Alternative Therapies and Treatment Options
updated Wednesday, February 25, 2009

Therapies listed do not represent the scope of therapies and treatments available.

Non-Conventional Therapies

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Acupuncture: Sharp answers to pointed questions Cupping therapy: Can it relieve fibromyalgia pain?
Medical benefits of aromatherapy questioned Life Without Pain, Revolutionary FDA Cleared Pain Therapy
What is Waon Therapy? Oxygen Therapy for Migraine, Cluster Headaches
Craniosacral Therapy Chelation Therapy
Efficacy of Waon therapy for fibromyalgia. Cupping therapy: Can it relieve fibromyalgia pain?
Magnets fail to ease back pain Pain-relieving magnets attract scientific scrutiny
Hypnosis Low Frequency Sound Therapy
Chelation Therapy - risks or side effects? Acupuncture/Hypnosis for Chronic Pediatric Pain
Fibromyalgia Pain and Substance P Decrease and Sleep Improves After Massage Therapy. Cupping Therapy
Acupuncture in the treatment of fibromyalgia in tertiary care - a case series. Marijuana Laws Ruin Lives, Legalize Cannabis, Say US Activists
Acupuncture & Myofascial Therapy Treat Same Pain Areas Transcutaneous Electrical Nerve Stimulation

 

 

 

Medical benefits of aromatherapy questioned

Aromatherapy is endorsed by some as an alternative medical treatment, but the results of one study failed to demonstrate that aromatherapy improves immune status, wound healing, or pain control, according to a March 3, 2008, news release from The Ohio State University, Columbus. Researchers monitored the effects of Lemon and Lavender aromatherapy treatments on 56 volunteers' blood pressure, heart rate, blood biochemistry, healing ability, reaction to pain, and results of psychological testing of mood and stress. Blood samples were analyzed to measure the effects of aromatherapy on immune and stress responses.

Aromatherapy treatment using Lemon or Lavender essential oils did not demonstrate a positive effect on biochemical markers for stress, pain control, or wound healing. Lemon oil did appear to enhance participants' mood, but lavender showed no measurable effect on mood or health.

Aromotherapy may make you feel good, but it won't make you well [news release]. Columbus, OH: The Ohio State University; March 3, 2008. http://reseorchnews.osu.edu/archive/aromathe.htm. Accessed March 10, 2008.

COPYRIGHT 2008 Association of Operating Room Nurses, Inc.

Table of Topics

Transcutaneous Electrical Nerve Stimulation

Vladimir Kaye, MD, Consulting Staff, Departments of Neurology and Psychiatry, Hoag Hospital
Murray E Brandstater, MBBS, PhD, Chairman and Program Director, Professor, Department of Physical Medicine and Rehabilitation, Loma Linda University School of Medicine

Updated: Oct 8, 2008

Introduction

Transcutaneous electrical nerve stimulation (TENS) currently is one of the most commonly used forms of electroanalgesia. Hundreds of clinical reports exist concerning the use of TENS for various types of conditions, such as low back pain (LBP), myofascial and arthritic pain, sympathetically mediated pain, bladder incontinence, neurogenic pain, visceral pain, and postsurgical pain. Because many of these studies were uncontrolled, there has been ongoing debate about the degree to which TENS is more effective than placebo in reducing pain.

The currently proposed mechanisms by which TENS produces neuromodulation include the following:

  • Presynaptic inhibition in the dorsal horn of the spinal cord

  • Endogenous pain control (via endorphins, enkephalins, and dynorphins)5

  • Direct inhibition of an abnormally excited nerve

  • Restoration of afferent input

    The results of laboratory studies suggest that electrical stimulation delivered by a TENS unit reduces pain through nociceptive inhibition at the presynaptic level in the dorsal horn, thus limiting its central transmission. The electrical stimuli on the skin preferentially activate low-threshold, myelinated nerve fibers. The afferent input from these fibers inhibits propagation of nociception carried in the small, unmyelinated C fibers by blocking transmission along these fibers to the target or T cells located in the substantia gelatinosa (laminae 2 and 3) of the dorsal horn.

    Studies show marked increases in beta endorphin and met-enkephalin with low-frequency TENS, with demonstrated reversal of the antinociceptive effects by naloxone.6 These effects have been postulated to be mediated through micro-opioid receptors. Research indicates, however, that high-frequency TENS analgesia is not reversed by naloxone, implicating a naloxone-resistant, dynorphin-binding receptor. A sample of cerebral spinal fluid in those subjects demonstrated increased levels of dynorphin A.

    The mechanism of the analgesia produced by TENS is explained by the gate-control theory proposed by Melzack and Wall in 1965.7 The gate usually is closed, inhibiting constant nociceptive transmission via C fibers from the periphery to the T cell. When painful peripheral stimulation occurs, however, the information carried by C fibers reaches the T cells and opens the gate, allowing pain transmission centrally to the thalamus and cortex, where it is interpreted as pain. The gate-control theory postulates a mechanism by which the gate is closed again, preventing further central transmission of the nociceptive information to the cortex. The proposed mechanism for closing the gate is inhibition of the C-fiber nociception by impulses in activated myelinated fibers.


    Technical Considerations

    A transcutaneous electrical nerve stimulation (TENS) unit consists of 1 or more electrical-signal generators, a battery, and a set of electrodes. The TENS unit is small and programmable, and the generators can deliver trains of stimuli with variable current strengths, pulse rates, and pulse widths. The preferred waveform is biphasic, to avoid the electrolytic and iontophoretic effects of a unidirectional current. The usual settings for the stimulus parameters used clinically are the following:

  • Amplitude - Current at a comfortable, low intensity level, just above threshold

  • Pulse width (duration) - 10-1000 microseconds

  • Pulse rate (frequency) - 80-100 impulses per second (Hz); 0.5-10 Hz when the stimulus intensity is set high

    When TENS is used analgesically, patients are instructed to try different frequencies and intensities to find those that provide them with the best pain control. Optimal settings of stimulus parameters are subjective and are determined by trial and error. Electrode positioning is quite important. Usually, the electrodes are initially placed on the skin over the painful area, but other locations (eg, over cutaneous nerves, trigger points, acupuncture sites) may give comparable or even better pain relief.

    The 3 options for the standard settings used in different therapeutic methods of TENS application include the following:

  • Conventional TENS has a high stimulation frequency (40-150 Hz) and low intensity, just above threshold, with the current set between 10-30 mA. The pulse duration is short (up to 50 microseconds). The onset of analgesia with this setup is virtually immediate. Pain relief lasts while the stimulus is turned on, but it usually abates when the stimulation stops. Patients customarily apply the electrodes and leave them in place all day, turning the stimulus on for approximately 30-minute intervals throughout the day. In individuals who respond well, analgesia persists for a variable time after the stimulation stops.

  • In acupuncturelike settings, the TENS unit delivers low frequency stimulus trains at 1-10 Hz, at a high stimulus intensity, close to the tolerance limit of the patient. Although this method sometimes may be more effective than conventional TENS, it is uncomfortable, and not many patients can tolerate it. This method often is considered for patients who do not respond to conventional TENS.

  • Pulsed (burst) TENS uses low-intensity stimuli firing in high-frequency bursts. The recurrent bursts discharge at 1-2 Hz, and the frequency of impulses within each burst is at 100 Hz. No particular advantage has been established for the pulsed method over the conventional TENS method.

    Patient comfort is a very important determinant of compliance and, consequently, of the overall success of treatment. The intensity of the impulse is a function of pulse duration and amplitude. Greater pulse widths tend to be more painful. The acupuncturelike method is less tolerable, because the impulse intensity is higher.

    The amount of output current depends on the combined impedance of the electrodes, skin, and tissues. With repetitive electrical stimuli applied to the same location on the skin, the skin impedance is reduced, which could result in greater current flow as stimulation continues. A constant current stimulator, therefore, is preferred in order to minimize sudden, uncontrolled fluctuations of current intensity related to changes in impedance. An electroconductive gel applied between the electrode and skin serves to minimize the skin impedance.

    Medical complications arising from use of TENS are rare. However, skin irritation can occur in as many as 33% of patients, due, at least in part, to drying out of the electrode gel. Patients need to be instructed in the use and care of TENS equipment, with particular attention to the electrodes.


    In some cases, individuals react to the tape used to secure the electrodes. Skin irritation is minimized by using disposable, self-adhesive electrodes and repositioning them slightly for repeated applications. The use of TENS is contraindicated in patients with a demand-type pacemaker, because the stimulus output of the TENS unit may drive or inhibit the pacemaker.

    A variety of newer transcutaneous or percutaneous electrical stimulation modalities have emerged. They include the following:

  • Interferential current therapy (IFC) is based on summation of 2 alternating current signals of slightly different frequency. The resultant current consists of a cyclical modulation of amplitude, based on the difference in frequency between the 2 signals. When the signals are in phase, they summate to an amplitude sufficient to stimulate, but no stimulation occurs when they are out of phase. The beat frequency of IFC is equal to the difference in the frequencies of the 2 signals. For example, the beat frequency and, hence, the stimulation rate of a dual channel IFC unit with signals set at 4200 and 4100 Hz is 100 Hz.

  • IFC therapy can deliver higher currents than TENS can. IFC can use 2, 4, or 6 applicators, arranged in either the same plane, for use on such regions as the back, or in different planes in complex regions (eg, the shoulder).

  • Percutaneous electrical nerve stimulation (PENS) combines advantages of electroacupuncture and TENS. Rather than using surface electrodes, PENS uses acupuncturelike needle probes as electrodes, with these placed at dermatomal levels corresponding to local pathology. The main advantage of PENS over TENS is that it bypasses local skin resistance and delivers electrical stimuli at the precisely desired level in close proximity to the nerve endings located in soft tissue, muscle, or periosteum.

    Applications of Tens in Clinical Practice

    Literature on the effectiveness of transcutaneous electrical nerve stimulation (TENS) in a variety of medical conditions reports a wide range of outcomes, from very positive to negative. Currently, there is an overall consensus favoring the use of TENS, with authorities differing on its value in different clinical situations. Generally, TENS provides initial relief of pain in 70-80% of patients, but the success rate decreases after a few months or longer to around 20-30%. To exclude a false-negative response, a trial of TENS for at least 1 hour should be given to confirm potential benefit from subsequent continuous use.

    According to Johnson, the time from the start of stimulation to the onset of analgesia varies from almost immediate to hours (on average, 20-30 minutes in over 75% of patients and 1 hour in 95% of patients).8 The duration of analgesia also varies considerably, continuing only for the duration of stimulation in some patients and providing considerable, prolonged poststimulation relief in others. The same TENS protocol may have different degrees of antinociception in acute experimental pain compared with chronic clinical pain in patients with chronic low back pain (LBP).

    Patients differ in their stimulus preferences and in their rates of compliance. In Johnson's study of compliance in patients who benefited from TENS, 75% used the device on a daily basis. Patients showed individual preferences for particular pulse frequencies and patterns, and they consistently adjusted their stimulators to these settings in subsequent treatment sessions.

    Indications for the use of TENS

  • Neurogenic pain (eg, deafferentation pain, phantom pain), sympathetically mediated pain, postherpetic neuralgia, trigeminal neuralgia, atypical facial pain, brachial plexus avulsion, pain after spinal cord injury (SCI)

  • Musculoskeletal pain - Examples of specific diagnoses include joint pain from rheumatoid arthritis and osteoarthritis, acute postoperative pain (eg, postthoracotomy), and acute posttraumatic pain.10, 11, 12, 13, 14, 15, 16 After surgery, TENS is most effective for mild to moderate levels of pain, and it is ineffective for severe pain. The use of TENS in chronic LBP and myofascial pain is controversial, with placebo-controlled studies failing to show statistically significant beneficial results. Uncertainty also exists about the value of TENS in tension headache.

  • Visceral pain and dysmenorrhea - TENS has been successfully applied to these conditions as well.17

  • Other disorders - TENS has been used successfully in patients with angina pectoris and urge incontinence, as well as in patients requiring dental anesthesia.18, 19 Reports discuss the use of TENS to assist patients in regaining motor function following stroke, to control nausea in patients undergoing chemotherapy, as an opioid -sparing modality in postoperative recovery, and in postfracture pain.

    Contraindications for the use of TENS

  • TENS should not be used in patients with a pacemaker (especially of the demand type).

  • TENS should not be used during pregnancy, because it may induce premature labor.

  • TENS should not be applied over the carotid sinuses due to the risk of acute hypotension through a vasovagal reflex.

  • TENS should not be placed over the anterior neck, because laryngospasm due to laryngeal muscle contraction may occur.

  • The electrodes should not be placed in an area of sensory impairment (eg, in cases of nerve lesions, neuropathies), where the possibility of burns exists.

  • A TENS unit should be used cautiously in patients with a spinal cord stimulator or an intrathecal pump.

    Comparison Between Tens and Other Electrical Modalities

    A number of studies have compared transcutaneous electrical nerve stimulation (TENS) with similar therapeutic modalities, including percutaneous electrical nerve stimulation (PENS), interferential current therapy (IFC), and acupuncture.17, 27 The results included the following:

  • In one study of elderly patients with chronic low back pain (LBP), acupuncture and TENS had demonstrable benefits, with the acupuncture group demonstrating improvement in spinal flexion.

  • In patients with chronic LBP and sciatica, PENS was more effective than TENS in providing short-term pain relief and improved function, including an improved quality of sleep and sense of well-being.

  • Overall, 91% and 73% of patients, respectively, chose PENS as the preferred modality for pain relief in LBP and sciatica.

  • PENS has been used successfully for pain relief in patients with acute herpes zoster and in persons suffering from cancer with bony metastases.

  • IFC and TENS had a statistically significant effect on the median nerve excitation threshold in young women.

    Table of Topics


    Acupuncture & Myofascial Trigger Therapy Treat Same Pain Areas

ScienceDaily (May 14, 2008) — Ancient acupuncture and modern myofascial pain therapy each focus on hundreds of similar points on the body to treat pain, although they do it differently, says a physician at Mayo Clinic in Jacksonville who analyzed the two techniques.

Results of the study, published May 10 in the Journal of Complementary and Alternative Medicine, suggest that people who want relief from chronic musculoskeletal pain may benefit from either therapy, says chronic pain specialist Dr. Peter Dorsher of the Department of Physical Medicine and Rehabilitation at Mayo Clinic.

“This may come as a surprise to those who perform the two different techniques, because the notion has been that these are exclusive therapies separated by thousands of years,” he says. “But this study shows that in the treatment of pain disorders, acupuncture and myofascial techniques are fundamentally similar – and this is good news for anyone looking for relief.”

Classic Chinese acupuncture treats pain and a variety of health disorders using fine needles to “reset” nerve transmission, Dorsher says. Needles are inserted in one or several of 361 classical acupoints to target specific organs or pain problems. “This is a very safe and effective technique,” he says.

