Combating Alzheimer's Disease

Alzheimer's disease (AD) is a form of dementia in the elderly which affects more than 4.5 million Americans. This progressive brain disease slowly deteriorates cognitive memory and thinking skills, resulting in severe brain damage and eventually death (2). There is no known cure for AD, but there are conventional drugs therapies that when prescribed in the early stages of the disease may limit or delay symptoms for a short period of time. Moreover, research is ongoing to understand natural preventative therapies, such as dietary supplements, which may prove to be beneficial in delaying, slowing the progression of, or even reversing Alzheimer's disease (3).

Dietary Supplement:	What the Science Says:	Cautions and Side Effects:
Antioxidants	While the NIH and NCCAM are currently involved in extensive research on antioxidants, there is currently not enough scientific evidence to determine whether antioxidants are effective for the treatment and  prevention of AD. Alpha-lipoic acid (ALA) and fish oil (omega-3 fatty acids) continue to be studied for their potential role in slowing the progression of Alzheimer's disease.	According to the FDA - omega-3 dietary supplements from fish are "generally recognized as safe," when consumed at low-to-moderate doses - Side effects may include minor GI upset (diarrhea, heartburn, indigestion, and abdominal bloating) - May interact with blood thinners and drugs used to treat high blood pressure.
Asian Ginseng (Panax Ginseng)	An adaptogen, this herb has been used for centuries for stress and heart health. NCCAM supports research on Asian ginseng’s potential effects on insulin resistance, cancer, and Alzheimer's disease. To date, only a few large, high-quality clinical trials have been conducted. Most evidence is preliminary (based on laboratory research or small clinical trials) so NCCAM can not provide any conclusive support for health claims associated with the herb at this time.	Short-term use at recommended doses appears to be safe. - Side effects of prolonged use may include headaches, sleep problems, GI upset and allergic reactions. - May lower levels of blood sugar (caution for diabetes and will concurrent use of medications / supplements that lower blood sugars)
Cat’s Claw (Uncaria tomentosa)	The National Institute on Aging has funded a study that looked at how cat's claw may benefit the immune system and  brain function. Findings may point to new avenues for research in Alzheimer's disease treatment. However, currently, there is not enough scientific evidence to determine the effect of cat's claw works on AD.	When taken at recommended doses, few side effects have been reported for cat's claw. - Rare side effects include headaches, dizziness, and vomiting. - Cat’s claw has been used in the past for preventing and aborting pregnancy, therefore, women who are pregnant or trying to become pregnant should avoid it. - Cat's claw is believed to stimulate the immune system, so it should be used with much caution in anyone with immune conditions. - May interfere with post-surgical blood pressure control.
Ginkgo  (Ginkgo biloba)	With anti-microbial and anti-tubercular actions, G. biloba has been used for centuries for memory enhancement and cognitive function. The Ginkgo Evaluation of Memory study (NCCAM funded) was a large study with over 3,000 volunteers age 75 and over who took 240 mg of ginkgo daily, and were followed for an average of 6 years. The study found Ginkgo ineffective in slowing cognitive decline and in lowering the overall incidence of AD. A National Institute on Aging study of more than 200 healthy adults over age 60 also found that ginkgo taken for 6 weeks did not improve memory. Some smaller studies of ginkgo for memory enhancement have had promising results.	Products made from standardized ginkgo leaf extracts appear to be safe when used orally and appropriately. Fresh (raw) ginkgo seeds contain large amounts of ginkgotoxin, which can cause serious adverse reactions, including seizures and death. - Side effects may include headache, nausea, GI upset, diarrhea, dizziness, or allergic skin reactions. - May increase bleeding risk (caution pre-surgery or with bleeding disorders)
Grape Seed Extract	Rich in flavonoids, linolic acid, and proanthocyanidins, the extract has been shown to reduce inflammation, high blood pressure, platelet aggregation, and lipid oxidation; as well as reducing the risk of cancer and inhibiting the growth of tumors.  NCCAM is currently studying whether the action of grape seed extract may treat or help prevent AD.  Although some studies indicate positive benefits, more research is needed in this area.	Grape seed extract is water soluble and generally well tolerated when taken orally. - Side effects may include a dry itchy scalp, dizziness, headache, high blood pressure, hives, indigestion, and nausea. - Interactions between grape seed extract and other medications and supplements have not been well studied.

When considering supplements for the prevention or slowing the progression of Alzheimer's, it is important to work with a trained physician adept at working in the field of Complementary and Alternative Medicine.  It is also very important to pick a reliable manufacturer/supplier from which the supplements come from.  The supplements should be free of pesticides, organic if possible, and made with only high quality ingredients.  Solubility and absorption are both essential aspects of any supplement.  The manufacturer should obtain all ingredients via responsible and sustainable methods.  When possible, ask for the manufacturer's white paper on the specific supplement and discuss it with the CAM provider.  Most CAM providers will recommend or even prescribe a combination of supplements which will all work synergistically together in order to provide the optimum benefits possible.      

