most children in the United States, are not clear.
4HE 7ORLD (EALTH /RGANIZATION AND 5.)#%& ;5NITED .ATIONS #HIL-
DRENS &UND= NOW RECOMMEND SHORT TERM ZINC SUPPLEMENTATION MG
OF ZINC PER DAY OR MG FOR INFANTS UNDER MONTHS FOR n DAYS
to treat acute childhood diarrhea.
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Immune System Support Supplements
211
Chapter 32
Chapter Contents
Section 32.1—Ginkgo Biloba ...................................................... 214
Section 32.2—St. John’s Wort..................................................... 216
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Section 32.1
Ginkgo Biloba
Excerpted from “Ginkgo,” by the National Center for Complementary
and Alternative Medicine (NCCAM, nccam.nih.gov), part of the National
Institutes of Health, November 2008.
This text provides basic information about the herb ginkgo. The
ginkgo tree is one of the oldest types of trees in the world. Ginkgo
seeds have been used in traditional Chinese medicine for thousands
of years, and cooked seeds are occasionally eaten. Common names
include ginkgo, Ginkgo biloba, fossil tree, maidenhair tree, Japanese
silver apricot, baiguo, bai guo ye, kew tree, and yinhsing (yin-hsing).
The Latin name is Ginkgo biloba.
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Mood and Brain Health Supplements
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Section 32.2
This text provides basic information about the herb St. John’s wort.
St. John’s wort is a plant with yellow flowers whose medicinal uses
were first recorded in ancient Greece. The name St. John’s wort appar-
ently refers to John the Baptist, as the plant blooms around the time of
the feast of St. John the Baptist in late June. Common names include
St. John’s wort, hypericum, Klamath weed, and goat weed. The Latin
name for St. John’s wort is Hypericum perforatum.
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Mood and Brain Health Supplements
217
Chapter 33
Probiotics: Supplements
for Gastrointestinal Health
Probiotics are live microorganisms (in most cases, bacteria) that are
similar to beneficial microorganisms found in the human gut. They are
also called friendly bacteria or good bacteria. Probiotics are available to
consumers mainly in the form of dietary supplements and foods. They
can be used as complementary and alternative medicine (CAM).
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and unfermented milk, miso, tempeh, and some juices and soy bever-
ages. In probiotic foods and supplements, the bacteria may have been
present originally or added during preparation.
Most probiotics are bacteria similar to those naturally found in
people’s guts, especially in those of breastfed infants (who have natu-
ral protection against many diseases). Most often, the bacteria come
from two groups, Lactobacillus or Bifidobacterium. Within each group,
there are different species (for example, Lactobacillus acidophilus and
Bifidobacterium bifidus), and within each species, different strains (or
varieties). A few common probiotics, such as Saccharomyces boulardii,
are yeasts, which are different from bacteria.
Some probiotic foods date back to ancient times, such as fermented
foods and cultured milk products. Interest in probiotics in general
HAS BEEN GROWING !MERICANS SPENDING ON PROBIOTIC SUPPLEMENTS FOR
example, nearly tripled from 1994 to 2003.
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Probiotics: Supplements for Gastrointestinal Health
s )NFECTIOUS DIARRHEA
s )RRITABLE BOWEL SYNDROME
s )NmAMMATORY BOWEL DISEASE EG ULCERATIVE COLITIS AND #ROHN
disease)
s )NFECTION WITH Helicobacter pylori (H. pylori), a bacterium
that causes most ulcers and many types of chronic stomach
inflammation
s 4OOTH DECAY AND PERIODONTAL DISEASE
s 6AGINAL INFECTIONS
s 3TOMACH AND RESPIRATORY INFECTIONS THAT CHILDREN ACQUIRE IN
daycare
s 3KIN INFECTIONS
Another part of the interest in probiotics stems from the fact there
are cells in the digestive tract connected with the immune system. One
theory is that if you alter the microorganisms in a person’s intestinal
tract (as by introducing probiotic bacteria), you can affect the immune
system’s defenses.
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Probiotics: Supplements for Gastrointestinal Health
223
Chapter 34
Sports and
Energy Supplements
Chapter Contents
Section 34.1—Sports Supplements ............................................ 226
Section 34.2—Energy Drinks ..................................................... 231
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Section 34.1
Sports Supplements
“Sports Supplements,” May 2008, reprinted with permission from
www.kidshealth.org. Copyright © 2008 The Nemours Foundation. This informa-
tion was provided by KidsHealth, one of the largest resources online for medi-
cally reviewed health information written for parents, kids, and teens. For more
articles like this one, visit www.KidsHealth.org, or www.TeensHealth.org.
226
Sports and Energy Supplements
For example, teen athletes who use medications like human growth
hormone (hGH) that haven’t been prescribed for them may have prob-
lems with development and hormone levels.
,OTS OF SPORTS ORGANIZATIONS HAVE DEVELOPED POLICIES ON SPORTS
supplements. The National Football League (NFL), the National Col-
legiate Athletic Association (NCAA), and the International Olympic
Committee (IOC) have banned the use of steroids, ephedra, and an-
drostenedione by their athletes, and competitors who use them face
fines, ineligibility, and suspension from their sports.
The National Federation of State High School Associations (NFHS)
strongly recommends that student athletes consult with their doctor
before taking any supplement.
Creatine
Creatine is already manufactured by the body in the liver, kidneys,
and pancreas. It also occurs naturally in foods such as meat and fish.
Creatine supplements are available over the counter, and teens make
up a large portion of the supplement’s users.
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Fat Burners
Fat burners (sometimes known as thermogenics) were often made with
an herb called ephedra, also known as ephedrine or ma huang, which acts
as a stimulant and increases metabolism. Some athletes use fat burners
to lose weight or to increase energy—but ephedra-based products can be
one of the most dangerous supplements. Evidence has shown that it can
cause heart problems, stroke, and occasionally even death.
Because athletes and others have died using this supplement,
ephedra has been taken off the market. Since the ban, “ephedra-
free” products have emerged, but they often contain ingredients with
ephedra-like properties, including bitter orange or country mallow.
Similar to ephedra, these supplements can cause high blood pressure,
HEART ATTACK STROKE AND SEIZURES
Many of these products also contain caffeine, along with other caf-
feine sources (such as yerba mate and guarana). This combination may
lead to restlessness, anxiety, racing heart, irregular heart beat, and
increases the chance of having a life-threatening side effect.
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Sports and Energy Supplements
program. But the fact is that using sports supplements may put you at
risk for serious health conditions. So instead of turning to supplements
to improve your performance, concentrate on nutrition and follow a
weight-training and aerobic-conditioning program.
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Sports and Energy Supplements
Section 34.2
Energy Drinks
Excerpted from “Energy Drinks: Power Boosts or Empty Boasts?” by the
Substance Abuse and Mental Health Services Administration (SAMHSA,
family.samhsa.gov), part of the U.S. Department of Health and Human
Services, April 30, 2007.
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Caffeine Concerns
Caffeine perks up the central nervous system and provides the lift
that energy drinks are all about. The central nervous system, which
includes the brain and the spinal cord, is the main “processing center”
that controls all of the body’s organs and systems.
However, the high levels of caffeine in energy drinks can cause prob-
lems. Because caffeine can send you to the bathroom more often, it can
dehydrate your body—meaning that you do not have as much water and
fluids as you should—when you are also sweating during exercise.
Caffeine also can speed up a person’s heart and raise blood pres-
sure. The amount of caffeine in energy drinks is not good for children.
Caffeine may cause a child to become agitated, irritable, or nervous.
In addition, caffeine is a concern for pregnant women as well as the
children they carry. The Food and Drug Administration advises preg-
nant women to use caffeine in moderation.
How much caffeine is too much? It depends—the effects of caffeine
VARY FROM ONE PERSON TO ANOTHER ACCORDING TO TRAITS SUCH AS AGE SIZE
and health. For most people, three 8-ounce cups of coffee per day is
considered a moderate amount of caffeine.
Mixing energy drinks with alcohol poses a special risk. The stimu-
lation from a caffeine-heavy energy drink can make a person feel less
intoxicated than she really is. As a result, she may keep drinking or
TAKE A RISK SUCH AS DRIVING WITHOUT REALIZING THE DANGER )N ADDITION
because caffeine dehydrates the body, alcohol becomes harder to ab-
sorb, which makes its toxic effects much more damaging to the body.
School starts early, activities and jobs create tight schedules, and
nighttime often finds today’s youth up late doing homework, listening
to music, playing computer games, and instant messaging their friends.
As a result, kids often do not get the sleep they need, leaving them
more likely to reach for a caffeine jolt. In fact, the more caffeine kids
consume, the less sleep they get. So, work with your child to adjust his
schedule so he has enough time for sleep and offer him noncaffeinated
drinks such as juice, milk, and water after dinner.
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Sports and Energy Supplements
Choosing Wisely
While an energy drink every so often will not be a problem for most
people, make sure that your child knows the real deal about these
products. Talk with him about situations in which sports drinks could
have unexpected effects. Remind him that many other products or just
plain water can give him the lift he is looking for, often at a much lower
cost than an energy drink. Making careful choices when he wants to
kick it up a notch will pay off in safety and results. As a bonus, he’ll
end up with more money in his pocket.
233
Chapter 35
Supplements Used
for Weight Loss
Chapter Contents
Section 35.1—Green Tea............................................................. 236
Section 35.2—Hoodia .................................................................. 238
235
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 35.1
Green Tea
Excerpted from text by the National Center for Complementary and Al-
ternative Medicine (NCCAM, nccam.nih.gov), part of the National Insti-
tutes of Health, November 2008.
This text provides basic information about green tea. All types of
tea (green, black, and oolong) are produced from the Camellia sinensis
plant using different methods. Fresh leaves from the Camellia sinensis
plant are steamed to produce green tea. Common names include green
tea, Chinese tea, and Japanese tea. The Latin name for green tea is
Camellia sinensis.
236
Supplements Used for Weight Loss
whether green tea can aid in weight loss, lower blood cholesterol
levels, or protect the skin from sun damage.
s .##!- IS SUPPORTING STUDIES TO LEARN MORE ABOUT THE COMPO-
nents in green tea and their effects on conditions such as cancer,
diabetes, and heart disease.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 35.2
Hoodia
Excerpted from text by the National Center for Complementary and
Alternative Medicine (NCCAM, nccam.nih.gov), part of the National
Institutes of Health, June 2008.
This text provides basic information about the herb hoodia. Hoo-
dia is a flowering, cactus-like plant native to the Kalahari Desert in
southern Africa. Its harvest is protected by conservation laws. Common
names include hoodia, Kalahari cactus, and Xhoba. The Latin name
for it is Hoodia gordonii.
238
Supplements Used for Weight Loss
239
Part Four
Biologically
Based Therapies
Chapter 36
Biologically Based
Therapies: An Overview
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
244
Biologically Based Therapies: An Overview
245
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Primary Challenges
Many clinical studies of dietary supplements are flawed because
of inadequate sample size, poor design, limited preliminary dosing
data, lack of blinding even when feasible, and/or failure to incorporate
objective or standardized outcome instruments. In addition, the lack
of reliable data on the absorption, disposition, metabolism, and excre-
tion of these entities in living systems has complicated the selection
of products to be used in clinical trials. This is more problematic for
complex preparations (e.g., botanicals) than for products composed of
single chemical moieties (e.g., zinc).
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
248
Biologically Based Therapies: An Overview
249
Complementary and Alternative Medicine Sourcebook, Fourth Edition
250
Biologically Based Therapies: An Overview
251
Chapter 37
Apitherapy
What is apitherapy?
As a technique, it is the medical use of the products of the honeybee
hive often used with essential oils.
As a philosophy, it is a form of harmony between the individual and
the environment.
As a medical principle, it is primarily the cultivation of health and
its re-establishment when sickness interferes.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
in the first half of the 1900s about using bee venom in the treatment
of osteoarthritis and rheumatoid arthritis and there is some ongoing
research now looking at its effect in multiple sclerosis. Anecdotal re-
ports suggest that it might have some usefulness in the treatment of
infectious, autoimmune, cardiovascular, pulmonary, gastrointestinal,
neuropathic pain, and other chronic pain conditions.
254
Apitherapy
255
Chapter 38
Aromatherapy and
Essential Oils
What is aromatherapy?
Aromatherapy is the use of essential oils from plants to support and
balance the mind, body, and spirit. It is used by patients with cancer
mainly as a form of supportive care that may improve quality of life
and reduce stress and anxiety. Aromatherapy may be combined with
other complementary treatments like massage therapy and acupunc-
ture, as well as with standard treatments.
Essential oils (also known as volatile oils) are the basic materials of
aromatherapy. They are made from fragrant essences found in many
plants. These essences are made in special plant cells, often under the
surface of leaves, bark, or peel, using energy from the sun and elements
from the air, soil, and water. If the plant material is crushed, the es-
sence and its unique fragrance are released.
When essences are extracted from plants in natural ways, they
become essential oils. They may be distilled with steam and/or water,
or mechanically pressed. Oils that are made with chemical processes
are not considered true essential oils.
There are many essential oils used in aromatherapy, including Ro-
man chamomile, geranium, lavender, tea tree, lemon, cedarwood, and
bergamot. Each type of essential oil has a different chemical structure
that affects how it smells, how it is absorbed, and how it is used by
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
the body. Even varieties of plants within the same species may have
chemical structures different from each other because they are grown
or harvested in different ways or locations.
Essential oils are very concentrated. For example, it takes about
220 pounds of lavender flowers to make about 1 pound of essential oil.
Essential oils are very volatile, evaporating quickly when they come
in contact with air.
258
Aromatherapy and Essential Oils
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
260
Aromatherapy and Essential Oils
261
Chapter 39
Diet-Based Therapies
Chapter Contents
Section 39.1—Detoxification Diets............................................. 264
Section 39.2—Fasting ................................................................. 267
Section 39.3—Gerson Therapy ................................................... 269
Section 39.4—Macrobiotics......................................................... 273
3ECTION 6EGANISM ............................................................. 275
3ECTION 6EGETARIANISM...................................................... 279
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 39.1
Detoxification Diets
“Are Detox Diets Safe?” January 2009, reprinted with permission from www
.kidshealth.org. Copyright © 2009 The Nemours Foundation. This information
was provided by KidsHealth, one of the largest resources online for medically
reviewed health information written for parents, kids, and teens. For more
articles like this one, visit www.KidsHealth.org, or www.TeensHealth.org.
264
Diet-Based Therapies
out the rectum and colon using water.) Others recommend that you
take special teas or supplements to help the “purification” process.
There are lots of claims about what a detox diet can do, from pre-
venting and curing disease to giving people more energy or focus. Of
course, eating a diet lower in fat and higher in fiber can help many
people feel healthier. But people who support detox diets claim that
this is because of the elimination of toxins. There’s no scientific proof
that these diets help rid the body of toxins faster or that the elimina-
tion of toxins will make you a healthier, more energetic person.
Detox diets don’t help people lose fat. Finally, people who fast
for several days may drop pounds, but most of it will be water and some
of it may be muscle. Most people regain the weight they lost soon after
completing the program.
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266
Diet-Based Therapies
Section 39.2
Fasting
Reprinted with permission from the website of the John Moores Univer-
sity of California–San Diego Cancer Center, http://cancer.ucsd.edu. © 2002
University of California–San Diego. All rights reserved. Reviewed by David
A. Cooke, MD, FACP, December 25, 2009.
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Diet-Based Therapies
Section 39.3
Gerson Therapy
PDQ® Cancer Information Summary. National Cancer Institute; Bethes-
da, MD. Gerson Therapy (PDQ®): CAM—Patient. Updated 06/2009.
Available at http://cancer.gov. Accessed December 10, 2009.
What is the history of the discovery and use of the Gerson ther-
apy as a complementary or alternative treatment for cancer?
The Gerson therapy was named after Dr. Max B. Gerson (1881–
1959), who first used it to treat his migraine headaches. In the 1930s,
Dr. Gerson’s therapy became known to the public as a treatment for a
type of tuberculosis (TB). The Gerson therapy was later used to treat
other conditions, including cancer.
What is the theory behind the claim that the Gerson thera-
py is useful in treating cancer?
The Gerson therapy is based on the idea that cancer develops when
there are changes in cell metabolism because of the buildup of toxic sub-
stances in the body. Dr. Gerson said the disease process makes more toxins
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
and the liver becomes overworked. According to Dr. Gerson, people with
cancer also have too much sodium and too little potassium in the cells in
their bodies, which causes tissue damage and weakened organs.
The goal of the Gerson therapy is to restore the body to health by
repairing the liver and returning the metabolism to its normal state.
According to Dr. Gerson, this can be done by removing toxins from
the body and building up the immune system with diet and supple-
ments. The enemas are said to widen the bile ducts of the liver so
toxins can be released. According to Dr. Gerson, the liver is further
overworked as the treatment regimen breaks down cancer cells and
rids the body of toxins. Pancreatic enzymes are given to decrease the
demands on the weakened liver and pancreas to make enzymes for
digestion. An organic diet and nutritional supplements are used to
boost the immune system and support the body as the regimen cleans
the body of toxins. Foods low in sodium and high in potassium are
said to help correct the tissue damage caused by having too much
sodium in the cells.
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Diet-Based Therapies
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Have any side effects or risks been reported from use of the
Gerson therapy?
Reports of three deaths that may be related to coffee enemas have
been published. Taking too many enemas of any kind can cause changes
in normal blood chemistry, chemicals that occur naturally in the body
and keep the muscles, heart, and other organs working properly.
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Diet-Based Therapies
Section 39.4
Macrobiotics
Reprinted with permission from the website of the John Moores Univer-
sity of California–San Diego Cancer Center, http://cancer.ucsd.edu. © 2002
University of California–San Diego. All rights reserved. Reviewed by David
A. Cooke, MD, FACP, December 25, 2009.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
and life philosophy. The macrobiotics diet can lower fat and cholesterol
and, like other fat-reducing diets, may help prevent some cancers that
appear to be related to higher fat intake, such as colon cancer. This
fat-free diet can also lower blood pressure and reduce the chance of
heart disease. Other aspects of the macrobiotics therapy may promote
a reduction in stress.
274
Diet-Based Therapies
Section 39.5
Veganism
h6EGAN $IETS IN A .UTSHELL v ¥ 6EGETARIAN 2ESOURCE 'ROUP
(www.vrg.org). Reprinted with permission.
What Is a Vegan?
6EGETARIANS DO NOT EAT MEAT lSH OR POULTRY 6EGANS IN ADDITION TO
being vegetarian, do not use other animal products and by-products
such as eggs, dairy products, honey, leather, fur, silk, wool, and cosmet-
ics and soaps derived from animal products.
Why Veganism?
People choose to be vegan for health, environmental, and/or ethical
reasons. For example, some vegans feel that one promotes the meat
industry by consuming eggs and dairy products. That is, once dairy
cows or egg laying chickens are too old to be productive, they are often
sold as meat. Some people avoid these items because of conditions as-
sociated with their production.
Many vegans chose this lifestyle in order to promote a more humane
and caring world. They know they are not perfect, but believe they have
a responsibility to try to do their best, while not being judgmental of
others.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Dairy substitutes:
s 3OY MILK RICE MILK POTATO MILK NUT MILK OR WATER IN SOME RECI-
pes) may be used.
s "UTTERMILK CAN BE REPLACED WITH SOURED SOY OR RICE MILK &OR
each cup of buttermilk, use 1 cup soy milk plus 1 tablespoon of
vinegar.
s 3OY CHEESE AVAILABLE IN HEALTH FOOD STORES "E AWARE THAT MANY
soy cheeses contain casein, which is a dairy product.)
s #RUMBLED TOFU CAN BE SUBSTITUTED FOR COTTAGE CHEESE OR RICOTTA
cheese in lasagna and similar dishes.
s 3EVERAL BRANDS OF NONDAIRY CREAM CHEESE ARE AVAILABLE IN SUPER-
markets and kosher stores.
Vegan Nutrition
The key to a nutritionally sound vegan diet is variety. A healthy
and varied vegan diet includes fruits, vegetables, plenty of leafy greens,
whole grain products, nuts, seeds, and legumes.
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Diet-Based Therapies
Protein
It is very easy for a vegan diet to meet the recommendations for
protein as long as calorie intake is adequate. Strict protein planning
or combining is not necessary. The key is to eat a varied diet.
Sources of protein: Almost all foods except for alcohol, sugar, and
FATS PROVIDE SOME PROTEIN 6EGAN SOURCES INCLUDE LENTILS CHICKPEAS
tofu, peas, peanut butter, soy milk, almonds, spinach, rice, whole wheat
bread, potatoes, broccoli, and kale.
For example, if part of a day’s menu included the following foods,
you would meet the Recommended Dietary Allowance (RDA) for pro-
tein for an adult male:
s CUP OATMEAL
s CUP SOY MILK
s SLICES WHOLE WHEAT BREAD
s BAGEL
s 4ABLESPOONS PEANUT BUTTER
s CUP VEGETARIAN BAKED BEANS
s OUNCES TOFU
s TABLESPOONS ALMONDS
s CUP BROCCOLI
s CUP BROWN RICE
Fat
6EGAN DIETS ARE FREE OF CHOLESTEROL AND ARE GENERALLY LOW IN SATU-
rated fat. Thus eating a vegan diet makes it easy to conform to recom-
mendations given to reduce the risk of major chronic diseases such as
heart disease and cancer. High-fat foods, which should be used spar-
ingly, include oils, margarine, nuts, nut butters, seed butters, avocado,
and coconut.
Vitamin D
6ITAMIN $ IS NOT FOUND IN THE VEGAN DIET BUT CAN BE MADE BY HUMANS
following exposure to sunlight. At least 10 to 15 minutes of summer
sun on hands and face two to three times a week is recommended for
adults so that vitamin D production can occur. Food sources of vitamin
D include vitamin D-fortified orange juice and vitamin D-fortified soy
milk and rice milk.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Calcium
Calcium, needed for strong bones, is found in dark green leafy vegetables,
tofu made with calcium sulfate, calcium-fortified soy milk and orange juice,
and many other foods commonly eaten by vegans. Although lower animal
protein intake may reduce calcium losses, there is currently not enough
EVIDENCE TO SUGGEST THAT VEGANS HAVE LOWER CALCIUM NEEDS 6EGANS SHOULD
eat foods that are high in calcium and/or use a calcium supplement.
Other good sources of calcium include: okra, turnip greens, soybeans,
tempeh, almond butter, broccoli, bok choy, calcium-fortified soy yogurt.
The recommended intake for calcium for adults 19 through 50 years
is 1,000 milligrams/day.
Note: It appears that oxalic acid, which is found in spinach, rhubarb,
chard, and beet greens, binds with calcium and reduces calcium absorp-
tion. Calcium is well absorbed from other dark green vegetables.
Zinc
6EGAN DIETS CAN PROVIDE ZINC AT LEVELS CLOSE TO OR EVEN HIGHER THAN
the RDA. Zinc is found in grains, legumes, and nuts.
Iron
Dried beans and dark green leafy vegetables are especially good
sources of iron, better on a per calorie basis than meat. Iron absorption
is increased markedly by eating foods containing vitamin C along with
foods containing iron.
Sources of iron: Soybeans, lentils, blackstrap molasses, kidney
beans, chickpeas, black-eyed peas, Swiss chard, tempeh, black beans,
prune juice, beet greens, tahini, peas, bulghur, bok choy, raisins, wa-
termelon, millet, kale.
Vitamin B12
The requirement for vitamin B12 is very low but it is an essential
nutrient. It is especially important for pregnant and lactating women,
infants, and children to have reliable sources of vitamin B12 in their
diets. Non-animal sources include cereals, soy milk, rice milk, and meat
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Diet-Based Therapies
analogues that have been fortified with vitamin B12. Also, around 2
TEASPOONS OF 2ED 3TAR NUTRITIONAL YEAST 4 OFTEN LABELED AS 6EG-
etarian Support Formula, supplies the adult RDA.
Read labels carefully or contact companies since fortification levels
CAN CHANGE 6ITAMIN "12 supplements are another option. There are
supplements which do not contain animal products. Claims of a high
vitamin B12 content in fermented soy foods (miso and tempeh) and for
sea vegetables and Spirulina are unfounded. Unless fortified, no plant
food contains significant amounts of active vitamin B12.
Section 39.6
Vegetarianism
h6EGETARIANISM v /CTOBER REPRINTED WITH PERMISSION FROM WWWKID-
shealth.org. Copyright © 2008 The Nemours Foundation. This information
was provided by KidsHealth, one of the largest resources online for medically
reviewed health information written for parents, kids, and teens. For more
articles like this one, visit www.KidsHealth.org, or www.TeensHealth.org.
279
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280
Diet-Based Therapies
s Iron: Eggs, dried beans, dried fruits, whole grains, leafy green
vegetables, and iron-fortified cereals and bread
s Zinc: Wheat germ, nuts, fortified cereal, dried beans, and pump-
kin seeds
Vegetarian Infants
The main sources of protein and nutrients for infants are breast
milk and formula (soy formula for vegan infants), especially in the
first 6 months of life. Breastfed infant vegans should receive a source
of vitamin B12, if the mother’s diet isn’t supplemented, and breastfed
infants and infants drinking less than 32 ounces (1 liter) of formula
should get vitamin D supplements.
Guidelines for the introduction of solid foods are the same for veg-
etarian and nonvegetarian infants. Breastfed infants 6 months and
older should receive iron from complementary foods, such as iron-
fortified infant cereal.
Once an infant is introduced to solids, protein-rich vegetarian foods
can include pureed tofu, cottage cheese, yogurt or soy yogurt, and pu-
reed and strained legumes (legumes include beans, peas, chickpeas,
and lentils).
Vegetarian Toddlers
Toddlers are already a challenge when it comes to eating. As they
come off of breast milk or formula, kids are at risk for nutritional de-
ficiencies. After the age of 1, strict vegan diets may not offer growing
toddlers enough essential vitamins and minerals, such as vitamin D,
vitamin B12, iron, calcium, and zinc. So it’s important to serve fortified
CEREALS AND NUTRIENT DENSE FOODS 6ITAMIN SUPPLEMENTATION IS RECOM-
mended for young children whose diets may not provide adequate
nutrients.
Toddlers are typically picky about which foods they’ll eat and,
as a result, some may not get enough calories from a vegetarian
diet to thrive. For vegan toddlers, the amount of vegetables needed
for proper nutrition and calories may be too bulky for their tiny
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
stomachs. During the picky toddler stage, it’s important for vegetar-
ian parents to make sure their young child eats enough calories.
You can get enough fat and calories in a vegan child’s diet, but you
have to plan carefully.
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Diet-Based Therapies
A Healthy Lifestyle
A vegetarian diet can be a healthy choice for all kids, as long as it’s
properly planned.