Myofascial trigger-point therapy, which has evolved since the mid-1800s, focuses on tender muscle or “trigger point” regions. There are about 255 such regions described by the Trigger Point Manual, the seminal textbook on myofascial pain. These are believed to be sensitive and painful areas of muscle and fascia, the web of soft tissue that surrounds muscle, bones, organs and other body structures. To relieve pain at these trigger points, practitioners use injections, deep pressure, massage, mechanical vibration, electrical stimulation and stretching, among other techniques.

In the study, Dorsher analyzed studies published on both techniques and demonstrated that acupuncture points and trigger points are anatomically and clinically similar in their uses for treatment of pain disorders.

In another recent study, he found that at least 92 percent of common trigger points anatomically corresponded with acupoints, and that their clinical correspondence in treating pain was more than 95 percent. “That means that the classical acupoint was in the same body region as the trigger point, was used for the same type of pain problem, and the trigger point referred pain pattern followed the meridian pathway of that acupoint described by the Chinese more than 2,000 years before,” Dorsher says. Myofascial pain therapy has lately incorporated the use of acupuncture needles in a treatment called “dry needling” to treat muscle trigger points.

“I think it is fair to say that the myofascial pain tradition represents an independent rediscovery of the healing principles of traditional Chinese medicine,” Dorsher says. “What likely unites these two disciplines is the nervous system, which transmits pain.”

The study was funded by Mayo Clinic.

Table of Topics

Cupping therapy: Can it relieve fibromyalgia pain?

Is there any evidence that cupping therapy relieves fibromyalgia pain? Mayo Clinic rheumatologist April Chang-Miller, M.D.

There's no conclusive evidence that cupping therapy relieves fibromyalgia pain. But anecdotal evidence suggests a benefit. Cupping therapy is typically practiced by traditional Chinese medicine practitioners. The theory behind cupping is that it moves or stimulates your body's natural energy — also called qi.

Basically, cupping involves heating the air inside a glass cup, which removes some of the air from the cup. The cup is then quickly placed on the skin and the resulting vacuum pulls the skin part of the way into the cup. The cup may be left in place for several minutes and then removed, leaving behind a bright red, circular welt. Although it sounds painful, it's not.

Many articles have been published on cupping. But many of these are case reports or anecdotes published in Chinese medical journals — and not always available in English. There have been no peer-reviewed clinical trials specifically evaluating cupping as a treatment for painful conditions. Thus, although cupping has been a part of Chinese healing traditions for at least 3,000 years, available research hasn't yet documented its effectiveness.

Table of Topics

Acupuncture in the treatment of fibromyalgia in tertiary care - a case series.
Acupunct Med. 2007 Dec;25(4):137-47. Duncan B, White A, Rahman A. NLM Citation: PMID: 18160924

AIMS: Fibromyalgia is a common cause of chronic widespread pain. The benefit of medication is often limited by its side effects, and the improvements obtained with exercise and education are inconsistent. Many patients seek acupuncture treatment, which is reported to be helpful in some cases. This study aimed to explore the acceptability and benefits of acupuncture offered in the setting of a tertiary referral clinic.

METHODS: An open, uncontrolled observational study was conducted among patients who met the usual fibromyalgia criteria and who had a pain score of at least 30 on a 100mm Visual Analogue Scale (VAS).
Patients were allowed to continue other treatments but not to introduce new ones. Acupuncture was given using a Western approach according to a protocol developed by consensus. Patients were offered eight treatments in eight weeks. Outcome measures included VAS of pain intensity and Fibromyalgia Impact Questionnaire (range 0 - 100), and were taken before and after treatment, and at 14, 20 and 34 weeks from enrolment.

RESULTS: Twenty four eligible patients were enrolled in a 12 month period. Baseline mean pain VAS score for these 24 patients was 74 (SD 18) and mean Fibromyalgia Impact Questionnaire score 78 (SD 12.4).
Only 14 patients completed the course of treatment within about 10 weeks. Compliance was poor in the remaining patients because of difficulty attending clinic, and in two cases because of exacerbation of pain. Completion of outcome measures was variable and therefore the analysis of data is limited. Five patients scored at least 20% reduction in Fibromyalgia Impact Questionnaire score which is a clinically relevant improvement. Two of these scored at least 50%
reduction.

CONCLUSION: Acupuncture appears to offer symptomatic improvement to some patients with fibromyalgia in a tertiary clinic who have failed to respond to other treatments. In view of its safety, further acupuncture research is justified in this population.


Table of Topics

Acupuncture: Sharp answers to pointed questions

(We were given this information without an author name or copyright attached. Deeming this important information to share with
our visitors we opted to publish. If this is your work and you would like a byline posted please contact us)

Acupuncture involves the insertion of extremely thin needles to various depths at strategic points on your body. Acupuncture originated in China thousands of years ago, but over the past two decades its popularity has grown significantly within the United States. Although scientists don't fully understand how or why acupuncture works, some studies indicate that it may provide a number of medical benefits — from reducing pain to helping with chemotherapy-induced nausea.

What happens during an acupuncture treatment session?

Acupuncture therapy usually involves a series of weekly or biweekly treatments in an outpatient setting. It's common to have up to 12 treatments in total. Although each acupuncture practitioner has his or her own unique style, each visit typically includes an exam and an assessment of your current condition, the insertion of needles, and a discussion about self-care tips. An acupuncture visit generally lasts 30 to 60 minutes.

During acupuncture treatment, the practitioner uses sterilized, individually wrapped stainless steel needles that are used only once and then thrown away. You may feel a brief, sharp sensation when the needle is inserted, but generally the procedure isn't painful. It's common to feel a deep aching sensation when the needle reaches the correct spot. After placement, the needles are sometimes moved gently or stimulated with electricity or heat.

How does acupuncture work?

The traditional Chinese theory behind acupuncture as medical treatment is very different from that of Western medicine. In traditional Chinese medicine, imbalances in the basic energetic flow of life — known as qi or chi (chee) — are thought to cause illness. Qi is believed to flow through pathways (meridians) in your body. These meridians and the energy flow are accessible through approximately 400 different acupuncture points. By inserting extremely fine needles into these points in various combinations, acupuncture practitioners believe that your energy flow will rebalance. This will allow your body's natural healing mechanisms to take over.

In contrast, the Western explanation of acupuncture incorporates modern concepts of neuroscience. According to the National Institutes of Health, researchers are studying at least three possible explanations for how acupuncture works:

Opioid release. During acupuncture, endorphins that are part of your body's natural pain-control system may be released into your central nervous system — your brain and spinal cord. This reduces pain much like taking a pain medication.

Spinal cord stimulation. Acupuncture may stimulate the nerves in your spinal cord to release pain-suppressing neurotransmitters. This has sometimes been called the "gate theory."

Blood flow changes. Acupuncture needles may increase the amount of blood flow in the area around the needle. The increased blood flow may supply additional nutrients or remove toxic substances, or both, promoting healing.

Who is acupuncture for?

Acupuncture seems to be useful as a stand-alone treatment for some conditions, but it's also increasingly being used in conjunction with more conventional Western medical treatments. For example, doctors may combine acupuncture and drugs to control pain during and after surgery.

Because of the difficulty of conducting valid scientific studies of acupuncture — numerous past studies have been proved inadequate — it's hard to create a definitive list of the conditions for which acupuncture might be helpful. However, preliminary studies indicate that acupuncture may offer symptomatic relief for a variety of diseases and conditions, including low back pain, headaches, migraines and osteoarthritis. In a 2006 Mayo Clinic study, acupuncture significantly improved symptoms of fibromyalgia.

In addition, research shows acupuncture can help manage postoperative dental pain and alleviate chemotherapy-induced nausea and vomiting. It also appears to offer relief for chronic menstrual cramps and tennis elbow.

Pros and cons

As with most medical therapies, acupuncture has both benefits and risks. Consider the benefits:

* Acupuncture is safe when performed properly.

* It has few side effects.

* It can be useful as a complement to other treatment methods.

* It's becoming more available in conventional medical settings.

* It helps control certain types of pain.

* It may be an alternative if you don't respond to or don't want to take pain medications.

Acupuncture isn't safe if you have a bleeding disorder or if you're taking blood thinners. The most common side effects of acupuncture are soreness, bleeding or bruising at the needle sites. You might feel tired after a session. Rarely, a needle may break or an internal organ might be injured. If needles are reused, infectious diseases may be accidentally transmitted. However, these risks are low in the hands of a competent, certified acupuncture practitioner.

How to choose an acupuncture practitioner

In the United States, acupuncture services are offered by two types of medical professionals:

Medical doctors. About 3,000 medical doctors use acupuncture as part of their clinical practice. Most states require that these doctors have 200 to 300 hours of acupuncture training in addition to their medical training.

Certified acupuncturists. About 11,000 certified acupuncturists who aren't medical doctors practice acupuncture in the United States. To be fully certified, these professionals complete between 2,000 and 3,000 hours of training in one of several independently accredited master's degree programs. They also must successfully complete board exams conducted by a national acupuncture accreditation agency, the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM)

If you're considering acupuncture, do the same things you would do if you were choosing a doctor:

* Ask people you trust for recommendations.

* Check the practitioner's training and credentials.

* Interview the practitioner. Ask what's involved in the treatment, how likely it is to help your condition and how much it will cost.

* Find out whether the expense is covered by your insurance.

Don't be afraid to tell your doctor you're considering acupuncture. He or she may be able to tell you about the success rate of using acupuncture for your condition or recommend an acupuncture practitioner for you to try.

Table of Topics

Fibromyalgia Pain and Substance P Decrease and Sleep Improves After Massage Therapy.

JCR: Journal of Clinical Rheumatology. 8(2):72-76, April 2002.
Field, Tiffany; Diego, Miguel; Cullen, Christy; Hernandez-Reif, Maria; Sunshine, William; Douglas, Steven

Abstract:
Massage therapy has been observed to be helpful in some patients with fibromyalgia. This study was designed to examine the effects of massage therapy versus relaxation therapy on sleep, substance P, and pain in fibromyalgia patients. Twenty-four adult fibromyalgia patients were assigned randomly to a massage therapy or relaxation therapy group. They received 30-minute treatments twice weekly for 5 weeks. Both groups showed a decrease in anxiety and depressed mood immediately after the first and last therapy sessions. However, across the course of the study, only the massage therapy group reported an increase in the number of sleep hours and a decrease in their sleep movements. In addition, substance P levels decreased, and the patients' physicians assigned lower disease and pain ratings and rated fewer tender points in the massage therapy group.

Table of Topics

Hypnosis

Hypnosis has long been used to treat both psychological and medical disorders. The Ancient Egyptians and Chinese used hypnosis to relieve symptoms of pain over two thousand years ago. Hypnosis was also used in the 1800s by medical doctors for anesthetic purposes. Recently, hypnosis has received more attention from the medical field; in fact, the National Institutes of Health (NIH) has now recommended that hypnosis be used as part of a treatment regime for chronic pain like that caused by fibromyalgia.

What is Hypnosis?
Hypnosis is a non-invasive technique that encourages you to achieve heightened levels of focus and sensation. People who practice hypnosis believe that there are two main components to the mind: the conscious mind and the unconscious mind. Through relaxation and suggestion, you are able to access your subconscious mind and stop behaviors or thoughts that may be contributing to pain or other unpleasant symptoms.

Contrary to popular belief, though, people who are in a state of hypnosis are not unaware of their actions and will not do anything that they have a serious moral or ethical objection to. In fact, you do have control over your actions as well as what you say while you are hypnotized. Moreover, you have the ability to remember what transpired while you were hypnotized. However, in some cases, your subconscious mind may choose to "forget" just what happened.

Types of Hypnosis
There are two main types of hypnosis techniques:

  1. Hypnosis Performed by a Clinical Hypnotist: This type of hypnosis is performed in-office by a licensed professional. The hypnotist will explain what hypnosis is and how it works to reduce pain. He or she will then lead you into hypnosis through a series of relaxation exercises. Once you are in a hypnotic state, the hypnotist will make suggestions as to how you can change your thoughts or behavior in order to minimize your symptoms.

  2. Self Hypnosis: Self hypnosis is a type of hypnosis that you can do yourself in the privacy of your own home. You can learn self hypnosis either from a clinical hypnotist or from one of a number of books available on the subject. Self hypnosis programs and hypnotherapy courses are also widely available. Self hypnosis techniques can be indispensable for fibromyalgia sufferers. Self hypnosis is usually used as a form of relaxation or meditation.

Stages of Hypnosis
There are three main stages of hypnosis. Your hypnotist will lead you into a certain stage of hypnosis, depending upon the illness or symptom you wish to treat.

First Stage: The first stage of hypnosis is often referred to as a superficial trance. This is the lightest stage of hypnosis, during which you are aware of all of your surroundings. This type of trance is commonly used to help correct addictive behaviors such as smoking. During a superficial trance, you will accept suggestions but may not act upon them afterwards.

Second Stage: The second stage, the alpha state, is a deeper level of hypnosis. You may notice that your breathing begins to slow down, as will your heart rate and blood pressure, It is this stage of hypnosis that is used to control pain.

Third Stage: The third stage of hypnosis is the deepest. Psychiatrists use this stage to access forgotten emotions, memories, and events. It is often used to help those who have undergone severe psychological trauma.

How Does Hypnosis Work?
Researchers are not completely sure how hypnosis therapy works or why it works so well in fibromyalgia patients. A recent study performed at the University of Iowa looked to explain what actually happens to the brain during hypnosis. Brain scans were taken of chronic pain sufferers in hypnotic trances and analyzed for activity changes. Researchers found that people under hypnosis had reduced activity in pain network areas of the brain. In particular, the area of the brain responsible for "feeling" pain had significantly reduced activity levels. This suggests that hypnosis treatment works because it actually has a physical effect on the brain.

Effects of Hypnosis on Fibromyalgia Sufferers
Many fibromyalgia sufferers attribute reduction in their symptoms to the power of hypnosis. Fibromyalgia sufferers often use hypnosis as a way to limit their pain symptoms and increase their energy and comfort level. A study conducted by the NIH showed that fibromyalgia sufferers undergoing hypnosis reported 80% fewer pain symptoms than those who received no hypnosis treatment. Other benefits of hypnosis include:

  • decreased muscle pain

  • decreased morning fatigue

  • fewer sleep difficulties

  • increased relaxation

Table of Topics

Craniosacral Therapy

Jane Kohler 2008

Craniosacral therapy is an alternative treatment technique that is very similar to osteopathy and physical therapy. It it a non-invasive treatment that uses gentle palpatations on your skin. It is believed this procedure reduces pain and bolsters your immune system. It was created in the nineteen-seventies by Dr. John Upledger, who based his treatment on theories developed in the early nineteen-thirties by William G. Sutherland.