References:

1. Alzheimer’s Disease and CAM: What the Science Says. NCCAM Clinical Digest. Available at http://nccam.nih.gov/health/providers/digest/alzheimers-science.htm. Retrieved 10/22/11

2. What is Alzheimer’s Disease. National Institute on Aging. Available at http://www.nia.nih.gov/Alzheimers/AlzheimersInformation/GeneralInfo/. Retrieved 10/22/11.

3. Alzheimer’s Disease and CAM. National Center for Complementary and Alternative Medicine. Available at http://nccam.nih.gov/health/providers/digest/alzheimers.htm. Retrieved 10/22/11

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DSHEA: The Regulation of Supplements

For some odd reason, many people still believe that the FDA regulates everything consumable in their daily lives.  In actuality, the FDA does not regulate much and they are not a very powerful entity either.  For almost all of the 20th century, there was almost no regulation on consumable products, including supplements and alternative medicine.  But it wasn't until the early 1990's when consumers pushed for regulation of alternative therapies, thus the creation of the Office of Alternative Medicine and subsequent passage of DSHEA were born.

Although the creation of DSHEA is relatively new, it still struggles to maintain order in such a fast-paced, over stimulated, market.  The result being that it sometimes fails to protect consumers from harmful products. Under DSHEA, the dietary supplement or dietary ingredient manufacturer is responsible for ensuring that the supplement or ingredient is safe before it is marketed.  There remains to be one large loophole and it is that the FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market.  This current supplement approval method explains why some supplements are allowed to contain ineffective ingredients, toxic ingredients, and powerful ingredients.  One such ingredient was ephedra, which was found to be unsafe in large dosages but remained on the market for years consequently being sold to millions.  It took twenty-three reports of serious health problems and one teenage death before the FDA could force the manufacturers to voluntarily recall it.  An amended DSHEA could place greater responsibility on the manufacturers to prove pre-market product safety and give the FDA more authority in the regulation of products being marketed.

 Sales of dietary supplements have approximately doubled since 1998. This means more consumers are using dietary supplements and/or those using supplements are consuming more. Many supplements are purchased over the internet from foreign countries, like China and South America, and are not made with the same quality checks required in the U.S.  Consumers need to be accurately informed of what products’ uses are and how safe they are. Only 19% of people are receiving their information from CAM providers, 28% from doctors, the remainder from friends/family, advertising, and heath food store sales people. Therefore, the majority of people using dietary supplements are receiving their information from unqualified sources. In 2009, US Government Accountability Office (GAO) reports determined that consumers have difficulty understanding labels on dietary supplements and are not well informed when it comes to safety and efficacy of products.

The supplemental hormone melatonin is now available in the US, but the FDA would have to prove melatonin unsafe before removing its over-the-counter status. We see a wider selection of supplements presently available through health food stores and mail order companies because the FDA bears the burden of proof for supplement safety, not the producers or retailers.  According to Jane E. Henney, M.D., Commissioner Food and Drug Administration, Department of Health and Human Services, “The dietary supplement industry has grown exponentially since the passage of DSHEA. Surveys show that more than half of the U.S. adult population uses dietary supplement products. Annually, consumers spend $12 billion on dietary supplements, according to Nutrition Business Journal in their 1998 Annual Industry Overview.”

As a preventive measure, DSHEA grants FDA explicit authority to establish good manufacturing practice regulations for dietary supplements. Such regulations are intended to assure purity and consistency in dietary supplement products. Regarding labeling, DSHEA seeks to provide consumers with information to help guide personal choice. This includes specially tailored requirements for ingredient and nutrition labeling.

DSHEA also provides for use of claims to affect the structure or function of the body, claims of general well-being from consumption of a nutrient or dietary ingredient, and claims of benefits related to classical nutrient deficiency diseases. These claims require notification to FDA within 30 days after marketing, must be substantiated, and must be accompanied by the disclaimer: "This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease." Finally, DSHEA contains ground rules for publications used in connection with the sale of dietary supplements.

Currently dietary products have to be proven unsafe, contain a controlled substance or have incorrect ingredient labeling to be removed from shelves. If the DSHEA continues to exist, it should impose more regulations to ensure the consumers’ safety. Supporting and strengthening DSHEA means dietary supplements will continue to be widely available and competitively priced for all who make or use them.  The European Union’s Food Supplements Directive is more restrictive than DSHEA. The Food Supplements Directive establishes a “positive list” that enumerates which vitamins, minerals, and other ingredients are permitted in dietary supplements. Amending DSHEA and incorporating several provisions of the Food Supplements Directive would be beneficial and better protect American consumers from unsafe dietary supplements.