The principles of planning a vegetarian diet are the same as plan-
ning any healthy diet—provide a variety of foods and include foods
from all of the food groups. A balanced diet will provide the right com-
binations to meet nutritional needs. But be aware of potential nutrient
deficiencies in your child’s diet and figure out how you’ll account for
them. With a little exploration, you may find more vegetarian options
than you realized.
If you aren’t sure your child is getting all necessary nutrients or
if you have any questions about vegetarian diets, check in with your
family doctor, pediatrician, or a registered dietitian.
283
Chapter 40
Oxygen Therapy
Overview
Hyperbaric oxygen therapy (HBOT) is the inhalation of 100 percent
oxygen inside a hyperbaric chamber that is pressurized to greater than
1 atmosphere (atm). HBOT causes both mechanical and physiologic
effects by inducing a state of increased pressure and hyperoxia.
HBOT is typically administered at 1 to 3 atm. While the duration of
an HBOT session is typically 90 to 120 minutes, the duration, frequen-
cy, and cumulative number of sessions have not been standardized.
HBOT is administered in two primary ways, using a monoplace cham-
ber or a multiplace chamber. The monoplace chamber is the less-costly
option for initial setup and operation but provides less opportunity for
patient interaction while in the chamber. Multiplace chambers allow
medical personnel to work in the chamber and care for acute patients
to some extent. The entire multiplace chamber is pressurized, so medi-
cal personnel may require a controlled decompression, depending on
how long they were exposed to the hyperbaric air environment.
The purpose of this text is to provide a guide to the strengths and
limitations of the evidence about the use of HBOT to treat patients who
have brain injury, cerebral palsy, and stroke. Brain injury can be caused by
an external physical force (also known as traumatic brain injury, or TBI);
Excerpted from “Hyperbaric Oxygen Therapy for Brain Injury, Cerebral Palsy,
and Stroke.” Summary, Evidence Report/Technology Assessment: Number 85.
AHRQ Publication Number 03-E049, September 2003. Agency for Healthcare Re-
search and Quality, Rockville, MD. http://www.ahrq.gov/clinic/epcsums/hypoxsum
.htm. Reviewed by David A. Cooke, MD, FACP, January 23, 2010.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
286
Oxygen Therapy
Findings
Brain Injury
s &OR TRAUMATIC BRAIN INJURY ONE RANDOMIZED TRIAL PROVIDED FAIR
evidence that HBOT might reduce mortality or the duration of
coma in severely injured TBI (traumatic brain injuries) patients.
However, in this trial, HBOT also increased the chance of a poor
functional outcome. A second fair quality randomized trial found
no difference in mortality or morbidity overall, but a significant
reduction in mortality in one subgroup. Therefore, they provide
insufficient evidence to determine whether the benefits of
HBOT outweigh the potential harms.
s 4HE QUALITY OF THE CONTROLLED TRIALS WAS FAIR MEANING THAT DEl-
ciencies in the design add to uncertainty about the validity of
results.
s $UE TO mAWS IN DESIGN OR SMALL SIZE THE OBSERVATIONAL STUDIES OF
HBOT in TBI do not establish a clear, consistent relationship be-
tween physiologic changes after HBOT sessions and measures of
clinical improvement.
s 4HE EVIDENCE FOR USE OF ("/4 IN OTHER TYPES OF BRAIN INJURY IS
inconclusive. No good- or fair-quality studies were found.
Cerebral Palsy
s 4HERE IS INSUFlCIENT EVIDENCE TO DETERMINE WHETHER THE USE OF
HBOT improves functional outcomes in children with cerebral
palsy. The results of the only truly randomized trial were diffi-
cult to interpret because of the use of pressurized room air in the
control group. As both groups improved, the benefit of pressur-
ized air and of HBOT at 1.3 to 1.5 atm should both be examined
in future studies.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Stroke
s !LTHOUGH A LARGE NUMBER OF STUDIES ADDRESS ("/4 FOR THE
treatment of stroke, the evidence is insufficient to determine
whether HBOT reduces mortality in any subgroup of stroke
patients because no controlled trial assessed was designed to
assess mortality.
s !MONG CONTROLLED TRIALS THE EVIDENCE ABOUT MORBIDITY IS CONmICT-
ing. The three best-quality trials found no difference in neuro-
logical measures in patients treated with HBOT versus patients
treated with pressurized room air.
s 4WO OTHER CONTROLLED TRIALS ONE RANDOMIZED AND ONE NONRANDOM-
ized, found that HBOT improved neurological outcomes on some
measures. However, both were rated poor-quality.
s -OST OBSERVATIONAL STUDIES REPORTED FAVORABLE AND SOMETIMES
dramatic, results, but failed to prove that these results can be at-
tributed to HBOT. For example, one retrospective study found
better mortality rates in patients who received HBOT than a com-
parison group of patients from a different hospital who did not. The
study did not provide information on mortality rates from other
causes in each hospital; this information would have made it easier
to judge whether the improved survival was due to HBOT or to
differences in overall quality of care at the HBOT hospital.
s 4HE OBSERVATIONAL STUDIES OF ("/4 PROVIDED INSUFlCIENT EVIDENCE
to establish a clear relationship between physiologic changes after
HBOT sessions and measures of clinical improvement. Few stud-
ies established that patients were stable at baseline.
288
Oxygen Therapy
Adverse Events
s %VIDENCE ABOUT THE TYPE FREQUENCY AND SEVERITY OF ADVERSE
events in actual practice is inadequate. Reporting of adverse ef-
fects was limited, and no study was designed specifically to as-
sess adverse effects.
s 4HE FEW DATA THAT ARE AVAILABLE FROM CONTROLLED TRIALS AND COHORT
studies of TBI suggest that the risk of seizure may be higher in
patients with brain injuries treated with HBOT.
s .O STUDY OF ("/4 FOR BRAIN INJURY CEREBRAL PALSY OR STROKE HAS
been designed to identify the chronic neurologic complications.
s 0ULMONARY COMPLICATIONS WERE RELATIVELY COMMON IN THE TRIALS
of brain-injured patients. There are no reliable data on the in-
cidence of aspiration in children treated for cerebral palsy with
hyperbaric oxygen.
s %AR PROBLEMS ARE A KNOWN POTENTIAL ADVERSE EFFECT OF ("/4
While ear problems were reported in brain injury, cerebral palsy,
and stroke studies the incidence, severity, and effect on outcome
are not clear. However, the rates reported among cerebral palsy
patients were higher (up to 47 percent experiencing a problem)
than reported with brain injury or stroke. However, the data in
brain injury are limited by the use of prophylactic myringotomies.
289
Part Five
Mind-Body Medicine
Chapter 41
Mind-Body Medicine:
An Overview
293
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Background
The concept that the mind is important in the treatment of illness is
integral to the healing approaches of traditional Chinese and Ayurvedic
medicine, dating back more than 2,000 years. It was also noted by Hip-
pocrates, who recognized the moral and spiritual aspects of healing, and
believed that treatment could occur only with consideration of attitude,
environmental influences, and natural remedies (ca. 400 BC). While this
integrated approach was maintained in traditional healing systems in the
East, developments in the Western world by the 16th and 17th centuries
led to a separation of human spiritual or emotional dimensions from the
physical body. This separation began with the redirection of science, dur-
ing the Renaissance and Enlightenment eras, to the purpose of enhancing
humankind’s control over nature. Technological advances (e.g., microscopy,
the stethoscope, the blood pressure cuff, and refined surgical techniques)
demonstrated a cellular world that seemed far apart from the world of
belief and emotion. The discovery of bacteria and, later, antibiotics further
dispelled the notion of belief influencing health. Fixing or curing an illness
became a matter of science (i.e., technology) and took precedence over, not
a place beside, healing of the soul. As medicine separated the mind and
the body, scientists of the mind (neurologists) formulated concepts, such
as the unconscious, emotional impulses, and cognitive delusions, that
solidified the perception that diseases of the mind were not “real,” that
is, not based in physiology and biochemistry.
In the 1920s, Walter Cannon’s work revealed the direct relation-
ship between stress and neuroendocrine responses in animals. Coining
the phrase “fight or flight,” Cannon described the primitive reflexes of
sympathetic and adrenal activation in response to perceived danger
and other environmental pressures (e.g., cold, heat). Hans Selye fur-
ther defined the deleterious effects of stress and distress on health. At
the same time, technological advances in medicine that could identify
specific pathological changes, and new discoveries in pharmaceuticals,
were occurring at a very rapid pace. The disease-based model, the search
for a specific pathology, and the identification of external cures were
paramount, even in psychiatry.
During World War II, the importance of belief reentered the web of
health care. On the beaches of Anzio, morphine for the wounded soldiers
was in short supply, and Henry Beecher, MD, discovered that much of the
pain could be controlled by saline injections. He coined the term “placebo
effect,” and his subsequent research showed that up to 35 percent of a
therapeutic response to any medical treatment could be the result of belief.
Investigation into the placebo effect and debate about it are ongoing.
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Mind-Body Medicine: An Overview
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
296
Mind-Body Medicine: An Overview
This result suggests that the placebo response involves the secretion
of dopamine, which is known to be important in a number of other re-
inforcing and rewarding conditions, and that there may be mind-body
strategies that could be used in patients with Parkinson disease in lieu
of or in addition to treatment with dopamine-releasing drugs.
Surgical Preparation
Mind-body interventions are being tested to determine whether
they can help prepare patients for the stress associated with surgery.
Initial randomized controlled trials—in which some patients received
audiotapes with mind-body techniques (guided imagery, music, and
instructions for improved outcomes) and some patients received con-
trol tapes—found that subjects receiving the mind-body intervention
recovered more quickly and spent fewer days in the hospital.
Behavioral interventions have been shown to be an efficient means
of reducing discomfort and adverse effects during percutaneous vas-
cular and renal procedures. Pain increased linearly with procedure
time in a control group and in a group practicing structured attention,
but remained flat in a group practicing a self-hypnosis technique. The
self-administration of analgesic drugs was significantly higher in the
control group than in the attention and hypnosis groups. Hypnosis
also improved hemodynamic stability.
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Conclusion
Evidence from randomized controlled trials and, in many cases,
systematic reviews of the literature, suggest the following:
s -ECHANISMS MAY EXIST BY WHICH THE BRAIN AND CENTRAL NERVOUS
system influence immune, endocrine, and autonomic functioning,
which is known to have an impact on health.
s -ULTICOMPONENT MIND BODY INTERVENTIONS THAT INCLUDE
some combination of stress management, coping skills train-
ing, cognitive-behavioral interventions, and relaxation therapy
may be appropriate adjunctive treatments for coronary artery
disease and certain pain-related disorders, such as arthritis.
s -ULTIMODAL MIND BODY APPROACHES SUCH AS COGNITIVE BEHAVIORAL
therapy, particularly when combined with an educational/infor-
mational component, can be effective adjuncts in the manage-
ment of a variety of chronic conditions.
s !N ARRAY OF MIND BODY THERAPIES EG IMAGERY HYPNOSIS RELAX-
ation), when employed presurgically, may improve recovery time
and reduce pain following surgical procedures.
s .EUROCHEMICAL AND ANATOMICAL BASES MAY EXIST FOR SOME OF THE
effects of mind-body approaches.
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Chapter 42
Art Therapy
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300
Art Therapy
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302
Chapter 43
Biofeedback
What is biofeedback?
Biofeedback is a mind-body technique using electronic instruments
to help individuals gain awareness and control over their body and
mind. Biofeedback instruments measure muscle activity, skin tem-
perature, electrodermal activity, respiration, heart rate, blood pressure,
brain electrical activity, and brain blood flow. Biofeedback is useful
in medical care, mental health treatment, physical and occupational
therapy, dental care, and education.
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Anyone who is suffering from life stress and anxiety can benefit
from biofeedback strategies for physical and mental relaxation. Any-
one suffering from medical problems that are caused or aggravated
by stress will benefit from biofeedback. In addition, individuals with
many organic medical problems, such as spinal injury related motor
control problems, may find that biofeedback helps them compensate
for their medical condition and function better.
304
Biofeedback
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306
Biofeedback
treatment for ADHD, reports that most of his patients function for
years with improved attention, and only occasionally come back for a
short refresher course. Some problems, like migraine headache, may
require extensive additional treatment at various times in life.
How many sessions are needed and generally what is the cost?
The length of treatment varies depending on the presenting prob-
lem. For most mental health problems and many medical problems
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References
Lawlis, G.F. (2001). Biofeedback (pp. 196–224). In L.W. Freeman, &
G.F. Lawlis (2001). Mosby’s Complementary and alternative medi-
cine: A research based approach. St. Louis, MO: Mosby.
Shellenberger, R., Amar, P., Schneider., P., & Turner, J. (1994). Clini-
cal efficacy and cost effectiveness of biofeedback therapy. Guidelines
for third party reimbursement. Wheat Ridge, Co.: Association for Ap-
plied Psychophysiology and Biofeedback.
308
Biofeedback
309
Chapter 44
Physical Interventions
Weakness, muscle wasting, and muscle/bone pain may be treated
with heat (a hot pack or heating pad); cold (flexible ice packs); massage,
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312
Deep Breathing Exercises
Relaxation Exercises
The following relaxation exercises may be helpful in relieving pain.
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Especially for the elderly person, a back rub that effectively pro-
duces relaxation may consist of no more than 3 minutes of slow,
rhythmic stroking (about 60 strokes per minute) on both sides of the
spine, from the crown of the head to the lower back. Continuous hand
contact is maintained by starting one hand down the back as the
other hand stops at the lower back and is raised. Set aside a regular
time for the massage. This gives the patient something pleasant to
anticipate.
Additional points: Some of the things that may comfort you, such as
your favorite music or a prayer, can probably be recorded for you. Then
you can listen to the tape whenever you wish. Or, if your memory is
strong, you may simply close your eyes and recall the events or words.
314
Deep Breathing Exercises
315
Chapter 45
Feng Shui
What Is It?
Feng shui is the study of how humans interact with their environ-
ment. More specifically feng shui is all about creating an atmosphere
in buildings in which the people who use them can best succeed. Feng
shui is based on the premise that human beings contain and are sur-
rounded by a subtle field of electromagnetic energy known as chi in
China. This can be photographed using Kirlian Photography and looks
like a multi colored gas flame around any living creature. In humans
the color and shape changes depending on emotional responses, so this
energy can be said to contain some of a person’s emotional energy.
In China this energy is called chi and chi is widely used in most
traditional oriental humanistic pursuits; including acupuncture, chi
GONG ;QIGONG= SHIATSU 2EIKI MARTIAL ARTS AND FENG SHUI 4HE IDEA IN
feng shui is that each building has its own atmospheric chi and that
this energy will influence the chi energy field around the human body.
Once a person interacts with the energy of a building he or she will
begin to feel different.
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something changes your chi you will find that you feel and think differ-
ently. Each building has its own atmosphere and this energy will influence
your own chi energy field. For example you will feel different standing in
a large empty cathedral and sitting in a small crowded cafe.
The aim of modern feng shui is to create buildings in which people
will be able to best succeed in that environment. Therefore the only
question a feng shui consultant will be interested in is how will people
who use the space feel whilst they are there and what kind of human
feelings will best help each person succeed.
318
Feng Shui
see the door to the office and any windows. This means most of what
is happening in an office is going on in front of the person and he or
she can feel protected from behind by a wall.
319
Chapter 46
Guided Imagery
and Hypnosis
Chapter Contents
Section 46.1—Guided Imagery................................................... 322
Section 46.2—Hypnosis .............................................................. 324
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Section 46.1
Guided Imagery
“Guided Imagery,” © Center for Integrative Health and Healing. Reprinted with
permission. For additional information, visit www.cihh.net. The date of this
document is unknown. The text that follows this document under the heading
“Health Reference Series Medical Advisor’s Notes and Updates” was provided to
Omnigraphics, Inc. by David A. Cooke, MD, FACP, January 23, 2010. Dr. Cooke
is not affiliated with the Center for Integrative Health and Healing.
Train your brain to improve your health. While that may sound
funny, it’s a powerful technique you can use to heal your body and
even prevent the onset of disease. It’s called guided imagery and it’s a
remarkable trend in holistic medicine.
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Section 46.2
Hypnosis
“Hypnosis Today: Looking beyond the media portrayal,” American Psycho-
logical Association Position Paper (2008), http://www.apa.org/releases/
hypnosis.html. Copyright © 2008 by the American Psychological As-
sociation. Reproduced with permission. No further reproduction or dis-
tribution is permitted without written permission from the American
Psychological Association.
While you may think of hypnosis as something you see only in the
movies or novels, hypnosis is used in real life as part of the treatment
plan for people with numerous health ailments ranging from depres-
sion to gastrointestinal disorders. Based on research showing that
hypnosis can help people manage—and in some cases recover from
illness, hypnosis is becoming a more common part of many patients’
recommended health treatment.
Definition
According to the American Psychological Association (APA)’s Divi-
sion of Psychological Hypnosis, hypnosis is a procedure during which a
health professional or researcher suggests while treating someone that
he or she experience changes in sensations, perceptions, thoughts, or
behavior. Although some hypnosis is used to make people more alert,
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Guided Imagery and Hypnosis
Is Hypnosis Therapy?
Hypnosis is not a type of psychotherapy. It also is not a treatment
in and of itself; rather, it is a procedure that can be used to facilitate
other types of therapies and treatments. Clinical hypnosis should
be conducted only by properly trained and credentialed health care
professionals (e.g., psychologists) who also have been trained in the
use of hypnosis and who are working within the limits of their pro-
fessional expertise.
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326
Guided Imagery and Hypnosis
327
Chapter 47
Meditation
Overview
The term meditation refers to a group of techniques, such as man-
tra meditation, relaxation response, mindfulness meditation, and Zen
Buddhist meditation. Most meditative techniques started in Eastern
religious or spiritual traditions. These techniques have been used by
many different cultures throughout the world for thousands of years.
Today, many people use meditation outside of its traditional religious
or cultural settings, for health and wellness purposes.
In meditation, a person learns to focus attention. Some forms of
meditation instruct the practitioner to become mindful of thoughts,
feelings, and sensations and to observe them in a nonjudgmental way.
This practice is believed to result in a state of greater calmness and
From “Meditation: An Introduction,” by the National Center for Complemen-
tary and Alternative Medicine (NCCAM, nccam.nih.gov), part of the National
Institutes of Health, February 2009.
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330
Meditation
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332
Meditation
NCCAM-Supported Research
Some recent NCCAM-supported studies have been investigating
meditation for the following:
s 2ELIEVING STRESS IN CAREGIVERS FOR ELDERLY PATIENTS WITH DEMENTIA
s 2EDUCING THE FREQUENCY AND INTENSITY OF HOT mASHES IN MENO-
pausal women
s 2ELIEVING SYMPTOMS OF CHRONIC BACK PAIN
s )MPROVING ATTENTION RELATED ABILITIES ALERTING FOCUSING AND
prioritizing)
s 2ELIEVING ASTHMA SYMPTOMS
333
Chapter 48
Music Therapy
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336
Music Therapy
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338
Music Therapy
Examples:
s Arizona: Medicaid coverage for music therapy provided to indi-
viduals with developmental disabilities; originally recognized as a
habilitation service but also considered as a socialization service.
s Minnesota: Individual music therapist received provider
number to service clients with mental illness and developmental
disabilities. Waiver program for children with developmental
disabilities provides coverage for music therapy.
s Pennsylvania: Department of Aging Waiver program allows
Medicaid payment for music therapy provided in a community
based setting. Music therapy is listed under health and mental
health related counseling services.
s North Carolina: Medicaid reimbursement is available for
music therapy services through the Community Alternatives
Program (CAP) for clients with developmental disabilities.
s Indiana: Waiver program for children with developmental
disabilities offers coverage for music therapy.
s Michigan: Music therapy is a covered service under the state’s
Medicaid Children’s Waiver Program.
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340
Chapter 49
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coping. Many caregivers also rely on spiritual coping. Each person may
have different spiritual needs, depending on cultural and religious
traditions. Some patients and their family caregivers may want doc-
tors to talk about spiritual concerns, but may feel unsure about how
to bring up the subject.
There is a growing understanding that doctors’ support of spiritual
well-being in very ill patients helps improve their quality of life. Health
care providers who treat patients coping with cancer are looking at
new ways to help them with religious and spiritual concerns. Doctors
may ask patients which spiritual issues are important to them, not
only for end-of-life issues but also during treatment.
342
Prayer and Spirituality
Spiritual Assessment
A spiritual assessment may help the doctor understand
how religious or spiritual beliefs will affect the way a
patient copes with cancer.
A spiritual assessment is a method or tool used by doctors to under-
stand the role that religious and spiritual beliefs have in the patient’s
life. This may help the doctor understand how these beliefs affect the way
the patient responds to the cancer diagnosis and decisions about cancer
treatment. Some doctors or caregivers may wait for the patient to bring
up spiritual concerns. Others may use an interview or a questionnaire.
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344
Chapter 50
Relaxation Training
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Everyday Meditation
Eliciting the relaxation response is simple, he explained: Once
or twice a day for 10 to 20 minutes, sit in a relaxed position, eyes
closed, and repeat a word or sound as you breathe. Some people use
such words as “love” or “peace.” Others say traditional prayers. If your
thoughts stray—which is normal and expected—just refocus on the
word repetition.
There are scores of other ways to summon the relaxation response,
as well, said Benson. “Anything that breaks the train of everyday
thought will evoke this physiological state.”
That includes participating in repetitive sports such as running, let-
ting go of tension through progressive muscular relaxation, practicing
yoga, knitting, crocheting, even playing musical instruments.
“You know how when you play an instrument and you become ‘one’
with that instrument and the time flits away? That is the relaxation
response,” he said. “You know the high you get from running? That
is the relaxation response coming about by the repetitive motion of
your footfall.”
346
Relaxation Training
Further Reading
For more information on Benson’s work and the relaxation response,
visit the Massachusetts General Hospital Benson-Henry Institute
for Mind Body Medicine at www.massgeneral.org/bhi.
Benson’s newest research, “Genomic Counter-Stress Changes In-
DUCED BY THE 2ELAXATION 2ESPONSE v APPEARS IN THE *ULY ;= EDI-
tion of PLoS One at www.plosone.org.
347
Chapter 51
Tai Chi
Overview
Tai chi developed in ancient China. It started as a martial art and
a means of self-defense. Over time, people began to use it for health
purposes as well.
Accounts of the history of tai chi vary. A popular legend credits its
origins to Chang San-Feng, a Taoist monk, who developed a set of 13 ex-
ercises that imitate the movements of animals. He also emphasized medi-
tation and the concept of internal force (in contrast to the external force
emphasized in other martial arts, such as kung fu and tae kwon do).
The term “tai chi” (shortened from “tai chi chuan”) has been trans-
lated in various ways, such as “internal martial art” and “supreme
ultimate fist.” It is sometimes called “taiji” or “taijiquan.”
Tai chi incorporates the Chinese concepts of yin and yang (opposing
forces within the body) and qi (a vital energy or life force). Practicing
tai chi is said to support a healthy balance of yin and yang, thereby
aiding the flow of qi.
Excerpted from “Tai Chi: An Introduction,” by the National Center for
Complementary and Alternative Medicine (NCCAM, nccam.nih.gov), part of the
National Institutes of Health, April 2009.
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350
Tai Chi
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NCCAM-Funded Research
NCCAM has supported studies of tai chi’s effects on the following:
s "ONE LOSS IN POSTMENOPAUSAL WOMEN
s #ANCER SURVIVORS
s $EPRESSION IN ELDERLY PATIENTS
s &IBROMYALGIA SYMPTOMS SUCH AS MUSCLE PAIN FATIGUE AND
insomnia
s /STEOARTHRITIS OF THE KNEE
s 0ATIENTS WITH CHRONIC HEART FAILURE
s 2HEUMATOID ARTHRITIS
352
Chapter 52
Yoga
Overview
Yoga in its full form combines physical postures, breathing exercis-
es, meditation, and a distinct philosophy. Yoga is intended to increase
relaxation and balance the mind, body, and the spirit.
Early written descriptions of yoga are in Sanskrit, the classical
language of India. The word “yoga” comes from the Sanskrit word yuj,
which means “yoke or union.” It is believed that this describes the
union between the mind and the body. The first known text, The Yoga
Sutras, was written more than 2,000 years ago, although yoga may
have been practiced as early as 5,000 years ago. Yoga was originally
developed as a method of discipline and attitudes to help people reach
spiritual enlightenment. The Sutras outline eight limbs or foundations
of yoga practice that serve as spiritual guidelines:
s 9AMA MORAL BEHAVIOR
s .IYAMA HEALTHY HABITS
Excerpted from “Yoga for Health: An Introduction,” by the National Center
for Complementary and Alternative Medicine (NCCAM, nccam.nih.gov), part of
the National Institutes of Health, May 2008.
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354
Yoga
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NCCAM-Funded Research
Recent studies supported by NCCAM have been investigating yoga’s
effects on the following:
s "LOOD PRESSURE
s #HRONIC LOW BACK PAIN
s #HRONIC OBSTRUCTIVE PULMONARY DISEASE
s $EPRESSION
s $IABETES RISK
s ()6 ;HUMAN IMMUNODElCIENCY VIRUS=
s )MMUNE FUNCTION
s )NmAMMATORY ARTHRITIS AND KNEE OSTEOARTHRITIS
s )NSOMNIA
s -ULTIPLE SCLEROSIS
s 3MOKING CESSATION
356
Chapter 53
Other Mind-Body
Medicine Therapies
Chapter Contents
Section 53.1—Color Therapy ...................................................... 358
Section 53.2—Dance Therapy .................................................... 359
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Section 53.1
Color Therapy
From “Chromotherapy,” © 2009 Natural Medicines Comprehensive
Database (www.naturaldatabase.com). Reprinted with permission.
www.naturaldatabase.com.
What is it?
Chromotherapy, or color therapy, is the use of color to treat medical
conditions.
Is it effective?
Natural Medicines Comprehensive Database rates effectiveness
based on scientific evidence according to the following scale: effective,
likely effective, possibly effective, possibly ineffective, likely ineffective,
and insufficient evidence to rate.
The effectiveness ratings for chromotherapy are as follows:
s )NSUFlCIENT EVIDENCE TO RATE EFFECTIVENESS FOR
s DEPRESSION ANXIETY STRESS FATIGUE PAIN CRAMPS HEADACHE
migraine headache, diabetes, hypertension, asthma, cough,
and many other conditions.
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Other Mind-Body Medicine Therapies
Section 53.2
Dance Therapy
“What Is Dance/Movement Therapy?” © 2009 American Dance Therapy
Association (www.adta.org). Reprinted with permission.
Based on the understanding that the body and mind are interrelated,
THE !MERICAN $ANCE 4HERAPY !SSOCIATION ;!$4!= DElNES DANCEMOVE-
ment therapy as the psychotherapeutic use of movement to further the
emotional, cognitive, physical, and social integration of the individual.
Dance/movement therapy is practiced in mental health, rehabilita-
tion, medical, educational, and forensic settings, and in nursing home,
day care center, disease prevention, private practice, and health pro-
motion programs.