Sutherland and Upledger theorized that the craniosacral system, which include the brain, spinal cord and the surrounding fluid play a large part in your overall health. Craniosacral therapists believe that the cerebrospinal fluid emits a measurable pulse as it rises and falls (called the cranial rhythmic impulse), much like your heart and blood vessels. If this pulse is upset it can cause a number of health problems, including fibromyalgia.

Therapists locate this pulse by placing their fingers over specific areas of the body and once located, they begin to restore a  normal pulse. Using gentle palpitations on areas of your head they restore a healthy, cranial rhythmic pulse, reducing your symptoms.

Treatments are received in individual offices and last from forty minutes to one hour, depending on your level of need. Unlike massage you will remain clothed and encouraged to relax as they work on your spine, head and neck.

Ask your local clinic, hospital or doctor for known, reputable craniosacral therapists or check with the Upledger Institute for one near you.

Table of Topics

Marijuana Laws Ruin Lives, Legalize Cannabis, Say US Activists

Over eight hundred thousand Americans were arrested for violating marijuana laws last year, according a report released by the Federal Bureau of Investigation (FBI).

Of those arrested, 89 percent of those were charged with simple pot possession -- the highest annual total ever recorded and nearly three times the number of citizens busted 15 years ago.

As per figures released by the Office of Applied Studies (OAS) 2006 National Survey on Drug Use and Health less than 2 percent increase in pot users was recorded from '05 to '06. But pot arrests jumped more than five percent. Activists and blame it all on the “zeal” of enforcement officials.

The bottom line: Since 1990 over 10.4 million Americans -- predominantly young people under age 30 -- have been busted for pot. Thousands have been disenfranchised, tens of thousands have been unnecessarily sent to "drug treatment," hundreds of thousands have lost their eligibility for student aid, and perhaps an entire generation (or two) has been alienated to believe that the police are an instrument of their oppression rather than their protection. These are the tangible results of the government's stepped up war on pot -- results that go beyond the FBI's record numbers, and it's high time that politicians and the general public began taking notice.

The National Organization for the Reform of Marijuana Laws (NORML) is campaigning in a big way supporting “the right of adults to use marijuana responsibly, whether for medical or personal purposes,” it says.

All penalties, both civil and criminal, should be eliminated for responsible use. Further, to eliminate the crime, corruption and violence associated with any "black market," a legally regulated market should be established where consumers could buy marijuana in a safe and secure environment.

According to the American Chronic Pain Association, one in three Americans lives in persistent pain. Isn’t it time to grant these patients legal access to a non-toxic alternative that can help them alleviate their pain and suffering? Paul Armentano, a senior policy analyst with the NORML asks and suggests that cannabis could be that option.

In 12 states, including New Mexico, patients now can use cannabis therapeutically under state law. Many of these patients use cannabis for pain relief.

Investigators at San Francisco General Hospital and the University of California’s Pain Clinical Research Center assessed the efficacy of inhaled cannabis on HIV-associated sensory neuropathy. Neuropathic pain, colloquially known as nerve pain, affects an estimated 1 percent of the world’s population and is typically unresponsive to both opioids and non-steroidal anti-inflammatory medications.

Researchers reported that patients who smoked low-grade cannabis three times daily experienced, on average, a 34 percent reduction in pain. Assessing the use of cannabinoids as analgesics has demonstrated that they also can alleviate the neuropathy associated with multiple sclerosis, diabetes, cancer and rheumatoid arthritis. Canadian health regulators just approved the use of an oral cannabis spray for the treatment of cancer pain.

Survey data from numerous studies also indicates that medicinal pot users typically require fewer pharmaceutical drugs than their non-using counterparts. In June, investigators at Columbia University reported that HIV patients who used cannabis therapeutically made fewer requests for over-the-counter medications, such as pain relievers and anti-nausea drugs, than subjects administered a placebo.

Evidence also demonstrates that cannabis has an adequate safety profile, particularly when compared to other pain medications. For instance, long-term use of non-steroidal anti-inflammatory drugs, such as ibuprofen and naproxen, is a leading cause of stomach ulcers and stomach bleeding, with some reports estimating that their use contributes to more than 100,000 hospitalizations and 16,500 deaths annually in the United States.

The use of narcotic painkillers such as oxycodone (OxyContin) to treat chronic pain also poses serious health risks, including death by overdose and addiction. Recently, a federal judge in Virginia ordered OxyContin-maker Purdue Pharma L.P. and three of its executives to pay more than $634 million in fines for misleading the public about the drug’s risk of addiction.

By contrast, few users of cannabis, less than 10 percent, according to the National Academy of Sciences Institute of Medicine, ever become dependent on the drug, and no human case of fatal overdose has ever been attributed to cannabis, argues Armentano.

Source-Medindia GPL /J

Table of Topics

Low Frequency Sound Therapy

Sound frequency is measured in units called Hertz. Low frequency sounds are comprised of those sound wavelengths that are between the range of 17 Hertz and 0.001 Hertz. Many animals, including elephants, whales, and giraffes, communicate with one another using low frequency sound. Humans cannot hear most of these low frequency sounds, because we only recognize sounds traveling at frequencies between 20 Hertz and 20,000 Hertz. However, our bodies can subconsciously receive and interpret low frequency sound waves.

What is Low Frequency Sound Therapy?
Low frequency sound therapy operates on the premise that low frequency sound actually has healing properties. Also known as infrasonic therapy (IST), low frequency sound is thought to travel through the body, directly stimulating your cells. Though you cannot actually hear these sounds, your body does receive the sound wavelengths and responds to them by healing areas that are affected by swelling, inflammation, or chronic or acute pain.

How Do You Use Low Frequency Sound Therapy? Low frequency or infrasonic therapy is typically delivered in a hand-held or portable device. This device has a transducer that is very similar to that used in ultrasound technology. You simply run this transducer over various parts of your body in order to receive the healing benefits of the low frequency sound waves.

Low frequency sound therapy can also be delivered in specially designed chairs that are equipped with internal speaker systems. These systems deliver low frequency sound to your body while you are sitting in the chair. Both chair and hand-held systems often incorporate massage therapy in order to maximize the benefits of low frequency sound therapy.

What are the Benefits of Low Frequency Sound Therapy?
Low frequency sound therapy is thought to help relieve a variety of unpleasant physical symptoms, including:

  • acute pain

  • chronic pain

  • joint pain and stiffness

  • muscle pain

  • fatigue

  • sleep disorders

How Does Low Frequency Sound Therapy Work?
Low frequency sound therapy is thought to be effective in reducing painful physical ailments by stimulating cell reproduction and other bodily changes. In particular, low frequency sound therapy is thought to increase the production of hyaluronic acid (HLA), which helps to lubricate joints and relieves muscle and joint pain and inflammation. Low frequency sound also stimulates cellular repair, helping to increase overall bodily health and stamina.

How Does Low Frequency Sound Therapy Help Fibromyalgia?
Low frequency sound therapy is now being recommended for use in fibromyalgia patients. A recent study performed by the Sound Health and Research Institute found that low frequency sound therapy helped to reduce the widespread pain associated with fibromyalgia. It also helped to increase overall mobility. Fibromyalgia sufferers may also find that symptoms of fatigue, stress, and sleep disorders are reduced by using low frequency sound therapy.

The study delivered low frequency sound therapy through a portable device to fibromyalgia sufferers on a daily basis. Upon completion of the study, 89% of participants were reported to have experienced at least a 50% reduction in pain symptoms. Many of these patients also experienced periods of complete symptom relief when exposed to the low frequency sound therapy.

Costs of Low Frequency Sound Therapy
Though you can purchase your own infrasonic therapy system, these systems do tend to be quite expensive: the average cost of a low frequency sound therapy system is about $800.
Physical therapists, massage therapists, chiropractors, and naturopaths often offer low frequency sound therapy services, which can reduce the cost of this treatment significantly.

Table of Topics

Cupping Therapy

Cupping therapy has been adapted for use from a form of traditional Chinese medicine. This type of therapy uses glass cups applied to the skin to help relieve pain, flush out toxins, and restore healthy blood flow to the body. Using heat or a suction pump, a vacuum is created inside of each glass cup. These cups are then placed on various acupuncture points throughout the body and left for about ten minutes.

Types of Cupping
There are two main types of cupping:

  • Stationary Cupping: During stationary cupping, each glass cup is left in one position on the skin. The glasses are not moved.

  • Massage Cupping: During massage cupping, the glass cups are moved around the skin in a massage-like technique.

History of Cupping
Though cupping may sound scary at first, it has actually been around for thousands of years. It was first used by various indigenous tribes in Africa, Asia, and South America. These tribesmen used hollowed-out horns to remove poisons passed through insect and snakebites. It was also used in traditional Chinese medicine to help prepare people for surgery and to divert blood from wounds.

Throughout the 18th, 19th, and early 20th centuries, cupping was commonly used to help cure common colds and chest infections. Nowadays, cupping is making a big comeback. In the United States, it is offered by many massage therapists and acupuncturists, with various celebrities, including Gwyneth Paltrow, taking advantage of this ancient technique..

The Benefits of Cupping
Whether or not you are suffering from symptoms of pain or muscle stiffness, cupping is a great therapy. It provides numerous benefits including:

  • improved circulation and blood flow

  • toxin release

  • faster healing of muscles, ligaments, and tendons

It also works to reduce pain and soften stiff muscles and tissues.

Cupping Therapy for Fibromyalgia
Cupping therapy is especially beneficial for people suffering from fibromyalgia. If you have fibromyalgia, you know how tender your muscles and joints are. Even a vigorous massage can send your body into spasm. Cupping, however, is a non-irritating type of treatment. It will not exacerbate your muscle pain in anyway, or compound any of your fibromyalgia symptoms. It is especially good for:

  • reducing trigger points

  • increasing muscle flexibility and range of motion

  • decreasing anxiety and depression

What to Expect During A Session
At your first cupping session, you will probably notice quite a few different tools that will be used during your treatment. These include:

  • glass cups

  • alcohol

  • cotton balls

  • candles

  • matches

Though these implements may worry you, rest assured, this is not a painful treatment. You will lie down on a massage table and your therapist will first locate areas that require treatment. Once these areas have been identified, the cupping procedure will begin.

  • A candle is lit and used to light on fire a cotton ball that has been soaked in alcohol.

  • This cotton ball is then held inside a glass cup, creating a vacuum.

  • The cotton ball is removed and the cup is placed immediately on your skin.

You will feel a slight suction where each cup has been applied. Typically, between four and six cups are applied during one session. These are left on the skin for no more than 15 minutes. If you are receiving a massage cupping treatment, oil will first be rubbed over your skin. The glass cups will then be moved over your skin to help massage sore muscles and joints.

After the Cupping Treatment
After your cupping treatment you may notice some red marks in the form of circles on your skin. Don’t worry – this is a sign that the cupping technique has worked to increase your circulation. You will also feel deeply relaxed and the areas that have been treated will feel flexible and light.

Finding a Cupping Therapist
Cupping therapy is available at various different spas and holistic treatment centers around the country. If you are interested in trying cupping, it is probably a good idea to ask your massage therapist for a recommendation. Costs per session vary, depending upon the skill of the therapist and the length of the treatment. A typical session can cost anywhere between $50 and $100.


Table of Topics

Toxic & hazardous chemicals found in top selling scented laundry products and air fresheners

University of Washington 08-24-2008

"Five of the six products emitted one or more carcinogenic 'hazardous air pollutants,' which are considered by the Environmental Protection Agency to have no safe exposure level." - Anne C. Steinemann

A University of Washington study of top-selling laundry products and air fresheners found the products emitted dozens of different chemicals. All six products tested gave off at least one chemical regulated as toxic or hazardous under federal laws, but none of those chemicals was listed on the product labels.

"I first got interested in this topic because people were telling me that the air fresheners in public restrooms and the scent from laundry products vented outdoors were making them sick," said Anne Steinemann, a UW professor of civil and environmental engineering and of public affairs. "And I wanted to know, 'What's in these products that is causing these effects?'"

She analyzed the products to discover the chemicals' identity. "I was surprised by both the number and the potential toxicity of the chemicals that were found," Steinemann said. Chemicals included:

"Nearly 100 volatile organic compounds were emitted from these six products, and none were listed on any product label. Plus, five of the six products emitted one or more carcinogenic 'hazardous air pollutants,' which are considered by the Environmental Protection Agency to have no safe exposure level," Steinemann said.

Her study was published online by the journal Environmental Impact Assessment Review. [See “Fragranced consumer products and undisclosed ingredients,” July 10, 2008.] Steinemann chose not to disclose the brand names of the six products she tested.

In a larger study of 25 cleaners, personal care products, air fresheners and laundry products, now submitted for publication, she found that many other brands contained similar chemicals. [Note: The Environmental Working Group offers detailed information on the fragrance & other chemicals in thousands of branded cosmetics. See "Online Safety Guide to Cosmetics and Personal Care Products."]

Because manufacturers of consumer products are not required to disclose the ingredients, Steinemann analyzed the products to discover their contents.

She studied:

  • Three common air fresheners (a solid deodorizer disk, a liquid spray and a plug-in oil)

  • And three laundry products (a dryer sheet, fabric softener and a detergent),

  • Selecting a top seller in each category.

She bought household items at a grocery store and asked companies for samples of industrial products. In the laboratory, each product was placed in an isolated space at room temperature and the surrounding air was analyzed for volatile organic compounds - small molecules that evaporate from the product's surface into the air.

Results showed 58 different volatile organic compounds above a concentration of 300 micrograms per cubic meter, many of which were present in more than one of the six products. For instance:

  • A plug-in air freshener contained more than 20 different volatile organic compounds.

  • Of these, seven are regulated as toxic or hazardous under federal laws.

  • The product label lists no ingredients, and information on the Material Safety Data Sheet, required for workplace handling of chemicals, lists the contents as "mixture of perfume oils."

This study does not address links between exposure to chemicals and health effects. However, two national surveys published by Steinemann and a colleague in 2004 and 2005 found that:

  • About 20 percent of the population reported adverse health effects from air fresheners,

  • And about 10 percent complained of adverse effects from laundry products vented to the outdoors.

  • Among asthmatics such complaints were roughly twice as common.

Manufacturers are not required to list the ingredients used in laundry products and air fresheners. Personal-care products and cleaners often contain similar fragrance chemicals, Steinemann said. And although cosmetics are required by the Food and Drug Administration to list ingredients, no law requires products of any kind to list chemicals used in fragrances.

"Fragrance chemicals are of particular interest because of the potential for involuntary exposure, or second-hand scents," Steinemann said.

