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Overview of Complementary and Alternative Healing Traditions


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An overview of alternative healing traditions and practices, presented by Dr. Michael Lara, MD

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Overview of Complementary and Alternative Healing Traditions

  1. 1. An Overview of Complementary and Alternative Medical Practices Michael Lara, MD Diplomate, American Board of Psychiatry & Neurology
  2. 2. Program Overview <ul><li>Overview of Complementary and Alternative Medicine (CAM) in the United States </li></ul><ul><li>Comparison of Health Belief Models </li></ul><ul><li>What Works: A Review of Studies in CAM </li></ul><ul><li>Review of Herbal Therapies </li></ul>
  3. 3. Complementary and Alternative Practices in America An Overview
  4. 4. What is CAM? <ul><li>“ CAM includes those medical systems, interventions, applications, theories or claims that are currently not part of the dominant (conventional) biomedical system. Classification of a practice as CAM may change, depending upon changing attitudes, scientific data, and experience.” </li></ul>National Center for Complementary and Alternative Medicine NCCAM
  5. 5. Who Uses CAM? <ul><li>Better educated </li></ul><ul><li>Have more health problems </li></ul><ul><ul><li>Back pain, obesity, anxiety, depression, insomnia, and chronic pain </li></ul></ul><ul><li>Do NOT express greater dissatisfaction with conventional care </li></ul><ul><li>Of those who do use CAM, only 5% rely primarily on CAM </li></ul>Source: Astin J., 1998
  6. 6. Causes of Death in the U.S. Source: National Center for Health Statistics, “Advance Report of Final Mortality Statistics 1990,” Monthly Vital Statistics Report , Vol. 41, No. 7. Heart disease 720,058 Cancer 505,322 Cerebrovascular disease 144,088 Unintentional injuries 91,983 Chronic lung disease 86,679 Pneumonia and influenza 79,513 Diabetes 47,664 Suicide 30,906 Chronic liver disease 25,815 HIV infection 25,188
  7. 7. Actual Causes of Death in the U.S. Source: J.M. McGinnis and W.H. Foege, “Actual Cuases of Death in the United States,” JAMA 1993, 270:2207-2212. Tobacco 400,000 Diet/inactivity 300,00 Alcohol 100,000 Infection 90,000 Toxic agents 60,000 Firearms 35,000 Sexual behavior 30,000 Motor vehicles 25,000 Drug use 20,000
  8. 8. NIH Research on CAM National Center for CAM Source: NCCAM, 1992 Therapy Condition Acupuncture Unipolar depression, osteoarthritis Acupuncture and herbs Cancer Chinese herbal medicine PMS, common warts Energetic medicine Basal cell carcinoma T’ai ch Mind balance disorders Imagery and relaxation Breast cancer Ayurvedic herbals Parkinson’s disease Music therapy Adjustments after brain surgery
  9. 9. Intercessory Prayer <ul><li>RCT of 393 cardiac patients at UCSF; patients randomized into two groups </li></ul><ul><ul><li>One group was prayed for; the control group was not </li></ul></ul><ul><li>Over ten months, the prayed for group had fewer deaths, required less ventilatory assistance, antibiotics, and diuretics </li></ul><ul><li>Overall, the prayer group required less CPR, had a lower incidence of pulmonary edema and required less time in the hospital </li></ul>Source: Byrd, R. (1988). Positive therapeutic effects of intercessory prayer in a coronary Care unit population. Southern Medical Journal , 81:826-29.