The dance/movement therapist focuses on movement behavior as it
emerges in the therapeutic relationship. Expressive, communicative,
and adaptive behaviors are all considered for both group and individual
treatment. Body movement as the core component of dance simultane-
ously provides the means of assessment and the mode of intervention
for dance/movement therapy.
Board Certified
The Dance/Movement Therapy Certification Board, Inc. follows
standards of the National Organization for Competency Assurance,
and awards the R-DMT (Registered-Dance/Movement Therapist) to
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Professional Training
Professional training of dance/movement therapists occurs on the
graduate level. ADTA has established an approval procedure for grant-
ing recognition to those institutions that fulfill the guidelines for mas-
ter’s degree programs in dance/movement therapy. Prerequisite study
includes Psychology, Anatomy and Kinesiology, and extensive dance
experience.
Course content includes: Dance/Movement Therapy Theory; Devel-
opment, Expressive, and Communicative Aspects of Verbal and Non-
verbal Behavior; Methods for Observation, Analysis, and Assessment;
Psychopathology and Diagnosis; Group Processes; Human Growth, De-
velopment, and Behavior; Research in Dance/Movement Therapy and
Human Behavior; Clinical Applications of Dance/Movement Therapy
and Related Psychological Theories; Clinical Fieldwork; Supervised
Clinical Internship.
360
Part Six
Manipulative and
Body-Based Therapies
Chapter 54
Manipulative and
Body-Based Therapies:
An Overview
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Primary Challenges
Different challenges face investigators studying mechanisms of ac-
tion than those studying efficacy and safety. The primary challenges
that have impeded research on the underlying biology of manual thera-
pies include the following:
s ,ACK OF APPROPRIATE ANIMAL MODELS
s ,ACK OF CROSS DISCIPLINARY COLLABORATIONS
s ,ACK OF RESEARCH TRADITION AND INFRASTRUCTURE AT SCHOOLS THAT
teach manual therapies
s )NADEQUATE USE OF STATE OF THE ART SCIENTIlC TECHNOLOGIES
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paraspinal tissues. Sensory input from these tissues has the capacity
to reflexively alter the neural outflow to the autonomic nervous system.
Studies are under way to determine whether input from the paraspinal
tissue also modulates pain processing in the spinal cord.
Animal models have also been used to study the mechanisms of
massage-like stimulation. It has been found that antinociceptive and
cardiovascular effects of massage may be mediated by endogenous opi-
oids and oxytocin at the level of the midbrain. However, it is not clear
that the massage-like stimulation is equivalent to massage therapy.
Although animal models of chiropractic manipulation and mas-
sage have been established, no such models exist for other body-based
practices. Such models could be critical if researchers are to evaluate
the underlying anatomical and physiological changes accompanying
these therapies.
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Risks
There are some risks associated with manipulation of the spine,
but most reported side effects have been mild and of short duration.
Although rare, incidents of stroke and vertebral artery dissection have
been reported following manipulation of the cervical spine. Despite the
fact that some forms of massage involve substantial force, massage is
generally considered to have few adverse effects. Contraindications for
massage include deep vein thrombosis, burns, skin infections, eczema,
open wounds, bone fractures, and advanced osteoporosis.
Utilization/Integration
In the United States, manipulative therapy is practiced primarily
by doctors of chiropractic, some osteopathic physicians, physical thera-
pists, and physiatrists. Doctors of chiropractic perform more than 90
percent of the spinal manipulations in the United States, and the vast
majority of the studies that have examined the cost and utilization of
spinal manipulation have focused on chiropractic.
Individual provider experience, traditional use, or arbitrary payer
capitation decisions—rather than the results of controlled clinical trials—
determine many patient care decisions involving spinal manipulation.
More than 75 percent of private payers and 50 percent of managed care
organizations provide at least some reimbursement for chiropractic care.
Congress has mandated that the Department of Defense (DOD) and the
Department of Veterans Affairs provide chiropractic services to their
beneficiaries, and there are DOD medical clinics offering manipulative
services by osteopathic physicians and physical therapists. The State of
Washington has mandated coverage of CAM services for medical condi-
tions normally covered by insurance. The integration of manipulative ser-
vices into health care has reached this level despite a dearth of evidence
about long-term effects, appropriate dosing, and cost-effectiveness.
Although the numbers of Americans using chiropractic and massage
are similar, massage therapists are licensed in fewer than 40 states,
and massage is much less likely than chiropractic to be covered by
HEALTH INSURANCE ,IKE SPINAL MANIPULATION MASSAGE IS MOST COM-
monly used for musculoskeletal problems. However, a significant frac-
tion of patients seek massage care for relaxation and stress relief.
Cost
A number of observational studies have looked at the costs as-
sociated with chiropractic spinal manipulation in comparison with
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Manipulative and Body-Based Therapies: An Overview
Patient Satisfaction
Although there are no studies of patient satisfaction with manip-
ulation in general, numerous investigators have looked at patient
satisfaction with chiropractic care. Patients report very high levels of
satisfaction with chiropractic care. Satisfaction with massage treat-
ment has also been found to be very high.
369
Chapter 55
Alexander Technique
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372
Alexander Technique
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374
Alexander Technique
What do I wear?
You come to your Alexander lesson wearing loose, comfortable
clothing.
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376
Alexander Technique
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378
Alexander Technique
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380
Alexander Technique
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What is AmSAT?
The American Society of the Alexander Technique is the largest pro-
fessional association of certified Alexander Technique teachers in the
United States. Its mission is to maintain the integrity of the Alexander
Technique as developed by F.M. Alexander (1869–1955). AmSAT main-
tains the nation’s highest standards for teacher training, certification,
and membership and maintains affiliations with similar credentialing
bodies worldwide. Since its formation in 1987, over 1,200 teachers have
completed a rigorous training process to earn AmSAT certification.
382
Chapter 56
Aquatic Therapy
(Hydrotherapy)
Definition of Hydrotherapy
Hydrotherapy is the use of water by external applications, either
for its pressure effect or as a means of applying physical energy to a
tissue. The term often refers to the use of water in wound manage-
ment, such as whirlpool baths, but can be used interchangeably with
the term, “aquatic therapy.”
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
including pool entry and exit and swimming skill development, and
should also encompass community referral.
384
Aquatic Therapy (Hydrotherapy)
Ai Chi Ne
Ai Chi Ne (pronounced Eye Chee Knee) is a partner stretching pro-
gram. “Ne” is the Japanese word for “two.” Ai Chi Ne involves breathing
techniques to increase relaxation and therefore enhance the stretch
abilities. Using the breathing techniques decreases stress, joint ten-
sion, muscular tension, and the stretch reflex response.
BackHab
This is an integrated program that the individual can do on his or
her own. It was developed for people with back problems but is now
being used by group programs for people with disabilities. Rather than
focusing on healing one part of the body, all the body parts coordinate
to work on healing and fixing the affected area. BackHab is an aquatic
walking program using various strides to accomplish a variety of ben-
efits. It is excellent for gait re-training.
Bad Ragaz
This technique originated in Germany in 1957 and was introduced
by a German therapist to the therapeutic thermal pools of Bad Ragaz
in Switzerland. The technique has since become more clearly defined
as the Bad Ragaz Ring Method. Bad Ragaz is a method of muscle re-
education utilizing specific patterns of resistance, endurance, elonga-
tion, relaxation, range of motion, and tonal reduction.
Feldenkrais
Developed by Dr. Moshe Feldenkrais, this method uses gentle move-
ment and directed attention to improve movement and enhance human
functioning. This method aims to increase ease and range of motion,
improve flexibility and coordination, and encourage the individual
to rediscover innate capacity for graceful, efficient movement. These
improvements will often generalize to enhance functioning in other
aspects of life.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Halliwick
The Halliwick concept is an approach to teaching people with physi-
cal and/or learning difficulties to participate in water activities, to move
independently in water, and to swim. The practice utilizes the Ten Point
Program, which includes essential components of motor learning, and even-
tually leads to independence in the water. The Ten Point Program includes
the concepts of mental adjustment, balance control, and movement.
Lyu Ki Dou
,YU +I $OU DEVELOPED FROM STUDIES OF VARIOUS HANDS ON HEALING
modalities, along with Ai Chi, Tai Chi, and Qi Gong. The name was
DERIVED FROM THE *APANESE TRANSLATION OF h&LOATING ,IFE %NERGY 0ATH-
WAYSv ,YU +I $OU EMPHASIZES THE FACILITATORS SELF CARE WHICH IN TURN
will benefit the clients/patients that are receiving any type of therapy
or exercise programming from an individual who has literally “turned
on” this vital life-giving energy source that is inside each of us.
Massage
Massage therapists have moved their practice to the water to ex-
pand the benefits and applications of massage. Water massage, the use
of soft tissue manipulation and body mobilization techniques in water
warmer than skin temperature (92 degrees Fahrenheit–93 degrees
Fahrenheit), is evolving as a therapeutic method. Practitioners find
that the use of massage in water is creative, innovative, and individu-
alized, and no two practitioners have the same approach.
Water Pilates
Pilates exercises have been adapted for the pool. Created by Joseph
Pilates, this body conditioning program is designed to improve strength,
flexibility, and range of motion, and also encourages musculoskeletal
alignment. The main tenets are resisting your own weight, controlled
breathing, spine alignment, and abdominal strengthening.
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Aquatic Therapy (Hydrotherapy)
Wassertanzen
Wassertanzen is a dynamic movement therapy that includes work below
the water surface with the aid of nose clips. Wassertanzen means “water
dance” and was created in 1987 by Swiss-Germans Arjana Brunschwiler
and Aman Schroter. “Wassertanzen is very different from watsu because
of the challenge it presents for a person to surrender control of his breath
to go underwater,” says Harold Dull, creator of Watsu.
Water Yoga
Hatha yoga poses performed in warm, waist- to chest-depth water
develop strength and static balance simultaneously. In addition, range
of motion increases in coordination with diaphragmatic breathing and
long exhalations.
Watsu
Developed by Harold Dull, watsu (water + shiatsu) is a cradling, one-
on-one program that is experienced in a very warm (approx. 94 degrees
Fahrenheit) pool. The client is held in the water by the practitioner and
moved using the water to massage the body. Shiatsu (acupressure) points
are stimulated along the meridians of the body during the massage. Watsu
is used for pain reduction, increased range of motion, increased circulation,
psychological problems, relaxation, and reduction of stress. It has been
used in rehabilitation programs for people with orthopedic problems or
physical disabilities, for pregnant mothers, and the elderly.
Yogalates
Fluid Yogalates, developed by Dr. Mary Wykle, combines Iyengar
Yoga, Pilates, and Ai Chi. Static poses and core stabilization exercises are
transitioned with circular movements and emphasis on deep breathing
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Program Modifications
s 5SE FEWER REPS OF THE SAME MUSCLE GROUP WHEN BEGINNING
s #ENTER THE BODY BETWEEN TRANSITIONS
s 2EACH ACROSS THE MIDLINE AND OVERHEAD ACROSS
s 5SE HANDS BEHIND HEAD AND BODY
s -OVE BACKWARD AS WELL AS FORWARD
s %XERCISE TO IMPROVE POSTURE
s 5SE SLOW CONTROLLED MOVEMENT
s "EGIN WEIGHT BEARING ISSUES IN DEEPER WATER AND PROGRESS TO
shallower.
s %NTER WATER SLOWLY SO ALL SYSTEMS HAVE AN OPPORTUNITY TO
gradually accommodate the environment.
s +EEP MEDICATIONS AT POOL EDGE
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Aquatic Therapy (Hydrotherapy)
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Exercise: On Toes
s 'OAL "ALANCE COORDINATION EXPERIENCE OF AXIAL ELONGATION
s #ONSIDERATIONS %LIMINATE LEANING FORWARD KEEP mOWING NOT JERKY
s 0ROGRESSION ,ENGTHEN STRIDE
Exercise: On Heels
s 'OAL "ALANCE STRETCH OF CALF MUSCLES GASTROCNEMIUS
endurance of tibialis anterior
s #ONSIDERATIONS +EEP TORSO UPRIGHT KEEP mOWING NOT JERKY
s 0ROGRESSION .O ARMS
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Aquatic Therapy (Hydrotherapy)
Fluid Yogalates
Pose—Warrior II:
1. In waist- to chest-deep water, separate legs approximately 4 feet.
2. Turn the right foot to the side and come into a lunge position.
The right ankle and knee align. The right thigh should be al-
most parallel to the bottom of the pool. The back leg (left) con-
tinues to bear weight, pushing the energy flow up to the torso.
3. The torso remains upright and facing forward. It does not rotate.
4. The arms extend out from the shoulders. Extension continues
through the fingertips. The shoulders remain relaxed and down.
5. The head turns to look through the fingers of the leading arm.
Maintain this position for five or more slow breaths.
6. Repeat to the left side.
Challenges: It is difficult to adequately separate the legs and main-
tain balance. The leading knee has a tendency to rotate inward. The
body leans forward or backward if the weight is not distributed be-
tween the legs.
Progression: Hold for longer periods. Add variations such as Side
Angle Pose.
Pose—Warrior I:
1. In waist- to chest-deep water, separate legs approximately 4 feet.
2. Turn the right foot and leg to the side. Rotate the entire body
to the same side. The left leg and foot also turn in the same
direction. Insure the pelvis is squared to the side.
3. Bend the right knee, aligning the knee over the ankle. The left
leg remains straight.
4. Extend the arms above the head with palm facing each other
and hold for approximately five breaths.
5. Repeat to the left side.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Pose—Tree:
3TAND ERECT IN WAIST TO CHEST DEEP WATER ,OOK STRAIGHT AHEAD
2. Balancing on one leg, flex the knee of the opposite leg and lift
that foot to the inside of the supporting leg.
3. Arms bend into prayer position at chest level.
4. Gradually extend the arms overhead, keeping the palms
together. Body stays straight and appears to lengthen.
5. Begin by trying to hold the position for five breaths. Repeat on
the other side.
Challenges: Do not place the foot of the bent leg against the sup-
porting knee. Extend the arms overhead only when balance is secure.
Watch the body position because of a tendency to shift one hip to the
side to assist with balance.
0ROGRESSION (OLD FOR LONGER PERIODS ,ENGTHEN BODY AND ARMS
upward.
Ai Chi
Accepting:
1. Exhale easily through your mouth, turn your palms down,
bring the right arm over to the left so the thumbs of both hands
touch each other, while pivoting both feet 90 degrees left so you’re
facing the left side. Your weight is evenly balanced between
both legs.
2. While still facing left, inhale through your nose, turn your
palms up, and pull both arms back so that your rib cage feels
fully opened. At the same time, shift your weight back on the
right leg so that you’re leaning back slightly. The trunk must
be stable.
3. While still facing left, exhale through your mouth, turn your
palms down, and bring both arms together so the thumbs of
both hands touch each other. At the same time, shift your weight
forward onto the left leg so you’re leaning forward slightly.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
5. Inhale through your nose, turn your palms up, bring the right
arm back to the right side, while pivoting both feet 90 degrees
right so you’re facing front.
6. Exhale easily through your mouth, turn your palms down,
bring the left arm over to the right so the thumbs of both
hands touch each other, while pivoting both feet 90 degrees
right so you’re facing the right side. Your weight is evenly
balanced between both legs.
7. While still facing right, inhale through your nose, turn your
palms up, pull arms back so that your rib cage feels fully opened.
At the same time step your left leg back and shift your weight
back so you’re leaning back slightly.
8. While still facing right, exhale through your mouth, turn your
palms down, and bring both arms together so the thumbs of
both hands touch each other. At the same time, lift your left leg
straight in front of you and lean forward slightly. Bring toes
and fingertips together.
9. Repeat steps seven and eight, flowing smoothly 5 to 10 times.
10. Inhale through your nose, turn your palms up, bring the left arm
back to the left side, while pivoting both feet 90 degrees left so
you’re facing front.
Balancing:
1. Exhale easily through your mouth, turn your palms down,
bring the right arm over to the left so the thumbs of both hands
touch each other, while pivoting both feet 90 degrees left so
you’re facing the left side. Your weight is evenly balanced be-
tween both legs.
2. While still facing left, inhale through your nose, turn your
palms up, and press both arms down and back (bilateral shoulder
extension) with hands supinated. At the same time, lift your
right (back) leg forward and lean forward slightly.
3. While still facing left, exhale through your mouth, turn your
palms down, and lift both arms forward and up (bilateral shoul-
der flexion with hands pronated). At the same time, stretch the
RIGHT LEG BACK BUT DO NOT STEP IT DOWN ,EAN FORWARD 2EPEAT
steps two and three, flowing smoothly 5 to 10 times without
stepping the right leg down. Inhale through your nose, turn
your palms up, bring the right arm back to the right side,
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Aquatic Therapy (Hydrotherapy)
while stepping the right foot down and pivoting both feet 90
degrees right so you’re facing front.
4. Exhale easily through your mouth, turn your palms down,
bring the left arm over to the right so the thumbs of both
hands touch each other, while pivoting both feet 90 degrees
right so you’re facing the right side. Your weight is evenly
balanced between both legs.
5. While still facing right, inhale through your nose, turn your
palms up, and press both arms down and back (bilateral shoul-
der extension with hands supinated). At the same time, lift
your left (back) leg forward and lean forward slightly.
6. While still facing right, exhale through your mouth, turn
your palms down, and lift both arms forward and up (bilat-
eral shoulder flexion with hands pronated). At the same time,
STRETCH THE LEFT LEG BACK BUT DO NOT STEP IT DOWN ,EAN FORWARD
7. Repeat steps seven and eight, flowing smoothly 5 to 10 times
without stepping the left leg down.
8. Inhale through your nose, turn your palms up, bring the left
arm back to the left side, while pivoting both feet 90 degrees
left so you’re facing front.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Organizations
1. American Alliance for Health, Physical Education, Recreation,
and Dance [http://www.ncpad.org/organizations/index.php?id=
1056&state=Virginia&city=Reston], Reston, Virginia
2. American Red Cross [http://www.ncpad.org/organizations/index
.php?id=974&state=District of Columbia&city=Washington],
Washington, District of Columbia
3. Aquatic Exercise Association (AEA) [http://www.ncpad.org/
organizations/index.php?id=876&state=Florida&city=North
Venice], North Venice, Florida
4. Aquatic Resources Network [http://www.ncpad.org/organizations/
index.php?id=1517&state=Wisconsin&city=Amery], Amery,
Wisconsin
5. Aquatic Therapy and Rehab Institute (ATRI) [http://www
.ncpad.org/organizations/index.php?id=877&state=Florida&cit
y=West Palm Beach], West Palm Beach, Florida
6. International Council for Aquatic Therapy and Rehabilitation
[http://www.ncpad.org/organizations/index.php?id=1518&state
=Washington&city=Spokane], Spokane, Washington
7. Jeff Ellis & Associates [http://www.ncpad.org/organizations/index
.php?id=1058&state=Texas&city=Kingwood], Kingwood, Texas
8. National Therapeutic Recreation Society [http://www.ncpad
.org/organizations/index.php?id=920&state=Virginia&city=As
hburn], Ashburn, Virginia
9. Worldwide Aquatic Bodywork Association [http://www.ncpad
.org/organizations/index.php?id=1520&state=California&city=
Middletown], Middletown, California
10. Aquatic Consulting & Education Resource Services [http://www
.ncpad.org/organizations/index.php?id=1521&state=Wisconsin&ci
ty=Milwaukee], Milwaukee, Wisconsin
11. Aquatic Consulting Services [http://www.ncpad.org/organizations/
index.php?id=1522&state=California&city=San Diego], San Di-
ego, California
12. Aquatic Healing Services [http://www.ncpad.org/organizations/
index.php?id=1523&state=Virginia&city=Charlottesville],
Charlottesville, Virginia
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Aquatic Therapy (Hydrotherapy)
Suppliers
1. Adolf Kiefer and Associates [http://www.ncpad.org/suppliers/
index.php?id=651&state=Illinois&city=Zion], Zion, Illinois
2. Aqua Gear, Inc. [http://www.ncpad.org/suppliers/index.php?id=
752&state=Florida&city=West Palm Beach], West Palm Beach,
Florida
3. Blue Moon Aqua Products, TRMN Enterprises, Inc. [http://
www.ncpad.org/suppliers/index.php?id=753&state=Ohio&city=
Columbus], Columbus, Ohio
4. Danmar Products, Inc. [http://www.ncpad.org/suppliers/index
.php?id=351&state=Michigan&city=Ann Arbor], Ann Arbor,
Michigan
5. Ferno-Washington, Inc. [http://www.ncpad.org/suppliers/index
.php?id=754&state=Ohio&city=Wilmington], Wilmington, Ohio
6. Fitness Mart Country Technology, Inc. [http://www.ncpad.org/
suppliers/index.php?id=755&state=Wisconsin&city=Gays
Mills], Gays Mills, Wisconsin
7. Hydro-Fit, Inc. [http://www.ncpad.org/suppliers/index.php?id=6
54&state=Oregon&city=Eugene], Eugene, Oregon
8. Orthopedic Physical Therapy Products (OPTP) [http://www
.ncpad.org/suppliers/index.php?id=756&state=Minnesota&city
=Minneapolis], Minneapolis, Minnesota
9. Recreonics, Inc. [http://www.ncpad.org/suppliers/index.php?id=
STATE+ENTUCKYCITY,OUISVILLE= ,OUISVILLE +ENTUCKY
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Books
1. Sova, R. Ai Chi: Balance, Harmony and Healing.
2. Sova, R. & Harpt, S. (1996). BACKHAB: The Water Way to Mo-
bility and Pain Free Living. 7ASHINGTON 7ISCONSIN $3, ,TD
3. Wykle, M. Transitioning Yoga and Pilates to the Water.
4. Grosse, Susan J. The Halliwick Method: Water Freedom for
Individuals with Disabilities.
5. Grosse, Susan. Sponges, Splashes, and Sprinkles.
398
Chapter 57
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Patterns of Use
According to the 2007 National Health Interview Survey, which
included a comprehensive survey of CAM use by Americans, about 8
percent of American adults and nearly 3 percent of children had re-
ceived chiropractic or osteopathic manipulation in the past 12 months.
Adjusted to nationally representative numbers, these percentages
mean that more than 18 million adults and 2 million children received
chiropractic or osteopathic manipulation in the previous year.
Many people who seek chiropractic care have chronic, pain-related
HEALTH CONDITIONS ,OW BACK PAIN NECK PAIN AND HEADACHE ARE COMMON
conditions for which people seek chiropractic treatment.
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Chiropractic Care and Osteopathic Manipulation
s 2EHABILITATIVE EXERCISE
s #OUNSELING ABOUT DIET WEIGHT LOSS AND OTHER LIFESTYLE FACTORS
s $IETARY SUPPLEMENTS
Qualifications to Practice
To practice chiropractic care in the United States, a practitioner
must earn a Doctor of Chiropractic (D.C.) degree from a college ac-
credited by the Council on Chiropractic Education (CCE). CCE is the
agency certified by the U.S. Department of Education to accredit chi-
ropractic colleges in the United States. Admission to a chiropractic
college requires a minimum of 90 semester hour credits (approximately
3 years) of undergraduate study, mostly in the sciences.
Chiropractic training is a 4-year academic program that includes
both classroom work and direct experience caring for patients. Course-
work typically includes instruction in the biomedical sciences, as well
as in public health and research methods. Some chiropractors pursue
a 2- to 3-year residency for training in specialized fields.
Regulation
Chiropractic is regulated individually by each state and the Dis-
trict of Columbia. Board examinations are required for licensing and
include a mock patient encounter. Most states require chiropractors to
earn annual continuing education credits to maintain their licenses.
Chiropractors’ scope of practice varies by state in areas such as labora-
tory tests or diagnostic procedures, the dispensing or selling of dietary
supplements, and the use of other CAM therapies such as acupuncture
or homeopathy.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Insurance Coverage
Compared with other CAM therapies, insurance coverage for chiro-
practic services is extensive. Many HMOs (health maintenance orga-
nizations) and private health care plans cover chiropractic treatment,
as do all state workers’ compensation systems. Chiropractors can bill
Medicare, and many states cover chiropractic treatment under Medic-
aid. If you have health insurance, check whether chiropractic services
are covered before you seek treatment.
NCCAM-Funded Research
Recent research projects on chiropractic care supported by the Na-
tional Center for Complementary and Alternative Medicine (NCCAM)
have focused on the following:
s %FFECTIVENESS OF CHIROPRACTIC TREATMENTS FOR BACK PAIN NECK PAIN
and headache, as well as for other health conditions such as tem-
poromandibular disorders
s $EVELOPMENT OF A CURRICULUM TO INCREASE THE NUMBER OF
chiropractors involved in research
s )NmUENCE OF PEOPLES SATISFACTION WITH CHIROPRACTIC CARE ON THEIR
response to treatment
402
Chapter 58
Craniosacral Therapy
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
How It Works
The craniosacral system consists of the brain, spinal cord, mem-
branes, and the fluid within it. This fluid has a pulse or rhythm not
unlike the pulse of the circulatory or respiratory systems.
After the body experiences a trauma such as a fall or accident or has
been in a cycle of repeated stress, the rhythm within the craniosacral
system can be disrupted and a restriction can occur in the natural flow
of this fluid. Because the system that is affected is the central nervous
system, a variety of different symptoms can occur from headaches to
chronic pain and many other neurological complaints.
Through light touch and gentle manipulation of areas on the head
and throughout the body including the spine, a trained practitioner
can detect where the natural flow is restricted and facilitate a release
where flow is then restored. The natural healing ability of the body is
the key to the effectiveness of this therapy.
This complementary therapy is gaining popularity due to its gentle
and non-invasive treatment of a variety of symptoms. In addition, cran-
iosacral therapy works well in conjunction with other therapeutic tech-
niques to promote balance and recovery for a variety of symptoms.
Case Study #1
A woman in her 50s came for an appointment with allergies that
developed into ear infections several months ago. The ear infections
cleared up but one ear remained plugged and filled with fluid and the
patient stated that she couldn’t hear out of it.
The patient’s ear, nose, and throat specialist recommended surgery but
the patient wanted to try an alternative approach instead. Our therapist
saw her a total of three times for craniosacral therapy. On the third visit
the patient stated that she could hear out of her ear and it was no longer
plugged. She also stated that she had her energy back as well.
Case Study #2
A female patient in her 50s came for an appointment complaining
of chronic low back pain that kept her from being able to sit for long
periods of time. This was difficult for her as she had a desk job. The
pain had been with her for many years. She had a history of several
falls on her tailbone as well as fractures to the tailbone.
After two sessions of craniosacral therapy, the client reported that
the pain was gone and she could sit at her desk for the length of her
shift. A monthly follow-up was recommended and the client continues
to be pain free.