"Be careful if you buy products with fragrance, because you really don't know what's in them," she added. "I'd like to see better labeling. In the meantime, I'd recommend that instead of air fresheners people use ventilation, and with laundry products, choose fragrance-free versions."

The European Union recently enacted legislation requiring products to list 26 fragrance chemicals when they are present above a certain concentration in cosmetic products and detergents. No similar laws exist in the United States.

"I hope this study will raise public awareness, and reduce exposures to potentially hazardous chemicals," said Steinemann.

For more information, contact Anne C. Steinemann at (206) 616-2661 or acstein@u.washington.edu

Note: This information has not been evaluated by the FDA. It is generic and is not meant to prevent, diagnose, treat or cure any illness, condition, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.

Table of Topics

Chelation Therapy - risks or side effects?

Chelation with EDTA has been used to treat heavy metal poisoning such as lead. For this use, there is a low occurrence of side effects. The safety of EDTA for treating heart disease has not been established.

The most common side effect is a burning sensation at the site where the EDTA is delivered into the vein. Rare side effects can include fever, headache, nausea, and vomiting. Even more rare are serious side effects that can include a sudden drop in blood pressure, abnormally low calcium levels in the blood, permanent kidney damage, and bone marrow depression (meaning that blood cell counts fall). Reversible injury to the kidneys, although infrequent, has been reported with EDTA chelation therapy. Other serious side effects can occur if EDTA is not administered by a trained health professional.

In addition, because chelation therapy removes important vitamins and minerals from the body, it will be very important for you to take the vitamin supplements

Table of Topics

A Comparative Analysis of Clinical Outcomes in the Refractive IBS Patient vs. the Newly Diagnosed

By Michael Mahoney Clinical Hypnotherapist
07 February 2007  

A Comparative Analysis of Clinical Outcomes in the Refractive IBS Patient vs. the Newly Diagnosed

The successful use of clinical hypnotherapy (CHT) for the treatment of patients with irritable bowel syndrome has been established in at least 14 published studies (1) (2) where it has been shown to produce significant reduction in the cardinal IBS symptoms and associated symptoms such as anxiety. The success of this treatment method in the clinical setting is contingent upon the protocol being gut-directed or gut-specific, i.e. directly addressing the digestive tract, balancing the dismotility and restoring its proper function while allowing the patient to take part in their own healing. Sufferers who consider hypnotherapy currently tend to do so as a 'last resort' rather than a first approach after diagnosis.

In treating IBS patients since 1991, I recognised a consistent trend in therapy outcomes and decided to investigate this further with an informal observational study. From September 2003 to January 2005, I assigned 40 patients with the same primary IBS diagnostic criteria into two groups.

The first group consisted of 20 IBS patients of long-standing, termed as refractory where no previous medical interventions provided relief.   Age ranges for this group was 27 years to 66 years; average age was 42.2 years; comprised of 10 males average age 38.7 years, 10 females average age 45.6 years.

The second group included 20 newly diagnosed IBS patients with ages ranging from (24 years) to (64 years); average age (40.1 years), there were (10) males average age 40.2 years and (10) females average age 40.1years.

The newly diagnosed patients had no prior IBS treatment intervention upon their arrival to me, however, they may have presented with symptoms for varying degrees of time.

The clinical protocol (3) consisted of an initial intake consultation session, where the IBS patient discusses symptoms and concerns.

A life-style, QOL and symptom questionnaire was also completed at this time, and again upon therapy completion to assess improvement rating.

The intake session was followed by an introductory session, where the patient was apprised of the method of CHT and assurances were given. Following that, five gut-specific sessions were presented to the patient dealing with:
1)  Building a foundation of self-esteem, relaxation and familiarity with the technique,
2) IBS and related symptoms, balancing of the digestive motility, the brain-gut connection,
3) pain, discomfort, bloating issues,
4) assurance that the patient always has control over their own healing and
5) reinforcement of previous sessions and resolution.

Standard treatment would allow for patients being seen five times over a 12 - 14 week period and all participants received a recording of each session which was listened to according to a specific schedule.

Psychological State and QOL of IBS Patient Prior to receiving CHT.

The intake information of the Refractory IBS Patient presented with two findings:

1. Higher Failure Expectation after years of frustration and unsuccessful treatment resolution.
2. Patients presented with more co-morbid emotional, psychological and physical symptomology and poor QOL, in addition to "basic" IBS symptoms. (4) This finding led me to believe that in many cases, if IBS is not initially treated on the psychological level, the condition usually escalates into a multi-faceted condition.

The intake information for the Newly Diagnosed presented with two findings:

1. Less expectation for either failure or success for therapy outcome.
2. General absence of comorbid psychological, emotional and additional physical symptomology.

Outcome of CHT treatment
Improvement levels for both patient groups were within the same symptom reduction range – with an average of 90% symptom reduction overall for 20 IBS and related symptoms listed.

However, refractory IBS patients who had received other forms of treatment first, had a longer recovery and symptom reduction time frame. It was found that for these patients, the time required to move forward to the next session became extended by an average of 1 to 3 weeks (or more in some cases) depending upon severity and longevity of symptoms and the resultant psychological issues. This group's confidence and self esteem was very low, and their ability to see things in perspective was significantly reduced. When talking about the psychological elements most of these patients wept. After sometimes years of pain and discomfort, and the following of unsuccessful treatment options it was clear this group of sufferers had become emotionally drained. Having presented with, for example, such symptoms as diarrhoea, 3 or more times a day, often uncontrollable and explosive for years, it was therefore not surprising that such patients presented with anxiety or various levels of depression.

Before these sufferers could even begin to work through the IBS, the hypnotherapy sessions first provided a strong emotional base that increased self-esteem, confidence, and allowed the sufferer to begin a journey of self improvement and management, and thereby equip themselves emotionally to move away from the symptoms and the familiarity of IBS thoughts and commence recovery initially at the emotional level.

The newly diagnosed group who received CHT as a first line of treatment showed a much quicker response towards their improvement in IBS symptoms, and did not require extensions in the standard protocol time frame.

It was my observation that early intervention with CHT may reduce or eliminate the multi-faceted component of IBS, thus leading to earlier/less prolonged symptom reduction. My findings appeared to confirm this trend that was observed early on. Since the subconscious mind does not have to deal with non-present comorbid complaints with the majority of newly diagnosed patients, the IBS symptoms are dealt with initially and directly and resolved more quickly. For the refractory patient, internal and emotional energies relegated to coping with the long-standing burden of IBS usually must first be dealt with by the subconscious before IBS issues can be addressed.

Implications and Conclusion
A negative aspect in all this is that in determining if CHT for IBS should be considered as a first line of treatment, it should be noted if the patient may have underlying "true" clinical psychological conditions that may become masked by the IBS related issues, and which will still need to be addressed directly.  As assessment tools, the QOL intake session may provide an insight to this, as a pattern for onset of symptoms and onset of emotional trends may be correlated: simply put – the co-morbid psychological condition may be secondary to the ongoing, long-standing IBS. Another potential negative perspective is the availability of a trained clinical hypnotherapist whom the physician may refer the newly diagnosed patient to at the outset of diagnosis when indicated.  However, for the primary IBS patient, this observation is promising.

This bears out a real look at providing CHT concurrently as a complementary therapy as a first line of treatment upon initial IBS diagnosis, and may prove to be a good defense in treating the whole person as the method has shown to improve the IBS symptom reduction rate, and may curtail or even eliminate possible further decline in QOL and psychological issues. (4)

So what does this tell us?
Further studies using clinical hypnotherapy initially alongside traditional medical interventions (medication) may prove helpful in considering the holistic nature of the condition and its optimal treatment.   Can the experiences of the refractory IBS patient who may endure the emotional burdens of hopelessness, (5) treatment resolution frustration, elevated stress and anxiety levels secondary to IBS, negativity, reduced QOL, and other multiple areas of suffering be alleviated or even eliminated if a psychological approach such as CHT be administered in conjunction with conventional treatment recommendations upon the initial diagnosis of IBS? It is the finding of this practice that this can be achieved when hypnotherapy is delivered professionally, however further investigation should be encouraged.

Reference List
1. Tan G, Hammond DC, Joseph G. Hypnosis and irritable bowel syndrome: a review of efficacy and mechanism of action.  Am J Clin Hypn. 2005 Jan;47(3):161-78.

2. Hauser W. Medizinische Klinik I, Klinikum Saarbrucken gGmbH, Saarbrucken. Hypnosis in Gastroenterology.   Z Gastroenterol 2003 May;41 5:405-12  PMID: 12772053  

3. In 1996 Mahoney was invited to participate in a medical research study funded by the UK National Health Service which was monitored and audited by the local Health Authority Audit Commission.  Medical centre GPs and hospital gastroenterologists screened 20 IBS patients: all were long-term sufferers, had undergone all medical diagnostic tests, and had taken prescription medications without attaining significant relief from their symptoms. Each patient underwent Mahoney's original protocol of the introductory and five subsequent hypnotherapy sessions.  At the end of the project, feedback sheets from the patients indicated an overall reduction of 80% in symptom severity and frequency of presentation.    In 1997, Mahoney developed new processes for IBS clinical protocol. Patients were monitored using audio tapes both during the program and for the next three subsequent years: 1998 through 2001. The final results of this study are intended for independent publication so that they may be subject to peer review and analysis. Success rates were close to or exceeding 90% for all symptoms and patients.

4. Spiegel BM, Gralnek IM, Bolus R, Chang L, Dulai GS, Mayer EA, Naliboff B. Clinical determinants of health-related quality of life in patients with irritable bowel syndrome.   Arch Intern Med. 2004 Sep 13;164(16):1773-80.

5.Miller V, Hopkins L, Whorwell PJ. Suicidal ideation in patients with irritable bowel syndrome. Clin Gastroenterol Hepatol. 2004 Dec;2(12):1064-8.

6. Pinto C, Lele MV, Joglekar AS, Panwar VS, Dhavale HS. Stressful life-events, anxiety, depression and coping in patients of irritable bowel syndrome.  J Assoc Physicians India. 2000 Jun;48(6):589-93.

7. Whitehead WE, Crowell MD. Psychologic considerations in the irritable bowel syndrome. Gastroenterol Clin North Am. 1991 Jun;20(2):249-67.

8. Lackner JM, Quigley BM. Pain catastrophizing mediates the relationship between worry and pain suffering in patients with irritable bowel syndrome. Behav Res Ther. 2005 Jul;43(7):943-57. Epub  2004 Sep 25.

9. Spiller RC. Potential future therapies for irritable bowel syndrome: will disease modifying therapy as opposed to symptomatic control become a reality? Gastroenterol Clin North Am. 2005 Jun;34(2):337-54.

10. Palsson OS, Drossman DA. Psychiatric and psychological dysfunction in irritable bowel syndrome and the role of psychological treatments. Gastroenterol Clin North Am. 2005 Jun;34(2):281-303.
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Author: Michael Mahoney Clinical Hypnotherapist

Michael Mahoney is a member of various primay care societies, the Hypnotherapy Association, The British Council of Hypnotist Examiners, as well as the International Foundation for Functional Gastrointestinal Disorders, the European Association for Cancer Education and the International Functional Brain-Gut Research Group.
Serves patients through NHS, non-NHS and BUPA
He has research and patient trials experience showing success rates of 85% - 95% IBS symptom reduction using his Ongoing Progressive Session Induction Method (OPSIM).
In 2005 he was awarded the Innovation and Research award for his work with IBS patients.  In 2003 he was named first in the Independent on Sunday ‘Top Brass Section’ of leading hypnotherapists in the UK.
His hypnotherapy practice sponsored the UK’s first IBS Awareness evening at Liverpool University in 1997

Table of Topics

Alternative Treatments for Irritable Bowel Syndrome

Alternative treatments such as acupuncture, dietary supplements, and herbs don't always get the official scientific nod, but some patients turn to them for help with irritable bowel syndrome (IBS).

Acupuncture for IBS

Acupuncture is a popular alternative therapy for IBS and other conditions. It's proven effective for treating chronic pain, according to researchers at the National Institutes of Health (NIH). However, the studies are mixed on whether the treatments really work for IBS.

Some studies show that acupuncture helps with abdominal pain and other IBS symptoms. Other studies show that it doesn't help.

Philip Schoenfeld, MD, MSEd, MSc, investigated various IBS treatments when he co-authored the treatment guidelines published by the American College of Gastroenterology. He says the hard data showing acupuncture's effectiveness isn't very good. Yet "that does not mean that acupuncture might not be helpful," he says. Many individuals say they feel better after acupuncture. Out of all alternative options, he suspects that acupuncture may help some people with IBS.

It is not entirely clear how this traditional Chinese treatment works. Some researchers believe the acupuncture needles stimulate electromagnetic signals in the body. These signals are thought to either encourage the release of pain-killing chemicals, or nudge the body's natural healing systems into action.

Acupuncture is ideally used with other treatments, says Jeanine Blackman, MD, PhD, medical director of the University of Maryland Center for Integrative Medicine. She says even in China, the therapy is never used on its own. Talk with your doctor if you are considering acupuncture.

Oils and Supplements for IBS

To help her IBS patients, Blackman recommends a combination of treatments, including changes in diet, stress reduction, and supplements such as evening primrose oil, borage oil, fish oil, or probiotics. She says the oil supplements help calm down the gut, and probiotics restore the good balance of bacteria in the digestive system.

Evening primrose oil comes from the seed of a small yellow wildflower, and borage oil comes from the seed of a common weed. Both supplements are similar in nature. Some proponents say evening primrose oil can help improve IBS symptoms, especially in women who experience a worsening of pain, discomfort, and bloating during their menstrual period. But claims about evening primrose oil are largely unproven, reports the University of California at Berkeley Wellness Guide to Dietary Supplements. Plus, side effects reportedly include stomach upset, headaches, and rashes.

Fish oil supplements have been examined along with fish for a number of benefits, including preventing heart disease and easing autoimmune disorders. There doesn't appear to be any scientific proof, however, that they work for IBS.

Herbs for IBS

Herbs are also popular options for people with IBS. Peppermint is used to calm muscles in the colon, which may cause some of the diarrhea and abdominal discomfort suffered by people with IBS. Studies have been mixed with this herb. The Mayo Clinic advises anyone who'd like to try it to get the enteric-coated capsules, and to be aware that it may make heartburn worse.

Registered herbalists never use peppermint on its own, nor do they recommend it for an extended period of time, says Jonathan Gilbert, who has a diplomate in herbology and acupuncture from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). He is a senior consultant for traditional oriental medicine at the Center for Integrative Medicine at the University of Maryland.

For people who are interested in true herbal therapy, Gilbert recommends a visit to an herbalist who has comprehensive training and is certified by the NCCAOM.

"In order to get a solution to a complex disorder, you need a complex formula, and in order to get that, you need to see someone who can actually prepare it," says Gilbert, noting he could combine up to 30 to 40 herbs for one formula. He says classic Chinese medicine has thousands of preset formulas for different ailments.