  10. 10. Impact of Meditative Practices Schwartz, J The Mind and The Brain: Neuroplasticity and the Power of Mental Force, 2002
  11. 11. An Overview of Health Belief Models Ayurveda, Chinese, and Latin American Models
  12. 12. Ayurvedic Medicine Key Concepts
  13. 13. Ayurvedic Medicine <ul><li>Ancient healing system first described 3500 B.C. in Hindu texts, Vedas </li></ul><ul><li>Ayurveda means “science of life” </li></ul><ul><li>Ayurveda has been continuously practiced for 5,500 years in India and Asia, and is claimed to be oldest natural healing system </li></ul>
  14. 14. Disease Management in Ayurveda <ul><li>Poorvakarma . Three to seven day preparatory program involving massage, sweating, herbs </li></ul><ul><li>Pancha Karma . One- to two-week detoxification involving vomiting, purgation, and enemas </li></ul><ul><li>Shaman . Focuses on spiritual dimension of healing; includes fasting, sunbathing, and yoga </li></ul><ul><li>Rasayana . “Rejuvenation” therapies including yoga and breathing exercises to restore vitality </li></ul><ul><li>Satvajaya . Focuses on psychotherapy, reduces stress, employs mantras Mantra demonstration </li></ul>
  15. 15. Traditional Ayurveda <ul><li>The doshas </li></ul><ul><ul><li>Vata (“Air”) </li></ul></ul><ul><ul><ul><li>Out of balance: gas and muscular or nervous energy </li></ul></ul></ul><ul><ul><li>Pitta (“Fire”) </li></ul></ul><ul><ul><ul><li>Out of balance: acid and bile, inflammation </li></ul></ul></ul><ul><ul><li>Kapha (“Water”) </li></ul></ul><ul><ul><ul><li>Out of balance: liquid and mucous </li></ul></ul></ul><ul><li>The gunas </li></ul><ul><ul><li>Sattva (balance) </li></ul></ul><ul><ul><li>Rajas (energy) </li></ul></ul><ul><ul><li>Tamas (inertia) </li></ul></ul>Frawley, Yoga and Ayurveda , 1999
  16. 16. Bhagavad Gita and The Gunas Of these three, sattva , untainted, Luminous, free from sorrow, Binds by means of attachment To knowledge and joy, Arjuna. Rajas is marked by passion Born of craving and attachment; It binds the embodied Self To never-ending activity Tamas , ignorance-born, Deludes all embodied beings; It binds them, Arjuna, by means of Dullness, indolence and sleep. Men of sattva go upward; Men of rajas remain In between; men of tamas , Lowest of all, sink downward. When a man sees clearly that there is No doer besides the gunas And knows what exists beyond them, He can enter my state of being. - Bhagavad Gita 14.15-14.19
  17. 17. Characteristics of the Doshas Dosha Vata Pitta Kapha Elements Ether + Air Fire + Water Earth + Water Build Tall and slender Medium Heavy Physiologic function Motion, activity Metabolism Physical structure Activity and habits Movement, activity Moderate, efficient Accumulation Sleep and digestion Erratic Regular Slow digestion, strong appetite Emotional Anxious Fiery, angry Slow, tranquil
  18. 18. The Yoga Sutra of Patanjali <ul><li>2,000 year-old spiritual document outlining and defining the path of yoga </li></ul><ul><ul><li>“ Yoga is the cessation of the fluctuations of the mind” </li></ul></ul><ul><li>Outlines eightfold path to enlightenment, ashtanga </li></ul><ul><li>First text to describe asana (yoga practices) as preparation for meditation ( dhyana ). </li></ul>
  19. 19. Ashtanga Yoga <ul><li>Yamas . External disciplines </li></ul><ul><li>Niyamas . Internal disciplines </li></ul><ul><li>Asana . Postures </li></ul><ul><li>Pranayama . Breath energy regulation </li></ul><ul><li>Pratyahara . Withdrawal of the senses </li></ul><ul><li>Dharana . Concentration </li></ul><ul><li>Dhyana . Absorption </li></ul><ul><li>Samadhi . Integration </li></ul>
  20. 20. The Chakras Number Name Location Element Organ First Muladhara Base of spine Earth Gonads Second Svadhisthana Lower abdomen Water Leydig cells Third Manipura Behind the navel Fire Adrenals Fourth Anahata Behind the heart Air Thymus Fifth Visuddhu Throat Ether Thyroid Sixth Ajna Forehead Pituitary Seventh Sahasrara Top of head Pineal Eighth Aura