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Craniosacral Therapy
405
Chapter 59
Feldenkrais Method
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
408
Feldenkrais Method
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
410
Feldenkrais Method
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Black Belt in Judo (1936) and to introduce Judo in the West through
his teaching and books on the subject. In the early 1940s, while work-
ing in anti-submarine warfare for the British Admiralty, he patented
a number of sonar devices.
After suffering crippling knee injuries, Feldenkrais used his own
body as his laboratory and merged his acquired knowledge with his
deep curiosity about biology, perinatal development, cybernetics, lin-
guistics, and systems theory. He taught himself to walk again and in
the process developed an extraordinary system for accessing the power
of the central nervous system to improve human functioning.
Feldenkrais studied intensively in psychology, neurophysiology,
and other health-related disciplines, and in 1949 he returned to Israel
where he continued to integrate and refine his ideas into the system
known as the Feldenkrais Method.
412
Chapter 60
Massage Therapy
Chapter Contents
Section 60.1—Massage Therapy Overview................................ 414
3ECTION ,YMPHATIC $RAINAGE -ASSAGE ............................ 419
Section 60.3—Tui Na: Chinese Massage ................................... 421
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 60.1
History of Massage
Massage therapy dates back thousands of years. References to
massage appear in writings from ancient China, Japan, India, Arabic
nations, Egypt, Greece (Hippocrates defined medicine as “the art of
rubbing”), and Rome.
Massage became widely used in Europe during the Renaissance. In
the 1850s, two American physicians who had studied in Sweden intro-
duced massage therapy in the United States, where it became popular
and was promoted for a variety of health purposes. With scientific and
technological advances in medical treatment during the 1930s and
1940s, massage fell out of favor in the United States. Interest in mas-
sage revived in the 1970s, especially among athletes.
414
Massage Therapy
Research Status
Although scientific research on massage therapy—whether it works
and, if so, how—is limited, there is evidence that massage may benefit
some patients. Conclusions generally cannot yet be drawn about its
effectiveness for specific health conditions.
According to one analysis, however, research supports the general
conclusion that massage therapy is effective. The studies included in the
analysis suggest that a single session of massage therapy can reduce
“state anxiety” (a reaction to a particular situation), blood pressure, and
heart rate, and multiple sessions can reduce “trait anxiety” (general
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
There are numerous theories about how massage therapy may affect
the body. For example, the “gate control theory” suggests that massage
may provide stimulation that helps to block pain signals sent to the
brain. Other examples include theories suggesting that massage might
stimulate the release of certain chemicals in the body, such as serotonin
or endorphins, or cause beneficial mechanical changes in the body. How-
ever, additional studies are needed to test the various theories.
Safety
Massage therapy appears to have few serious risks—if it is per-
formed by a properly trained therapist and if appropriate cautions are
followed. The number of serious injuries reported is very small. Side
effects of massage therapy may include temporary pain or discomfort,
bruising, swelling, and a sensitivity or allergy to massage oils.
Cautions about massage therapy include the following:
s 6IGOROUS MASSAGE SHOULD BE AVOIDED BY PEOPLE WITH BLEEDING
disorders or low blood platelet counts, and by people taking
blood-thinning medications such as warfarin.
s -ASSAGE SHOULD NOT BE DONE IN ANY AREA OF THE BODY WITH BLOOD
clots, fractures, open or healing wounds, skin infections, or weak-
ened bones (such as from osteoporosis or cancer), or where there
has been a recent surgery.
416
Massage Therapy
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
418
Massage Therapy
Section 60.2
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
The Technique
,YMPHATIC DRAINAGE MASSAGE USES VERY LIGHT PRESSURE OF THE lNGERS
and hands, just slightly moving the skin, a technique quite different
from the long deeper flowing strokes of regular massages. The pattern
of strokes in lymphatic drainage massage is very small and precise,
moving very slowly and rhythmically, and repeating over and over.
Because of this, lymphatic drainage massage is very relaxing and
therefore excellent for reducing the effects of stress and tension.
420
Massage Therapy
Section 60.3
“The mind, the spirit, and the hands are the most fundamental
tools of healing we possess. Tui Na makes use of all three to promote
health and well being through the individual’s muscular, skeletal, and
ENERGETIC SYSTEMSv#HRISTOPHER 2EILLY ,!C -3!
Tui Na is perhaps the oldest branch of traditional Chinese medi-
cine (TCM). The first written record of Tui Na dates to 2700 BCE
[Before the Common Era], and the official Tui Na department was
established in the State Office of Imperial Physicians in China’s Sui
AND 4ANG $YNASTIES n #% ;#OMMON %RA= ,ITERALLY TRANS-
lated as “pushing and grasping,” Tui Na encompasses an extremely
broad set of hands-on techniques whose applications are guided by
the same theory and physiological concepts that govern acupuncture
and herbal therapy. Throughout the past 5,000 years, Tui Na experts
have developed methods of bone-setting, joint manipulation, trauma
therapy, massage therapy, pediatric therapy, preventive therapy, and
topical herbal applications.
The Tui Na form of bodywork differs from most Swedish and west-
ern styles in the speed and vigor with which certain techniques are
applied, the TCM theory and philosophy embedded within the Tui Na,
and an emphasis on the stimulation of acupuncture points and merid-
ians. There are a variety of techniques, such as dragon and phoenix
rolling, zhen’s single finger pushing, and trembling that are unique to
Tui Na. In modern terms, Tui Na as it is practiced in America can be
understood as a hands-on form of bodywork which uses acupressure
and traditional Chinese medical theory to achieve a variety of wellness
goals, including pain relief and muscular health.
Tui Na is often the treatment of choice for TCM practitioners, and
is used in place of acupuncture in children. The first treatise on pe-
diatric Tui Na in China dates to 1601 CE. Areas of the body that are
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
422
Chapter 61
Pilates
What Is Pilates?
Pilates is a body conditioning routine that seeks to build flexibility,
strength, endurance, and coordination without adding muscle bulk.
In addition, Pilates increases circulation and helps to sculpt the body
and strengthen the body’s “core” or “powerhouse” (torso). People who
do Pilates regularly feel they have better posture, are less prone to
injury, and experience better overall health.
Joseph H. Pilates, the founder of the Pilates exercise method, was
born in Germany. As a child he was frail, living with asthma in addition
to other childhood conditions. To build his body and grow stronger, he
took up several different sports, eventually becoming an accomplished
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Getting Started
The great thing about Pilates is that just about everyone—from
couch potatoes to fitness buffs—can do it. Because Pilates has gained
lots of attention recently, there are lots of classes available. You’ll
probably find that many fitness centers and YMCAs offer Pilates
classes, mostly in mat work. Some Pilates instructors also offer pri-
vate classes that can be purchased class by class or in blocks of
classes; these may combine mat work with machine work. If your
health club makes Pilates machines available to members, make sure
there’s a qualified Pilates instructor on duty to teach and supervise
you during the exercises.
The fact that Pilates is hot and classes are springing up everywhere
does have a downside, though: inadequate instruction. As with any
form of exercise, it is possible to injure yourself if you have a health
condition or don’t know exactly how to do the moves. Some gyms send
their personal trainers to weekend-long courses and then claim they’re
qualified to teach Pilates (they’re not!), and this can lead to injury.
So look for an instructor who is certified by a group that has a
rigorous training program. These instructors have completed several
hundred hours of training just in Pilates and know the different ways
to modify the exercises so new students don’t get hurt.
The Pilates mat program follows a set sequence, with exercises fol-
lowing on from one another in a natural progression, just as Joseph
Pilates designed them. Beginners start with basic exercises and build
up to include additional exercises and more advanced positioning.
424
Pilates
Keep these tips in mind so that you can get the most out of your
Pilates workout.
s Stay focused. Pilates is designed to combine your breathing
rhythm with your body movements. Qualified instructors teach
ways to keep your breathing working in conjunction with the
exercises. You will also be taught to concentrate on your muscles
and what you are doing. The goal of Pilates is to unite your mind
and body, which relieves stress and anxiety.
s Be comfortable. Wear comfortable clothes (as you would for
yoga—shorts or tights and a T-shirt or tank top are good choic-
es), and keep in mind that Pilates is usually done without shoes.
If you start feeling uncomfortable, strained, or experience pain,
you should stop.
s Let it flow. When you perform your exercises, avoid quick, jerky
movements. Every movement should be slow, but still strong and
flexible. Joseph Pilates worked with dancers and designed his
movements to flow like a dance.
s Don’t leave out the heart. The nice thing about Pilates is
you don’t have to break a sweat if you don’t want to—but you
can also work the exercises quickly (bearing in mind fluidity, of
course!) to get your heart rate going. Or, because Pilates is pri-
marily about strength and flexibility, pair your Pilates workout
with a form of aerobic exercise like swimming or brisk walking.
Most fans of Pilates say they stick with the program because it’s
diverse and interesting. Joseph Pilates designed his program for
variety—people do fewer repetitions of a number of exercises rather
than lots of repetitions of only a few. He also intended his exercises
to be something people could do on their own once they’ve had proper
instruction, cutting down the need to remain dependent on a trainer.
Before you begin any type of exercise program, it’s a good idea to
talk to your doctor, especially if you have a health problem.
425
Chapter 62
Qigong
427
Complementary and Alternative Medicine Sourcebook, Fourth Edition
,IKE ANY OTHER SYSTEM OF HEALTH CARE 1IGONG IS NOT A PANACEA BUT
it is certainly a highly effective health care practice. Many health care
professionals recommend Qigong as an important form of alternative
complementary medicine.
Qigong creates an awareness of and influences dimensions of our
being that are not part of traditional exercise programs. Most exer-
cises do not involve the meridian system used in acupuncture nor do
they emphasize the importance of adding mind intent and breathing
techniques to physical movements. When these dimensions are added,
the benefits of exercise increase exponentially.
The gentle, rhythmic movements of Qigong reduce stress, build
stamina, increase vitality, and enhance the immune system. It has
also been found to improve cardiovascular, respiratory, circulatory,
lymphatic, and digestive functions.
Those who maintain a consistent practice of Qigong find that it
helps one regain a youthful vitality, maintain health even into old
age, and helps speed recovery from illness. Western scientific research
confirms that Qigong reduces hypertension and the incidence of falling
in the aged population. One of the more important long-term effects is
that Qigong reestablishes the body/mind/soul connection.
428
Qigong
429
Chapter 63
Reflexology
This chapter contains text from “A Brief History of Foot Reflexology” and “The
Differences between Reflexology and Massage,” © 2008 American Reflexology
Certification Board (www.arcb.net). Reprinted with permission.
431
Complementary and Alternative Medicine Sourcebook, Fourth Edition
432
Reflexology
Techniques
Uses small muscle movements; pri- Uses large muscle movement;
marily thumbs and fingers are used. hands (either opened or closed),
and sometimes feet, arms, and
elbows.
Purpose
To improve the function of organs Primarily to change the soft tis-
and glands and all systems of the sue directly stimulated. Works
body. Works with the function of the with the structure of the body.
body.
Benefit
Total body relaxation leading to the Local muscle relaxation or if the
balancing of all internal and external entire body is massaged then to
body systems; improving circulation muscular system improving cir-
via stimulation to the nervous and culation and reducing muscular
subtly, energy systems. tension.
433
Chapter 64
Structural
Integration Techniques
Chapter Contents
Section 64.1—Hellerwork Structural Integration..................... 436
Section 64.2—Rolfing.................................................................. 438
435
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 64.1
436
Structural Integration Techniques
437
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 64.2
Rolfing
“Frequently Asked Questions,” © 2009 Rolf Institute of Structural
Integration (www.rolf.org). Reprinted with permission.
438
Structural Integration Techniques
439
Complementary and Alternative Medicine Sourcebook, Fourth Edition
440
Structural Integration Techniques
441
Complementary and Alternative Medicine Sourcebook, Fourth Edition
started along the upper leg, hamstrings, neck, and spine. The second ses-
sion helps give the body a stable foundation by balancing the foot and
muscles of the lower leg. Number three typically involves a “side view” for
an understanding of how the head, shoulder girdle, and hips are position-
ally related to one another when standing under the influence of gravity.
Then, the body is addressed within the context of this new vision.
Sessions 4–7: Four through seven are referred to as “core” sessions
and examine terrain found between the bottom of the pelvis and top
of the head. The idea of core also includes the deep tissue of the legs
for its role in support.
Session four begins this journey; its territory extends from the in-
side arch of the foot and up the leg, to the bottom of the pelvis. The
fifth session is concerned with balancing surface and deep abdominal
muscles to the curve of the back. Number six seeks to enlist more sup-
port and momentum from the legs, pelvis, and lower back, while the
seventh session turns its sole attention to the neck and head.
Session 8–10: “Integration” is emphasized throughout the remain-
ing three sessions, as eight, nine, and ten provide an opportunity for
the practitioner to blend previously established advancements, and
ones yet to be made, into the body in a way that encourages smooth
movement and natural coordination.
During sessions eight and nine, the practitioner is free to decide
how best to achieve this integration, as the protocol is unique for each
individual. The tenth and final session is also one of integration, but
more importantly, serves to inspire a sense of order and balance. Once
completed, the wisdom of the Rolfing Ten Series will drive and support
the body with health for years to come.
442
Structural Integration Techniques
443
Complementary and Alternative Medicine Sourcebook, Fourth Edition
should not enter the Rolfing process anticipating such a major release
but should remember that a Rolfer’s actual expertise is integrating and
balancing connective tissue. The emotional component, as attractive
or dreaded as it may be, remains an ancillary aspect of the Rolfing
process and not its primary intention.
444
Structural Integration Techniques
445
Complementary and Alternative Medicine Sourcebook, Fourth Edition
446
Chapter 65
Chapter Contents
Section 65.1—Applied Kinesiology............................................. 448
Section 65.2—Bowen Technique................................................. 449
Section 65.3—Trager Approach.................................................. 450
447
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 65.1
Applied Kinesiology
From “Applied Kinesiology,” © 2009 Natural Medicines Comprehensive
Database (www.naturaldatabase.com). Reprinted with permission.
What is it?
Kinesiology is an alternative medicine system used to diagnose and
treat medical conditions.
Is it effective?
Natural Medicines Comprehensive Database rates effectiveness
based on scientific evidence according to the following scale: effective,
likely effective, possibly effective, possibly ineffective, likely ineffective,
and insufficient evidence to rate.
The effectiveness ratings for kinesiology are as follows:
s ,IKELY INEFFECTIVE FOR
s DISEASE DIAGNOSIS
s )NSUFlCIENT EVIDENCE TO RATE EFFECTIVENESS FOR
s LEARNING DISABILITIES
s MASTALGIA BREAST PAIN
448
Other Manipulative and Body-Based Therapies
Section 65.2
Bowen Technique
From “Bowen Technique,” © 2009 Natural Medicines Comprehensive Da-
tabase (www.naturaldatabase.com). Reprinted with permission.
What is it?
The Bowen technique is a manipulative technique.
Is it effective?
Natural Medicines Comprehensive Database rates effectiveness
based on scientific evidence according to the following scale: effective,
likely effective, possibly effective, possibly ineffective, likely ineffective,
and insufficient evidence to rate.
The effectiveness ratings for the Bowen technique are as follows:
s )NSUFlCIENT EVIDENCE TO RATE EFFECTIVENESS FOR
s PAIN FATIGUE RELAXATION FROZEN SHOULDER AND OTHER CONDITIONS
449
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 65.3
Trager Approach
“What Is the Trager Approach?” © 2005 Trager International (www.trag-
er.com). Reprinted with permission. Reviewed by David A. Cooke, MD,
FACP, December 25, 2009.
450
Other Manipulative and Body-Based Therapies
451
Part Seven
Energy-Based Therapies
Chapter 66
Energy Medicine:
An Overview
Excerpted from text by the National Center for Complementary and Alter-
native Medicine (NCCAM, nccam.nih.gov), part of the National Institutes of
Health, March 2007.
455
Complementary and Alternative Medicine Sourcebook, Fourth Edition
with this subtle energy, see it with their own eyes, and use it to effect
CHANGES IN THE PHYSICAL BODY AND INmUENCE HEALTH
0RACTITIONERS OF ENERGY MEDICINE BELIEVE THAT ILLNESS RESULTS FROM
disturbances of these subtle energies (the biofield). For example, more
THAN YEARS AGO !SIAN PRACTITIONERS POSTULATED THAT THE mOW AND
balance of life energies are necessary for maintaining health and de-
scribed tools to restore them. Herbal medicine, acupuncture, acupres-
sure, moxibustion, and cupping, for example, are all believed to act by
correcting imbalances in the internal biofield, such as by restoring the
mOW OF QI THROUGH MERIDIANS TO REINSTATE HEALTH 3OME THERAPISTS ARE
believed to emit or transmit the vital energy (external qi) to a recipi-
ent to restore health.
Examples of practices involving putative energy fields include the
following:
s 2EIKI AND *OHREI BOTH OF *APANESE ORIGIN
s 1I GONG A #HINESE PRACTICE
s (EALING TOUCH IN WHICH THE THERAPIST IS PURPORTED TO IDENTIFY
imbalances and correct a client’s energy by passing his or her
hands over the patient
s )NTERCESSORY PRAYER IN WHICH A PERSON INTERCEDES THROUGH PRAYER
on behalf of another
456
Energy Medicine: An Overview
457
Complementary and Alternative Medicine Sourcebook, Fourth Edition
458
Energy Medicine: An Overview
Complementary and Alternative Medicine Sourcebook, Fourth Edition
460
Energy Medicine: An Overview
Chapter 67
Magnet Therapy
-AGNETS HAVE BEEN USED FOR HEALTH PURPOSES FOR CENTURIES 3TATIC
or permanent, magnets are widely marketed for pain control and are
considered part of complementary and alternative medicine (CAM).
About Magnets
! MAGNET PRODUCES A MEASURABLE FORCE CALLED A MAGNETIC lELD 3TATIC
magnets have magnetic fields that do not change (unlike another type
called electromagnets, which generate magnetic fields only when elec-
TRICAL CURRENT mOWS THROUGH THEM -AGNETS ARE USUALLY MADE FROM
metals (such as iron) or alloys (mixtures of metals, or of a metal and
a nonmetal).
Magnets come in different strengths, often measured in units called
GAUSS ' OR ALTERNATIVELY UNITS CALLED TESLA TESLA ' -AG-
nets marketed for pain usually claim strengths of 300 to 5,000 G—
many times stronger than the Earth’s magnetic field (about 0.5 G) and
MUCH WEAKER THAN THE MAGNETS USED FOR -2) ;MAGNETIC RESONANCE
IMAGING= MACHINES APPROXIMATELY ' OR HIGHER
6ARIOUS PRODUCTS WITH MAGNETS IN THEM ARE MARKETED FOR HEALTH PUR-
poses, including shoe insoles, bracelets and other jewelry, mattress pads,
bandages, headbands, and belts. These products are often placed in contact
with painful areas of the body with the goal of providing relief.
&ROM h-AGNETS FOR 0AIN v BY THE .ATIONAL #ENTER FOR #OMPLEMENTARY AND
Alternative Medicine (NCCAM, nccam.nih.gov), part of the National Institutes
OF (EALTH -ARCH
463
Complementary and Alternative Medicine Sourcebook, Fourth Edition
464
Magnet Therapy
465
Complementary and Alternative Medicine Sourcebook, Fourth Edition
466
Chapter 68
Polarity Therapy
4HIS CHAPTER INCLUDES h7HAT IS 0OLARITY 4HERAPYv AND h7HAT CAN ) EXPECT IN
A TYPICAL 0OLARITY 4HERAPY SESSIONv REPRINTED WITH PERMISSION FROM THE !MERICAN
0OLARITY 4HERAPY !SSOCIATION ¥ !MERICAN 0OLARITY 4HERAPY !SSOCIATION !LL
rights reserved. For additional information visit www.polaritytherapy.org.
467
Complementary and Alternative Medicine Sourcebook, Fourth Edition
and therapeutic methods are designed to balance the field for health
benefit. There are three types of energy fields in the human body: long
line currents that run north to south on the body; transverse currents
that run east-west in the body; and spiral currents that start at the
navel and expand outward.
)N THE HEALING ARTS 0OLARITY 4HERAPY IS SPECIAL IN ITS COMPREHENSIVE
exploration of the different dimensions of the human condition (physi-
CAL MENTAL AND EMOTIONAL 0OLARITY 4HERAPY SEEKS TO BRIDGE THE FULL
spectrum of body, mind, and spirit: The body is designed by nature to
HEAL ITSELF 0OLARITY 4HERAPY ASSISTS IN THIS NATURAL OCCURRENCE !PPLY-
ING THE 0OLARITY 4HERAPY SYSTEM CAN TAKE DIVERSE FORMS ALWAYS BASED
on the underlying intention to support the client’s inherent self-healing
intelligence as expressed in its energetic patterns.
0OLARITY 4HERAPY WAS DEVELOPED BY $R 2ANDOLPH 3TONE $/ $# .$
n WHO CONDUCTED A THOROUGH INVESTIGATION OF ENERGY IN THE
HEALING ARTS OVER THE COURSE OF HIS YEAR MEDICAL CAREER $RAWING ON
information from a wide range of sources, he found that the Human
Energy Field is affected by touch, diet, movement, sound, attitudes,
RELATIONSHIPS LIFE EXPERIENCE TRAUMA AND ENVIRONMENTAL FACTORS 3INCE
0OLARITY 4HERAPY LENDS AN ENERGY BASED PERSPECTIVE TO ALL THESE SUB-
JECTS THE SCOPE OF 0OLARITY PRACTICE IS OFTEN VERY BROAD WITH IMPLICA-
tions for health professionals in many therapeutic disciplines.
!S A RESULT 0OLARITY SUPPORTS STRONG CONNECTIONS TO MANY OTHER
healing and holistic health systems. For example, basic characteristics
of the Human Energy Field are described in many sources, both ancient
AND MODERN &ROM THE !YURVEDIC TRADITION 0OLARITY INTEGRATES THE
h4HREE 0RINCIPLES AND &IVE #HAKRASv AND HAS BEEN CALLED THE MODERN
MANIFESTATION OF ANCIENT (ERMETIC 0HILOSOPHY 0OLARITY IS EXPERIENCED
as the universal pulsation of expansion/contraction or repulsion/attrac-
tion known as Yang and Yin in Oriental therapies. Energy moves out
from a central source—which is repulsion, then back to the source—
WHICH IS ATTRACTION 0OLARITY PRACTITIONERS USE THIS NATURAL PHENOMENON
AS A WAY OF TRACKING ENERGY mOW
468
Polarity Therapy
Chapter 69
Reiki
History
4HE WORD h2EIKIv IS DERIVED FROM TWO *APANESE WORDS REI OR UNI-
VERSAL AND KI OR LIFE ENERGY #URRENT 2EIKI PRACTICE CAN BE TRACED
TO THE SPIRITUAL TEACHINGS OF -IKAO 5SUI IN *APAN DURING THE EARLY
TH CENTURY 5SUIS TEACHINGS INCLUDED MEDITATIVE TECHNIQUES AND
HEALING PRACTICES /NE OF 5SUIS STUDENTS #HUJIRO (AYASHI FURTHER
developed the healing practices, placing less emphasis on the medita-
TIVE TECHNIQUES !N !MERICAN NAMED (AWAYO 4AKATA LEARNED 2EIKI
from Hayashi in Japan and introduced it to Western cultures in the
LATE S
4HE TYPE OF 2EIKI PRACTICED AND TAUGHT BY (AYASHI AND 4AKATA MAY
BE CONSIDERED TRADITIONAL 2EIKI .UMEROUS VARIATIONS OR SCHOOLS OF
2EIKI HAVE SINCE BEEN DEVELOPED AND ARE CURRENTLY PRACTICED
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Practice
2EIKI IS BASED ON THE IDEA THAT THERE IS A UNIVERSAL OR SOURCE ENERGY
THAT SUPPORTS THE BODYS INNATE HEALING ABILITIES 0RACTITIONERS SEEK TO AC-
CESS THIS ENERGY ALLOWING IT TO mOW TO THE BODY AND FACILITATE HEALING
!LTHOUGH GENERALLY PRACTICED AS A FORM OF SELF CARE 2EIKI CAN BE
received from someone else and may be offered in a variety of health
care settings, including medical offices, hospitals, and clinics. It can be
practiced on its own or along with other CAM therapies or conventional
medical treatments.
)N A 2EIKI SESSION THE CLIENT LIES DOWN OR SITS COMFORTABLY FULLY
clothed. The practitioner’s hands are placed lightly on or just above
THE CLIENTS BODY PALMS DOWN USING A SERIES OF TO DIFFERENT HAND
positions. Each position is held for about 2 to 5 minutes, or until the
PRACTITIONER FEELS THAT THE mOW OF ENERGYEXPERIENCED AS SENSATIONS
such as heat or tingling in the hands—has slowed or stopped. The
number of sessions depends on the health needs of the client. Typically,
THE PRACTITIONER DELIVERS AT LEAST FOUR SESSIONS OF TO MINUTES EACH
4HE DURATION OF 2EIKI SESSIONS MAY BE SHORTER IN CERTAIN HEALTH CARE
settings (for example, during surgery).
0RACTITIONERS WITH APPROPRIATE TRAINING MAY PERFORM 2EIKI FROM
a distance, that is, on clients who are not physically present in the
office or clinic.
Uses
!CCORDING TO THE .ATIONAL (EALTH )NTERVIEW 3URVEY WHICH
included a comprehensive survey of CAM use by Americans, more than
MILLION ADULTS HAD USED AN ENERGY HEALING THERAPY SUCH AS 2EIKI
IN THE PREVIOUS YEAR 4HE SURVEY ALSO FOUND THAT APPROXIMATELY
children had used an energy healing therapy in the previous year.
0EOPLE USE 2EIKI FOR RELAXATION STRESS REDUCTION AND SYMPTOM
RELIEF IN EFFORTS TO IMPROVE OVERALL HEALTH AND WELL BEING 2EIKI HAS
BEEN USED BY PEOPLE WITH ANXIETY CHRONIC PAIN ()6!)$3 ;HUMAN
immunodeficiency virus/acquired immunodeficiency syndrome], and
other health conditions, as well as by people recovering from surgery
OR EXPERIENCING SIDE EFFECTS FROM CANCER TREATMENTS 2EIKI HAS ALSO BEEN
given to people who are dying (and to their families and caregivers) to
help impart a sense of peace.
472
Reiki
Tell your health care providers about any complementary and al-
ternative practices you use. Give them a full picture of what you do to
manage your health. This will help ensure coordinated and safe care.
NCCAM-Funded Research
3OME RECENT .##!- SUPPORTED STUDIES HAVE BEEN INVESTIGATING
the following areas:
s (OW 2EIKI MIGHT WORK
473
Complementary and Alternative Medicine Sourcebook, Fourth Edition
474
Chapter 70
Shiatsu
What Is Shiatsu?