A lot of these formulas can't be bought on store shelves, adds Gilbert.

If you are interested in herbal therapy, dietary supplements, acupuncture, or any other treatment for your IBS, make sure you talk with your doctor. Herbs may interact with other medications you may be taking. Dietary supplements may become toxic if not used properly. Your doctor can also advise you on medicines for IBS with constipation and IBS with diarrhea.

Probiotics for IBS

On the other hand, there's some evidence that taking probiotics help IBS sufferers. Probiotics are bacteria that naturally live in the gut. Some people believe that several intestinal disorders may arise when there isn't enough good bacteria in the gut.

One study found that probiotic treatment significantly improved IBS symptoms and quality of life. In the study, researchers primarily used the bacteria Lactobacillus acidophilus and Bifidobacteria infantis. People with IBS reported fewer symptoms and, in general, a higher quality of life after taking the probiotics for four weeks.

Just as significant, the probiotic therapy did not appear to cause side effects, according to the study's author, Stephen M. Faber, MD, from Albemarle Gastroenterology Associates, PC, in Elizabeth City, North Carolina.

"These are organisms that are supposed to be in the gut. The body knows how to control them," Farber told WebMD.

Therapy and Hypnosis for IBS

Researchers have found that focusing the mind with hypnotherapy can improve the emotional and physical symptoms in those with IBS.

In one study, 20 men and 55 women received between five and seven half-hour hypnotherapy sessions over a three-month period. Afterwards, patients reported a 30% improvement in emotional quality of life and a 16% increase in overall physical health.

Two other studies conducted by one researcher included 135 people with IBS. The study participants who received 12 weekly one-hour hypnotherapy sessions focusing on their troubles with IBS showed a 52% improvement in their physical symptoms. Improvements were also maintained when researchers checked in with participants six months after the end of the study.

Cognitive behavior therapy (CBT) trains people to identify and change inaccurate perceptions they may have of themselves and the world around them. It's also been used to help IBS patients ease symptoms and improve quality of life.

Researchers gave a group of IBS patients up to 10 weekly sessions of CBT in one study. The sessions covered information on IBS, muscle relaxation training, development of a flexible set of problem-solving skills related to IBS, and ways to curb worries about the illness. Results showed that 60% to 75% of participants had improvement in their symptoms.

Table of Topics

Chelation Therapy

Chelation therapy is based on the concept that when an amino acid complex known as EDTA (ethylene-diamine-tetra-acetic acid) comes into contact with positively charged metals and other substances, it will bind these toxins and remove them from the body. When EDTA binds to toxins, a stable compound will be formed that will then be excreted from the system.

While synthetic amino acids are used in chelation therapy, the process actually takes place naturally in our bodies. For instance, during digestion amino acids will naturally bind to minerals such as iron in order to transport them to other parts of the body where they will be released.

Chelation therapy for fibromyalgia treatment can help eliminate built-up ionic substances such as lead, iron, calcium, magnesium, zinc, plutonium and manganese.

The Food and Drug Administration has approved chelation therapy for the treatment of metal toxicity such as lead poisoning. Beginning in the 1940’s, the amino acid complex EDTA (ethylene-diamine-tetra-acetic acid) was used to treat heavy metal poisoning; however, chelation therapy has been recognized as an effective treatment for hypercalcemia and ventricular arrhythmias as well. *Note: The American Heart Assoc. has issued a stern warning on this therapy pending further study.

Chelation has been used for both fibromyalgia  and chronic fatigue syndrome, believed to be aggravated by heavy metal toxicity. Chelation therapy can be used as a natural fiibromyalgia treatment for its cleansing properties, as the accumulation of toxic exposure may contribute to cellular damage and future health problems.

A reputable practicioner will submit you to a series of examinations and medical tests before begining treatment. They will also take a complete medical history that touches on your diet, health, family history, medications, injuries and stress levels. X-rays and blood work should also be expected.

EDTA for Fibromyalgia can be administered orally or by blood infusion. Treatment may be two to three times a week and may last up to thirty sessions. The IV drip therapy may last up to three hours. Edta may not be the only additive to your drip, if your practicioner deems it necessary he/she may also add vit. C, B and heparin, to prevent clotting.

After treatment you may experience headaches, skin irritation, nausea, diarrhea, fatigues or joint pain. This is attributed to the fact that your body may be addicted to the metals the EDTA has removed from your body, causing you to go through a period of withdrawl.

Do NOT attempt this line of treatment without consulting with your primary care provider.

Table of Topics

Cupping therapy: Can it relieve fibromyalgia pain?

Q.Is there any evidence that cupping therapy relieves fibromyalgia pain?

A.There's no conclusive evidence that cupping therapy relieves fibromyalgia pain. But anecdotal evidence suggests a benefit.

Cupping therapy is typically practiced by traditional Chinese medicine practitioners. The theory behind cupping is that it moves or stimulates your body's natural energy — also called qi.

Basically, cupping involves heating the air inside a glass cup, which removes some of the air from the cup. The cup is then quickly placed on the skin and the resulting vacuum pulls the skin part of the way into the cup. The cup may be left in place for several minutes and then removed, leaving behind a bright red, circular welt. Although it sounds painful, it's not.

Many articles have been published on cupping. But many of these are case reports or anecdotes published in Chinese medical journals — and not always available in English. There have been no peer-reviewed clinical trials specifically evaluating cupping as a treatment for painful conditions. Thus, although cupping has been a part of Chinese healing traditions for at least 3,000 years, available research hasn't yet documented its effectiveness.

By Mayo Clinic Staff

Table of Topics

Eastern Medicine Offers Alternative IBS Treatments
Kelli M. Donley

There is nothing conventional about irritable bowel syndrome (IBS). For some patients, this mysterious ailment means diarrhea, while for others constipation.

Additional symptoms include gas, bloating and stomach cramps. Traditional treatments are understandably varied considering the inconsistency of the illness. Behavioral options include high fiber diets, limiting alcohol and caffeine consumption, regular exercise and some form of stress relief (yoga, meditation). Pharmaceutical treatments include the recently approved Zelnorm, for female patients suffering from constipation, and Lotronex, approved (on a special circumstance basis) for women suffering from diarrhea.

However, no pharmaceutical on the market provides relief for all IBS patients. In lieu of a chemical solution, many patients are turning to alternative methods of treatment to find relief from their nagging symptoms.

CHINESE MEDICINE

There are eight branches of Chinese medicine; each emphasize balancing a person's chi, or energy, in relation to their three realms: heaven, human and earth. These branches include: herbal therapy, acupuncture, diet, massage, exercise, mediation, cosmology and feng shui.1

According to traditional Chinese medicine, IBS is the product of an infection of heat and dampness of the gastrointestinal system. The head and dampness may be caused from external sources (weather) or internal sources (eating improper food).2

A study published in the Journal of the American Medical Association in 1998 followed 116 patients who were suffering from IBS. Participants were divided into three treatment groups: individualized Chinese herbal formulations, standard Chinese herbal formulations or a placebo.

The results of the double-blind placebo-controlled trial found patients being actively treated saw significant improvement in their bowel condition. Herbal treatments tailored to the patient were no more effective than the standard treatment.

Researchers concluded Chinese herbal formulations improved the conditions of IBS patients.3

Acupuncture has long been used in Eastern cultures as a method of treating a variety of ailments. There are some 2,000 acupuncture points where needles can reportedly stimulate and regulate the flow of chi. Acupuncture is a method of keeping yin, the soft and feminine qualities, in balance with yang, the dark and masculine qualities.1

Pam Marsh, an IBS patient in Golden, Colo., turned to acupuncture after suffering for many years.

"My internist referred me to an acupuncturist for treatment," she says. "He had seen good results with other patients with IBS and Crohn's symptoms."

Marsh receives treatment in a healthcare center that offers both Eastern and Western medicine.

"The process takes about an hour," she describes. "The acupuncturist first takes my pulse and other readings. He sometimes checks my tongue, puts pressure on certain points, etc. I lie on my back on a massage table and needles are applied. Usually the needles are left in for 20 to 30 minutes. They are placed in a variety of places: toes, foot, stomach, hands and wrist. It never hurts, but will sometimes create a burning sensation for the first couple of seconds. Breathing deeply and slowly helps reduce the sensation. Afterward, I feel a bit spacey for a half an hour or so. If I have symptoms or discomfort before a session, I most likely leave feeling much better."

Marsh says she is using this alternative treatment, along with behavioral changes, to improve the illness she has been suffering from for 20 years.

"I have used various medicines," she says, "but I have also made changes to my diet and keep to a daily exercise program."

She says while initially hesitant to trust treatment outside of the Western methodology, she recommends the procedure to others.

"I am a believer," she says. "I have been able to go off of the over-the-counter and prescriptive drugs with the acupuncture treatments. I was raised with traditional Western medicine beliefs, with my father being a pharmacist. So it was a stretch for me to trust this Eastern medicine. I believe acupuncture can help with a variety of problems. I recently had damage to the trigeminal nerve and have found relief through acupuncture. Like any other medical practice, however, I think you need to search out acupuncturists who are well-respected and recommended in the community."

OVERLAPPING IDEAS

Although Western and Eastern medical ideologies seem distinctly different, there are several treatment options both trains of thought agree on. Diet, exercise and finding a method of stress relief, possibly meditation, are three behavioral methods of treatment for IBS urged by both ideologies.

Changing a person's diet for IBS is also a conundrum based on symptoms. Flax seed is often recommended as a natural laxative for those suffering from IBS-related constipation. Chinese herbs for treating constipation include: aquilaria root, white atractylodes rhizome, szechuan pepper fruit, melia fruit, codonopsis root, torreya seeds, poria, rubia, licorice root, dried ginger, myrobalan fruit, omphalia gruiting body, nutme seed and more.

Patients suffering from diarrhea related to IBS may be advised to stay away from dairy products.

Additionally, limiting alcohol, caffeine and nicotine are recommended for all patients. Drinking at least eight glasses of water daily can also help alleviate some symptoms.

Exercise and finding a method to relieve stress are also important behavioral changes that should be made by IBS patients. Ideally, patients should try to exercise 60 minutes daily, per the new Institute of Medicine guidelines.

Methods of meditation and stress relief include: yoga, stretching, Pilates, qui gong, tai chi, other martial arts, journaling, daydreaming, walking, hiking, etc. Meditation requires mindful concentration. While a spiritual practice for some, today the practice can be applied to nearly any activity that requires focus.

Herbert Benson, MD, was one of the first Western physicians to write about the health benefits of meditation. The first article published on the topic was written by Benson in 1970 in the Journal of Transpersonal Psychology. The Harvard researcher wrote mediation could reduce heart rate, respiratory rate, blood pressure, oxygen consumption and muscle tension.5

FINDING AN ACUPUNCTURIST

The National Certification Commission for Acupuncture and Oriental Medicine has a list of acupuncturists nationally. They also have certification information for those interested in studying the practice.

NCCAOM: (703) 548-9004 www.acupuncture.com

The American Academy of Medical Acupuncture can recommend an acupuncturist who is also a physician.

AAMA: (323) 937-5514 www.medicalacupuncture.org6

With a vague cloud hanging over IBS research and treatment options, it is important to have information about other medical ideologies that may provide relief for your patients

Table of Topics

Natural Remedies for Irritable Bowel Syndrome (IBS)

  • Peppermint Oil

    Peppermint oil is widely used for irritable bowel syndrome. It is thought to reduce the abdominal pain and bloating of irritable bowel syndrome, possibly by blocking the movement of calcium into muscle cells in the intestines and easing excessive muscle contraction there. Peppermint is considered a carminative herb, which means that it is used to eliminate excess gas in the intestines.

    Eight out of twelve studies on peppermint for irritable bowel syndrome have found that it is more effective than a placebo.

    Although peppermint oil is available in many forms, it should only be used in enteric-coated capsules otherwise the oil can relax the lower esophageal sphincter and cause heartburn.

    Peppermint oil, especially in excessive doses, may result in nausea, loss of appetite, heart problems, nervous system disorders, and lead to kidney failure and even death.

    Peppermint oil should not be taken internally by children or pregnant or nursing women. Peppermint oil may interact with the drug cyclosporine (used to prevent organ transplant rejection and for rheumatoid arthritis and psoriasis), so they should not be combined unless under medical supervision. To read more about peppermint oil, go to my Peppermint Oil Fact Sheet1

  • Probiotics

    Probiotics are live microbial organisms that are naturally present in the digestive tract and vagina. Sometimes referred to as "friendly" bacteria, probiotics are thought to promote health include suppressing the growth of potentially harmful bacteria, improving immune function, enhancing the protective barrier of the digestive tract, and helping to produce vitamin K.

    There are over 400 species of microorganisms in the human digestive tract and the balance between beneficial bacteria and potentially harmful bacteria is important. One theory is that people with irritable bowel syndrome may have an imbalance in their normal intestinal bacteria, with an overgrowth of gas-producing bacteria.

    Studies have found that probiotics may be helpful for people with irritable bowel syndrome. For example, a fairly large study published in the American Journal of Gastroenterology examined the use of three different doses of Bifidobacterium infantis or a placebo in 362 women with irritable bowel syndrome. After four weeks, the B. infantis dose of 1 x 10(8) c.f.u. was found to be more effective than a placebo at reducing abdominal pain, bloating, bowel dysfunction, incomplete evacuation, straining, and gas.

    There are many different probiotic strains, and some may be more effective for irritable bowel syndrome. Another study compared lactobacillus salivarius, bifidobacterium infantis, or a placebo in 77 people with irritable bowel syndrome. Only people who took B. infantis had a greater reduction in abdominal pain, bloating, and bowel movement difficulty. For more information on probiotics, read my Probiotics Fact Sheet2.

  • Partially Hydrolyzed Guar Gum

    Partially hydrolyzed guar gum (PHGG) is a water soluble, non-gelling fiber that may help to reduce constipation and to a lesser extent diarrhea and abdominal pain in people with irritable bowel syndrome. PHGG also appears to increase the amount of beneficial bacteria, lactobacilli and bifidobacteria in the intestines.

    One study compared PHGG (5 grams per day), wheat bran (30 grams per day), and a placebo in 199 people with irritable bowel syndrome. After 12 weeks, both the PHGG and wheat bran resulted in an improvement in absominal pain and bowel habits, but the PHGG was better tolerated and preferred.

  • Food Intolerances

    Food intolerances may play a role in irritable bowel syndrome, possibly by triggering immune responses in the gut, leading to low-grade inflammation and an imbalance of intestinal bacteria.

    The most common food intolerances reported by people with irritable bowel syndrome are dairy and grains.