  21. 21. Pranayama Techniques <ul><li>Ujjayi . Throat breathing; done by contracting the larynx slightly on the in breath and out breath. </li></ul><ul><li>Nadi Sodhana . Alternate nostril breathing done with the use of a hand mudra. </li></ul><ul><li>Sitali . “Cool” breathing done through curled tongue. </li></ul><ul><li>Kapalabhati . Forceful diaphragmatic breathing used for cleansing. </li></ul>
  22. 22. An Overview of Ayurvedic Herbs <ul><li>Ashwagandha protects the heart and has anticoagulant properties; demonstrated antitumor effects </li></ul><ul><li>Boswellia serrata effective in bronchial asthma, arthritis, diarrhea, and tumors </li></ul><ul><li>Ginger may relieve migraine headaches and motion sickness, postoperative nausea, and vertigo </li></ul><ul><li>Guggul effective in lowering serum cholesterol </li></ul>
  23. 23. The man whom desires enter as rivers Flow into the sea, filled yet always Unmoving-- That man finds perfect peace. -Bhagavad Gita Demonstration: The Stimulating Breath
  24. 24. Traditional Chinese Medicine Key Concepts
  25. 25. Traditional Chinese Medicine (TCM) <ul><li>Most widely used form of CAM </li></ul><ul><ul><li>Currently 1/4 of world’s population uses TCM </li></ul></ul><ul><ul><li>Out of $14 billion/year that Americans spend on alternative medicine, TCM accounts for $1 billion, 75% of which goes for acupuncture </li></ul></ul><ul><li>TCM focuses on identifying patterns of disharmony and imbalance that lead to disease </li></ul><ul><li>TCM codified about 100 B.C. in The Yellow Emperor’s Classic of Internal Medicine </li></ul>
  26. 26. Syndrome Differentiation <ul><li>Syndromes of Yang </li></ul><ul><ul><li>Fever </li></ul></ul><ul><ul><li>Increased gastric motility </li></ul></ul><ul><ul><li>Sympathetic hyperactivity </li></ul></ul><ul><ul><li>Intolerance of heat </li></ul></ul><ul><ul><li>Red or rosy complexion </li></ul></ul><ul><li>Syndromes of Yin </li></ul><ul><ul><li>Chills </li></ul></ul><ul><ul><li>Decreased gastric motility </li></ul></ul><ul><ul><li>Parasympathetic activity </li></ul></ul><ul><ul><li>Intolerance of cold </li></ul></ul><ul><ul><li>Pale complexion </li></ul></ul>
  27. 27. Wu Xing Fire Water Wood Earth Metal
  28. 28. Wu Xing Fire Water Wood Earth Metal
  29. 29. Five Phases and Ying/Yang Goldberg B. Alternative Medicine, The Definitive Guide, 2 nd Edition, 458. Element Yin Organ Yang Organ Fire Heart Small intestine Earth Spleen Stomach Metal Lungs Large intestine Water Kidneys Bladder Wood Liver Gallbladder
  30. 30. Treatments in Traditional Chinese Medicine <ul><li>Herbal Medicine </li></ul><ul><ul><li>Astragalus is most widely used; more than 2,500 different herbs </li></ul></ul><ul><li>Diet Therapy </li></ul><ul><li>Accupuncture and moxibustion </li></ul><ul><li>Massage </li></ul><ul><ul><li>Tui Na </li></ul></ul><ul><li>Energy healing </li></ul><ul><ul><li>Qigong, tai chi </li></ul></ul>
  31. 36. Tai Chi
  32. 37. Qigong and Tai Chi <ul><li>Combine movement, meditation, and breath to enhance flow of vital energy, improve blood circulation, and enhance immune function </li></ul><ul><li>Used in the treatment of balance disorder, chronic pain, and anxiety </li></ul><ul><li>Shares similarities to other energy-based systems of healing Demonstration: Qi Gong </li></ul>
  33. 38. An Overview of TCM Herbs <ul><li>Ginseng . Reported to help the body adapt to change, and thus prevent stress-related illness. </li></ul><ul><li>Ma huang . Used as stimulant; it opens the breathing passages, relieves lung congestion, and enhances weight loss. </li></ul><ul><li>Ginger . Beneficial to digestion, neutralizes toxins in foods, increases circulation, soothes nausea </li></ul><ul><li>Astragalus . Most commonly used; normalizes immune function; aids digestion, used in treatment of AIDS and hepatitis. </li></ul>