Sources:

Bimal, H, Ashar, M, et al. Physician’s Understanding of Regulation of Dietary Supplements. Arch Intern Med. 2007;167(9):966-969.

Denham BE. Dietary Supplements-Regulatory Issues and Implications for Public Health. JAMA July 5, 2011.

Dietary Supplements. U.S. Food and Drug Administration. (2011) accessed on October 22, 2011, from http://www.fda.gov/food/dietarysupplements/default.htm

Gurley BJ, Gardner SF, Hubbard MA: Content versus label claims in ephedra-containing dietary supplements. Am J Health Syst Pharm 2000, 57:963–969.

Nowak RE. DSHEA’s Failure: Why a Proactive Approach to Dietary Supplement Regulation is Needed to Effectively Protect Consumers. U Ill L Rev. 1045. 2010.

http://illinoislawreview.org/article/dsheaas-failure-why-a-proactive-approach-to-dietary-supplement-regulation-is-needed-to-effectively-protect-consumers/ Accessed October 22, 2011. Full PDF: http://illinoislawreview.org/wp-content/ilr-content/articles/2010/3/Nowak.pdf

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The Use of Homeopathy: Is It Worth It?

Homeopathic practitioners tend to believe that a combination of treatments for symptom relief as well as for disease progression is the most beneficial for the patient.  Those who do not believe in the effectiveness of homeopathy consider successful treatments a result of the placebo effect or positive thinking.  In the age of scientific positivism, idealistic philosophies generally do not fare well.  This brings us to the question: does homeopathy actually work, or is it just a under-studied, over-hyped philosophy?

Similar to allopathic medicine, homeopathy studies the outcome of the treatment and remedy compared to the placebo, and also relies on prescriptions after the full homeopathic evaluation of the patient.   However, different from allopathic medicine, homeopathy considers the whole constitution of the person as opposed to the sole presentation of symptoms.  Some of the diagnosis rely on examination of mental or emotional symptoms, certain sensations, location of symptoms, direction of symptoms, concomitant symptoms, modalities of sensations, intensity and duration of symptoms, onset and sequence of events leading up to the problem are taken into consideration.  Homeopathic practitioners often spend considerable amount of time with patients, obtaining a detailed history, which helps the homeopathic doctor to match the person and the remedy. Although patients may have the same diagnosis, the homeopathic treatment and/or dose is individualized therefore making it difficult conduct large studies.  There have been clinical trials done in homeopathy; however, since homeopathic treatments are personalized to an individual it is difficult to conduct the strict double-blind scientific studies which are generally used to test the validity of allopathic treatments. Conventional scientific wisdom states that homeopathy should have no effect above and beyond placebo. There are however, some experiments on ultra-high dilutions of solutes together with some clinical data that suggests the possibility that there may be health benefits under some circumstances.   Most of the clinical evidence comes from treating relatively minor self-limiting diseases and little comes from treating life-threatening disorders such as cancer, for example    Patients receiving homeopathic care may feel worse before they become better because homeopathic medicines often stimulate, rather than suppress, symptoms. This seeming reversal of logic is a relevant part of homeopathy because symptoms are viewed as the body's effort to restore health.

The experimental aspects of homeopathy date back to the beginning of the practice with outcome measures based upon improvement of symptoms and/or recovery from illness. Homeopathy began with hypotheses based on finding effective ways to improve caring for patients through less barbaric ways than were in practice in the mid 1700’s, including use of bloodletting, purging, cathartics and cupping.  The Law of Similars, formulated by Samuel Hahnemann puts forth the concept that a remedy can cure a disease if it produces similar symptoms in a healthy person. .  Hahnemann used scientific principles and methods to develop chemical compounds.  Hahnemann believed that the detailed association between patient’s clinical symptoms and the experimental pathogenesis of remedies mirrored a universal law of healing with medicinal substances. He first used himself and his family to experiment with various chemical compounds in healthy people.  Hahnemann was very meticulous about recording his observations and his results which are still the basis of the development of homeopathy today.  More clearly stated, the Law of Similars implies that a substance that can produce symptoms in a healthy person can stimulate self healing in a person with similar psychosomatic responses to an illness.   By definition, the underlying principles of homeopathy include treating “like with like” by remedies which are potentized by serial dilution and succession.