    A trained practitioner can supervise an elimination and challenge diet. Many foods are removed from the diet for a brief period of time, then re-introduced sequentially to isolate the body's reaction to the offending foods. Since grains are a common culprit, it is important to remember that carbohydrate digestion begins in the mouth and that chewing grains thoroughly allows amylase, the digestive enzyme present in saliva, to digest the grains.

  • Other Natural Remedies for Irritable Bowel Syndrome

    Pancreatic enzymes have been suggested for irritable bowel syndrome symptoms that are aggravated after a fatty meal.

    Hypnosis, or hypnotherapy, has also been used for irritable bowel syndrome. Sources
    Atkinson W, Sheldon TA, Shaath N, Whorwell PJ. Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial. Gut. 53.10 (2004): 1459-1464.

    Bausserman M, Michail S. The use of Lactobacillus GG in irritable bowel syndrome in children: a double-blind randomized control trial. J Pediatr. 147.2 (2005): 197-201.

    Drisko J, Bischoff B, Hall M, McCallum R. Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics. J Am Coll Nutr. 25.6 (2006): 514-522.

    Giannini EG, Mansi C, Dulbecco P, Savarino V. Role of partially hydrolyzed guar gum in the treatment of irritable bowel syndrome. Nutrition. 22.3 (2006): 334-342.

    Jun DW, Lee OY, Yoon HJ, Lee SH, Lee HL, Choi HS, Yoon BC, Lee MH, Lee DH, Cho SH. Food intolerance and skin prick test in treated and untreated irritable bowel syndrome. World J Gastroenterol. 12.15 (2006): 2382-2387.

    Lim B, Manheimer E, Lao L, Ziea E, Wisniewski J, Liu J, Berman B. Acupuncture for treatment of irritable bowel syndrome. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD005111.

    Miller V, Lea R, Agrawal A, Whorwell PJ. Bran and irritable bowel syndrome: the primary-care perspective. Dig Liver Dis. 38.10 (2006): 737-740.

    Niv E, Naftali T, Hallak R, Vaisman N. The efficacy of Lactobacillus reuteri ATCC 55730 in the treatment of patients with irritable bowel syndrome--a double blind, placebo-controlled, randomized study. Clin Nutr. 24.6 (2005): 925-931.

    O'Mahony L, McCarthy J, Kelly P, Hurley G, Luo F, Chen K, O'Sullivan GC, Kiely B, Collins JK, Shanahan F, Quigley EM. Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles. Gastroenterology. 128.3 (2005): 541-551.

    Parisi GC, Zilli M, Miani MP, Carrara M, Bottona E, Verdianelli G, Battaglia G, Desideri S, Faedo A, Marzolino C, Tonon A, Ermani M, Leandro G. High-fiber diet supplementation in patients with irritable bowel syndrome (IBS): a multicenter, randomized, open trial comparison between wheat bran diet and partially hydrolyzed guar gum (PHGG). Dig Dis Sci. 47.8 (2002): 1697-1704.

    Whorwell PJ, Altringer L, Morel J, Bond Y, Charbonneau D, O'Mahony L, Kiely B, Shanahan F, Quigley EM. Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome. Am J Gastroenterol. 101.7 (2006): 1581-1590.

    Table of Topics

Younger America's Wholly-Owned Subsidiary, Life Without Pain, Offers Revolutionary FDA Cleared Pain Therapy Product

FT. LAUDERDALE, Fla. -- Younger America (Pink Sheets:YNGR) is pleased to announce that the Company's wholly-owned subsidiary, Life Without Pain, has a revolutionized pain therapy process applying its MEDLIGHT[TM] MD630PRO. This process uses a Light Emitting Diode (LED) for pain therapy. Relying on narrow band near infrared energy, the MEDLIGHT[TM] MD630PRO is able to temporarily relieve minor aches and pains, such as arthritis, joint pain, muscle spasms, or relaxing stiff and sore muscles.

Based on the NASA-developed LED technology, the MEDLIGHT[TM] MD630PRO offers Life Without Pain's patented 81 LED array in a lightweight and easy-to-use AC-powered device. The MEDLIGHT[TM] MD630PRO offers powerful affordable pain relief and will not damage any tissue. The device is Food and Drug Administration cleared, Underwriters Laboratories approved, and CE approved. The CE mark is a mandatory European marking for certain product groups to indicate conformity with the essential health and safety requirements set out in European Directives and allows Life Without Pain to sell the device in the European Union. Life Without Pain has sold the MEDLIGHT[TM] MD630PRO on the Home Shopping Network and the company's Web site.

"We're very excited to be offering the MEDLIGHT[TM] MD630PRO to pain sufferers around the world. Our goal at Life Without Pain is to continue offering the most revolutionary products in pain therapy and develop new cutting edge products to help reduce pain suffering," stated Irwin Newman, President of Life Without Pain.

For more information about the MEDLIGHT[TM] MD630PRO, please visit: www.lifewithoutpain.net.

Younger America recently announced that Mark Cobb has been appointed to the board of directors and will also serve as the Company's Chief Operating Officer. Mr. Cobb is a respected and successful leader in the technology industry. Mr. Cobb's career spans over 30 years as an executive officer, as well as executive level sales and management experience within different companies.

About Younger America:

Younger America is a holding Company that develops and acquires under-valued companies that provide products to improve the quality of life without the use of potentially harmful drugs or chemicals. The Company aims to acquire a portfolio of companies that provide leading-edge alternative medical devices, systems and services. The roll-up of these companies will create value for the shareholders and provide innovative technologies and products that can enhance the quality of life for their customers.

Forward-Looking Statements:

Please be advised that statements made herein, other than historical data, constitute forward-looking statements that involve risks and uncertainties that could cause actual results to differ materially from those stated or implied by such forward-looking statements. The potential risks and uncertainties include, among others, potential volatility in the company's stock price, increased competition, customer acceptance of new products and services offered by the company, and uncertainty of future revenue and profitability and fluctuations in its quarterly operating results. Please also be advised that the company's stock is not currently registered with the Securities and Exchange Commission.

Table of Topics

What is Waon Therapy?

Medical progress in the 20th century has been striking, and the advancement of the diagnosis and treatment of cardiovascular diseases has greatly contributed toward prolonging life expectancy. However, for patients who receive treatment for diseases, this being not limited to cardiovascular diseases, there is no way of determining the gravity of internal suffering and conflict. Patients accept any examination and treatment that can help them to recover from diseases, even when it may involve pain. All surgery, radiotherapy, chemotherapy, and transplant therapy are therapies that inflict considerable pain and long term suffering on patients, mentally and physically. Patients still accept such therapy, because they expect it to help them recover from their disease.\

Without suffering from the diseases, it is impossible to understand the extent of pain, tension, and stress that are imposed on patients with the purpose of saving life. Even if the suffering of patients arising from various intractable diseases can be treated with inpatient hospital care at a large hospital combined with state-of-the-art medical facilities, patients have no opportunity, during the course of treatment, to experience a feeling of comfort and a pleasant state of mind arising from refreshing perspiration.

The treatment modality “thermal therapy” that I have worked on since 1989 is a warming therapy for soothing the mind and body equally, with 60°C dry far-infrared sauna bathing. Therefore, if “thermal therapy” is referred to as “Waon therapy,” it is easy to understand the true meaning as distinguished from, for example, “local high-heat therapy for cancer.” “Soothing warmth: Waon” is a word I have coined, and “Waon” can be understood in Japanese as “soothing warmth,” meaning “warmth that comfortably refreshes the mind and body.” In other words, “Waon” is the essence of the “thermal therapy” that I have been improving and refining for eighteen years. Therefore, to obtain a correct understanding of my “thermal therapy” modality, I would like to refer to it as “Waon therapy: soothing warmth therapy” and I would like to familiarize readers further with the idea.

“Waon therapy” is defined as “therapy in which the entire body is warmed in an evenly heated chamber (device) for 15 minutes at a temperature that soothes the mind and body, and after the deep-body temperature has increased by approximately 1.0?1.2°C, the soothing warmth effects are sustained by maintaining the warmth at rest for an additional 30 minutes, with fluids corresponding to perspiration being supplied at the end.”

There are various clinical applications 1-11) of “Waon therapy,” and the effects are dramatic. In particular, a drastic recovery is often seen in intractable diseases that are resistant to drug therapy such as severe heart failure 1), which is an indication of the need for a heart transplant, peripheral artery disease with intractable ulcer 6), severe fibromyalgia syndrome 9), chronic fatigue syndrome 8), and salivary secretion failure caused by Sjogren’s syndrome 10)). The effects are remarkable, and “Waon therapy” is not simply therapy for organs and local sites. It also improves the systemic vascular function, corrects central and peripheral autonomic nerves and neurohumoral factors (hormonal activity), and activates autoimmunity and the bio-defense mechanism.

If “Waon therapy” is performed once a day for 3?5 days a week over the course of a 2?6-week period (10 weeks for peripheral artery disease) a clearly positive effect on the intractable diseases mentioned above can be obtained. Furthermore, with subsequent continuation for 2?3 days a week, the effects of “Waon therapy” can also be steadily maintained.

To demonstrate the effectiveness of “Waon therapy” as a comprehensive therapy, the effects on chronic heart failure are briefly described in the following example. “Waon therapy” improves the clinical conditions, cardiac function, and vascular function of patients with chronic heart failure and corrects abnormal autonomic nervous response and neurohumoral factors 3). It dilates systemic arteries and veins to reduce the preload and afterload on the heart and significantly increase cardiac output 1). Arrhythmia caused by chronic heart failure is significantly decreased 4). In addition, “Waon therapy” considerably improves a depressive state, insomnia, anorexia, and ill feelings of patients with heart failure 3). If “Waon therapy” is performed once a day for 5 days a week over the course of a 2-week period (10 times in total), cardiomegaly is significantly reduced, the cardiac function is improved, and ANP and BNP can be significantly decreased 3). If “Waon therapy” is subsequently continued even furth er, then the prognosis of patients with chronic heart failure tends to significantly improve. In an investigation using a heart failure model (TO-2 hamsters), it was verified that the group for which “Waon therapy” was continually repeated once a day had a 35% improved survival rate compared to the group without this therapy 12).

“Waon therapy” significantly improves the endothelium-dependent vasodilatory potency of patients with heart failure. In an experiment using heart failure model hamsters, “Waon therapy” considerably increased the expression of mRNA of vascular endothelial nitric oxide synthase (eNOS) in vascular endothelial and intensified the expression of eNOS protein 13,14). A remarkable expression of mRNA and protein of eNOS was also observed in an experiment with peripheral arterial disease models 15). Specifically, after an apolipoprotein E-knockout mouse has a femoral artery removed, if “Waon therapy” is continually repeated once a day for 35 days, the expression of mRNA and the protein level of eNOS also considerably increases, while the number of blood capillaries increases, the blood flow remarkably improves in the ischemic limbs, and angiogenesis can be achieved. In other words, “Waon therapy” is deeply involved in the production of effects on genetic, molecular, and cellular levels, and this treatment modality therefore plays an important role in the recovery of the living body.

“Waon therapy” is safe and highly cost-efficient, and is also a gentle comprehensive therapy that soothes patients and encourages refreshing perspiration, unlike conventional therapy, which often requires the patient’s endurance. I sincerely hope that “Waon therapy” will be approved for coverage by medical insurance as soon as possible, as a new therapy for the 21st century. Such approval would be very good news for our patients.

Table of Topics

Efficacy of Waon therapy for fibromyalgia.

Matsushita K, Masuda A, Tei C.

The First Department of Internal Medicine, Kagoshima University Hospital.

OBJECTIVE: Fibromyalgia syndrome (FMS) is a chronic syndrome characterized by widespread pain with tenderness in specific areas.
We examined the applicability of Waon therapy (soothing warmth therapy) as a new method of pain treatment in patients with FMS.

METHODS: Thirteen female FMS patients (mean age, 45.2+/-15.5 years old; range, 25-75) who fulfilled the criteria of the American College of Rheumatology participated in this study. Patients received Waon therapy once per day for 2 or 5 days/week. The patients were placed in the supine or sitting position in a far infrared-ray dry sauna maintained at an even temperature of 60 degrees C for 15 minutes, and then transferred to a room maintained at 26-27 degrees C where they were covered with a blanket from the neck down to keep them warm for 30 minutes. Reductions in subjective pain and symptoms were determined using the pain visual analog scale (VAS) and fibromyalgia impact questionnaire (FIQ).

RESULTS: All patients experienced a significant reduction in pain by about half after the first session of Waon therapy (11-70%), and the effect of Waon therapy became stable (20-78%) after 10 treatments. Pain VAS and FIQ symptom scores were significantly (p<0.01) decreased after Waon therapy and remained low throughout the observation period. CONCLUSION: Waon therapy is effective for the treatment of fibromyalgia syndrome.

PMID: 18703857

Table of Topics

5 alternative medicine treatments that work By Elizabeth Cohen CNN

Empowered Patient is a regular feature from CNN Medical News correspondent Elizabeth Cohen that helps put you in the driver's seat when it comes to health care.


ATLANTA, Georgia (CNN) -- Dr. Andrew Weil wasn't sure exactly how he hurt his knee; all he knew was that it was painful. But instead of turning to cortisone shots or heavy doses of pain medication, Weil turned to the ancient Chinese medicine practice of acupuncture. "It worked -- my knee felt much better," says Weil.
Americans spend billions of dollars each year on alternative medicine, everything from chiropractic care to hypnosis.
Weil says alternative medicine can work wonders -- acupuncture, certain herbs, guided imagery.
For example, Dr. Brian Berman, director of the Center for Integrative Medicine at the University of Maryland School of Medicine, has done a series of studies showing acupuncture's benefits for osteoarthritis of the knee.
Extensive studies have also been done on mind-body approaches such as guided imagery, and on some herbs, including St. John's wort.
But on the other hand, there also is a lot of quackery out there, Weil says. "I've seen it all, [including] products that claim to increase sexual vigor, cure cancer and allay financial anxiety."
So how do you know what works and what doesn't when it comes to alternative medicine? Just a decade ago, there weren't many well-done, independent studies on herbs, acupuncture, massage or hypnosis, so patients didn't have many facts to guide them.
But in 1999, eight academic medical centers, including Harvard, Duke and Stanford, banded together with the purpose of encouraging research and education on alternative medicine. Eight years later, the Consortium of Academic Health Centers for Integrative Medicine has 38 member universities, and has gathered evidence about what practices have solid science behind them.
Here, from experts at five of those universities, are five alternative medicine practices that are among the most promising because they have solid science behind them.
1. Acupuncture for pain
Hands, down, this was the No. 1 recommendation from our panel of experts. They also recommended acupuncture for other problems, including nausea after surgery and chemotherapy.