3HIATSU IS A MODERN BODYWORK THERAPY WITH ITS ORIGINS IN ANCIENT
Oriental medical philosophy. It is a form of acupressure, originating
in Japan, that uses finger pressure to stimulate acupoints (“tsubos”),
which are the same points used in acupuncture. It also uses the hands,
fists, elbows, and feet to apply pressure to larger areas of the body.
3HIATSU INCORPORATES GENTLE ASSISTED STRETCHING AND MANIPULATION TECH-
niques to relax the joints.
3HIATSU WORKS WITH THE LIFE FORCE ENERGYCALLED CHI OR QI KI
ENCOURAGING IT TO mOW MORE SMOOTHLY ALONG THE ENERGY PATHWAYS THE
h3HIATSU v ¥ #ENTER FOR )NTEGRATIVE (EALTH AND (EALING 2EPRINTED WITH PERMIS-
sion. For additional information, visit www.cihh.net. The date of this document is
unknown. The text that follows this document under the heading “Health Reference
Series -EDICAL !DVISORS .OTES AND 5PDATESv WAS PROVIDED TO /MNIGRAPHICS )NC
BY $AVID ! #OOKE -$ &!#0 *ANUARY $R #OOKE IS NOT AFlLIATED WITH
the Center for Integrative Health and Healing.
475
Complementary and Alternative Medicine Sourcebook, Fourth Edition
MERIDIANS OF THE BODY 3HIATSU STIMULATES THE BODYS OWN HEALING SYS-
tems and brings the body into balance, energetically and physically.
Benefits of Shiatsu
s 2ELIEVES PAIN CHRONIC AND ACUTE
s 2ELEASES STRESS AND ITS EFFECTS
s )NCREASES THE CIRCULATION OF BLOOD AND LYMPH
s "OOSTS THE IMMUNE SYSTEM
s 2ELAXES TIGHT MUSCLES
s 2ELIEVES HEADACHES AND MIGRAINES
s %ASES AND BALANCES DIGESTION
s %ASES ANXIETY AND DEPRESSION
s "ALANCES HORMONES
s )NCREASES ENERGY VITALITY STAMINA AND WELL BEING
Case Studies
Osteoarthritis: A 57-year-old female presented with osteoarthri-
TIS IN HER KNEE ANKLES AND TOES &OUR SESSIONS OF 3HIATSU RESULTED IN
significant improvement of her medical condition allowing the client to
awake without morning stiffness and to be significantly less dependent
on medication.
476
Shiatsu
History of Shiatsu
3HIATSU IS A BLEND OF ANCIENT %ASTERN MEDICAL PHILOSOPHY AND MODERN
Western science. China has always held high regard for the effectiveness
of massage and acupressure for the treatment of a wide variety of health
PROBLEMS FOR OVER YEARS 3HIATSU HAS ITS ROOTS IN A TRADITIONAL
form of massage and acupressure called Anma Therapy. Anma Therapy
originated in China hundreds of years ago and was then brought to
Japan. It was used to treat pain and many common ailments as well as
SERIOUS DISEASES AND IS STILL PRACTICED TODAY 3HIATSU IS THE CULMINATION
OF %ASTERN AND 7ESTERN INmUENCE ON THIS ANCIENT HEALING ART
3HIATSU CONTINUES TO EVOLVE )N *APAN WHERE THERE ARE CURRENTLY
OVER REGISTERED 3HIATSU PRACTITIONERS 3HIATSU HAS BEEN HIGHLY
respected for its effectiveness in the treatment and prevention of dis-
ease for hundreds of years.
477
Complementary and Alternative Medicine Sourcebook, Fourth Edition
one lens; perhaps the most important factor is whether the patient
improves, whatever the mechanism.
478
Chapter 71
Therapeutic Touch
Complementary and Alternative Medicine Sourcebook, Fourth Edition
THE EARLY S !T lRST +RIEGER AND +UNZ ONLY TAUGHT THE TECHNIQUES
to Krieger’s graduate school nursing students, but Krieger’s profes-
sional research and writing increased the popularity of the technique,
particularly among nurses. The practice grew primarily through a
GRASSROOTS EFFORT OF NURSES THROUGHOUT THE 5NITED 3TATES 4ODAY THERA-
peutic touch is taught at hospitals and health centers worldwide and
is most commonly practiced by nurses.
480
Therapeutic Touch
Complementary and Alternative Medicine Sourcebook, Fourth Edition
482
Chapter 72
Other Energy-Based
Therapies
Chapter Contents
3ECTION "IORESONANCE 4HERAPY......................................... 484
3ECTION #RYSTAL AND 'EM 4HERAPY................................... 486
3ECTION :ERO "ALANCING..................................................... 487
483
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 72.1
Bioresonance Therapy
“Turn off Allergies,” by Nanci Bompey, Asheville Citizen-Times—
!SHEVILLE .# ¥ 'ANNETT #OMPANY )NC 2EPRODUCED WITH PERMIS-
sion of the Gannett Company, via Copyright Clearance Center.
*ULIA 2OSA HAS SUFFERED FROM SEASONAL ALLERGIES AND ASTHMA HER
whole life, but after undergoing allergy desensitization at her natur-
OPATHS OFlCE THE #ANDLER ;.ORTH #AROLINA= RESIDENT SAID SHE HASNT
sneezed this allergy season.
h(ANDS DOWN THERE REALLY IS NO COMPARISON v 2OSA SAID
Asheville naturopath Eric Lewis is one of the few practitioners
in the region using electrodermal screening and acupressure to help
desensitize patients to potential allergens.
“The goal of this is to change the way the body perceives a substance,”
Lewis said of the process. “The goal is to reverse sensitivity to these
things so that a patient can tolerate these things in the future.”
4HE TECHNIQUE WHICH IS NOT APPROVED BY THE &OOD AND $RUG !DMIN-
istration, first uses an electrodermal screening machine to determine
what substances cause a person to have an allergic reaction.
$URING THE PROCESS THE PATIENT HOLDS A ROD CONTAINING THE NEGATIVE
end of a circuit while Lewis uses another rod, the positive end, to touch
different acupuncture points on the patient’s body. These points corre-
spond to different substances that could trigger an allergic reaction.
The machine then measures the electrical conductivity, or current,
THROUGH THE CIRCUIT THAT HAS BEEN CREATED ! DROP IN CURRENT mOW IN-
dicates a resistance to electrical conductance, indicating a person’s
sensitivity to a particular substance, Lewis said.
h! CHANGE IN THE ENERGY mOW MEANS THAT SHE IS LIKELY SENSITIVE TO
THAT ALLERGEN v ,EWIS SAID AS HE DEMONSTRATED THE TECHNIQUE ON 2OSA
“It shows her body’s energy is reacting negatively to that substance.
That’s when we know that we have a problem.”
Lewis said the machine he uses can screen for thousands of aller-
gens that are environmental, like pollen, chemical, perfume or from
food. He said because each substance has its own electromagnetic
field, the machine is able to screen down to specific substances to
484
Other Energy-Based Therapies
485
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 72.2
486
Other Energy-Based Therapies
Section 72.3
Zero Balancing
h!BOUT :ERO "ALANCING v ¥ :ERO "ALANCING (EALTH !SSOCIATION
WWWZEROBALANCINGCOM 2EPRINTED WITH PERMISSION
487
Complementary and Alternative Medicine Sourcebook, Fourth Edition
to promote balance and local change; those which work as fields to re-
lease weaker, or less organized vibration; and those which engage the
client’s own energy to promote change. The fulcrums in the first group
are held stationary for brief periods; the second group utilizes the form
of a curve or so-called half moon vector; and the third are moving foci
of energy. In all cases the fulcrum is performed at interface of touch
to ensure clear boundaries, and contacts both the energy body and the
structural body of the person.
:ERO "ALANCING TEACHES THAT THE DEEPEST CURRENTS OF ENERGY ARE IN
bone, that memory can be held in tissue, that energy fields in the body
underlie mind, body, and emotions, and that imbalances in the field
precede pathology.
488
Part Eight
Alternative Treatments
for Specific Diseases and
Conditions
Chapter 73
491
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Thunder God vine: Thunder God vine (TGV for short; botanical
name Tripterygium wilfordii Hook F) is a perennial vine native to
China, Japan, and Korea. Preparations made from the skinned root of
TGV have been used in traditional Chinese medicine to treat inflam-
matory and autoimmune diseases. Interestingly, TGV also has a history
of use to kill insects in farm fields.
Some anti-inflammatory and immune-system-suppressing activ-
ity for TGV has been seen in laboratory and animal studies. The first
clinical trial on TGV in the United States (the earlier ones were done
in China) was carried out at the University of Texas Southwestern
Medical Center and the National Institutes of Health (NIH). Its results
were published in 2002. Twenty-one patients for whom conventional
RA treatment had not worked completed the trial. Eighty percent of
those who received a high-dose TGV extract and 40 percent of those
who received a low-dose TGV extract experienced improvement in
RA symptoms and physical functioning. No one in the placebo group
improved. Longer and larger studies are needed to confirm these find-
ings and to find out more about TGV.
Parts of the TGV plant are dangerous. The leaves, the flowers, the
main stem, and the skin covering the root are poisonous, to a point
that they could cause death. People should never try to make TGV
medications themselves.
Currently, there are no consistent, high-quality TGV products being
manufactured in the United States. Preparations of TGV made outside
the United States (for example, in China) can sometimes be obtained,
but it is not possible to verify whether they are safe and effective. An
expert from the University of Texas/NIH study advises that consumers
not use TGV until reliable TGV preparations become available.
If taken for a long time (according to one study, for more than 5
years), TGV may decrease the density of the minerals in women’s
bones, which would be of special concern for women who have osteo-
porosis or are at risk for it. If taken at high doses, TGV could suppress
the immune system and increase the effects of immune-suppressing
drugs.
492
Arthritis and CAM
The TGV extract made for the NIH study discussed in the previous
text was well tolerated by study participants. However, side effects can
occur and may include stomach upset, diarrhea, skin rash, changes in
menstrual periods, and hair loss.
Fish oil: Fish oil contains high amounts of two omega-3 fatty ac-
ids: EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). As
with GLA, the body can use omega-3s to make substances that reduce
inflammation.
There is some encouraging evidence from a number of laboratory
studies, animal studies, and clinical trials about the potential useful-
ness of fish oil or omega-3 supplementation for various aspects of
RA—such as the number of tender joints, morning stiffness, and the
493
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Valerian: The herb valerian has a history of use for sleep problems
and anxiety disorders. Disrupted sleep has been called a common and
often neglected symptom of arthritis. A large, nationally representative
survey of people over 65 with arthritis in 2000 found that disruption of
sleep, among all the disruptions of arthritis, was the main reason that
people sought a variety of CAM, self-care, and conventional medical
treatments. Valerian has also been taken for other reasons, such as the
intent to relieve muscle and joint pain. The species of valerian most
used in American supplements is Valeriana officinalis.
The evidence suggests that valerian has at least mild benefits for
sleep problems in the general population, including insomnia. It has
been theorized that valerian may have benefit for people with sleep
problems from RA. However, research on valerian for RA specifically
has not been done to answer this question.
494
Arthritis and CAM
495
Complementary and Alternative Medicine Sourcebook, Fourth Edition
effects of drugs for high blood pressure and heart disease; and add to
the blood-sugar-lowering effects of diabetes drugs.
Curcumin can have side effects of stomach problems, including nausea
and diarrhea. Curcumin could add to the effects of other herbs and drugs
that slow blood clotting. Curcumin can cause gallbladder contractions and
should not be used by people with gallbladder disease or gallstones.
"OSWELLIA CAN HAVE SIDE EFFECTS OF STOMACH PAIN STOMACH UPSET
NAUSEA AND DIARRHEA )T IS NOT KNOWN WHETHER "OSWELLIA INTERACTS
with any drugs, supplements, or diseases and conditions.
Feverfew appears to be safe for short-term use, but the safety of long-
term use is not known. Feverfew can cause an allergic reaction, especially
in people who are allergic to the daisy family. Side effects can include
diarrhea and other stomach upsets. Chewing fresh leaves of feverfew may
cause mouth irritation and sores. Feverfew might interact with medica-
tions broken down by the liver and increase the actions of drugs that slow
blood clotting. Pregnant women should not take feverfew.
496
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discuss any major dietary changes with your health care provider or
a registered dietitian.
A true food allergy may exist in a small percentage of patients with
RA. Many people think they have food allergies when they do not have
them or when they have a different condition called food intolerance.
498
Arthritis and CAM
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heat or cold or for too long a time, and being sure to drink enough
fluid. However, hydrotherapy is riskier and could even be dangerous
for certain people:
s 4HOSE WHO HAVE A CONDITION THAT COULD BE WORSENED BY EXPOSURE
to extremes of heat or cold (for example, heart disease, lung dis-
ease, circulation disorder, Raynaud phenomenon, or chilblains)
or by strong motions from water jets
s 4HOSE WHO HAVE DIFlCULTY PERCEIVING TEMPERATURE FOR EXAMPLE
from neuropathy, or damage to the nerves)
s 7OMEN WHO ARE PREGNANT
s 0EOPLE WHO HAVE IMPLANTED MEDICAL DEVICES SUCH AS PACEMAKERS
or pumps
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patients from seeing the knee treatment area and learning which treat-
ment they received. In the education control group, 189 participants
attended six, 2-hour group sessions over 12 weeks based on the Arthritis
Foundation’s Arthritis Self-Help Course, a proven, effective model.
On joining the study, patients’ pain and knee function were assessed
using standard arthritis research survey instruments and measure-
MENT TOOLS SUCH AS THE 7ESTERN /NTARIO -C-ASTERS /STEOARTHRITIS
)NDEX 7/-!# 0ATIENTS PROGRESS WAS ASSESSED AT AND
WEEKS "Y WEEK PARTICIPANTS RECEIVING ACUPUNCTURE WERE SHOWING A
significant increase in function and by week 14 a significant decrease in
pain, compared with the sham and control groups. These results, shown
BY DECLINING SCORES ON THE 7/-!# INDEX HELD THROUGH WEEK
Overall, those who received acupuncture had a 40 percent decrease
in pain and a nearly 40 percent improvement in function compared to
baseline assessments.
“This trial, which builds upon our previous NCCAM-funded re-
search, establishes that acupuncture is an effective complement to
conventional arthritis treatment and can be successfully employed
as part of a multidisciplinary approach to treating the symptoms of
OSTEOARTHRITIS v SAID $R "ERMAN
Acupuncture—the practice of inserting thin needles into specific
body points to improve health and well-being—originated in China
more than 2,000 years ago. In 2002, acupuncture was used by an es-
timated 2.1 million U.S. adults, according to the Centers for Disease
Control and Prevention’s 2002 National Health Interview Survey.2
The acupuncture technique that has been most studied scientifically
involves penetrating the skin with thin, solid, metallic needles that
are manipulated by the hands or by electrical stimulation. In recent
years, scientific inquiry has begun to shed more light on acupuncture’s
possible mechanisms and potential benefits, especially in treating
painful conditions such as arthritis.
References
"ERMAN "- ,AO , ,ANGENBERG 0 ,EE 7, 'ILPIN !-+ (OCH-
berg MC. Effectiveness of Acupuncture as Adjunctive Therapy
in Osteoarthritis of the Knee: A Randomized, Controlled Trial.
Annals of Internal Medicine. 2004; 141(12):901–910.
"ARNES 0 0OWELL 'RINER % -C&ANN + .AHIN 2 CDC Advance
Data Report #343. Complementary and Alternative Medicine
Use Among Adults: United States, 2002. May 27, 2004.
502
Chapter 74
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
s ,ASER THERAPY
s -ASSAGE
s (YPNOSIS
s !RT OR MUSIC THERAPY
504
Asthma, Allergies, and CAM
illness (like a cold or flu) runs its course. If you use prescribed medica-
tions for your allergy or asthma symptoms, it may take time for them to
“kick in.” So you may simply be feeling better because your medications
started working—not because the alternative medicine is working.
505
Complementary and Alternative Medicine Sourcebook, Fourth Edition
506
Chapter 75
This chapter includes text from “Cancer and CAM,” by the National Center for
Complementary and Alternative Medicine (NCCAM, nccam.nih.gov), part of the
National Institutes of Health, June 2007. It also includes text from “PC-SPES,”
0$1 #ANCER )NFORMATION 3UMMARY .ATIONAL #ANCER )NSTITUTE "ETHESDA -$
PC-SPES (PDQ®): CAM—Patient. Updated 09/2007. Available at http://cancer.
gov. Accessed January 12, 2010; and from “Selected Vegetables/Sun’s Soup,” PDQ®
#ANCER )NFORMATION 3UMMARY .ATIONAL #ANCER )NSTITUTE "ETHESDA -$ 3ELECTED
Vegetables/Sun’s Soup (PDQ®): CAM—Patient. Updated 02/2007. Available at
http://cancer.gov. Accessed December 11, 2009.
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508
Cancer and CAM
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
PC-SPES
What is PC-SPES?
PC-SPES is a mixture of herbs that was sold as a complementary
and alternative medicine (CAM) treatment for prostate cancer. The
mixture contains these eight herbs:
s "AIKAL SKULLCAP Scutellaria baicalensis)
s ,ICORICE Glycyrrhiza glabra or Glycyrrhiza uralensis)
s 2EISHI MUSHROOM Ganoderma lucidum)
s )SATIS Isatis indigotica)
s 'INSENG Panax ginseng or Panax pseudoginseng var. notoginseng)
s #HRYSANTHEMUM mOWERS Dendranthema morifolium)
s 2ABDOSIA RUBESCENS Isodon rubescens)
s 3AW PALMETTO Serenoa repens)
PC-SPES was taken off the market because some batches were
found to contain prescription medicines in addition to the herbs.
Clinical trials of PC-SPES that were underway were stopped. There
are products being sold now as substitutes for PC-SPES, but they are
not the same mixture.
510
Cancer and CAM
511
Complementary and Alternative Medicine Sourcebook, Fourth Edition
512
Cancer and CAM
513
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514
Cancer and CAM
515
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516
Chapter 76
This chapter contains text from “Grape Seed Extract May Help Prevent and
Treat Alzheimer’s,” by the National Center for Complementary and Alternative
Medicine (NCCAM, nccam.nih.gov), part of the National Institutes of Health,
June 2008; “Pilot Study Provides New Insight on Effect of Ginkgo Extract on
Dementia in the Elderly,” by the NCCAM, 2008; and “Study Suggests Coenzyme
Q10 Slows Functional Decline in Parkinson Disease,” by the National Institute
of Neurological Disorders and Stroke (NINDS, www.ninds.nih.gov), part of the
National Institutes of Health, October 14, 2002. Reviewed and revised by David
A. Cooke, MD, FACP, January 23, 2010.
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518
Cognitive Decline and CAM
519
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520
Cognitive Decline and CAM
says Dr. Shults. The findings are consistent with those of a published
study of patients with early Huntington disease—another degenerative
neurological disorder—that showed slightly less functional decline in
groups that received 600 mg/day of coenzyme Q10.
The new study also used an efficient phase II clinical trial design—
developed by biostatistician David Oakes, PhD, of the University of Roch-
ester, and other study investigators—which should be useful for testing
other drugs that might slow the progression of PD, says Dr. Shults. The
design allowed the researchers to study the effects of three doses plus
a placebo in less than 3 years, and to obtain useful data about the com-
pound’s effectiveness. Dr. Shults and his colleagues strongly caution pa-
tients against taking coenzyme Q10 until a larger, definitive trial can be
CONDUCTED "ECAUSE COENZYME 1 IS CLASSIlED AS A DIETARY SUPPLEMENT
it is not regulated by the U.S. Food and Drug Administration. The ver-
sions of the supplement sold in stores may differ, they may not contain
potentially beneficial amounts of the compound, and taking coenzyme
Q10 over a number of years may be costly, says Dr. Shults. In addition,
the current study included only a small number of patients, and the find-
ings may not extend to people in later stages of PD or to those who are at
risk but have not been diagnosed with the disorder, he notes. Finally, if
many people begin taking coenzyme Q10 because of these early results,
it might make it impossible for investigators to find enough patients to
carry out definitive studies of the compound’s effectiveness and the proper
dosages, since patients must not be taking any treatments in order to be
considered for enrollment in a definitive trial.
The investigators are now planning a larger clinical trial that will
examine the effects of 1,200 mg/day of coenzyme Q10 , and possibly a
higher dose as well, in a larger number of patients.
521
Chapter 77
About Diabetes
Diabetes encompasses a group of diseases. Type 2 diabetes accounts
for 90 to 95 percent of all diagnosed cases and occurs more frequently
in older people. Type 1 diabetes, which accounts for 5 to 10 percent of
cases, usually strikes children and young adults. A third form, gesta-
tional diabetes, develops in some women during pregnancy.
In all forms of diabetes, the body’s ability to convert food into energy
is impaired. After a meal, the body breaks down most food into glucose
(a kind of sugar), the main source of fuel for cells. In people with dia-
betes, the body does not make enough insulin—a hormone that helps
glucose enter cells—or the cells do not respond to insulin properly. Of-
TEN BOTH INSULIN PRODUCTION AND INSULIN ACTION ARE IMPAIRED 7ITHOUT
treatment, glucose builds up in the blood instead of moving into the
cells, where it can be converted into energy. Over time, the high blood
glucose levels caused by diabetes can damage many parts of the body,
Excerpted from “CAM and Diabetes: A Focus on Dietary Supplements,” by the
National Center for Complementary and Alternative Medicine (NCCAM, nccam
.nih.gov), part of the National Institutes of Health, June 2009.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
including the heart and blood vessels, eyes, kidneys, nerves, feet, and
skin. Such complications can be prevented or delayed by controlling
blood glucose, blood pressure, and cholesterol levels.
Type 2 diabetes, the focus of this text, most often is associated with
older age (although it is increasingly being diagnosed in children), obe-
sity (about 80 percent of people with type 2 diabetes are overweight),
a family history of diabetes, and physical inactivity. Certain minority
population groups are at greater risk, as are women who have had
gestational diabetes. Type 2 diabetes usually begins as insulin resis-
tance, a disorder in which cells do not use insulin properly. Symptoms
develop gradually and may include fatigue, frequent urination, exces-
sive thirst and hunger, weight loss, blurred vision, and slow-healing
wounds or sores. However, it is possible to have type 2 diabetes without
experiencing any symptoms.
People with diabetes should try to keep their blood glucose in a
healthy range. The basic tools for managing type 2 diabetes are healthy
eating, physical activity, and blood glucose monitoring. Many people
also need to take prescription pills, insulin, or both.
524
Diabetes and CAM
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526
Diabetes and CAM
527
Chapter 78
About Fibromyalgia
Fibromyalgia is a disorder that causes muscle pain and fatigue.
People with fibromyalgia have chronic widespread pain, as well as
“tender points” on the neck, shoulders, back, hips, arms, and legs, which
hurt when slight pressure (about 9 pounds) is applied.
People with fibromyalgia may also have other symptoms, such as
the following:
s 4ROUBLE SLEEPING
s -ORNING STIFFNESS
s (EADACHES
s 0ROBLEMS WITH THINKING AND MEMORY SOMETIMES CALLED hlBRO FOGv
s )RRITABLE BOWEL SYNDROME
Excerpted from “CAM and Fibromyalgia: At a Glance,” by the National Cen-
ter for Complementary and Alternative Medicine (NCCAM, nccam.nih.gov),
part of the National Institutes of Health, July 2009.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
530
Fibromyalgia and CAM
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532
Chapter 79
Acupuncture
This form of treatment originated in China some 3,000 years ago.
Although widely used in Europe since early in this century and univer-
sally acclaimed for its pain-relieving qualities, it has been of interest
in the United States for a much shorter time.
Physicians in the United States have not embraced acupuncture
mainly because it has lacked documented scientific validity and has
been taught as a practice based on Taoist philosophy passed down
through the centuries with relatively little change.
A small but increasing number of U.S. physicians have found acu-
puncture to be a useful part of their practice, despite the inability to
explain in terms acceptable to their colleagues how they obtained
favorable results by this method of treatment. Thus every day in the
United States and elsewhere, thousands of patients are being treated
with acupuncture for a variety of issues and reporting favorable re-
sults. Family physicians are with increasing frequency being asked
about acupuncture if established medical treatments have not relieved
the pain.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
Biofeedback
"IOFEEDBACK CAN BE AN EFFECTIVE NON MEDICINAL MODALITY UTILIZED
in managing headache (both migraine and tension-type). It is a way
that sufferers can learn to control body functions that were previously
thought to be involuntary. The patient becomes integrally involved in
his or her own headache treatment.
A person must be amenable to this type of therapy and willing to
practice and make a commitment. Relaxation techniques, through
warming of the hands and muscle relaxation, are practiced with the
aid of instruments such as a finger thermometer or computer for mea-
suring temperature or muscle tension. Some biofeedback techniques
monitor brain wave activity. After repeated exercise, the patient gradu-
ally learns physiological sensations or body cues that eventually allow
534
Headache and CAM
Chiropractors
Chiropractors are health care professionals that utilize manual
therapy as a component of their treatments.
Chiropractic manipulation can be of help in relaxing muscles in
cases where there is muscle spasm present. Sometimes a chiropractor
may refer to the vertebrae of the neck or back being out of alignment.
This does not represent a serious structural defect such as would occur
if a vertebra were dislocated. It is believed to be used in reference to the
visual changes seen on x-rays of the back associated with postural and
mechanical abnormalities of the back including muscle spasm. Other
manual techniques such as massage and heat also can be soothing.
The U.S. Headache Guidelines Consortium did not find evidence to
recommend manual therapy including chiropractic manipulation as a
treatment for migraine headache. There is no consistent evidence for
manual therapy being effective in tension-type headache.
There are several different methods of applying manual treatments
to the back and neck. They vary in the amounts of rotation and force
used. Rarely manipulative treatment of the neck has been associated
with serious injury.
Chiropractors are not allowed to prescribe medications.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
The average dosage for patients prior to the test was around 60 mg/
day. During the test, the fixed dose was 25 mg per capsule of freeze-
dried feverfew leaf. The freeze-dried herb was chosen because it is most
like fresh leaves. Preparations like powdered extract or air-dried herb
may be too old or have been heated to 100 degrees Celsius, possibly
making it inactive.
The result of this test was that the patients now receiving the place-
bo had “significant increase in the frequency and severity of headache,
nausea, and vomiting” while the feverfew group “showed no change in
frequency or severity of symptoms of migraine.” Johnson, et al. (1985)
concluded that feverfew does in fact prevent migraine attacks. Most
people need to take feverfew for many months before fully realizing
the beneficial effects.
A low starting dose of 50 mg a day is recommended because the po-
tential for side effects is then reduced. One problem is that freeze-dried
feverfew capsules are not standardized in manufacture and different
preparations may vary in the active ingredients.
Feverfew is currently receiving a great deal of interest in the
United States although most headache experts still regard its use as
experimental. The recent reports of research indicate that continu-
ally taking feverfew extracts may decrease the symptoms of migraine
headaches.