  34. 39. Tao Te Ching In the pursuit of knowledge, Every day something is added. In the pursuit of the Tao, Every day something is dropped. Less and less do you need to force things, Until finally you arrive at non-action. When nothing is done, Nothing is left undone. True mastery can be gained By letting things go their own way. It can’t be gained by interfering -Tao Te Ching 48
  35. 40. Latin American Medicine Essential Concepts
  36. 41. Curanderismo <ul><li>A synthesis of indigenous health beliefs (Aztec, Toltec, and Mayan) and traditional religion (Roman Catholicism) </li></ul><ul><li>Disease originates from natural, psychological, or spiritual causes </li></ul><ul><li>Treatments involve incantations, confession, herbs, praying, chanting, incense, candles </li></ul><ul><li>No codified practices or guidelines; many varieties and “subspecialties” </li></ul>
  37. 42. Latin-Based Healing Systems <ul><li>Santeria . An Afro-Carribean synthesis of African and christian healing beliefs. </li></ul><ul><li>Sobadora . Latin folk equivalent of chiropractic. </li></ul><ul><li>Herbalista . Latin folk equivalent of herbal medicine. </li></ul><ul><li>Curanderos also referred to as medicas, senoras, parcheras , depending on geographic region. </li></ul><ul><li>Nagual . Native American shaman popularized by Carlos Casteneda </li></ul>
  38. 43. Culture-Bound Syndromes <ul><li>Ataque de nervios </li></ul><ul><ul><li>Uncontrollable shouting, attacks of crying, trembling, verbal or physical aggression. Presentation similar to panic attacks. </li></ul></ul><ul><li>Locura </li></ul><ul><ul><li>Severe form of chronic psychosis as a result of multiple life difficulties. Typically, though not always, stress related. </li></ul></ul><ul><li>Mal de ojo </li></ul><ul><ul><li>“ Evil eye”; children believed to be especially at risk. Symptoms include fitful sleep, crying, diarrhea, vomiting </li></ul></ul><ul><li>Nervios </li></ul><ul><ul><li>General state of vulnerability to stressful life experiences. Includes a range of symptoms of emotional distress, somatic disturbance, and inability to function. </li></ul></ul><ul><li>Susto </li></ul><ul><ul><li>“ Fright”; Attributed to a frightening event that causes soul to leave the body and results in unhappiness or sickness </li></ul></ul>DSM-IV-TR, 2000, Appendix I
  39. 44. Somatization across Culture <ul><li>Puerto Ricans, Mexican Americans, Whites </li></ul><ul><ul><li>Stomach disturbances, excessive gas, palpitations, chest pains </li></ul></ul><ul><li>Africans, South Asians </li></ul><ul><ul><li>Burning hands and feet, the experience of worms in the head or ants crawling under the skin </li></ul></ul><ul><li>Asian </li></ul><ul><ul><li>Cardiopulmonary and vestibular symptoms such as dizziness, vertigo and blurred vision </li></ul></ul>Surgeon General’s Report, Mental Health: Culture, Race, and Ethnicity, 2001
  40. 45. Correspondences of Major Healing Systems <ul><li>Meditative practices </li></ul><ul><ul><li>Prayer, visualization, and mantra </li></ul></ul><ul><li>Movement practices </li></ul><ul><ul><li>Tai Chi, Qi Gong, Asana </li></ul></ul><ul><li>Dietary practices </li></ul><ul><ul><li>Includes use of herbal medicines </li></ul></ul><ul><li>Spiritual practices </li></ul><ul><ul><li>Guidelines for living, relating to others </li></ul></ul>
  41. 46. Evidence Based Practices in CAM What Works
  42. 47. Studies in Ayurveda <ul><li>RCT of effects of Ayurvedic treatment over 1 year on 90 healthy individuals randomized to three groups </li></ul><ul><ul><li>Ayurvedic treatment: diet, meditation, and yoga </li></ul></ul><ul><ul><li>Jacobsen progressive relaxation training (PRT) </li></ul></ul><ul><ul><li>No treatment </li></ul></ul><ul><li>Ayurvedic group showed greatest improvement in health perceptions, decrease in depression, and decreased use of Western prescription medications </li></ul><ul><li>Adherence to meditation was higher than in PRT </li></ul><ul><li>Estimated health care costs were more than double for the untreated group </li></ul>Source: NCCAM,