 The aspect of the homeopathic treatment working is measured through improvement, which occurs because the body is able to activate its innate ability to heal, leading to important philosophical principles of the practice.  An important foundational and philosophic concept of homeopathy defines health “as a state of freedom existing on three interrelated levels: the physical, the emotional and mental”.   When symptoms are more serious they are affecting the person more deeply. Hering’s Law of Cures, helps to provide a holistic assessment of individual progress following use of specific provings. The three laws describe progression of healing which begins with the deepest part of the organism; the mental and emotional parts and the vital organs. The second law describes the symptoms appearing and disappearing in reverse chronological order of appearance. The third law is that healing will progress from the upper part of the body to the lower part of the body. When there are exceptions to this, the homeopathic principle of assessing if the patient is improving is the final measure of continuation or change in type of treatment used.  Just as in so many scientific disciplines homeopathy is based upon strong scientific mathematical calculations which are driven by hypothesis to prove or disprove a belief or a question. In the case of homeopathy it is “is the patient getting better”? This yields the philosophy of practice. 

            The National Center for Complementary and Alternative Medicine of the United States’ National Institutes of Health states: “Homeopathy is a controversial area of CAM because a number of its key concepts are not consistent with established laws of science (particularly chemistry and physics). Critics think it is implausible that a remedy containing a miniscule amount of an active ingredient (sometimes not a single molecule of the original compound) can have any biological effect—beneficial or otherwise. For these reasons, critics argue that continuing the scientific study of homeopathy is not worthwhile. Others point to observational and anecdotal evidence that homeopathy does work and argue that it should not be rejected just because science has not been able to explain it.”

            Due to the lack of evidence in research, homeopathy remains controversial. In an evidence report review by British House of Commons Science and Technology Committee it was recommended that because the evidence was lacking in homeopathic treatments, the government should stop funding for research. The committee felt that due to the lack of active ingredients, it was basically placebo treatment and deceptive to consumers and patients. The government’s response included comments that CAM, including homeopathy has a long standing history and because the complexities of the placebo effect are not fully understood that it was not the place of the Department of Health to comment on the ethics of treatment in a particular setting.  They did comment that they expected all practitioners to use treatments that are in the best interest of the patient.

        

References:

1. Berquist P. Therapeutic Homeopathy. In D. Rakel, Integrative Medicine (pp. 1175-1186). Philadelphia: Elsevier-Saunders; 2007.

2. Cummings, S., & Ullman, D. Everybody's Guide to Homeopathic Medicines. Los Angeles: Tarcher Inc. 1991.

3.  Carlston M. Homeopathy. In: Fundamentals of Complementary and Alternative Medicine. 4e. St. Louis, Missouri: Saunders Elsevier; 2011(pp343-354).

4.  Homeopathy: Efficacy and Evidence Base. American Institute of Homeopathy. http://homeopathyusa.org/homeopathy-now.html Accessed October 15, 2011.

5.  Shalts E. Homeopathy. In B. Kliger, & R. Lee, Integrative Medicine, Prinicples for Practice (pp. 255-270). New York City: McGraw Hill; 2004.

6.  Paterson, I.C.M. Homeopathy: What Is It and Is It of Value in the Care of Patients with Cancer? Clinical Oncology. 2002;14(3):250-253.

7.  Stehlin I. Homeopathy: Real Medicine or Empty Promises? FDA Consumer. 1996. http://findarticles.com/p/articles/mi_m1370/is_n10_v30/ai_18979004/ Accessed October 15, 2011.

8.  Frass M, SchusterE, Muchitsch I, Duncan J, Kozel G, Reiter C, Endler C, Oberbaum M.   Bias in the trial and reporting of trials of homeopathy: A fundamental breakdown in peer review and standards? American Journal of Alternative and Complementary Medicine. 2005. 11(5):780-782.

9.  Homeopathy; Overview. NWHRC Health Center - Homeopathy. National Women's Health Resource Center. Sept 8, 2008. http://galenet.galegroup.com.libproxy2.umdnj.edu/servlet/HWRC/hits?docNum=A185391654&year2=&year1=&index3=KE&index2=KE&index1=RN&tcit=0_1_0_0_0_0&index=BA&locID=umdnj&rlt=2&text3=&text2=&origSearch=true&text1=A185391654&op2=AND&op1=AND&t=RK&s=11&r=d&o=&secondary=false&n=10&day2=&l=d&day1=&month2=&month1=&searchTerm=2NTA&c=1&bucket=per Accessed October 16, 2011.

10. Milgrom, L.  Falling Trees, Tractals, and Sophistry:Some Philosphical "Biohazards" En Route to Reconciling Biomedicine and Homeopathy. The Journal of Alternative and Complimentary Medicine. Volume 15. Number 11, 2009. Pp.1247-1254.

11.  Homeopathy: An Introduction. Controversies Regarding Homeopathy. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/homeopathy/#contoversiesAccessed October 15, 2011.

12.  Evidence Check 2: Homeopathy. http://www.parliament.uk/business/committees/committees-a-z/commons-select/science-and-technology-committee/inquiries/homeopathy-/ Accessed October 15, 2011.

13.  Government Response to the Science and Technology Committee report 'Evidence Check 2: Homeopathy’. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_117811.pdf   Accessed October 16, 2011.