Recently there has been a commercial product developed that uti-
lizes a standardized dose of feverfew based on the activity of the pur-
PORTED ACTIVE AGENT ALONG WITH THERAPEUTIC AMOUNTS OF VITAMIN "
and Magnesium. This may be a more suitable formulation than others
of feverfew.
536
Chapter 80
Excerpted from “Questions and Answers: The NIH Trial of EDTA Chelation
Therapy for Coronary Artery Disease,” by the National Center for Complementary
and Alternative Medicine (NCCAM, nccam.nih.gov), part of the National Insti-
tutes of Health, June 2004. Reviewed and revised by David A. Cooke, MD, FACP,
January 23, 2010.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
A person with CAD may or may not have symptoms. Symptoms can
include chest pain from angina, shortness of breath, lightheadedness,
cold sweats, or nausea.
538
Heart Disease and Chelation Therapy
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
540
Chapter 81
About Hepatitis C
Hepatitis C, a communicable (contagious) disease of the liver, is
caused by the hepatitis C virus (HCV). The term “hepatitis” means
inflammation of the liver; HCV is one of several viruses in the hepatitis
family. If the liver becomes inflamed, it cannot function properly and
remove harmful material from the blood or convert food into energy.
Hepatitis C is transmitted primarily through contact with infected
blood. It is not spread through sneezing, coughing, food or water, or
casual contact. There is no vaccine for hepatitis C; the only way to
prevent it is to avoid exposure.
People who are newly infected have what is called acute hepatitis
C. Most people with acute hepatitis C develop chronic hepatitis C,
which can injure the liver over time. Many people with hepatitis C
show no symptoms for many years; others experience mild or more
serious symptoms.
Excerpted from “CAM and Hepatitis C: A Focus on Herbal Supplements,” by the
National Center for Complementary and Alternative Medicine (NCCAM, nccam
.nih.gov), October 2008.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
The following text summarizes what is known about the safety and
effectiveness of milk thistle and some of the other CAM products that
people with hepatitis C use.
542
Hepatitis C and CAM
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
NCCAM-Funded Research
Recent NCCAM-supported research includes projects studying the
effectiveness of the following:
s 3ILYMARIN FOR PREVENTING AND REVERSING COMPLICATIONS OF CHRONIC
hepatitis C
s 3ILYMARIN FOR THE TREATMENT OF CHRONIC HEPATITIS # IN PEOPLE
who did not respond to conventional antiviral therapy, and in
people with nonalcoholic steatohepatitis (a type of fatty liver
disease)
544
Hepatitis C and CAM
Also, NCCAM has supported studies that test the safety and toler-
ability of different dosages of silymarin in people with hepatitis C.
545
Chapter 82
People are living longer. In 1970, the average life expectancy at birth
was 70.8 years; in 2000, it was 76.9 years; and by 2030 it is estimated
that the “oldest-old,” age 85 and older, could grow to 10 million people.
Views on aging are also changing. It no longer necessarily means
physical decline and illness—in the last two decades, the rate of dis-
ability among older people has declined dramatically.
The National Institute on Aging (NIA), part of the federal gov-
ernment’s National Institutes of Health (NIH), investigates ways to
support healthy aging and prevent or delay the onset of diseases that
disproportionately affect us as we age. These studies not only may
increase what is known as “active life expectancy”—the time of ad-
vancing years free of disability—but also may promote longevity. NIA’s
research includes hormone and dietary approaches, including calorie
restriction.
Results from NIA-sponsored studies and others are likely to im-
prove our understanding of the benefits and risks of hormone supple-
ments, calorie restriction, and other interventions to promote healthy
aging. This text provides an overview of what we know about hormone
supplements and calorie restriction and the research needed to learn
more. Until we have a better understanding, it is a good idea to be
skeptical of claims that hormone or other supplements can solve your
age-related problems. Instead, focus on what is known to help promote
healthy aging: healthy eating and physical activity.
&ROM h#AN 7E 0REVENT !GINGv BY THE .ATIONAL )NSTITUTE ON !GING .)!
nia.nih.gov), part of the National Institutes of Health, February 19, 2009.
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
What Is a Hormone?
The word “hormone” comes from the Greek word, hormo, mean-
ing to set in motion. Hormones are chemical messengers that set in
motion different processes to keep our bodies working properly. For
example, they are involved in our metabolism, immune function, sexual
reproduction, and growth. Hormones are made by specialized groups
of cells within the body’s glands. The glands—such as the pituitary,
thyroid, adrenals, ovaries, and testes—release hormones into the body
as needed to stimulate, regulate, and control the function of other vari-
ous tissues and organs involved in biological processes.
7E CANNOT SURVIVE WITHOUT HORMONES !S CHILDREN HORMONES HELP
us “grow up.” In teenagers, they drive puberty. As we get older, some
OF OUR HORMONE LEVELS NATURALLY DECLINE "UT WHAT DOES THAT MEAN
Scientists do not know exactly. In order to know more, NIA investi-
gates how replenishing hormones in older people affects frailty and
function. Many of these studies focus on hormones that decline with
age, including:
s 'ROWTH HORMONE
s -ELATONIN
s $EHYDROEPIANDROSTERONE $(%!
s 4ESTOSTERONE
s %STROGEN AND PROGESTERONE AS PART OF MENOPAUSAL HORMONE
therapy)
548
Hormones, CAM, and Aging
Hormone Supplements
Levels of some hormones change naturally over the lifespan. Some
hormones increase with age, like parathyroid hormone that helps
regulate the amount of calcium in the blood and bone. Some tend
to decrease over time, such as testosterone in men and estrogen in
WOMEN 7HEN THE BODY FAILS TO MAKE ENOUGH OF A HORMONE BECAUSE OF
a disease or disorder, a doctor may prescribe hormone supplements.
As opposed to hormones produced naturally by the body, hormone
supplements come in many forms such as pills, shots, topical (rub-on)
gels, and medicated skin patches.
You may have read magazine articles or seen television segments
suggesting that hormone supplements can make people feel young
again or can slow or prevent aging. That’s because finding a “fountain
of youth” is an attractive story that captivates us all. The truth is no
research to date has shown that hormone supplements add years to
life or prevent age-related frailty. And, while some supplements have
real health benefits for people with clinical hormone deficiencies due
to a disease or disorder, they also can cause harmful side effects. That’s
why people who have a diagnosed hormone deficiency should still only
take hormone supplements under a doctor’s supervision.
In some cases, the U.S. Food and Drug Administration (FDA) may
have approved a hormone supplement for one purpose, but it is pre-
scribed by physicians for another. This “off-label” use may occur when
physicians believe that research, such as clinical studies done on other
groups of people, demonstrates a supplement’s usefulness for another
CONDITION 7HILE THIS IS THE NORMAL PROCESS FOR EVALUATING DRUGS ALREADY
approved by the FDA, consumers should be aware that a particular
off-label use of a drug may not have been tested and verified to the
same degree as the original use of the drug.
549
Complementary and Alternative Medicine Sourcebook, Fourth Edition
550
Hormones, CAM, and Aging
Melatonin
Melatonin is a hormone involved with our daily sleep/wake cycle. It
is made by the pineal gland located in the brain. Despite some claims
to the contrary, melatonin production and release does not necessar-
ily decrease with age. Instead, a number of factors, including light
exposure and use of some common medications can affect melatonin
secretion in people of any age.
As with other hormones, melatonin is marketed as a dietary supple-
ment. Consumers should look with caution at claims about melatonin
supplements’ effects.
One claim for melatonin supplements is that they are an anti-aging
remedy, but research on the anti-aging effects has been very limited
and focused on animals, not humans. There are also claims that mela-
tonin helps with sleep. Research findings have shown that melatonin
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
DHEA
Dehydroepiandrosterone, or DHEA, is made from cholesterol by the
adrenal glands, which sit on top of each kidney. It is converted by the
body into two other important hormones: testosterone and estrogen.
For most people, DHEA production peaks in the mid-20s and then
gradually declines with age. The effects of this decline including its role
in the aging process are unclear. Even so, some proponents claim that
over-the-counter DHEA supplements can improve energy and strength
and boost immunity. Claims are also made that supplements increase
muscle and decrease fat. To date, there is no conclusive scientific evi-
dence that DHEA supplements have any of these benefits.
The conversion of naturally produced DHEA into a different amount
of estrogen and testosterone is highly individualized. There is no way
to predict whose body will make more and whose will make less of
these hormones. Having an excess of testosterone and estrogen in your
body can be risky.
Scientists do not yet know the effects of long-term use (over 1 year) of
DHEA supplements. Early indications are that these supplements, even
when taken briefly, may have several detrimental effects on the body, in-
552
Hormones, CAM, and Aging
CLUDING LIVER DAMAGE "UT THE PICTURE IS NOT CLEAR 4WO SHORT TERM STUDIES
showed that taking DHEA supplements has no harmful effects on blood,
prostate, or liver function. However, these studies were too small to lead
to conclusions about the safety or efficacy of DHEA supplementation.
Researchers are working to find more definite answers about
DHEA’s effects on aging, muscles, and the immune system. In the
meantime, if you are thinking about taking DHEA supplements, be
aware that the effects are not fully known and might turn out to cause
more harm than good.
Testosterone
Most people know testosterone as the hormone that transforms a
boy into a man and is somehow associated with sex drive. That may be
why some men are concerned about a possible decrease in testosterone
production as they age.
Testosterone is a vital sex hormone that plays an important role in
puberty. In men, testosterone not only regulates sex drive (libido), it also
helps regulate bone mass, fat distribution, muscle mass and strength,
AND THE PRODUCTION OF RED BLOOD CELLS AND SPERM "UT TESTOSTERONE ISNT
exclusively a male hormone—women produce small amounts, as well.
In men, testosterone is produced in the testes, the reproductive glands
that also produce sperm. The amount of testosterone produced in the
testes is regulated by the hypothalamus and the pituitary gland.
As men age, their testes often produce somewhat less testosterone,
especially when compared to years of peak testosterone production dur-
ing adolescence and early adulthood. Normal testosterone production
ranges widely, and it is unclear what amount of decline or how low a
level of testosterone will cause adverse effects.
In recent years, the popular press has reported frequently about
male menopause, a condition supposedly caused by diminishing tes-
tosterone levels in aging men. There is scant scientific evidence that
this condition, also known as andropause or viropause, exists. And
the likelihood that an aging man will experience a major shutdown
of testosterone production similar to a woman’s menopause is very
remote. In fact, many of the changes that take place in older men
often are incorrectly attributed to decreasing testosterone levels. For
instance, some men experiencing erectile difficulty (impotence) may
be tempted to blame it on lowered testosterone, when in many cases
erectile problems are due to circulatory problems.
In certain cases, such as in men whose bodies make very little or no
testosterone, testosterone supplementation may offer benefits. FDA-
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Hormones in Women
Estrogen and progesterone are two hormones that play an impor-
tant part in women’s menstrual cycle and pregnancy. Estrogen also
helps maintain bone strength and might prevent heart disease and
PROTECT MEMORY BEFORE MENOPAUSE "OTH ESTROGEN AND PROGESTERONE
are produced naturally by the ovaries. However, after menopause, the
ovaries stop making these hormones. For more than 60 years, millions
554
Hormones, CAM, and Aging
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Complementary and Alternative Medicine Sourcebook, Fourth Edition
For all the research findings, there are still many unknowns about
the risks of MHT. For instance, scientists have not yet determined
if risks differ between women who have menopausal symptoms and
those who don’t. Also, because women in their early 50s were only a
SMALL PART OF THE 7() SCIENTISTS DO NOT YET KNOW IF CERTAIN RISKS ARE
applicable to younger women who use estrogen to control symptoms
during the menopausal transition.
You may also have heard about a relatively new approach to hor-
mone therapy for women—bioidentical hormones. These are man-
made hormones (from plants such as soy or yams) that have the same
chemical structure as hormones produced by the human body. The
term “bioidentical hormones” is now also being applied to the practice
of compounding or combining hormones such as estrogen and proges-
terone, theoretically based on a woman’s individual hormonal needs.
Large clinical trials of these compound hormones have not been done,
and many bioidentical hormones that are available without a prescrip-
tion are not regulated or approved for safety and efficacy by the FDA.
FDA-regulated bioidentical hormones, such as estradiol and proges-
terone, are available by prescription for women considering MHT.
For middle age and older women, the decision to take hormones
is far more complex and difficult than ever before. Questions about
MENOPAUSAL HORMONE THERAPY REMAIN 7OULD USING A DIFFERENT ESTROGEN
ANDOR PROGESTIN OR DIFFERENT DOSE CHANGE THE RISKS 7OULD THE RESULTS
be different if the hormones were given as a patch or cream, rather
THAN A PILL 7OULD TAKING THE PROGESTIN LESS OFTEN BE AS EFFECTIVE AND
SAFE $OES STARTING MENOPAUSAL HORMONE THERAPY AROUND THE TIME OF
MENOPAUSE COMPARED TO YEARS LATER CHANGE THE RISKS #AN WE PREDICT
556
Hormones, CAM, and Aging
557
Complementary and Alternative Medicine Sourcebook, Fourth Edition
558
Chapter 83
Chapter Contents
Section 83.1—Herbal Remedies for Infertility .......................... 560
Section 83.2—Infertility and CAM............................................. 561
559
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 83.1
Herbs are not regulated by the FDA [U.S. Food and Drug
Administration], but are they safe?
In general, herbs are safe to use. However, there are herbs that
should not be taken during pregnancy, so it is always important to
discuss with your healthcare provider which herbs are safe to take.
7HEN USING HERBS TO ENHANCE FERTILITY IT IS RECOMMENDED THAT YOU
consult a healthcare provider who is familiar with which herbs affect
different aspects of your fertility.
560
Infertility and CAM
Section 83.2
561
Complementary and Alternative Medicine Sourcebook, Fourth Edition
References
-ANHEIMER % :HANG ' 5DOFF , ET AL %FFECT OF ACUPUNCTURE ON RATES
of pregnancy and live birth among women undergoing in vitro fertiliza-
tion: systematic review and meta-analysis. British Medical Journal.
Published online, February 2008.
562
Chapter 84
&ROM h3PINAL -ANIPULATION FOR ,OW "ACK 0AIN v FROM THE .ATIONAL #ENTER
for Complementary and Alternative Medicine (NCCAM, nccam.nih.gov), part of
the National Institutes of Health, April 2009.
563
Complementary and Alternative Medicine Sourcebook, Fourth Edition
564
Low Back Pain and CAM
findings when what is being measured varies widely from one study
to the next. Recent research has begun to address these issues.
Serious Complications
The rate of serious complications from spinal manipulation, al-
though not definitely known, appears to be very low overall. A potential
complication from low-back manipulation is cauda equina syndrome, a
condition in which nerves in the lower part of the spinal cord become
compressed, resulting in pain, weakness, and loss of feeling in one or
both legs. Other functions—such as bowel or bladder control—may
also be affected. Reports indicate that cauda equina syndrome is an
extremely rare complication. In people whose pain is caused by a her-
niated disc, manipulation of the low back also appears to have a very
low chance of either causing or worsening cauda equina syndrome.
NCCAM Research
Projects supported by NCCAM to study spinal manipulation for
low-back pain include studies of the following:
s 4HE OPTIMAL NUMBER AND FREQUENCY OF TREATMENTS AND THE DURA-
tion of care
s %STIMATED USE COSTS AND OUTCOMES OF CHIROPRACTIC CARE FOR RECUR-
rent back pain
s 7HAT HAPPENS IN THE BODY DURING MANIPULATION OF THE LOW BACK
565
Chapter 85
Menopausal Symptoms
and CAM
About Menopause
A woman is said to have completed natural menopause when she
has not had a period for 12 consecutive months. For American women,
this typically happens at around age 51 or 52. Menopause occurs im-
mediately if the uterus or both ovaries are surgically removed, or if
the ovaries are damaged in cancer treatment with radiation therapy
or certain drugs.
From “Menopausal Symptoms and CAM,” by the National Center for Com-
plementary and Alternative Medicine (NCCAM, nccam.nih.gov), part of the Na-
tional Institutes of Health, January 2008.
567
Complementary and Alternative Medicine Sourcebook, Fourth Edition
568
Menopausal Symptoms and CAM
Botanicals
Black cohosh (Actaea racemosa, Cimicifuga racemosa): This
herb has received more scientific attention for its possible effects on
menopausal symptoms than have other botanicals. Studies of its ef-
fectiveness in reducing hot flashes have had mixed results. A study
funded by NCCAM and the National Institute on Aging found that
black cohosh, whether used alone or with other botanicals, failed to
relieve hot flashes and night sweats in postmenopausal women or those
approaching menopause. Other research suggests that black cohosh
does not act like estrogen, as once was thought.
United States Pharmacopeia experts suggest women should dis-
continue use of black cohosh and consult a health care practitioner if
they have a liver disorder or develop symptoms of liver trouble, such as
abdominal pain, dark urine, or jaundice. There have been several case
reports of hepatitis (inflammation of the liver), as well as liver failure,
in women who were taking black cohosh. It is not known if black cohosh
was responsible for these problems. Although these cases are very rare
and the evidence is not definitive, scientists are concerned about the
possible effects of black cohosh on the liver.
569
Complementary and Alternative Medicine Sourcebook, Fourth Edition
and increase the activity in the body of, the blood-thinning medicine
warfarin. This can lead to bleeding complications in women who take
this medicine.
570
Menopausal Symptoms and CAM
s WOMEN WHO ARE TAKING DRUGS THAT INCREASE ESTROGEN LEVELS IN THE
body, such as birth control pills; MHT; or a type of cancer drug
called selective estrogen receptor modulators (SERMs), such as
tamoxifen.
DHEA [Dehydroepiandrosterone]
DHEA is a naturally occurring substance that is changed in the
body to the hormones estrogen and testosterone. It is also manufac-
tured and sold as a dietary supplement. A few small studies have sug-
gested that DHEA might possibly have some benefit for hot flashes and
decreased sexual arousal, although small randomized controlled trials
HAVE SHOWN NO BENElT "ECAUSE LEVELS OF NATURAL $(%! IN THE BODY
decline with age, some people believe that taking a DHEA supplement
can help treat or prevent conditions related to aging; however, there
is no good scientific evidence to support this notion.
Concerns have been raised about whether DHEA is safe and effective.
Its long-term effects, risks, and benefits have not been well studied, and
scientists are not certain whether it might increase the risk for breast
OR PROSTATE CANCER "EFORE USING $(%! FOR ANY PURPOSE PEOPLE SHOULD
talk to their health care provider about potential benefits and risks.
571
Complementary and Alternative Medicine Sourcebook, Fourth Edition
572
Chapter 86
Chapter Contents
Section 86.1—Overview of CAM Used in Mental
Health Care ......................................................... 574
Section 86.2—Alcohol Addiction and
Electroacupuncture............................................. 579
Section 86.3—Attention Deficit Hyperactivity
Disorder (ADHD) and CAM................................ 580
Section 86.4—Anxiety and Self-Hypnosis ................................. 582
Section 86.5—Posttraumatic Stress Disorder
and Acupuncture ................................................. 583
573
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 86.1
Self-Help
Many people with mental illnesses find that self-help groups are
an invaluable resource for recovery and for empowerment. Self-help
generally refers to groups or meetings that have the following char-
acteristics:
s )NVOLVE PEOPLE WHO HAVE SIMILAR NEEDS
s !RE FACILITATED BY A CONSUMER SURVIVOR OR OTHER LAYPERSON
s !SSIST PEOPLE TO DEAL WITH A hLIFE DISRUPTINGv EVENT SUCH AS A
death, abuse, serious accident, addiction, or diagnosis of a physi-
cal, emotional, or mental disability, for oneself or a relative
s !RE OPERATED ON AN INFORMAL FREE OF CHARGE AND NONPROlT BASIS
s 0ROVIDE SUPPORT AND EDUCATION
s !RE VOLUNTARY ANONYMOUS AND CONlDENTIAL
574
Mental Health Care and CAM
Pastoral Counseling
Some people prefer to seek help for mental health problems from
their pastor, rabbi, or priest, rather than from therapists who are not
affiliated with a religious community. Counselors working within tra-
ditional faith communities increasingly are recognizing the need to
incorporate psychotherapy and/or medication, along with prayer and
spirituality, to effectively help some people with mental disorders.
Animal-Assisted Therapies
7ORKING WITH AN ANIMAL OR ANIMALS UNDER THE GUIDANCE OF A HEALTH
care professional may benefit some people with mental illness by fa-
cilitating positive changes, such as increased empathy and enhanced
socialization skills. Animals can be used as part of group therapy pro-
grams to encourage communication and increase the ability to focus.
Developing self-esteem and reducing loneliness and anxiety are just
some potential benefits of individual-animal therapy.
Expressive Therapies
Art therapy: Drawing, painting, and sculpting help many people
to reconcile inner conflicts, release deeply repressed emotions, and
foster self-awareness, as well as personal growth. Some mental health
providers use art therapy as both a diagnostic tool and as a way to
help treat disorders such as depression, abuse-related trauma, and
schizophrenia. You may be able to find a therapist in your area who
has received special training and certification in art therapy.
575
Complementary and Alternative Medicine Sourcebook, Fourth Edition
576
Mental Health Care and CAM
577
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Technology-Based Applications
The boom in electronic tools at home and in the office makes access
to mental health information just a telephone call or a mouse click
away. Technology is also making treatment more widely available in
once-isolated areas.
578
Mental Health Care and CAM
Section 86.2
Alcohol and drug addiction pose serious medical, social, and eco-
nomic problems in the United States. However, finding effective treat-
ments for addiction is challenging. Many people relapse due to intense
cravings and/or painful withdrawal symptoms. Electroacupuncture
(acupuncture combined with electrical stimulation) is currently be-
ing studied as a possible treatment option, and preliminary evidence
suggests that electroacupuncture can counteract addiction by affecting
related chemicals (opiates) in the brain.
In a study funded through a research center program jointly spon-
sored by NCCAM and the National Institute on Alcohol Abuse and
Alcoholism (NIAAA), researchers examined the effects of electroa-
cupuncture on alcohol intake by alcohol-preferring rats. After being
trained to drink alcohol voluntarily and then subjected to alcohol de-
privation, the rats received either electroacupuncture or sham elec-
troacupuncture, and their alcohol intake was monitored after the
intervention. Some rats were also pretreated with naltrexone (a drug
579
Complementary and Alternative Medicine Sourcebook, Fourth Edition
that blocks the effects of opiates), so researchers could look for evidence
that opiate mechanisms are involved in electroacupuncture’s effects.
The results showed that electroacupuncture reduced the rats’ al-
cohol intake. The researchers also found that injecting the rats with
naltrexone blocked the effect of electroacupuncture on alcohol intake—
an indication that this effect may be through the brain’s opiate system.
On the basis of their findings, the researchers recommend rigorous
clinical trials to study the effects of electroacupuncture in alcohol-
addicted people. They also recommend further investigation of how
electroacupuncture affects the brain.
Reference
Overstreet DH, Cui C-L, Ma Y-Y, et al. Electroacupuncture reduces vol-
untary alcohol intake in alcohol-preferring rats via an opiate-sensitive
mechanism. Neurochemical Research. 2008;33(10):2166–2170.
Section 86.3
580
Mental Health Care and CAM
Reference
7EBER 7 6ANDER 3TOEP ! -C#ARTY 2, ET AL (YPERICUM PERFORATUM
3T *OHNS 7ORT FOR !TTENTION $ElCIT(YPERACTIVITY $ISORDER IN #HIL-
dren and Adolescents. JAMA. 2008;299(22):2633–2641.
581
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Section 86.4
Reference
%LVIRA 6 ,ANG +EVIN 3 "ERBAUM 3ALOMAO &AINTUCH ET AL !DJUNCTIVE
self-hypnotic relaxation for outpatient medical procedures: A prospec-
tive randomized trial with women undergoing large core breast biopsy.
Pain, December 2006.
582
Mental Health Care and CAM
Section 86.5
A pilot study shows that acupuncture may help people with posttrau-
matic stress disorder. Posttraumatic stress disorder (PTSD) is an anxiety
disorder that can develop after exposure to a terrifying event or ordeal
in which grave physical harm occurred or was threatened. Traumatic
events that may trigger PTSD include violent personal assaults, natural
or human-caused disasters, accidents, or military combat.
Michael Hollifield, MD, and colleagues conducted a clinical trial
examining the effect of acupuncture on the symptoms of PTSD. The
researchers analyzed depression, anxiety, and impairment in 73 people
with a diagnosis of PTSD. The participants were assigned to receive ei-
ther acupuncture or group cognitive-behavioral therapy over 12 weeks,
or were assigned to a wait-list as part of the control group. The people
in the control group were offered treatment or referral for treatment
at the end of their participation.
The researchers found that acupuncture provided treatment effects
similar to group cognitive-behavioral therapy; both interventions were
superior to the control group. Additionally, treatment effects of both
the acupuncture and the group therapy were maintained for 3 months
after the end of treatment.
The limitations of the study are consistent with preliminary re-
search. For example, this study had a small group of participants that
lacked diversity, and the results do not account for outside factors that
may have affected the treatments’ results.
Reference
-ICHAEL (OLLIlELD .ITYAMO 3INCLAIR ,IAN 4EDDY $ 7ARNER AND 2ICH-
ard Hammerschlag. Acupuncture for Posttraumatic Stress Disorder: A
583
Complementary and Alternative Medicine Sourcebook, Fourth Edition
584
Chapter 87
585
Complementary and Alternative Medicine Sourcebook, Fourth Edition
586
Sleep Disorders and CAM
NCCAM Research
NCCAM supports studies on whether certain CAM therapies might
be helpful for sleep disorders. Some examples include the following:
s 5NIVERSITY OF 7ASHINGTON RESEARCHERS ARE TESTING THE HERB VALER-
ian in healthy older adults who experience sleep disturbances.
At Emory University, valerian is being studied in people with
587
Complementary and Alternative Medicine Sourcebook, Fourth Edition
588
Sleep Disorders and CAM
589
Complementary and Alternative Medicine Sourcebook, Fourth Edition
s 4RY THESE TIPS AND RECORD YOUR SLEEP AND SLEEP RELATED ACTIVITIES
in a sleep diary. If problems continue, discuss the sleep diary
with your doctor.
Source for tips: National Institute on Aging, with credit also to the
National Sleep Foundation.