  43. 48. Studies in Yoga <ul><li>RCT of osteoarthritis patients found that after eight weeks of yoga training, pain, tenderness, and range of motion were improved.1 </li></ul><ul><li>RCT of sixty-one drug addicted methadone clinic patients found that patients engaged in yoga had reductions in drug use and criminal activities.2 </li></ul><ul><li>Schell, FJ; et al. (1994). Physiological and psychological effects of Hatha-Yoga exercise in healthy women. International Journal of Psychosomatics , 41(1-4):46-52. </li></ul><ul><li>Shaffer, H.; et al. (1997). Comparing hatha yoga with dynamic group psychotherapy for for enhancing methadone maintenance treatment: a randomized clinical trial. Alternative Therapies , 3(4):57-67. </li></ul>
  44. 49. Health Conditions Benefited by Yoga Goldberg B. Alternative Medicine, The Definitive Guide, 2 nd Edition, 469. Ailment Number of Cases % Claiming Benefit Back pain 1,142 98 Premenstrual 848 77 Anxiety 838 94 Migraine 464 80 Arthritis 589 90
  45. 50. Clinical Studies of Tai Chi <ul><li>Elderly people in a tai chi training course reduced risk of falling by 47.5%, compared to controls, who took a training course in balance 1 </li></ul><ul><li>Tai chi compared to balance training, strength training, and combined balance and strength training; Tai chi practitioners gained significantly more balance and strength than in other groups 2 </li></ul><ul><li>Wolf, S; et al. (1996). Reducing frailty and falls in older persons: an investigation of tai chi and computerized balance training, J Am Geriatric Society, 44:489-97. </li></ul><ul><li>Wolfson, L.; et al. (1996). Balance and strength training in older adults: intervention gains and tai chi maintenance. J Am Geriatric Society, May, 44:498-506. </li></ul>
  46. 51. Clinical Studies of Qigong <ul><li>Patients using Qi Gong averaged a drop in blood pressure of 10% </li></ul><ul><li>Ninety-three patients with advanced cancer treated with drugs and Qi Gong, control group with drugs only </li></ul><ul><ul><li>81% showed improvement in strength v. 10% control </li></ul></ul><ul><ul><li>63% showed improvement in appetite v. 10% control </li></ul></ul><ul><ul><li>33% were free from diarrhea groups v. 6% control </li></ul></ul>
  47. 52. Studies in Acupuncture <ul><li>91% of patients showed relief of dysmenorrhea v. 36% of patients in a sham acupuncture group. 1 </li></ul><ul><li>58% of patients receiving acupuncture achieved moderate to complete pain relief v. 46% undergoing TENS therapy. 2 </li></ul><ul><li>Of 48 migraine patients, 59% reported improvement with acupuncture v. 25% who benefited from drug therapy . 3 </li></ul><ul><li>Helms, JM. (1987). Acupuncture for the management of primary dysmenorrhea. Obstet. Gynecol., 69:51-56. </li></ul><ul><li>Laitinen, J. (1976). Acupuncture and transcutaneous electric stimulation in the treatment of chronic sacrolumbalgia and ischialgia. American Journal of Chinese Medicine, 4:169-75. </li></ul><ul><li>Loh, L; et al. (1984). Acupuncture v. medical treatment for migraine. J. Neurological Neurosurg Psychiatry, 47:333-37. </li></ul>
  48. 53. Research on Meditation <ul><li>Participants in mindfulness meditation program experienced less pain, anxiety, and depression than patients treated with conventional medicines. 1 </li></ul><ul><li>Meditators utilize medical care services 30 to 87% less than a control group utilizing conventional practices. 2 </li></ul><ul><li>Chronic pain patients practicing meditation noted a 36% reduction in their use of clinics during the first year. 3 </li></ul><ul><li>Kabat-Zinn, J et al. (1987). Four-year follow-up of a meditation-based program for the self-regulation of chronic pain: Treatment outcomes and compliance. Clin J Pain, 2:159-73. </li></ul><ul><li>Orme-Johnson, DW (1987). Medical care utilization and the Transcendental Meditation program. Psychosomatic Medicine, 49:493-507. </li></ul><ul><li>Caudill, M. et al. (1991). Decreased clinic use by chronic pain patients: response to behavioral medicine intervention. Journal of Chronic Pain, 7:305-10. </li></ul>