2.Calcium, magnesium, and vitamin B6 for PMS
When pre-menstrual syndrome rears its ugly head, gynecologist Dr. Tracy Gaudet encourages her patients to take these dietary supplements. "They can have a huge impact on moodiness, bloating, and on heavy periods," says Gaudet, who's the executive director of Duke Integrative Medicine at Duke University Medical School.

3. St. John's Wort for depression
The studies are a bit mixed on this one, but our panel of experts agreed this herb -- once thought to rid the body of evil spirits - is definitely promising. "It's worth a try for mild to moderate depression," says Weil, founder and director of the Program in Integrative Medicine at the University of Arizona. "Remember it will take six to eight weeks to see an effect." Remember, too, that St. John's wort can interfere with some medicines; the University of Maryland Medical Center has a list.

4. Guided imagery for pain and anxiety
"Go to your happy place" has become a cliché, but our experts say it really works. The technique, of course, is more complicated than that. "In guided imagery we invite you to relax and focus on breathing and transport you mentally to a different place," says Mary Jo Kreitzer, Ph.D., R.N., founder and director of the Center for Spirituality and Healing at the University of Minnesota.
There's a guided imagery demo at the University of Minnesota's Web site.

5. Glucosamine for joint pain
"It's safe, and it looks like it's effective," says Dr. Frederick Hecht, director of research at the Osher Center for Integrative Medicine at the University of California, San Francisco. "It may be the first thing that actually reverses cartilage loss in osteoarthritis."
All our experts warn that since alternative medicine is financially lucrative, a lot of charlatans have gotten into the business. They have these tips for being a savvy shopper:

1. Look for "USP" or "NSF" on the labels
"The biggest mistake people make is they don't get a good product," says Dr. Mary Hardy, medical director of the Sims/Mann-UCLA Center for Integrative Oncology. She says the stamp of approval from the United States Pharmacopoeia or NSF International, two groups with independent verification programs, means what's on the label is in the product.

2. Find a good practitioner
Make sure the alternative medicine practitioner you're going to is actually trained to practice alternative medicine. One place to start is the Consortium for Academic Health Centers for Integrative Medicine

3. Be wary of crazy claims
"Anything that sounds too good to be true probably is," says Weil.
And once you do start on your journey with alternative medicine, here's a piece of advice: Take it slow. Alternative medicine works, but sometimes not as quickly as taking a drug. "I tell people it's going to take a while," says Hardy. "I tell them to do a six- to eight-week trial, or even 12 weeks."

Table of Topics

Can Alternative Therapies Enhance Conventional Medicine?
By Deepak Chopra, M.D.

The great promise of mind-body medicine will never be fulfilled as long as the treatments are unpredictable. This has been a major stumbling block in the West, ever since the original excitement over acupuncture in the '70s and Ayurveda in the '80s. Patients who have been helped sing the praises of alternative medicine while official clinical trials don't satisfy the skeptics.
In the East it is more easily accepted that each patient is unique, and therefore one cannot expect that the same therapy will lead to the same results in
everybody. One sees this in the placebo effect, also. You can give inert sugar pills to cure pain, and the pain will go away in some patients but not others.

To a Western-trained physician, this lack of reliability undermines the treatment's credibility. Medical schools teach their students to expect a shot of penicillin or an appendectomy to lead to a cure as reliably for patient A as for patient B. In practice there is no such thing as complete reliability, however, and one must consider how many patients die on the operating table or suffer extreme side effects from drugs.

There is also the problem that drugs become less effective over time - the phenomenon known as tachyphylaxis - and that "super germs" develop in hospitals, causing a serious rise in illness and death caused by the treatment - a phenomenon known as iatrogenic disease.

In response to the growing resistance of microbes to standard antibiotics, drug companies promise to develop new alternatives as the germs learn to beat the old drugs, but unless there's big money in it, the pharmaceutical research isn't undertaken with any great enthusiasm or speed. Hence the vicious circle of ineffective drugs, smarter germs, and rising drug prices that plagues American medicine.

That's one reason, among many, why mind-body medicine poses a brighter future than the proponents of standard drugs and surgery are willing to concede. (The fact that the average American over 70 takes seven prescription drugs a day must make anyone pause.)
The public already trusts alternative medicine far more than the official voices who warn against it year after year. One reads of the dire effects of vitamin A poisoning, for example, when in reality the number of megavitamin overdoes in this country is minuscule compared to the thousands of people who get sick and die from hospital infections.

It's like condemning nutmeg as a hallucinogen while and ignoring the crash of five jumbo jets. The New England Journal of Medicine has been much less sympathetic to alternative medicine than the leading British journal, The Lancet, which ran a 2005 article on the effectiveness of homeopathy in treating and preventing colds and flu.
Almost immediately The Lancet ran a counter article bolstering the conventional view that homeopathy isn't effective. This represents the usual confusion. Adherents to alternative medicine clash with the establishment, both sides pointing to their own research, but both sides also having to admit that definitive results never seem to settle their disputes.

I've come to feel that the argument will never be settled until we accept a fact of nature: everyone has a unique response to disease. No single treatment can be expected to cure or prevent illness with complete reliability, and even if Western medicine is right to claim that a drug like penicillin works more often than any alternative, Eastern medicine can point to drug intolerance, side effects, and expense as considerable drawbacks. (Not to mention the exponential risks that often mount when pharmaceuticals are mixed with one another, or with alcohol consumption.)

Therefore, each of us needs to consider our own bodies, our own life history, and our own susceptibility. Mainstream medicine constantly tries to sell its one-size-fits-all position, and it shouldn't. For decades all patients with high blood pressure were put on reduced salt diets that they found hard to tolerate, despite the fact that over 80 percent of people are not salt sensitive and can eat as much salt as they want.

Over that same period, low-cholesterol diets were pushed for all patients at risk for premature heart attacks, even though the connection between the cholesterol you eat and the cholesterol in your blood varies widely. To claim that there was a simple correlation was bad science.
Meanwhile, the strong correlation between heart attacks and psychological stress was pursued with much less enthusiasm, if at all. Today, of course, newer and better drugs are meant to solve all problems. What, then, can you and I do to offset the unpredictable nature of healing? The answer doesn't lie in a simplistic choice between drugs and surgery all the time or none of the time. We have to envision a new future for the body, and with that in hand, intelligent choices can be made from both sides of the medical menu, mainstream and alternative.

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Could "alternative" therapies do more harm than good? Experts caution that supplementation could be dangerous

There's no shortage of "alternative" treatment options available today, but some therapies are not only unproven--they're also potentially dangerous. Physicians warn that while the makers of dietary supplements may claim to offer "natural" treatments, any pill you take can act like a drug and therefore carries a risk of adverse events and drug interactions. On top of that, there is no guarantee that these supplements even work.

As we grow older, it's normal for the levels of certain chemicals and hormones--such as testosterone--to decline, but taking a pill to replace what you've lost isn't always the safest solution. "The blood level of a substance declines with age, but returning it to 'youthful' levels doesn't necessary help and may actually cause harm," says Rosanne Leipzig, MD, PhD, professor and vice chairman of geriatrics at Mount Sinai School of Medicine.

For example, postmenopausal women do not produce as much estrogen as they used to and, as a result, they can experience bothersome symptoms such as hot flashes and vaginal dryness. However, while estrogen-replacement therapy can alleviate these symptoms, it also can increase the risk of breast cancer and blood clots.

The dangers of dietary supplements. The same problems surround the use of dietary supplements. There is no proof that using supplements to replace what you've lost is safe and effective. For example, the antioxidant selenium tends to decrease as we age, but recent studies have shown that taking selenium supplements could actually increase the risk of developing type 2 diabetes. In addition, a lot of the claims made about dietary supplements have not been scientifically proven.

"Clearly, further studies have to be done before we can make a decision about whether or not a particular supplement is safe," Dr. Leipzig says. "We really have no way of knowing the effects on people without seeing the results of large, randomized, controlled trials."
Unlike prescription drugs, dietary supplements are not currently monitored to make sure that what is stated on the label is actually what is in each pill. "Because dietary supplements are not FDA-approved, anything can be in the bottle," Dr. Leipzig warns. "So you end up paying good money and you don't really know what you're getting."

There is also the risk of interaction between dietary supplements and other drugs you may be taking. For example, ginkgo biloba, ginseng, and garlic should not be taken with blood-thinners because they increase the risk of bleeding. It's important to consult with your doctor to decide if the potential for benefit outweighs the potential for harm.

Truly "natural" therapy. Although aging is a natural process and many people want to live as long as possible, most people don't want to look or feel older. "There are lots of things you can do instead of taking dietary supplements to help prolong your life and ensure maximum health," advises Dr. Leipzig. "The four most important things are to always wear your seat belt, quit smoking, maintain a healthy weight, and exercise regularly."

Dr. Leipzig acknowledges that some dietary supplements, such as glucosamine and chondroitin for arthritis pain, do show promise, but at this point, it's too early to tell which therapies are both effective and safe. You can find more high quality information about alternative medicine at www.jr2.ox.ac.uk/bandolier/booth/ booths/altmed.html and nccam.nih.gov.
COPYRIGHT 2007 Belvoir Media Group, LLC
COPYRIGHT 2008 Gale, Cengage Learning

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Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies
*Note – This book is a bit pricey for most of us, but most libraries should be able to get a copy for you.
Mario Roxas

Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies
Mitchell Bebel Stargrove, ND, LAc; Jonathan Treasure, MA, MNIMH, RH (AHG); Dwight L. McKee, MD

Use of nutritional and herbal products is a multi-billion dollar industry in the United States. As more people take nutritional supplements and herbal medicines, a growing concern among alternative and conventional practitioners is potential drug/herb and drug/nutrient interactions. Consequently, this book--Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies (HNDI)--comes at an opportune time.

The authors have performed the Herculean task of creating, from a vast collection of references, a detailed guide to potential interactions of the most commonly encountered herbs and nutrients with common prescription and over-the-counter (OTC) drugs.

Published in January 2008, HNDI consists of 70 monographs--30 herbs (from Aloe to Vitex) and 40 nutrients (subcategorized as vitamins, minerals, amino acids, and nutraceuticals and physiologics).

Each monograph starts with a quick, at-a-glance summary table identifying the particular drug/ drug class, a brief mechanism of interaction, and a recommended course of action. The body of the monograph supplies the reader with detailed information outlined by the following subheadings:

* Herb/Nutrient Description: General background about the herb/nutrient (e.g., common species, country of origin, parts used, chemical formula, etc.)
* Herb/Nutrient in Clinical Practice: Historical and contemporary indications for usage, key chemical constituents, and dosage ranges
* Interactions Review: General information regarding interactions with drugs
* Herb-Drug/Nutrient-Drug Interactions: More detailed information about herb/nutrient and specific drugs or drug categories
* Theoretical, Speculative, and Preliminary Interactions Research, Including Overstated Interactions Claims
There is a system of symbols throughout the book to aid the reader in determining the level of clinical significance of the herb- or nutrient-drug interaction, type and clinical significance of the interaction, and strength and quality of the source evidence. Although the symbols are intended to be helpful, they can be somewhat confusing. For instance, the same symbol is used more than once to describe different and, at one point, opposing situations.

The authors have compiled a substantial amount of information into one text. And therein lies the value of this book--pertinent drug interaction data for numerous herbs and nutrients in a single reference.
Elsevier Mosby, St Louis, MO 63146
ISBN-13: 978-0-323-02964-3; Softcover; 932 pages; $88.95
Book Review by Mario Roxas, ND

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Complementary therapies may help your chronic pain: acupuncture, hypnosis, and other alternative treatments may ease pain that doesn't respond to medical therapy, says an MGH expert
May 2008

When traditional medical treatment fails to ease your chronic pain, consider trying a complementary therapy. There are a number of non-medical treatments with established safety records--such as hypnosis, massage, acupuncture, mind-body techniques, and psychological counseling--that have been shown to relieve pain in some patients.

For example, researchers have found that a form of interpersonal therapy called cognitive behavioral therapy (CBT)--which helps people replace
unhealthy beliefs and behaviors with more positive ones--may be associated with significant pain reduction in people with irritable bowel syndrome (IBS) who do not respond to medications and dietary changes. A study reported in the August 2007 issue of Gastroenterology revealed that subjects with IBS showed significant improvements in symptoms of pain and bloating after participating in a program of once-a-week CBT sessions for 10 weeks, or four months of once-a-month CBT combined with a regimen of relaxation and problem-solving exercises at home.

"If standard medical treatment doesn't work, it's a good idea to look elsewhere for help," says Randy L. Gollub, MD, PhD, Associate Director of the Psychiatric Neuroimaging Research Program at Massachusetts General Hospital. "Complementary medicine can sometimes bring relief of pain where traditional medicine cannot. It's always best to check with a doctor before choosing a complementary therapy; as long as your doctor has no objections, it may be worth a try."

UNDERSTANDING PAIN
There are many categories of pain, Dr. Gollub explains, and some of these may not respond to standard treatment.
"Some types of pain are caused by ongoing physiological or mechanical processes that can be identified, such as pain following an injury or arising from a specific disorder," she says. "These types of pain are addressable by medical interventions.
"But other types of pain--such as pain that lingers after physical injury has healed or fibromyalgia (a disorder characterized by chronic widespread pain)--are not yet well understood. Such conditions are associated with pathological processes that often fail to respond to our best treatment efforts. In these cases it makes sense to consider exploring complementary treatments to see if any can help bring relief."

OTHER APPROACHES
Although complementary treatments may not work in all cases and scientific data to support the use of some therapies may not be extensive, the principal therapies have minimal side effects and are safe for most individuals. Among the most promising therapies are:
* Psychological counseling: Seeing a mental health professional for treatment of anxiety disorders and mood disorders such as depression can help reduce levels of perceived pain. It also may help individuals with chronic pain to learn relaxation techniques, stress reduction, and other effective strategies for coping with pain.
* Acupuncture: This ancient Chinese form of medicine can be very effective in relieving pain from conditions such as arthritis, headaches and aches in muscles and connective tissues. Therapy consists of inserting slender needles through the skin, muscles and connective tissues at any of nearly 1,000 points along energy channels (meridians) to remove blockages and achieve energy balance. The procedure, which itself is essentially pain-free, is thought to cause the release of natural painkillers called endorphins.
* Massage: There are more than 80 types of massage therapy, which involves manipulating muscles and other soft tissues of the body to improve circulation and flexibility, reduce stress and promote relaxation, among other benefits. Massage has been shown to effectively relieve musculoskeletal pain in some individuals. In one group of subjects with low back pain who underwent 10 weeks of massage treatment, benefits from massage were still evident a year after treatment.
* Hypnosis: Individuals who undergo hypnosis are induced to enter a state of deep relaxation called a "trance," during which concentration is focused and awareness of external noises and activity is diminished. In this state, the hypnotized person is open to suggestions from a health practitioner that may lead to changes in thoughts, perceptions, behavior, or sensations. Imaging studies have shown the technique can reduce activity in brain regions responsible for pain perception.
* Mind-body techniques: Significant pain reduction may be achieved in some people by harnessing the power of the mind to address bodily pain. Mind-body practices include techniques such as guided imagery (in which pleasing mental images are used as a distraction from pain and a means of promoting relaxation), meditation, progressive muscle relaxation, and yoga. They are thought to stimulate the brain's production of endorphins.
* Neurofeedback: Research has shown that chronic pain can be reduced by training the brain to function within certain brain wave frequencies. A patient is connected by sensors attached at the ear and scalp to a computer graphic display that represents his or her brain waves. Patients are trained to modify their brain waves to achieve specific changes in the display while they watch. To decrease chronic pain, patients learn to decrease activity in a region of the brain believed to process the perception and regulation of pain.