590
Part Nine
Glossary of Terms
Related to Alternative and
Complementary Medicine
593
Complementary and Alternative Medicine Sourcebook, Fourth Edition
594
Glossary of Terms
200 mg of calcium per serving would state on the label that the % DV
for calcium is 20%.3
dietary supplement: A product that is intended to supplement the
diet; contains one or more dietary ingredients (including vitamins,
minerals, herbs or other botanicals, amino acids, and certain other
substances) or their constituents; and is intended to be taken by mouth,
in forms such as tablet, capsule, powder, softgel, gelcap, or liquid.1
energy medicine: Energy medicine is a domain in CAM that deals
with energy fields of two types: veritable, which can be measured,
and putative, which have yet to be measured. Practitioners of energy
medicine believe that illness results from disturbances of these subtle
energies (the biofield).1
guided imagery: A type of CAM that encourages imagining a pleas-
ant scene to take your mind off your pain or anxiety.4
herbal supplements: One type of dietary supplement. An herb is a
plant or plant part (such as leaves, flowers, or seeds) that is used for
its flavor, scent, and/or therapeutic properties. Botanical is often used
as a synonym for herb. An herbal supplement may contain a single
herb or mixtures of herbs.1
homeopathy: A whole medical system that originated in Europe.
Homeopathy seeks to stimulate the body’s ability to heal itself by giv-
ing very small doses of highly diluted substances that in larger doses
would produce illness or symptoms (an approach called “like cures
like”).1
hypnosis: A trance-like state in which a person becomes more aware
and focused and is more open to suggestion.2
magnet therapy: A magnet produces a measurable force called a
magnetic field. Magnets are used for many different types of pain,
including foot pain and back pain from conditions such as arthritis
and fibromyalgia. Magnets in products such as magnetic patches and
disks, shoe insoles, bracelets, and mattress pads are used for pain in
the foot, wrist, back, and other parts of the body.1
manipulation: The application of controlled force to a joint, moving
it beyond the normal range of motion in an effort to aid in restoring
health. Manipulation may be performed as a part of other therapies
or whole medical systems, including chiropractic medicine, massage,
and naturopathy.1
595
Complementary and Alternative Medicine Sourcebook, Fourth Edition
massage: Pressing, rubbing, and moving muscles and other soft tis-
sues of the body, primarily by using the hands and fingers. The aim is
to increase the flow of blood and oxygen to the massaged area.1
596
Glossary of Terms
qi: In traditional Chinese medicine, the vital energy or life force pro-
posed to regulate a person’s spiritual, emotional, mental, and physical
health and to be influenced by the opposing forces of yin and yang.1
reflexology: A type of massage, which applies pressure to the feet
(or sometimes the hands or ears), to promote relaxation or healing in
other parts of the body.1
Reiki: A healing practice that originated in Japan. Reiki practitioners
place their hands lightly on or just above the person receiving treatment,
with the goal of facilitating the person’s own healing response.1
spirituality: Spirituality may be defined as an individual’s sense of
peace, purpose, and connection to others, and beliefs about the meaning
of life. Spirituality may be found and expressed through an organized
religion or in other ways.2
tai chi: Tai chi, which originated in China as a martial art, is a mind-
body practice in complementary and alternative medicine. Tai chi is
sometimes referred to as moving meditation—practitioners move their
bodies slowly, gently, and with awareness, while breathing deeply.1
traditional Chinese medicine: A whole medical system that origi-
nated in China. It is based on the concept that disease results from
disruption in the flow of qi and imbalance in the forces of yin and yang.
Practices such as herbs, meditation, massage, and acupuncture seek to
aid healing by restoring the yin-yang balance and the flow of qi.1
vegan: A person who does not eat any foods that come from animals,
including meat, eggs, and dairy products.2
vegetarian: A person who eats a diet free of meat. Lacto-vegetarians
consume milk and milk products along with plant-based foods. They
do not eat eggs. Lacto-ovo vegetarians eat eggs and milk and milk
products, in addition to plant-based foods.4
vitamin: A nutrient that the body needs in small amounts to function
and maintain health. Examples are vitamins A, C, and E.3
whole medical system: A complete system of theory and practice that
has evolved over time in different cultures and apart from conventional
medicine. Examples of whole medical systems include traditional Chi-
nese medicine, Ayurvedic medicine, homeopathy, and naturopathy.1
yin and yang: The concept of two opposing yet complementary forces
described in traditional Chinese medicine. Yin represents cold, slow,
597
Complementary and Alternative Medicine Sourcebook, Fourth Edition
598
Chapter 89
Directory of Organizations
That Provide Information
about Alternative and
Complementary Medicine
Government Agencies That Provide Information about
Alternative and Complementary Medicine
Agency for Healthcare Healthfinder®
Research and Quality National Health Information
Office of Communications and Center
Knowledge Transfer P.O. Box 1133
540 Gaither Road, Second Floor Washington, DC 20013-1133
Rockville, MD 20850 Toll-Free: 800-336-4797
Phone: 301-427-1364 Phone: 301-565-4167
Fax: 301-427-1873 Fax: 301-984-4256
Website: www.ahrq.gov Website: www.healthfinder.gov
E-mail: healthfinder@nhic.org
Centers for Disease Control
and Prevention National Cancer Institute
1600 Clifton Road 6116 Executive Blvd. Rm 3036A
Atlanta, GA 30333 Bethesda, MD 20892-8322
Toll-Free: 800-CDC-INFO Toll-Free: 800-4-CANCER
(232-4636) (422-6237)
Phone: 404-639-3311 TTY Toll-Free: 800-332-8615
Website: www.cdc.gov Website: www.cancer.gov
E-mail: cdcinfo@cdc.gov E-mail: cancergovstaff@mail.nih
.gov
Resources in this chapter were compiled from several sources deemed reli-
able; all contact information was verified and updated in January 2010.
599
Complementary and Alternative Medicine Sourcebook, Fourth Edition
600
Directory of Organizations
601
Complementary and Alternative Medicine Sourcebook, Fourth Edition
602
Directory of Organizations
603
Complementary and Alternative Medicine Sourcebook, Fourth Edition
604
Directory of Organizations
605
Complementary and Alternative Medicine Sourcebook, Fourth Edition
606
Directory of Organizations
607
Complementary and Alternative Medicine Sourcebook, Fourth Edition
608
Directory of Organizations
609
Complementary and Alternative Medicine Sourcebook, Fourth Edition
610
Directory of Organizations
611
Index
Index
615
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Agency for Healthcare Research Alzheimer’s Disease Cooperative
and Quality (AHRQ), continued Study 146
hyperbaric oxygen therapy American Academy of Anti-Aging
publication 285n Medicine, contact information 601
Age-Related Eye Disease American Academy of Family
Study 157–58, 210–11 Physicians (AAFP), contact
age-related macular information 602
degeneration (AMD) American Academy of Medical
vitamin E 157–58 Acupuncture, contact information
zinc 210–11 602
AHRQ see Agency for Healthcare American Apitherapy Association,
Research and Quality apitherapy publication 253n
AI see Adequate Intakes American Apitherapy Society,
ai chi, described 384, 392–95 contact information 602
ai chi ne, described 385 American Art Therapy Association
alcohol addiction, art therapy publication 299n
electroacupuncture 579–80 contact information 602
alcohol use American Association of Acupuncture
beta-carotene 134 and Oriental Medicine, contact
energy drinks 232 information 602
vitamin B6 139 American Association of Colleges
Alexander, F.M. 379, 381–82 of Osteopathic Medicine, contact
Alexander Technique, overview information 602
371–82 American Association of Integrative
Alexander Technique International, Medicine, contact information 602
contact information 601 American Association of Naturopathic
allergies Physicians, contact information 268,
bee sting 255 602
bee stings 255 American Board of Psychological
bioresonance therapy 484–85 Hypnosis, contact information 326
CAM therapies 503–6 American Botanical Council,
echinacea 207 contact information 603
fish oils 185 American Chiropractic Association,
alpha-carotene, vitamin A 130 contact information 603
alpha-linolenic acid 176 American Dance Therapy Association
alpha-lipoic acid, diabetes mellitus contact information 603
524–25 dance therapy publication 359n
alpha-tocopherol, vitamin E 153–54 American Feng Shui Institute,
Alpha-Tocopherol Beta-Carotene contact information 603
Cancer Prevention Study 131 American Heart Association,
“Alternative Approaches to Mental contact information 603
Health Care” (SAMHSA) 574n American Herbalists Guild,
alternative medicine, described 4, 21 contact information 603
Alternative Medicine Foundation, American Holistic Health Association,
contact information 601 contact information 603
“Alternative Therapies” (AAFA) 503n American Holistic Medical Association,
Alzheimer disease contact information 603
grape seed extract 517–18 American Massage Therapy
research 27–28 Association, contact information 603
616
Index
American Music Therapy Association antioxidants
contact information 604 age-related macular
music therapy publication 335n degeneration 210–11
American Naturopathic Medical research 250
Association, contact information vitamin A 130
604 vitamin E 153–54, 158
American Oriental Bodywork anxiety, self-hypnosis 582
Therapy Association, contact apitherapy, overview 253–55
information 604 “Applied Kinesiology” (Natural
American Osteopathic Association, Medicines Comprehensive
contact information 604 Database) 448n
American Polarity Therapy applied kinesiology, overview 448–49
Association apricot pits 54
contact information 604 “Aquatic Therapy” (NCPAD) 383n
polarity therapy publication 467n aquatic therapy, overview 383–98
American Pregnancy Association, “Are Detox Diets Safe?” (Nemours
infertility treatment publication Foundation) 264n
560n “Are You Considering CAM?”
American Psychological Association (NCCAM) 7n
contact information 604 ARIC study see Atherosclerosis Risk
publications in Communities study
hypnosis 324n Arizona Center for Integrative
relaxation training 345n Medicine, contact information 605
American Reflexology Certification Arnold, Joan 371n
Board aromatherapy
contact information 604 defined 593
reflexology publication 431n overview 257–61
American Society for the Alexander “Aromatherapy and Essential
Technique, contact information 604 Oils” (NCI) 257n
American Society of Clinical Hypnosis, Artemisia annua 61
contact information 326, 605 artemisinin 61
American Tai Chi and Qigong arthritis
Association, contact information 605 Alexander technique 374
American Yoga Association, contact apitherapy 253–54
information 605 CAM therapies 491–502
anaphylaxis, bee stings 255 health fraud 46
M.D. Anderson Cancer Center, selenium 195
contact information 611 art therapy
androstenedione, described 227 mental health care 575
anemia overview 299–302
folic acid 161 Associated Bodywork and
vitamin B12 144 Massage Professionals,
angina pectoris, fish oils 178 contact information 605
angioplasty, fish oils 181 Association for Applied
animal-assisted therapies, Psychophysiology and Biofeedback
mental health care 575 biofeedback publication 303n
antibiotic medications, probiotics 220 contact information 605
anticonvulsant medications, folic acid Association of American Indian
163 Physicians, contact information 80
617
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Association of Reflexologists, barbiturates, folic acid 163
contact information 605 Bastyr Center for Natural Health,
asthma contact information 606
Alexander technique 374–75 Beal, Flint 520
CAM therapies 503–6 Beecher, Henry 294
fish oils 179 bee stings see apitherapy
Asthma and Allergy Foundation Bekhterev, Vladimir 431
of America (AAFA), alternative Benefin 54
therapies publication 503n Benson, Herbert 345–47
atherosclerosis, fish oils 176, 179 Benson-Henry Institute for
Atherosclerosis Risk in Communities Mind Body Medicine, contact
study (ARIC study) 172 information 606
athletes Berman, Brian M, 501–2
Alexander technique 378 beta-carotene, vitamin A 130
sports supplements 226–30 beta-cryptoxanthin, vitamin A 130
Atlantic Institute of Aromatherapy, Bifidobacterium bifidus 220
contact information 605 Biodynamic Craniosacral Therapy
attention deficit hyperactivity disorder Association of North America,
(ADHD), CAM therapies 580–81 contact information 606
autonomic nervous system, bioelectromagnetic-based
meditation 331 therapies, described 5
Awareness Through biofeedback
Movement 409–10 allergies 506
Ayurveda defined 593
defined 593 headache 534–35
described 25, 61–62 mental health care 577
mental health care 577 overview 303–9
overview 65–71 “Biofeedback” (National
Ayurvedic Institute, contact Headache Foundation) 533n
information 605 Biofeedback Certification Institute of
“Ayurvedic Medicine: An America, contact information 606
Introduction” (NCCAM) 65n “Biofeedback: Consumer Questions
Answered” (Moss) 303n
biofield, described 456
B
biofield therapies, described 5
The Bach Centre, contact “Biologically Based Practices: An
information 605 Overview” (NCCAM) 243n
BackHab, described 385, 390 biologically based therapies
back pain, CAM therapies 563–65 defined 594
bacteria, probiotics 219–20 described 4, 22
Bad Ragaz, described 385 overview 243–51
baiguo 214 bioresonance therapy, overview
bai guo ye 214 484–85
balance bipolar disorder, fish oils 179
acupuncture 81–82 Black Beauties (slang) 53–54
Ayurvedic medicine 67–69 black cohosh, menopause 569
Native American medicine 79 blood pressure levels,
naturopathy 91 magnesium 169–70
traditional Chinese medicine 75 body-based practices, defined 596
618
Index
Bompey, Nanci 484n “CAM and Diabetes: A Focus on
bone health Dietary Supplements” (NCCAM)
calcium 198–200 523n
vitamin D 147 “CAM and Fibromyalgia: At a
borage, arthritis 493 Glance” (NCCAM) 529n
Boswellia, arthritis 496 “CAM and Hepatitis C: A Focus on
“Botanical Dietary Supplements: Herbal Supplements” (NCCAM)
Background Information” (ODS) 541n
107n Camellia sinensis 236
botanicals “Cam Use and Children” (NCCAM) 17n
arthritis 491–97 “Cancer and CAM” (NCCAM) 507n
Ayurvedic medicine 70 cancers
defined 594 aromatherapy 258
menopause 569–71 CAM therapies 507–16
overview 107–10 deep breathing exercises 311–15
“Bowen Technique” (Natural Medicines fish oils 179
Comprehensive Database) 449n folic acid 165
Bowen technique, overview 449–50 Gerson therapy 269–72
brain injury, hyperbaric oxygen health fraud 45–46
therapy 287 macrobiotics 273–74
breastfeeding research 26–27
fish oils 186–87 selenium 193–94
probiotics 220 spiritual distress 342–44
“A Brief History of Foot Reflexology” vitamin A 131
(American Reflexology Certification vitamin D 150–51
Board) 431n vitamin E 156–57
Briggs, Josephine 201 Cannon, Walter 294
Brunschwiler, Arjana 387 “Can’t Sleep? Science Is Seeking
Burdenko Method, described 385 New Answers” (NIH) 585n
Buteyko Breathing Association, “Can We Prevent Aging?” (NIA) 547n
contact information 606 Caraka Samhita 66
carbohydrate metabolism,
magnesium 170–71
C
carbohydrates, energy drinks 233
caffeine cardiac arrhythmias, fish oils 179
energy drinks 231–32 cardiovascular disease
green tea 237 fish oils 177–78, 181
sports supplements 228 folic acid 164
calcidiol, described 147 magnesium 173–74
calcitriol, described 147 vitamin B12 144–45
calcium Carotene and Retinol Efficiency
bone health 147, 198–200 Trial (CARET) 131
vegans 278 carotenoids, overview 129–35
vegetarians 280 carpal tunnel syndrome
“Calcium Supplements: What to Alexander technique 375, 377
Look for” (NIAMS) 198n vitamin B6 139
calorie restriction, described 557–58 cataracts, vitamin E 157–58
CAM see complementary and CDC see Centers for Disease
alternative medicine Control and Prevention
619
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Cellular Tea 54 children
Center for Integrative Health complementary and alternative
and Healing medicine 16, 17–19
contact information 606 Rolfing 446
publications vegetarians 281–82
craniosacral therapy 403n Chinese herbal medicine, described 75
guided imagery 322n Chinese massage, overview 421–22
lymphatic drainage Chinese Materia Medica, described 61
massage 419n Chinese tea 236
Shiatsu 475n chiropractic
Tui Na 421n allergies 506
Center for Integrative Medicine, defined 594
contact information 606 described 23
Center for Mindfulness in Medicine, headache 535
Health Care, and Society, contact overview 399–402
information 607 “Chiropractic: An Introduction”
Centers for Disease Control and (NCCAM) 399n
Prevention (CDC), contact “Chiropractors” (National
information 599 Headache Foundation) 533n
cerebral palsy, hyperbaric cholecalciferol, described 148
oxygen therapy 287–88 cholesterol levels
certification fish oils 177
art therapy 299–300, 302 selenium 195
Ayurvedic medicine 70 vitamin E 154–55
biofeedback 306 chondroitin
CAM practitioners 33 arthritis 496–97
dance therapy 359–60 overview 201–4
homeopathy 88–89 research 27
massage therapy 417 chromium, diabetes mellitus 525
naturopathy 94 “Chromotherapy” (Natural Medicines
Reiki 473 Comprehensive Database) 358n
traditional Chinese Clegg, Daniel O. 201, 203
medicine 77 Cleland, Rich 51–52
Trager approach 451 clinical trials
yoga 355 aromatherapy 259
see also licensing requirements beta-carotene 134
chakras CAM practitioners 36
color therapy 358 complementary and alternative
polarity therapy 468 medicine 11
CHD see coronary heart defined 594
disease dietary supplements 246, 249–51
chelation therapy Gerson therapy 271–72
defined 594 ginkgo biloba 215
heart disease 537–40 homeopathy 63–64
research 26 magnesium 170, 172
chi see qi manipulative and body-based
Chi Energy practices 364–67
feng shui publication 317n PC-SPES 510, 512
website address 607 selenium 194
620
Index
clinical trials, continued cupping, described 76
thunder god vine 492 curcumin, arthritis 496
vitamin D 150–51 cyclosporine, fish oils 178, 182
vitamin E 155–59 cystic fibrosis, fish oils 180
zinc 209–11
cod liver oil 176
D
coenzyme Q10
Parkinson disease 519–21 Daily Value (DV), defined 594–95
research 250 dance therapy
cognitive function mental health care 576
vitamin B12 145–46 overview 359–60
vitamin E 158–59 DASH diet see Dietary Approaches
coldwater fish 176 to Stop Hypertension
colonic irrigation, detoxification decoction, described 108
diets 264–65 deep breathing exercises,
color therapy, overview 358–59 overview 311–15
complementary and alternative dehydroepiandrosterone (DHEA)
medicine (CAM) described 227, 552–53
defined 594 menopause 571
overview 3–11 dementia
“Complementary and Alternative CAM therapies 517–19
Medicine (CAM)” (NIA) 21n fish oils 180
Complementary Healthcare vitamin B12 145–46
Information Service, contact Department of Health and Human
information 607 Services (DHHS) see US Department
complementary medicine, of Health and Human Services
described 3–4, 21 depression
constitution, Ayurvedic medicine 67 fish oils 180
conventional medicine, defined 594 St. John’s wort 216
Cooke, David A. 78n, 267n, 273n, detoxification diets, overview 264–66
285n, 303n, 322n, 403n, 419n, 450n, DHA (docosahexaenoic acid)
486n, 491n, 503n, 517n, 537n, 574n described 55
Cornelius, Alfons 431 fish oils 176
coronary artery bypass grafting, DHEA see dehydroepiandrosterone
fish oils 181 DHHS see US Department of Health
coronary heart disease (CHD) and Human Services
chelation therapy 537–40 diabetes mellitus
vitamin E 154–56 CAM therapies 523–27
cranberry juice, research 250–51 fish oils 182
“Craniosacral Therapy” (Center for health fraud 47
Integrative Health and Healing) magnesium 170–72
403n diarrhea, zinc 209
craniosacral therapy, overview 403–5 diet and nutrition
creatine, described 227–28 arthritis 497–98
Crohn disease, fish oils 179–80 CAM therapies 264–83
“Crystal and Gem Therapy” folic acid 161–62
(University of California) 486n Gerson therapy 269–72
crystal therapy 486–87 macrobiotics 273–74
Cuentos, mental health care 577 mental health care 575
621
Complementary and Alternative Medicine Sourcebook, Fourth Edition
diet and nutrition, continued drug interactions
veganism 275–79 fish oils 187–88
vegetarianism 279–83 St. John’s wort 217, 251
vitamin A 130–31, 135 vitamin B6 139
vitamin B6 138, 140–41 DrWeil.com, website address 607
Dietary Approaches to Stop Dull, Harold 387
Hypertension (DASH diet) 170 DV see Daily Value
Dietary Reference Intakes (DRI), dysmenorrhea, fish oils 180
folic acid 162
Dietary Supplement Health and
E
Education Act (DSHEA; 1994)
biologically based therapies 243–44 echinacea
definitions 101, 107–8, 111 naturopathy 62
regulations 53 overview 206–7
dietary supplements research 251
adolescents 117–19 “Echinacea” (NCCAM) 206n
arthritis 491–97 eczema, fish oils 180
defined 595 EDTA chelation therapy, heart
described 121–22 disease 537–40
diabetes mellitus 525–27 EGCG (epigallocatechin gallate) 236
health fraud 47 “Electroacupuncture May Help
online safety 52–56 Alcohol Addiction” (NCCAM) 579n
overview 101–5, 111–15 electromagnetic energy
vitamin B12 144 arthritis 498–99
vitamin D 148 described 460–61
see also botanicals feng shui 317–19
“Dietary Supplements: Background electronic communications,
Information” (ODS) 101n mental health care 578
“Dietary Supplements Glucosamine elements, traditional Chinese
and/or Chondroitin Fare No Better medicine 75
than Placebo in Slowing Structural enemas, Gerson therapy 270–72
Damage of Knee Osteoarthritis” see also detoxification diets
(NIH) 201n energy drinks, overview 231–33
dietary therapy, described 76 “Energy Drinks: Power Boosts or
“The Differences between Reflexology Empty Boasts?” (SAMHSA) 231n
and Massage” (American Reflexology energy medicine
Certification Board) 431n defined 595
digestive tract, probiotics 220–21 described 5, 22–23
digitalis 491 overview 455–61
dilutions principle 86 “Energy Medicine: An Overview”
distant healing, described 460 (NCCAM) 455n
DNA (deoxyribonucleic acid) EPA (eicosapentaenoic acid)
folic acid 161 described 55
vitamin B12 143 fish oils 176
Dodge, Hiroko 518 ephedra
dong quai, menopause 569–70 adolescents 118
doshas traditional Chinese medicine 77
Ayurvedic medicine 67–68 ephedrine, dietary supplements 53
described 25 epigallocatechin gallate (EGCG) 236
622
Index
epinephrine, bee stings 255 financial considerations
ergocalciferol, described 148 acupuncture 84
ergogenic aids, described 226 biofeedback 308
essential oils CAM therapies 39–40, 44
apitherapy 253 dietary supplements 245
overview 257–61 macrobiotics 274
estrogen, described 554–57 manipulative and body-based
evening primrose oil, arthritis 493 practices 368–69
exercises see also insurance coverage
relaxation 313–15 fish body oil 176
water therapy 389–95 fish extract 176
extract, described 108 fish liver oil 176
eye disorders, vitamin E 157–58 fish oils
arthritis 493–94
overview 176–90
F
Fitzgerald, William 431
fasting flaxseed, overview 190–91
hormone therapy 557–58 “Flaxseed and Flaxseed Oils”
overview 267–68 (NCCAM) 190n
“Fasting” (University of California) flexible spending arrangements
267n (FSA), described 42
fat burners, sports supplements 228 Flower Essence Society, website
fats, vegans 277 address 607
FDA see US Food and Drug “Folate” (ODS) 161n
Administration folic acid (folate), overview 161–67
“FDA 101: Health Fraud Food, Drug, and Cosmetic Act (1938)
Awareness” (FDA) 45n 86
Feldenkrais, Moshe 385, 407, 411–12 Food and Drug Administration
Feldenkrais Educational Foundation (FDA) see US Food and Drug
of North America Administration
Feldenkrais method fossil tree 214
publication 407n fraud
website address 607 dietary supplements 124
Feldenkrais method overview 45–49
described 385 frequency therapy 458
overview 407–12 “Frequently Asked Questions”
Feldenkrais Resources, website (Arnold; Gillerman) 371n
address 607 “Frequently Asked Questions”
feng shui, overview 317–19 (Feldenkrais Educational
“Feng Shui Principles” (ChiEnergy) Foundation) 407n
317n “Frequently Asked Questions”
feverfew (Rolf Institute of Structural
arthritis 496 Integration) 438n
headache 535–36 “Frequently Asked Questions
“Feverfew (Tanacetum Parthenium)” about Apitherapy” (American
(National Headache Foundation) Apitherapy Association) 253n
533n “Frequently Asked Questions About
fibromyalgia, CAM therapies 529–32 Music Therapy” (American Music
fight or flight, described 294 Therapy Association) 335n
623
Complementary and Alternative Medicine Sourcebook, Fourth Edition
FSA (flexible spending arrangements), “Guided Imagery” (Center for
described 42 Integrative Health and Healing)
Functional Integration 410 322n
G H
gamma-linolenic acid 493 Haas, Richard 520
garlic, research 26 Hahnemann, Samuel
gem therapy 486–87 Christian 63, 85
Gerson, Max B. 269–71 halibut oil 176
“Gerson Therapy” (NCI) 269n Halliwick, described 386
Gerson therapy, overview 269–72 hatha yoga see yoga
Gillerman, Hope 371n Hayashi, Chujiro 471
ginger, arthritis 495–96 Head, Henry 431
“Ginkgo” (NCCAM) 214n headache, CAM therapies 533–36
ginkgo biloba healing touch therapy, described 22
dementia 518–19 health care providers
overview 214–15 CAM discussions 37–38
ginseng dietary supplements 123
hepatitis C 542 see also practitioners
menopause 570 Healthfinder, contact
glucosamine information 599
arthritis 496–97 health fraud, overview 45–49
overview 201–4 health insurance see insurance
research 27 coverage
glycyrrhizin, hepatitis C 542 Health Professionals’
GMP see good manufacturing Follow-up Study (HFS)
practices magnesium 171
goat weed 216 vitamin E 157
good manufacturing practices health risks
(GMP) acupuncture 82
biologically based therapies 243 carotenoids 134–35
botanicals 110 chiropractic 401