  49. 54. All of man’s miseries derive from not Being able to sit quietly in a room alone. -Blaise Pascal (1623-1662) Demonstration: Vipassana
  50. 55. An Overview of Herbal Therapies What Works
  51. 56. Nontraditional Remedies <ul><li>Growing dissatisfaction with medical profession </li></ul><ul><li>Patient’s desire for autonomy </li></ul><ul><li>Availability of natural medications without a prescription </li></ul><ul><li>Increasing non-physician practitioners who recommend medications </li></ul>
  52. 57. Are There Ethnic Differences in Perception of Medication? Buckalew, Drug Expectations Associated with Perceptual Characteristics: Ethnic Factors , Percept Mot Skills, Apr 1983 Color of Drug Black Subjects White Subjects White capsule Stimulants Analgesics Black capsule None Stimulants, analgesics Orange capsule Weak stimulants Stimulants Yellow capsule Psychedelics Stimulants Light green capsule Sedatives None
  53. 58. Food Products and P450 Adapted from Gaw, Cross-Cultural Psychiatry, 2001; Ruiz, Ethnicity and Psychopharmacology Carne Asada, Garlic, Onions Induction 1A2 Grapefruit juice Inhibition 3A4 Cabbage Induction 1A2 Caffeine, Guarana, Yerba Mate Induction 1A2 Corn Based Diet Inhibit 3A4 Cigarette Smoke Induction 1A2 Black Pepper Inhibition 2D6
  54. 59. The Effects of Guggul on Serum Lipids <ul><li>40 patients with hyperlipidemia treated with guggul (gum of Boswellia serrata ). In guggul -treated group… </li></ul><ul><ul><li>Serum cholesterol decreased by 21.75% by 16 weeks </li></ul></ul><ul><ul><li>Triglycerides decreased by 27.1%, with HDL increased by 35.8% after 16 weeks </li></ul></ul><ul><ul><li>Significant decreases in LDL </li></ul></ul>Verma, SK; et al. (1988). Effect of Commiphora mukul (gum guggulu) in patients of hyperlipidemia with special reference to HDL-cholesterol. Indian Journal of Medical Research , April, 87:356-60.
  55. 60. Astragalus <ul><li>Used in TCM to support and enhance immune system </li></ul><ul><li>One AIDs study suggests that astragalus could induce seronegative conversion in small number of HIV patients. </li></ul><ul><li>Increased NK activity from 11.5% to 44.9% in patients with viral myocarditis. 1 </li></ul><ul><li>Improved anginal pain and EKG readings v. nifedipine. </li></ul><ul><li>Yang, YZ; et al. (1990). Effect of Astragalus on natural killer cell activity and induction with Coxsackie B Viral Myocarditis, Chin Med J 103(4):304-7. </li></ul>
  56. 61. Dong Quai <ul><li>Used for gynecologic disorders, including dysmenorrhea, chronic pelvic pain, and PMS </li></ul><ul><li>Side effects: diarrhea, bleeding, increased photosensitivity, fever </li></ul><ul><li>May enhance effects of anticoagulants and antiplatelet drugs </li></ul><ul><li>Contraindicated in pregnant or breast-feeding patients </li></ul>Fetrow, CW; et al. (2001) Complementary and Alternative Medicines, p. 272-274.
  57. 62. Ephedra or Ma Huang <ul><li>Used for arthralgia, asthma, chills, colds, coughs, edema, fever, headaches, and nasal congestion </li></ul><ul><li>Works as CNS stimulant, producing mydriasis, enhanced myocardial contraction, increased heart rate, decreased GI motility </li></ul><ul><li>May interact with beta blockers, phenothiazines, theophylline </li></ul><ul><li>Side effects include anxiety, confusion, dizziness, headache, nervousness, psychosis, seizure, CVA </li></ul>Fetrow, CW; et al. (2001) Complementary and Alternative Medicines, p. 284-287.
  58. 63. Ginseng <ul><li>Antidepressant, aphrodisiac, diuretic, sedative and sleep aid; also reported to improve concentration, healing, stamina, work efficiency </li></ul><ul><li>One study demonstrated improvements in blood glucose and hemoglobin A1c levels </li></ul><ul><li>Other studies have demonstrated modest improvements in cognitive function </li></ul><ul><li>May increase hypoglycemic effects of antidiabetic drugs </li></ul><ul><li>Contraindicated in pregnant or breast-feeding women </li></ul>Fetrow, CW; et al. (2001) Complementary and Alternative Medicines, p. 338-342.