14.  Vickers, AJ, Smith C.Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes. Memorial Sloan-Kettering Cancer Center, Integrative Medicine Service. Cochrane Database Syst Rev. 2009;(3):CD001957.

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Cleaner Products Protect Children

When it comes to cleaning our homes, we look for safe and effective products that will clean surfaces and kill harmful viruses or bacteria.  But many consumers are tricked into purchasing products which are not safe. In fact, many cleaning products sold to millions of households across America contain harmful ingredients which cause very dangerous ailments when inhaled, ingested, or even  absorbed through the dermis.  The trickery continues when we are convinced that we need to use the dangerous products around our children and pets, only to cause irreversible damage.  Unfortunately, every 30 seconds, another child is poisoned by household cleaning products, and 70% of which are children under age 6.  The reality of it is, many of these young children do not survive; those who do are left permanently damaged.

If you have not seen this short film yet, I ask that you take a moment:
Part 1:  http://www.youtube.com/watch?v=XADBY9-0Io4  
Part 2:  http://www.youtube.com/watch?v=X4yxp7ZemjQ&feature=related


The solution comes in several parts, a) educate yourself with MSDS and product labels, and Google the ingredients you are not familiar with,  b) boycott because it works, refuse to purchase any of these products which have harmful ingredients in them, c) do your research and find products which are naturally derived and safe, d) spread the word, because doing so will save lives.   


For more information, go to my website at www.naturallylivingmom.com

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Consider Acupuncture When Walking With Back Pain is too Painful

Chronic low back pain (CLBP) can be a debilitating disorder which can lead to loss of ambulation, often resulting in loss of quality of life.  When it comes to treating the loss of ambulation due to CLBP, there is no one-size-fits-all cure; in fact, managing CLBP alone can be a frustrating ordeal taking many months of trial and error therapies to find the best-fit therapy.  In the medical field, many treatments focus on relieving the pain by addressing only the anatomical problems, leaving limited options such as prescription medication or surgery but fails to address the ambulatory issues associated with the causal symptoms.  However, other means of treating CLBP can provide temporary relief from pain and aid in the restoration of ambulation over time.  One such therapy to consider is acupuncture.

Acupuncture has been around for 3000 years, originating in China.  Acupuncture uses the concept of Qi, or energy, to heal the body.  In America, this ancient art is brought to life by licensed acupuncturists adept in Traditional Chinese Medicine.  For many practitioners, incorporating this ancient healing tradition into modern day practice has many advantages, including enabling their patients to have the capacity of customizing a treatment best suited for them.    

When looking at studies which refer to acupuncture for sufferers of CLBP, it was important to segregate those studies which incorporated exercise or walking as part of the study, either as the control or in both.  Secondly, it was important to look for similarities in those studies and look for correlations.  What I found was absolutely shocking.  

 

Article	Sample	Intervention/ Treatment	Outcomes/ Relieve Pain	Correlation with Ambulation
Witt, C; et al, (2011) Randomized Control Trial Class A	Size: 9,990 Age: Adult Location: Germany Inclusions: Patients with osteoarthritis of knee or hip, low back pain, neck pain, or headache. Exclusions: All patients fulfilled predefined diagnosis-specific criteria.	Patients randomized into groups which received routine care, or 10 acupuncture treatments plus routine care for 3 months.	Positive outcome in acupuncture group.	Manipulation techniques and exercise for chronic pain positively correlates with outcome independent of the intervention.
Haake, M; et. al, (2007) Randoized Control Trial Class A	Size: 1162 Age: 18 - 86 Location: Germany Inclusions: History of chronic low back pain for ≥6 months. Exclusions: Previous spinal surgery, spinal fractures, infectious or tumorous spondylopathy or disease-influenced chronic pain.	Patients randomized into 3 groups, acupuncture, sham, and conventional therapy. Conventional therapy included 10 sessions with personal contact with a physician or physiotherapist who administered physiotherapy and exercise.	Acupuncture was not superior to sham. Both treatments were positive over conventional treatment alone.	Half the patients in both groups experienced clinically relevant improvement in pain intensity or back-specific disability.
Weidenhammer, W. et al. (2007) Cohort Observational Study Class A	Size: 2564 Age: adult Location: Germany Inclusions: Diagnosis of either lumbago with sciatica or back pain with complaints lasting ≥6 months. Exclusions: No indication of other disease conflicting and no acupuncture treatments in previous 6 months.	Patients filled out questionnaires which included intensity and frequency of pain, functionality, depression, and QOL before and after 6 months of acupuncture treatments.	45.5% of patients showed significant improvement in functionality. Mean number of days with pain decreased by half. Employed patients reported 30% decrease from baseline of work days lost.	Number of days off work for employed patients decreased over 6-month observational period and their functionality improved slightly.
MacPherson, H; et al, (2004) Randomized Control Trial Class A	Size: 148 Age: Adults Location: UK Inclusions: Low back pain lasting more than 4 weeks and less than a year. Exclusions: Patients with back pain resolved prior to treatments.	241 patients randomized in a ratio 2:1 leaving 160 to receive up to ten individualized treatments including acupuncture, cupping, herbs, exercise and lifestyle advice (12 patients were excluded).	Diagnoses among patients were individually based, however, a theme emerged with Qi and Blood Stagnation being the most prevalent.	A combination of adjunct therapies were also prescribed, including yoga and specific exercises.
Yip, Y; et al (2004) Randomized Controlled Trial Class A	Size: 51 Age: adult Location: China Inclusions: Patients who had non-specific sub-acute LBP for most days in the past 4 weeks, had not received acupuncture, physiotherapy, or manipulative therapy in the past week, and would comprehend and comply with the study guidelines. Exclusions: Patients who had LBP caused by disorders, infections, or diseases, undergone surgery, pregnant, had allergies to lavender, or had wounds at acupoint sites.	Patients randomized into control group or treatment group for a 3 week trial. Control group received normal therapy while treatment group received 8 sessions of relaxation acupoint stimulation and acupressure with lavender oil.	8 sessions of acupoint and acupressure with lavender oil was not effective in relieving short-term LBP.	By combining traditional therapies with alternative therapies, short-term reduction in LBP is possible.