dietary supplements 104, 112 dietary supplements 122–23
sports supplements 226 folic acid 166–67
grape seed extract, Alzheimer homeopathy 88
disease 517–18 magnet therapy 466
“Grape Seed Extract May Help manipulative and body-based
Prevent and Treat Alzheimer’s” practices 368
(NCCAM) 517n naturopathy 95–96
Green Hornet 54 online products 52
“Green Tea” (NCCAM) 236n probiotics 222–23
green tea, overview 236–37 spinal manipulation 565
guarine, energy drinks 232 tai chi 351
guided imagery vitamin A 133–34
defined 595 vitamin B6 140
mental health care 577 yoga 355
overview 322–24 health savings account (HSA),
see also imagery described 43
624
Index
heart disease HSA (health savings account),
selenium 195 described 43
vitamin B6 140 Huang Di Nei Jing 75
Heart Outcomes Prevention Hubbard, William 51–52
Evaluation (HOPE) 155, 157 human growth hormone,
Heller, Joseph 436 described 550–51
Hellerwork International human pathogenic trial,
Hellerwork publication 436n homeopathy 63
website address 607 hydrotherapy
Hellerwork structural integration, arthritis 499–500
overview 436–37 naturopathy 92
hemoglobin overview 383–98
described 137 hyperbaric oxygen therapy,
vitamin B12 143 overview 285–89
hemoglobin A1C levels, “Hyperbaric Oxygen Therapy for
magnesium 172 Brain Injury, Cerebral Palsy, and
hepatitic C, CAM therapy 541–45 Stroke” (AHRQ) 285n
herbal supplements hypercholesterolemia, fish oils 182
adolescents 117–19 hyperglycemia, magnesium 171
defined 595 Hypericum perforatum
hepatitis C 542 see St. John’s wort
see also botanicals hypertension (high blood
HFS see Health Professionals’ pressure), fish oils 177
Follow-up Study hypertriglyceridemia, fish oils 177
HHS see US Department of hypervitaminosis A, described 133
Health and Human Services hypnosis
high blood pressure see hypertension allergies 506
HIV (human immunodeficiency virus) anxiety 582
health fraud 46 defined 595
selenium 195–96 described 312
Holistic Network, website address 607 overview 324–27
Homeopathic Educational Services, “Hypnosis Today: Looking beyond
contact information 607 the media portrayal” (American
homeopathy Psychological Association) 324n
arthritis 500 hypomagnesemia,
defined 595 magnesium 170–73
described 25, 63–64, 459
overview 85–89
I
“Homeopathy: An Introduction”
(NCCAM) 85n IgA nephropathy, fish oils 180
homocysteine imagery, described 24, 296, 312
Alzheimer disease 28 see also guided imagery
vitamin B6 140 immune system
“Hoodia” (NCCAM) 238n craniosacral therapy 403
hoodia, overview 238–39 echinacea 206–7
hormones, sports supplements 227–28 mind-body medicine 295–96
hormone therapies probiotics 221
menopause 568 touch therapy 460
overview 547–58 vitamin B6 137
625
Complementary and Alternative Medicine Sourcebook, Fourth Edition
immune system, continued International Society of Hypnosis,
vitamin D 147 contact information 327
vitamin E 153–54 International Thai Therapists
zinc 208–11 Association, contact information 608
infants “An Introduction to Naturopathy”
eye/brain development (NCCAM) 91n
and omega 3 fatty acids180 “An Introduction to Probiotics”
vegetarians 281 (NCCAM) 219n
infertility iron
CAM therapies 561–62 vegans 278
herbal remedies 560–61 vegetarians 281
influenza, health fraud 48 isoniazid, vitamin B6 139
infusion, described 108 isotretinoin, acne 134
Ingham, Eunice D. 431
Inner Canon of the Yellow J
Emperor 75
Institute for Traditional Medicine, Japanese silver apricot 214
contact information 80 Japanese tea 236
Institute of Traditional Medicine, juice therapies, overview 267–68
contact information 608
insurance coverage
K
alternative medicine 504
apitherapy 254 Kalahari cactus 238
CAM practitioners 33, 34 Kano, Jigaro 411–12
CAM therapies 39–44 kapha, Ayurvedic medicine 68
chiropractic 402 Katz, Stephen I. 203, 501
music therapy 338–40 kava
integrative medicine, menopause 570
described 4, 21 research 251
interconnectedness, kew tree 214
Ayurvedic medicine 67 ki see qi
International Association kinesiology 448–49
of Reiki Professionals, Kirlian photography 317
contact information 608 Klamath weed 216
International Association of Yoga Kneipp, Sebastian 92
Therapists, contact information 608 Konno, Jun 384
International Center for Reiki Krieger, Dolores 479–80
Training, contact information 608 Kunz, Dora 479–80
International Chiropractors
Association, contact information 608 L
International College of Applied
Kinesiology, website address 608 labels, dietary supplements 102–4,
International Feng Shui Guild, 114–15
contact information 608 Lactobacillus acidophilus 220
International Institute of Reflexology, lactoferrin 544
contact information 608 lacto-ovo vegetarians, defined 279, 597
International Medical and Dental lacto-vegetarians, defined 280, 597
Hypnotherapy Association, contact Laetrile 54
information 608 Lane, Andrew J. 54
626
Index
laser therapy, allergies 506 ma huang (ephedra)
law of minimum dose 86 adolescents 118
licensing requirements described 228
biofeedback 306 traditional Chinese
CAM practitioners 18, 33 medicine 77
chiropractic 401 maidenhair tree 214
homeopathy 88–89 Manheimer, Eric 562
massage therapy 417 manipulation
naturopathy 94 defined 595
Reiki 473 described 23
yoga 355 naturopathy 92
see also certification see also chiropractic; Rolfing
licorice, hepatitis C 543 manipulative and body-based
life forces, Ayurvedic practices
medicine 67–68 described 4, 23
light therapy, described 458 overview 363–69
like cures like 85 “Manipulative and Body-Based
list of medications Practices: An Overview”
CAM practitioners 35 (NCCAM) 363n
health care providers 38 manipulative practices,
long chain polyunsaturated defined 596
fatty acids 176 marine oil 176
Lubar, Joel 306 massage, defined 596
lupus erythematosus, massage therapy
fish oils 180 described 23, 313–17
Lust, Benedict 92 hydrotherapy 386
lutein, vitamin A 130 mental health care 578
lycopene, vitamin A 130 overview 414–18
“Lymphatic Drainage Massage” “Massage Therapy: An
(Center for Integrative Health Introduction” (NCCAM) 414n
and Healing) 419n Mayo Clinic, website address 608
lymphatic drainage massage, medications
overview 419–20 folic acid 163
Lyu Ki Dou, described 386 online cautions 51–56
see also drug interactions
meditation
M
defined 596
mackerel oil 176 described 24, 296
“Macrobiotics” (University of guided imagery 322–23
California) 273n mental health care 577
macrobiotics, overview 273–74 overview 329–33
“Magnesium” (ODS) 169n “Meditation: An Introduction”
magnesium, overview 169–74 (NCCAM) 329n
“Magnets for Pain” (NCCAM) 463n melatonin
magnet therapy described 551–52
arthritis 498–99 sleep disorders 588–89
defined 595 menhaden oil 176
described 22, 457 “Menopausal Symptoms and
overview 463–66 CAM” (NCCAM) 567n
627
Complementary and Alternative Medicine Sourcebook, Fourth Edition
menopause, CAM therapies 567–72 National Association of Cognitive-
mental health care, Behavioral Therapists, contact
CAM therapies 574–79 information 609
Mentastics 451 National Association of Nutrition
meridians Professionals, contact information
acupuncture 82 609
described 60 National Cancer Institute (NCI)
traditional Chinese contact information 599
medicine 75 publications
metformin, folic acid 163 aromatherapy 257n
methionine, described 143 cancer, CAM 507n
methotrexate, folic acid 163, 165 deep breathing exercises 311n
MGN-3 54 Gerson therapy 269n
milk thistle spirituality 341n
hepatitis C 542 National Center for Complementary
research 250 and Alternative Medicine (NCCAM)
millimeter wave therapy, contact information 600
described 457–58 publications
mind-body medicine acupuncture 81n
defined 596 alcohol addiction 579n
described 4, 23–24 arthritis 491n
overview 293–98 attention deficit hyperactivity
“Mind-Body Medicine: disorder 580n
An Overview” (NCCAM) 293n Ayurvedic medicine 65n
mindfulness meditation, biologically based practices
described 331 243n
mineral, defined 596 CAM, children 17n
Moores Cancer Center, CAM, United States 13n
contact information 609 CAM overview 3n, 7n
Moss, Donald 303n CAM practitioners 32n, 37n
movement therapy, CAM treatment financial
mental health care 576 considerations 39n
moxibustion, described 25, 60, 76 cancer 507n
multiple sclerosis (MS) chelation therapy, heart
apitherapy 253–54 disease 537n
shiatsu 477 chiropractic 399n
music therapy diabetes mellitus 523n
described 315 dietary supplements 111n
mental health care 576 echinacea 206n
overview 335–40 energy medicine 455n
sound energy therapy 458 fibromyalgia 529n
flaxseed 190n
ginkgo biloba 214n
N ginkgo extract 517n
National Association for Drama grape seed extract 517n
Therapy, contact information 609 green tea 236n
National Association for Holistic hepatitis C 541n
Aromatherapy, contact homeopathy 85n
information 609 hoodia 238n
628
Index
National Center for Complementary National Institute of Ayurvedic
and Alternative Medicine (NCCAM), Medicine, contact information 610
continued National Institute of Diabetes and
publications, continued Digestive and Kidney Diseases
infertility treatment 561n (NIDDK), contact information 600
low back pain 563n National Institute of Neurological
magnet therapy 463n Disorders and Stroke (NINDS)
manipulative and body based coenzyme Q10 publication 517n
therapies 363n contact information 600
massage therapy 414n National Institute on Aging (NIA)
meditation 329n contact information 600
menopausal symptoms 567n publications
mind-body medicine 293n aging prevention 547n
naturopathy 91n CAM use 21n
posttraumatic stress National Institutes of Health (NIH)
disorder 583n contact information 600
probiotics 219n publications
Reiki 471n glucosamine/
St. John’s wort 216n chondroitin 201n
self-hypnosis 582n sleep disorders 585n
tai chi 349n National Library of Medicine
traditional Chinese (NLM), contact information 601
medicine 74n National Qigong Association
whole medical systems 59n contact information 610
yoga 353n qigong publication 427n
National Center for Homeopathy, Native American medicine
contact information 609 mental health care 577
National Center on Physical Activity overview 78–80
and Disability (NCPAD) “Native American Medicine”
contact information 609 (University of California) 78n
hydrotherapy publication 383n Natural Medicines Comprehensive
National Certification Commission for Database, publications
Acupuncture and Oriental Medicine, applied kinesiology 448n
contact information 609 Bowen technique 449n
National College of Naturopathic color therapy 358n
Medicine, contact information 609 Natural Medicines Comprehensive
National Headache Foundation Database, website address 610
contact information 610 Natural Standard, fish oils
publications publication 176n
acupuncture 533n naturopathy
biofeedback 533n defined 596
chiropractic 533n described 26, 62–63
feverfew 533n overview 91–97
National Institute of Arthritis NCCAM see National Center for
and Musculoskeletal and Skin Complementary and Alternative
Diseases (NIAMS) Medicine
calcium supplements NCI see National Cancer Institute
publication 198n NCPAD see National Center on
contact information 600 Physical Activity and Disability
629
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Nemours Foundation Office of Dietary Supplements
contact information 610 (ODS), continued
publications publications, continued
detoxification diets 264n vitamin A 129n
Pilates 423n vitamin B6 137n
sports supplements 226n vitamin B12 143n
vegetarianism 279n vitamin D 147n
Neoral (cyclosporine), fish oils 178, vitamin E 153n
182 zinc 208n
nephrotic syndrome, fish oils 181 Ogden, David 387
new dietary ingredient, older adults
described 101, 102–3 CAM therapies 547–58
NIA see National Institute on complementary and alternative
Aging medicine 21–30
niacin, vitamin B6 137 dietary supplements 121–27
NIAMS see National Institute of folic acid 166
Arthritis and Musculoskeletal omega-3 fatty acids
and Skin Diseases Alzheimer disease 28
NIDDK see National Institute defined 596
of Diabetes and Digestive and diabetes mellitus 525–26
Kidney Diseases overview 176–91
NIH see National Institutes regulations 55
of Health vegans 278
NINDS see National Institute of see also fish oils; flaxseed
Neurological Disorders and Stroke “Omega-3 Fatty Acids, Fish Oil,
NLM see National Library of Alpha-Linoleic Acid” (Natural
Medicine Standard) 176n
noise, feng shui 319 omega-6 fatty acids 493
Nurses’ Health Study omega fatty acids 176
magnesium 171 osteoarthritis
vitamin A 132 acupuncture 27, 500–502
vitamin E 157 shiatsu 476
Nutrition Labeling and Education osteopathic manipulation,
Act (NLEA; 1990) 245 overview 399–402
osteoporosis
magnesium 174
O vitamin A 132–33
Oakes, David 521 vitamin D 149–50
ODS see Office of Dietary Otikon Otic Solution 62–63
Supplements otitis media, naturopathy 62–63
Office of Dietary Supplements out of pocket expenses,
(ODS) CAM therapies 39
contact information 600 see also financial considerations;
publications insurance coverage
botanicals 107n ovo-vegetarians, defined 279
dietary supplements 101n oxalic acid, calcium 278
folate 161n oxygen therapy, overview
magnesium 169n 285–89
selenium 193n oxymatrine 544
630
Index
P potentization, described 86
“The power of the relaxation
paclitaxel 491 response” (American Psychological
“Pain” (NCI) 311n Association) 345n
pain management practitioners
Alexander technique 373–74 acupuncture 83–84
CAM therapies 563–65 apitherapy 254
chiropractic 23 art therapy 301–2
deep breathing exercises 311–15 Ayurvedic medicine 70
magnet therapy 457 biofeedback 306–8
mind-body medicine 294–95 chiropractic 400–401
therapeutic touch 480 complementary and
panchakarma, Ayurvedic medicine 69 alternative medicine 10
parasympathetic nervous system, Feldenkrais method 411
meditation 332 guided imagery 323
pastoral counseling, mental health manipulative and body-based
care 575 practices 363–64
Pavlov, Ivan 431 music therapy 336
“Paying for CAM Treatment” naturopathy 93–95
(NCCAM) 39n overview 32–36
“PC-SPES” (NCI) 507n polarity therapy 468–69
PC-SPES, described 510–13 Reiki 473
Pearson, Nancy J. 586, 589 tai chi 351
pediatricians, complementary therapeutic touch 480, 482
and alternative medicine 18–19 traditional Chinese
pernicious anemia, vitamin B12 144 medicine 77–78
Physicians Association of yoga 355
Anthroposophic Medicine, contact prakriti, Ayurvedic medicine 67
information 610 prayer, overview 341–44
phytoestrogens, menopause 570–71 prebiotics, described 219
Pilates preeclampsia, fish oils 181
hydrotherapy 386 preformed vitamin A,
overview 423–25 described 129
“Pilates” (Nemours Foundation) 423n pregnancy
Pilates, Joseph 386 Alexander technique 378
Pilates, Joseph H. 423–24 fish oils 186–87
“Pilot Study Provides New Insight magnet therapy 499
on Effect of Ginkgo Extract on premenstrual syndrome,
Dementia in the Elderly” (NCCAM) vitamin B6 139
517n principle of dilutions 86
pitta, Ayurvedic medicine 68 principle of similars 63, 85
placebo effect probiotics
alternative medicine 504–5 defined 596
described 294, 296–97 overview 219–23
polarity therapy, overview 467–69 professional organizations,
polyphenols, diabetes mellitus 526–27 CAM practitioners 33
polyunsaturated fatty acids (PUFA) 176 progesterone, described 554–57
posttraumatic stress disorder (PTSD), proprioceptive neuromuscular
acupuncture 583–84 facilitation, described 386
631
Complementary and Alternative Medicine Sourcebook, Fourth Edition
proteins reflexology
vegans 277 defined 597
vegetarians 280 described 23
provitamin A carotenoid, overview 431–33
described 129–30 Reflexology Association of America,
psoriasis, fish oils 181 contact information 610
purification, detoxification regulations
diets 265 dietary supplements 53, 102–3,
putative energy fields, 112–13
described 455, 458–61 omega-3 fatty acids 55
pyridoxal 137 Reiki
pyridoxamine 137 defined 597
pyridoxine 137 described 23
overview 471–74
“Reiki: An Introduction”
Q
(NCCAM) 471n
qi (chi) relaxation therapy
acupuncture 82 allergies 506
defined 597 described 312
described 24, 69 overview 345–47
feng shui 317–18 sleep disorders 588
shiatsu 475 religious traditions
tai chi 349 counseling, described 313
traditional Chinese meditation 329
medicine 75 spirituality 341–44
qi gong repetitive strain injury,
described 24, 76, 458–59 Alexander technique 375, 377
overview 427–29 resveratrol, described 557–58
“Questions and Answers: retinal, described 129
The NIH Trial of EDTA retinoic acid, described 129
Chelation Therapy for retinoids, described 134
Coronary Artery Disease” retinol, described 129–30
(NCCAM) 537n rheumatoid arthritis
CAM therapies 491–502
fish oils 178
R
“Rheumatoid Arthritis and
radio psychiatry, mental health Complementary and Alternative
care 578–79 Medicine” (NCCAM) 491n
RDA see Recommended Dietary rickets, vitamin D 148
Allowances Riley, Joe Shelby 431
reactive oxygen species (ROS), RNA (ribonucleic acid), folic acid 161
vitamin E 153–54 Roaccutane (isotretinoin), acne 134
Recommended Dietary Rolf, Ida 436, 438–40, 445–46
Allowances (RDA) Rolfing, overview 438–46
folic acid 162 Rolf Institute of Structural
vitamin A 130–31 Integration
vitamin B6 138 contact information 610
red clover, menopause 570 Rolfing publication 438n
redirected thinking, described 312 ROS see reactive oxygen species
632
Index
S selenium
overview 193–96
Saccharomyces boulardii 220 prostate cancer 156–57
safety considerations research 27, 194
aromatherapy 260 “Selenium” (ODS) 193n
Ayurvedic medicine 70–71 Selenium and Vitamin C Cancer
botanicals 109–10 Prevention Trial (SELECT) 27, 194
CAM therapies 28–30 self-hypnosis, anxiety 582
color therapy 359 “Self-Hypnosis Beneficial for
complementary and Women Undergoing Breast
alternative medicine 8–9, 18 Biopsy” (NCCAM) 582n
dietary supplements 29, 114–15, serotonin, vitamin B6 138
122–23 sexual enhancement, health
fish oils 184–85 fraud 47
massage therapy 416–17 shark liver oil 176
online medical products 51–56 Sherrington, Charles 431
Reiki 472–73 “Shiatsu” (Center for Integrative
supplements 118–19 Health and Healing) 475n
traditional Chinese shiatsu, overview 475–78
medicine 76–77 Shults, Clifford 519–21
see also fraud side effects
St. John’s wort acupuncture 82
attention deficit hyperactivity aromatherapy 260
disorder 580–81 chiropractic 401
overview 216–17 detoxification diets 265
research 251 echinacea 207
“St. John’s Wort” (NCCAM) 216n fish oils 185–86
“St. John’s Wort Shows No Impact flaxseed 191
on the Symptoms of ADHD” Gerson therapy 272
(NCCAM) 580n ginkgo biloba 215
salmon oil 176 green tea 237
SAMe (S-adenosyl-L-methionine), homeopathy 88
research 250 isotretinoin 134
SAMHSA see Substance Abuse magnet therapy 466
and Mental Health Services meditation 332
Administration naturopathy 95–96
Sawitzke, Allen D. 201–2 probiotics 222–23
schisandra 544 spinal manipulation 565
schizophrenia, fish oils 181 tai chi 351
Schroter, Aman 387 yoga 355
Scripps Center for Integrative similars principle 63, 85
Medicine, contact information 610 SkinAnswer 54
SeaSilver 54 sleep disorders, CAM
Selected Vegetables/Sun’s Soup therapies 585–90
513–16 Society for Clinical and Experimental
“Selected Vegetables/Sun’s Soup” Hypnosis, contact information 327
(NCI) 507n Society for Light Treatment and
“Selecting a CAM Practitioner” Biological Rhythms, website
(NCCAM) 32n address 610
633
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Society of Auricular Acupuncturists, “Study Suggests Coenzyme Q10 Slows
contact information 611 Functional Decline in Parkinson
sound energy therapy, described 458 Disease” (NINDS) 517n
Sova, Ruth 395 Substance Abuse and Mental Health
soy, menopause 570 Services Administration (SAMHSA)
spinal manipulation contact information 601
described 23 publications
pain management 563–65 energy drinks 231n
see also chiropractic mental health care 574n
“Spinal Manipulation for supplements 117n
Low-Back Pain” (NCCAM) 563n sulfasalazine, folic acid 163
spirituality Sun’s Soup 513–16
defined 597 supplements see dietary
overview 341–44 supplements; herbal supplements
“Spirituality in Cancer Care” “Supplements: Added Risk, Doubtful
(NCI) 341n Benefit” (SAMHSA) 117n
sports supplements support groups, described 313
adolescents 117–19 surgical preparation, mind-body
overview 226–30 medicine 297
“Sports Supplements” Sushruta Samhita 66
(Nemours Foundation) 226n sympathetic nervous system,
statistics meditation 332
acupuncture 82 synbiotics, described 219
Ayurvedic medicine 66
CAM therapies 508
T
complementary and
alternative medicine 13–16, 17 tai chi
dietary supplements 112, 244–45 defined 597
homeopathy 86 described 24, 76
manipulative and body-based overview 349–52
practices 363 qi gong 429
massage therapy 414 “Tai Chi: An Introduction” (NCCAM)
meditation 330 349n
naturopathy 92–93 Takata, Hawayo 471
Reiki 472 TCM see traditional Chinese medicine
tai chi 350 telemedicine, mental health care 578
traditional Chinese medicine 74 telephone counseling, mental health
yoga 354 care 578
Stone, Randolph 468 testosterone, described 553–54
Straus, Stephen E. 501, 585 Thai Yoga Center/Soma Veda
stress management Institute, contact information 611
Alexander technique 373 therapeutic touch see touch therapy
massage therapy 415–516 “Therapeutic Touch” (A.D.A.M., Inc.)
mental health care 577–78 479n
mind-body medicine 297 Therapeutic Touch International
relaxation therapy 347 Association, contact
stroke information 611
fish oils 182 thermogenics, described 228
hyperbaric oxygen therapy 288 Thomas, Jennifer 53
634
Index
thunder god vine United States Pharmacopeia (USP),
arthritis 492–93 described 199
described 61 University of California,
tincture, described 108 publications
“Tips for Older Dietary crystal therapy 486n
Supplement Users” (FDA) 121n fasting 267n
“Tips for Talking with Your Health macrobiotics 273n
Care Providers about CAM” Native American medicine 78n
(NCCAM) 37n University of Minnesota Center for
TJ-108 544 Spirituality and Healing, contact
Tolerable Upper Intake Levels (UL), information 611
vitamin A 130–31, 134 unpredictable command
touch therapy technique, described 387
described 313, 459–60 urinary tract infections,
overview 479–82 naturopathy 62–63
toxins, described 264 US Department of Health and
traditional Chinese medicine (TCM) Human Services (DHHS; HHS),
defined 597 contact information 601
described 24–25, 59–60 “Use Caution Buying Medical
mental health care 576–77 Products Online” (FDA) 51n
overview 74–78 “The Use of Complementary and
“Traditional Chinese Medicine: An Alternative Medicine in the
Introduction” (NCCAM) 74n United States” (NCCAM) 13n
Trager approach, overview 450–51 US Food and Drug Administration
Trager International (FDA)
contact information 611 contact information 601
Trager approach publication 450n publications
transcendental meditation, described dietary supplements 121n
331 health fraud awareness 45n
transplant rejections, fish oils 178, 182 online medical products 51n
“Treating Infertility with Herbal “Using Dietary Supplements Wisely”
Medications” (American Pregnancy (NCCAM) 111n
Association) 560n USP see United States
triamterene, folic acid 163 Pharmacopeia
triglyceride levels, fish oils 177 Usui, Mikao 471
Tripterygium wilfordii Hook F 61
tryptophan, vitamin B6 137
V
Tui Na, overview 421–22
“Tui Na: Chinese Massage” (Center valerian
for Integrative Health and Healing) arthritis 494–95
421n research 251
tuning fork therapy 458 vata, Ayurvedic medicine 68
“Turn off Allergies” (Bompey) 484n “Vegan Diets in a Nutshell”
(Vegetarian Resource Group) 275n
veganism, overview 275–79
U
vegans, defined 280, 597
UL see Tolerable Upper Intake Levels “Vegetarianism” (Nemours
ulcerative colitis, fish oils 182 Foundation) 279n
ultra-high dilutions, described 87 vegetarianism, overview 279–83
635
Complementary and Alternative Medicine Sourcebook, Fourth Edition
Vegetarian Resource Group “What is CAM?” (NCCAM) 3n
contact information 611 “What Is Dance/Movement
veganism publication 275n Therapy?” (American Dance
vegetarians, defined 597 Therapy Association) 359n
veritable energy fields, “What is Polarity Therapy?”
described 455, 456–58 (American Polarity Therapy
vibrational therapy 458 Association) 467n
vis medicatrix naturae 91 “What is Qigong?” (National
vitamin A, overview 129–35 Qigong Association) 427n
“Vitamin A and Carotenoids” “What Is the Trager Approach?”
(ODS) 129n (Trager International) 450n
“Vitamin B6” (ODS) 137n WholeHealthMD, contact
vitamin B6, overview 137–41 information 611
vitamin B12 whole medical systems
overview 143–46 defined 597
vegans 278–79 described 4, 24–26
vegetarians 280 energy medicine 459
“Vitamin B12” (ODS) 143n overview 59–64
vitamin B17 54 “Whole Medical Systems: An
vitamin C, research 250 Overview” (NCCAM) 59n
vitamin D Wills, Lucy 161
overview 147–51 wind chime therapy 458
vegans 277 Women’s Angiographic
vegetarians 280 Vitamin and Estrogen
“Vitamin D” (ODS) 147n study 155
vitamin E Women’s Antioxidant and
overview 153–59 Folic Acid Cardiovascular
research 27, 250 Study 146
“Vitamin E Fact Sheet” (ODS) 153n Women’s Health Study,
vitamins, defined 597 magnesium 171
wound healing
hydrotherapy 383
W millimeter wave therapy 457
Wassertanzen, described 387 mind-body medicine 297
water Pilates, described 386 zinc 208–9
Watsu, described 387 Wykle, Mary 387
weight management
fish oils 182 X
green tea 236–37
health fraud 47 Xhoba 238
hoodia 238–39
resveratrol 557–58
Y
“What can I expect in a typical
Polarity Therapy session?” yang see yin/yang
(American Polarity Therapy Yellow Jackets (slang) 53–54
Association) 467n yinhsing 214
“What Hellerwork Structural yin/yang
Integration Is” (Hellerwork acupuncture 81
International) 436n defined 597–98
636
Index
yin/yang, continued Z
described 24, 69
macrobiotics 273 zeaxanthin, vitamin A 130
polarity therapy 468 Zen macrobiotic diet 273
traditional Chinese medicine 75 zero balancing, overview 487–88
yoga Zero Balancing Health Association
defined 598 contact information 611
described 24 zero balancing publication 487n
hydrotherapy 387 zinc
mental health care 577 overview 208–11
overview 353–56 research 251
“Yoga for Health: An Introduction” vegans 278
(NCCAM) 353n vegetarians 281
Yogalates, described 387–88, 391–92 “Zinc” (ODS) 208n
637