  59. 64. Ginkgo Biloba <ul><li>For the treatment of cardiovascular disease, impotence, PMS, and glaucoma </li></ul><ul><li>Cognitive benefits include improvements in memory and abstract thinking </li></ul><ul><li>Stimulates functional nerve cells and protects against neurodegeneration </li></ul><ul><li>Side effects: seizures, bleeding, hypersensitvity reactions </li></ul>Fetrow CW, et al. Professional’s Handbook of Complementary and Alternative Medicines, 2 nd Edition, Springhouse, PA. 2001.
  60. 65. Valerian <ul><li>Sedating, mild hypnotic; also used as antispasmodic </li></ul><ul><li>Decreases GABA breakdown </li></ul><ul><li>May interact with alcohol and CNS depressants; valerian and disulfiram </li></ul><ul><li>Side effects: blurry vision, dystonias, hepatotoxicity, especially with Mexican or Indian valerian </li></ul>Fetrow, CW; et al. (2001) Complementary and Alternative Medicines, p. 284-287.
  61. 66. Mint <ul><li>Used as anesthetic, antiemetic, antiflatulent, a digestive aid, and a stimulant </li></ul><ul><li>Menthol is pharmacologically active component; depresses sensory cutaneous receptors and alleviates itching and irritation; spasmolytic effect on smooth muscle of GI tract </li></ul><ul><li>Side effects: asthma exacerbation, bronchial or laryngeal spasms, allergic reactions; may increase effects of calcium channel blockers </li></ul>Fetrow CW, et al. Professional’s Handbook of Complementary and Alternative Medicines, 2 nd Edition, Springhouse, PA. 2001.
  62. 67. U ñ a De Gato <ul><li>Treatment of systemic inflammatory diseases and inflammatory GI disorders </li></ul><ul><li>May inhibit sympathetic nervous system </li></ul><ul><ul><li>Reduce heart rate, peripheral vascular resistance, lower blood pressure </li></ul></ul><ul><li>Contraceptive: drinking tea during menstrual cycle for 3 consecutive months believed to prevent pregnancy for about 4 years </li></ul>Fetrow CW, et al. Professional’s Handbook of Complementary and Alternative Medicines, 2 nd Edition, Springhouse, PA. 2001.
  63. 68. Capsicum <ul><li>Used as topical analgesic, bowel disorders, chronic laryngitis, diabetic neuropathy, postherpetic neuralgia, rheumatoid arthritis, and and forms of neuropathic pain </li></ul><ul><li>Interacts with ACE inhibitors (to increase cough reflex), anticoagulants, MAOIs, sedatives </li></ul><ul><li>Side effects: GI upset, blepharospasm, bronchocontriction, erythema </li></ul>Fetrow, CW; et al. (2001) Complementary and Alternative Medicines, p. 144-48.
  64. 69. Arnica <ul><li>In vitro antibacterial and antiinflammatory properties </li></ul><ul><li>Useful for relieving muscle and joint aches; promotes wound healing </li></ul><ul><li>Analgesic effects failed to be verified in a double-blind study of arnica, metronidazole, and a placebo among postoperative dental patients. 1 </li></ul><ul><li>Kaziro, GS. (1984). Metronidazole and Arnica Montana in the Prevention of postsurgical complications: A comparitive placebo-controlled trial. Br j Oral Maxillofac Surg 22:42-49. </li></ul>
  65. 70. Chamomile <ul><li>Used to aid wound healing and treat stomach disorders; also for insomnia, menstrual disorders and migraine </li></ul><ul><li>May enhance effects of anticoagulants </li></ul><ul><li>Contraindicated in pregnant or breast-feeding patients </li></ul><ul><li>Side effects: allergic conjunctivitis, menstrual irregularities, contact dermatitis </li></ul>Fetrow, CW; et al. (2001) Complementary and Alternative Medicines, p. 173-175.
  66. 71. Healing Beliefs and Practices Summary and Recommendations
  67. 72. There are more things in heaven and earth, Horatio, than are dreamt of in your philosophies -Shakespeare Hamlet
  68. 73. Michael Lara, MD <ul><li>For information about this presentation or Dr. Lara’s practice, please visit his website at: </li></ul><ul><li> </li></ul>Always seek the advice of a trained health professional before seeking any new treatment regarding your medical diagnosis or condition. Any information received from this presentation is not intended to diagnose, treat, or cure. This presentation is for information purposes only.