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What was found is that although acupuncture did not appear to work on CLBP alone, however conjunctive therapies which incorporated acupuncture worked on the majority of the patients.  Part of the therapies which helped decrease pain was exercise, changing to a better diet, and physician-monitored care.  More importantly, when looking at a study focusing on acupoint therapy, the subjects were able to walk for longer and  farther after the sessions than before the study started.

Conclusion:  Considering acupuncture for CLBP may be a good idea, but it is an even better when it is used as a part of a therapeutic routine which includes exercise, healthy diet, and the normal medical treatments prescribed by physician.  It perhaps is circular logic, but in order to walk farther without CLBP, one needs to walk more.  As far as enhancing quality of life, incorporating a healthy routine with preventative maintenance and sticking with the new regimen will help to decrease the pain enough to lead a relatively normal life.       

Resources 

Haake, M; Muller, H; Schade-Brittinger. C; Basler, H; Schafer, H; Maier, C;
Endres, H; Trampisch, H; Molsberger, A, (2007) German Acupuncture Trials (GERAC)
for Chronic Low Back Pain Randomized, Multicenter, Blinded, Parallel-Group Trial With 3 Groups Arch Intern Med. 2007;167(17)   

 MacPhersona, H; Thorpe, L;  Thomasb, K; Campbellc, M. (2003) Acupuncture for low back pain: traditional diagnosis and treatment of 148 patients in a clinical trial. Complimentary Therapies in Medicine V 12: 38-44

Weidenhammer, Q; Linde, K; Streng, A;  Hoppe, A; Melchart, D. (2007) Acupuncture for Chronic Low Back Pain in Routine Care A Multicenter Observational Study Clinical Journal of Pain Volume 23: 2
  

Witt, C.;  Schutzler, L; Ludtke, R; Wegscheider, R;  Willich, S.  (2011)

Patient Characteristics and Variation in Treatment Outcomes:
Which Patients Benefit Most From Acupuncture for Chronic Pain? Clinical Journal of Pain V 27:550–555

Yip, Y; Tse, S. (2004) The effectiveness of relaxation acupoint stimulation and acupressure with aromatic lavender essential oil for non-specific low back pain in Hong Kong: a randomised controlled trial. Complimentary Therapies in Medicine V 12: 28-37

        

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Chiropractic Care for Tension Headaches

In the United States, headaches are responsible for more than 18 million office visits annually, and are the most common reason for using over-the-counter medications. It is estimated that 156 million work days are lost each year because of headaches, translating to $25 billion in lost productivity. Of the categories of chronic headaches, tension-type headaches are most common. (Erickson, 2004)

With this said, many people may want to seek out other therapies for their tension-type headaches.   There are many reasons for seeking alternative therapies.  Perhaps traditional treatments are not effective, the headaches are worsening, or maybe popping medications like M&M's have become a pain in and of itself?  Whatever the case, there are alternative therapies for treating tension-type headaches which are surprisingly as effective as medications, but without all of the side effects.  My favorite happens to be chiropractic therapy so that is what I am going to talk about today.  

 First and foremost, it is important to get a proper diagnosis.  Headaches can be triggered by a multitude of things from loud noises to neurological problems (lesions, aneurisms, tumors, and the like).  It is very important to rule out causal factors which may become severely worse (or even deadly) if not treated and that the headache is in fact a tension-type headache, (Mann & Coeytaux,2007; Erickson, 2004). 

When picking a chiropractor, like any health professional, it is important to get a professional and reputable one.  I have heard of too many horror stories of people going into a friends' of an acquaintance's basement to have a $10 adjustment done.  I do not even recommend doing this for a tattoo let alone getting a chiropractic adjustment.  So, as a rule of thumb, I always look for three major qualities: experience, certification, and most importantly, location, location, location.  Believe this or not, the location will tell you almost everything you need to know about a professional, e.g. who is the professional, what their clientele is like, where their offices are in terms of the city, when the business first opened, and how long they have been in business in the same area.   I learned my lesson about a decade ago when I went to a dentist with a hole-in-the wall, smoke filled, office next to a bar in a really slummy part of the city.  (In the waiting area, there was a half full ash tray on a broken lamp stand and a box of stale doughnuts next to a pot of coffee on a desk in the corner). I should have walked out but I didn't and I regret it to this day.  But I digress.   Just follow the three rules,  do your research, and listen to your gut instincts and you will be fine.

When you find a chiropractor who meets your approval, they will take a health history in addition to a physical exam. Chiropractic practitioners utilize spinal treatments among other methods to correct alignment problems and open up the central nervous system which improves mobility, decreases pain and allows the body to heal naturally (1, NCAM).  Don't be afraid to ask questions during your visit.  A chiropractor who answers your questions thoroughly shows that they not only knows what he is doing, but who also cares as well.   

When it comes to your tension headaches, your chiropractor should focus on the upper spine. The upper spine, (called the cervical) is usually the major culprit in causing tension headaches.  Damage to C1 or C2 may occur for many reasons and often without notice, but when the upper cervical becomes contorted, the muscles in the upper back and neck tries to compensate, thus results in stiff and tight muscles.  This is why pain killers and muscle relaxers do not cure the headaches.  By not correcting or improving the stress on the nervous system related to the subluxations or subluxation complex may result in continued pain and suffering, often becoming more severe over time.  Chiropractic care, however,  has been found to improve most headaches (Bryans 2011).

Not surprisingly, chiropractic care may yield results very quickly.  Some patients feel immediate improvement, while others may feel drastic improvement in less than six sessions. The philosophy behind this field of care works with the correction of subluxations and or the subluxations complex, which is the primary cause of tension headaches. Typical adjustments work toward the restoration of the central nervous system which allows improved neural function and the allowance of nutrients to enter without restrictions, (Epstein & Posa, 1999).  

A chiropractic professional will take a health history in addition to a physical exam. If chiropractic treatment is deemed appropriate, then treatment will be performed. Chiropractic practitioners utilize spinal treatments among other methods to correct alignment problems, which improve function and pain and allow the body to heal naturally, (1, NCAM).

Another benefit of the chiropractic adjustment is that it reduces stress on the nervous system, (Toftness, 1977). The reduction of stress often leads to a reduction in pain, and consequently, a reduction in pain medication as well. All too often, chiropractors see patients who were being treated by their primary physician with medication in order to mask the symptoms, causing further stress (and damage) on the vertebrae.  The result of medication in these cases often leads to a circular pattern (stress -> pain -> medication -> side effects) where more medication is prescribed as the amount of pain increases.  From a chiropractic standpoint, pain is thought of as an alarm and if the body is allowed to heal naturally, the pain is naturally reduced.  

Sources:

Bryans R, Descarreaux M, Duranleau M,  Marcouz H, Potter B, Ruegg R, Shaw L, Watkin R, White E.  Evidence-based guidelines for the chiropractic treatment of adults with headaches. 34(5):274-289. 2011.

Chiropractic: An Introduction. NCAM. http://nccam.nih.gov/health/chiropractic/introduction.htm Accessed October 1, 2011.

Epstein, D., & Posa, A. (1999, Feb-March). Breaking New Ground for Long Term Health and Wellness: Network Spinal Analysis. Retrieved 10 2, 2011, from Association for NetworkCare: http://wwwassociationfornetworkcare.com/articles/breakingnewground/networkspinalanalysis

Erickson, K. (2004). Chiropractic and Osteopathic Care. In B. Kliger, Integrative Medicine (pp. 153-176). New York: McGraw-Hill.

Ernst, E. "Chiropractic Maintenance Treatment, a Useful Preventative Approach?" Preventative Medicine 49.2-3 (2009): 99-100.

Liliedahl, Richard, David V. Axene , Christine M. Goertz, (2010). "Cost of Care for Common Back Pain Conditions Initiated with Chiropractic Doctor vs Medical Doctor/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer." Journal of Manipulative and Physiological Therapeutics 33(9): 640-643

Mann, D., & Coeytaux, R. (2007). Migraine and Tension-Type Headache. In D. Rakel, Integrative Medicine (pp. 143-151). Philadelphia: Elseviere Saunders.

Toftness, I. (1977). Chiropractic Spinal Correction :Philosophy of Chiropractic Correction. Cumberland, Wisconsin: Toftness Publishing

Bronfort, G., Haas,M, Evans, R., Bouter,L (2004) Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. The Spine Journal. (4); 335-356

Rubinstein, S., Leboeuf-Yde,C.,Knol, D., deKoekkoef,T.Pfeifle,C.,vanTudder,M.  ^{The Benefits Outweigh the Risks for Patients Undergoing Chiropractic Care for Neck Pain: A Prospective, Multicenter, Cohort Study. Journal of Manipulative and Physiological Therapeutics Volume 30, Issue 6, July 2007, Pages 408-418}

Wolsko, Peter M. MD, MPH, Eisenberg, David M. MD; Davis, Roger B. ScD; Kessler, Ronald PhD and; Phillips, Russell S. MD. Patterns and Perceptions of Care for Treatment of Back and Neck Pain: Results of a National Survey. Spine: 1 February 2003 - Volume 28 - Issue 3 - pp 292-297

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Insight into herbs

Herbs have been used for centuries in healing and therapy.  In fact, Ancient Chinese Medicine is still utilized today.  In Chinese, it is believed that Qi (Chi) is our life force or vital force energy.  It represents a flow of energy which circulates through everything on Earth.  Chinese have used Qi for thousands of years to heal and perfect the body.  The three vital treasures are believed by the Chinese to be the combination of the life force elements as they represent the different functions of the body, the mind, and the spirit as one.  Each function is clearly different but as the Taoists believe, they  all make up the same individual. 
What does this have to do with herbs?  The herbs we collect are filled with energy and life force.  Each herb has a different effect depending upon what elemental energy it possesses. This is only one theory  and only one way of utilizing herbs.

Yin and Yang is a Taoist philosophy which incorporates all opposites which intertwine to form balance.  Yin represents water, cold, heavy, fluidity, rest, passiveness, and earthy. Yang represents fire, activity, hot, light, energetic, aggressive, and quickness.  Those with too much of either show symptoms corresponding to the representation and therefore need more balance.
The five elements, Fire, Earth, Metal, Water, and Wood, are symbolic of the energies which manifest through the natural cycles found on Earth.  These elements are quite useful in healing but can be also applied to astrology, Feng Shui, and art, among other such practices.  This cycle represents the creation cycle where one element transitions and manifests from the previous element in a continuous loop.    Teas are a great way to receive and benefit from the photochemicals within various plants.  Start by researching different teas and trying out a variety of flavors.  The longer the tea steeps, the more phytochemicals are released.  The more tea an individual drinks, the more the oximation (dying) process is reversed.

An herbal medicine, also known as botanical medicine or phytotherapy, is medicine in the form of natural herbs, plants and natural substances for medicinal purposes.  Since the dawn of hominids, herbs have aided in the cure and recovery of most illness and cause of pain.  It wasn’t until later when the invent of the pill took over and herbal treatments phased out.  Only until recently, we have seen a rise in herbal treatments once more. 
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Synergism: are the active chemicals in herbs which work in sync with its other substances that enhance the overall effect of the herb.
Phytonutrients: are chemicals in herbs which make them biologically active.  These chemicals also give the plants their color, their flavor and natural disease resistance. 
Antioxidants: are agents such as plants, vitamins, minerals, and enzymes which naturally fight against damaging free radicals.
Free radicals: are essentially oxygen molecules which lose their electrons and then take other electrons from stable molecules.  Over time, the body undergoes considerable amount of changes and becomes unhealthy.
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The properties of alkaloids are nitrogen based compounds including analgesic, local anesthetic, sedating antispasmodic, hallucinogens, and varying poisons.  The uses of these alkaloids affect the nervous system and the circulatory system.  Some everyday alkaloids are nicotine and caffeine, which both have been known to cause serious health risks; as well as doctors prescribe drugs such as morphine and quinine to their patients for pain relief.

The properties of fatty oils are triglycerides, glycerol and fatty acids most commonly used as omega-3 fatty acids known to fight cardiovascular disease and depression.  
The properties of isoflavones are certain compounds closely related to the human hormone estrogen.  Isoflavons are found in soy milk and other soy products.  These compounds may prevent cancers related to hormones.  Isoflavons also may lower cholesterol and relieve symptoms of menopause while even preventing osteoporosis. 
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Almost 30% of prescription drugs are originally derived from plants.  Some well known drugs include aspirin, quinine, and morphine.  These all are derivatives from everyday natural sources like flowers and tree bark.
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The American Herbal Pharmacopoeia was organized in 1995 as a foundation to educate America on the pharmacology, dosages, side effects, and other health related topics concerning the use of herbs.

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