WHAT YOU CAN DO
Follow these suggestions offered by the National Center for Complementary and Alternative medicine (NCCAM) when you look for complementary medicine health care:
* Gather information about the type of therapy you are considering from sources such as professional organizations, academic Web sites, and publications.
* Check with your insurance company to determine whether the therapy you are interested in is covered.
* Discuss the therapy with your primary health care provider and ask for a referral. If your doctor cannot recommend someone, seek a referral from a professional organization.
* When considering a complementary therapy practitioner, ask about the person's training, credentials, and experience.

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Fibromyalgia Patients: A Real Pain in the Muscles and Fibers
Dynamic Chiropractic, Jun 3, 2008 Bomar, John R.

They usually come in "hurting all over." They often are depressed, discouraged and not sleeping well. They frequently arise stiff and sore in the morning, feeling fatigued. They have suffered bouts of irritable bowel symptoms. They appear anxious and feel chronically "burned out."

According to the American Academy of Rheumatology (ACR), 3 million to 6 million Americans suffer from some form of the disorder fibromyalgia. A majority of them are women of childbearing age. However, fibromyalgia also can affect children, the elderly and men.

Conventional Wisdom
Fibromyalgia is characterized by widespread muscle, ligament and tendon pain, chronic fatigue and multiple areas of trigger-point tenderness. The condition was recognized in previous generations, but was known by other names such as muscular rheumatism, fibrocitis and tension myalgia.

Allopathic medicine does not recognize a cause for fibromyalgia. Current thinking centers on internal imbalances that cause an increase in sensitivity to pain signals. Sleep disturbance, past injury, infection, metabolic muscle changes, hormonal imbalance and stress are other considerations in the etiology of fibromyalgia. Interestingly for chiropractors, abnormalities of sympathetic nervous system function also have been postulated as a factor in its etiology.
Diagnosing fibromyalgia can be difficult, as it can mimic many other disorders. The ACR has established the criteria of at least three months of chronic widespread pain and tenderness in at least 11 of 18 specific trigger-point sites.

Medical treatment involves recommendations for aerobic exercise such as swimming and walking, heat and massage treatments, antidepressant and analgesic/muscle relaxant medications, sleep aids, physical therapy and relaxation techniques of guided imagery. Many physicians also recommend stress-management strategies, improved diet and a healthier lifestyle.

Alternative/Holistic Perspective
Many in the alternative health care community see systemic toxicity as a fundamental consideration in fibromyalgia. They believe physiological disturbances from impaired heart, liver, lung and kidney function are at the root of the problem. As we know, the liver and kidneys are the primary detoxifiers of the body. Thus, systemic toxicity (autointoxication) can be the end result of impaired function in these organs.
As specialists in neuromusculoskeletal disorders, we can forget that life itself, as we know it, is basically an electromagnetic phenomenon. In the East, they describe this essential internal energy reserve as qi. Some even see the liver and kidneys as akin to batteries of the body, with the liver serving as the positive pole and the kidneys as the negative. When these organs are deficient in functioning, the body's "battery" is said to be run down. Chronic fatigue, low vitality and organic depression are the result, features common in fibromyalgia patients.

Just as the internal composition of a regular battery can influence its charge, the inner atmosphere of the human body can influence its vitality and strength. Scientific evidence increasingly points to the fact that, for maximum health and wellness, we should be primarily vegetarians, with fruits and vegetables making up the great majority (70 percent to 80 percent) of consumed food. Good-quality grains, nuts and oils, dairy and lean meats should make up the other 20 percent to 30 percent. This has an anti-inflammatory effect and creates an alkalized internal atmosphere, which also produces the health benefit of discouraging reproduction of most pH-dependent human pathogens that are acid-loving.

Therapeutic Regimen
Systemic toxicity demands that primary attention be given to the basic processes of adequate hydration and increased eliminations. My personal observation is that very few patients consume sufficient water for bodily needs, which is estimated to be at least 64 ounces (eight glasses) daily. They tend to try and substitute colas, teas and coffee, all of which are diuretic, resulting in little or no net fluid gain. Almost all human biochemical processes require hydrogen. Without sufficient hydration, these processes slow, contributing to fatigue and accentuating the accumulation of metabolic wastes. Under- or frank dehydration also slows bowel motility, which contributes to reabsorption of toxic waste into the general circulation. "Water is medicine" is my advice to these patients, along with a cleansing diet of fresh fruits and vegetables. Enemas and laxatives also might be useful in internal cleansing, especially if a patient has been constipated. For the most severe cases of long-standing autointoxication, I recommend patients consider a series of colonic irrigations.
Manual therapy (spinal adjustment and massage) will prove very beneficial to most sufferers of fibromyalgia. Spinal biomechanical lesions and nerve "impingements" almost always reflexly stimulate some degree of associated regional muscular spasm, which leads to a relative ischemia and toxemia in and around the tissue. Chronic, longstanding myospasm creates adhesions, scarring and fibrosis.

In applying any form of manual therapy to those with fibromyalgia, one should take great care in the early stages. Since these patients have heightened sensitization to pain, overly aggressive, hamfisted approaches to treatment often will backfire, creating such additional suffering pain as to lose a patient. In the early days, many osteopaths and chiropractors recommended sustained anti-inflammatory measures such as repetitive cold packs and a series of hands-on massages before even attempting spinal manipulation for those with severe pain syndromes.

In recommending dietary changes to patients, I have found it beneficial to discuss the "opportunity of illness." While this sounds counterintuitive, I explain that the reason for the pain signal is to alert them to the underlying condition that needs to be changed for the better. I believe most frank pathology is the result of long-term imbalance in normal physiology, often caused by errors in diet and lifestyle and exacerbated by past injury or chronic inflammation.

Some form of moderate exercise such as walking or swimming is essential to recovery from fibromyalgia. Also frequently beneficial is the discipline of yoga-type stretching. Being out in the open as much as possible while exercising has been shown to be superior to time spent inside on the treadmill. Both walking and swimming mobilize needed lymphatic flow in the body. Arm swings pump this "dirty seawater" back into the veins under the clavicle, where it eventually is cleansed. Of course, the skin and lungs play an important role in metabolic waste elimination as well, so heating a well-hydrated body (hot baths, sauna) to create increased heart rate, perspiration and aerobic breathing also is beneficial.

Finally, "the mind is the builder, or the mind is the slayer" is a wellrecognized axiom that acknowledges the health or disease effect of attitude and emotion. Fear-filled, angry folk who habitually engage in what motivational speaker Zig Ziglar called "stinking thinking," eventually pay a price in their body's lack of wellness. Taking in lots of information that creates distress and inner turmoil, while feeling completely helpless to improve the situation, is what Hans Selye (who coined the term stress) called "pathologically alarming" to us human animals. Conversely, time spent in reading and positive thought of our highest purposes and ideals can contribute substantially to the healing process.

Fibromyalgia can be healed and left behind in a person's life experience. Recognizing its multi-faceted causes and taking a comprehensive approach to its treatment is essential to success in your efforts as true healer.
BY JOHN R. BOMAR, DC
DR. JOHN R. BOMAR is a 1978 graduate of Palmer College of Chiropractic. A past board member of the Arkansas Chiropractic Association and the Arkansas Chiropractic Educational Society, he maintains private practices in Arkadelphia and hot Springs, Ark. He can be contacted at johnrbomar@ hotsprings.net.

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Pain-relieving magnets attract scientific scrutiny

Magnets and pain are an old married couple. As early as 200 AD, Greek healers prescribed magnetic rings to people wracked by arthritic pains. In 19th century America, magnetic salves, corsets, belts, suspenders, insoles, liniments and even underwear were sold as balms for joint pain.

Today, the market for magnetic cures remains huge—an estimated US$500 million in the US and US$5 billion around the world. It includes wrist and knee bands, neck and back braces, magnetic dog collars and resting pads, as well as blankets, toothbrushes, water, soap, dental floss, razors, car seats, exercise balls, face masks, horse massagers, panties, head caps, pillows and mattresses. In short, if you want a magnetic anything, you can probably find it.
 
And yet despite nearly 2,000 years of medical use, separating magnetic flim-flam from real pain relief is hugely contentious.

When it comes to magnets, most do not work; almost none have been clinically tested, and just because something says it is magnetic doesn’t mean it is biologically effective. Most aren’t,” says Michael Weintraub, a professor of neurology and internal medicine at New York Medical College.

Sole support

What makes Weintraub’s views especially worth noting is that he actually is, in a massively skeptical medical community, a proponent of magnetic pain relief for some conditions. In 2003, he published a landmark study showing that magnetic shoe insoles were able to significantly reduce pain in 375 people with diabetes-induced foot aches. The pain reduction was equal or superior to what people reported after taking painkilling drugs.

What made the study even more significant is that, unlike most studies about magnets, it came with the highest research pedigree. Namely, there were a large enough number of patients to make the results statistically significant, the magnetic insoles were compared to nonmagnetic insoles, people were assigned to both soles at random, and nobody knew who had what insole.

The latter issue highlights a huge issue in magnetic pain reduction research. “It’s impossible not to detect a magnetic field, therefore, somebody who wants to see if their device is actively magnetic can easily do so,” says Weintraub.
 
All you have to do is pass it near something iron and see if it attracts.

And if study participants know the device they have been given is magnetic, then any improvement may be a result of the placebo effect—the mind’s presumption that any new treatment must produce a positive result. As an example, a 2002 study of magnetism and carpal tunnel syndrome found that after 45 minutes of treatment there were significant improvements from braces with and without magnets. The phantom improvements continued to be seen after two weeks.

More consistent improvement, but not absolutely consistent, has been found in patients using magnetic fields generated by electricity to treat pains ranging from low back pain, to arthritic knee pain, to facial pain.
 
Mysterious but not magical

One explanation of the failure to conclusively prove or disprove magnetism’s claims might be lack of standardization amongst manufacturers. “We did a study on back pain with a magnet a manufacturer said penetrated into the body, but when we tested it we found it didn’t,” says Weintraub.

Another problem is that there is no generally agreed upon explanation for how magnets might work in dulling pain. In 2004, the National Center for Complementary and Alternative Medicine (NCCAM) of the US National Institutes of Health listed eight possible reasons for how magnets might affect the body.

These ranged from changing how nerve cells respond to pain, to increasing blood flow, to changing the brain’s perception of pain, to allowing the body to flush toxins more easily. “None of the theories or claims…have been conclusively proven,” said NCCAM.

So what is a cautious consumer to do in a world replete with claims for miraculous pain alleviation with magnets? Investigate before you buy, says Weintraub. This means you have to check to see if a magnet is as powerful as it claims, if its force can actually penetrate the skin, and if any benefit has been reported in the scientific literature in careful studies.

“Magnets are not magical; people have to be aware of this. Just because they put magnets on doesn’t mean it will work,” says Weintraub. “Let the buyer beware.”   © 2007

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Magnets fail to ease back pain

JOHN FAUBER of the Journal Sentinel staff

In a test that pitted one of America's most common health complaints against one of the hottest forms of alternative medicine, therapeutic magnets failed to help low back pain, according to a study published today in JAMA, the Journal of the American Medical Association.

It is estimated that 85% of Americans will experience back pain during their lives. At the same time, a media campaign promoting magnets for pain has resulted in worldwide sales of $5 billion, according to the authors of the study.

The study found that magnet therapy applied for six hours a day, three times during one week of treatment had no effect on chronic low back pain.

But the study, which looked at 20 patients from a Veterans Affairs hospital in Arizona, is not likely to end the debate over whether magnets are humbug or healing. The patients all had chronic low back pain that had lasted an average of 19 years. Each patient received a week of treatment with both sham magnets and real magnets.

At the end of each treatment regimen, the patients were given standard tests designed to assess pain levels. The magnet group fared no better the placebo group.

Although the study is one of the few randomized, double-blind, placebo-controlled tests of magnet therapy, the study's authors said it was not intended to definitively prove or disprove the effectiveness of magnets in general.

Stronger magnets might have yielded different results, the authors said. For the study, researchers used 300 gauss, bipolar permanent magnets. Gauss is the unit of measurement used in rating a magnet's strength.

Although the popularity of magnets has grown, testimonials are easier to find than scientific evidence showing they have benefit.

There have been only two previous, small double-blind, placebo- controlled studies, one involving patients with post-polio pain and the other involving peripheral neuropathy, foot pain caused by a circulation problem.

The Arthritis Foundation, the Food and Drug Administration and the Federal Trade Commission warn that science does not support the use of magnets.

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American College of Physicians on Malic Acid for Treating Fibromyalgia and CFS

In a report titled “Management of Fibromyalgia,” the American College of Physicians & American Society of Internal Medicine listed malic acid among treatments recommended for Fibromyalgia pain. The report was published in the December 1999 issue of the Annals of Internal Medicine and was authored by Lawrence J. Levanthal, M.D.

In their 1999 book, Making Sense of Fibromyalgia, by Daniel J. Wallace, M.D. and Janice Brock Wallace, the authors noted the success of malic acid and magnesium in FM patients with the following observations:

“An interesting preparation, containing magnesium and malic acid is now available… Controlled studies from England and Texas in peer-reviewed journals have documented modest effects of this preparation in muscle spasm, fatigue and pain in Fibromyalgia. If patients take a dose larger than recommended on the bottle…its effects become apparent within a week; side effects are uncommon. This combination may work as a result of interactions between magnesium and calcium channels within muscles and the generation of adenosine triphosphate (ATP), our cellular fuel.”

Research Confirms Malic Acid’s Use to Alleviate Pain and Fatigue

Leading healthcare professionals familiar with CFS are continuing to recommend malic acid for the chronic muscle soreness and fatigue that most patients experience.

They have found that patients using a combination of malic acid and magnesium hydroxide report improvements with reduction of muscle pain and tiredness.

Among those physicians recommending the malic acid/magnesium hydroxide combination are Daniel Peterson, M.D., of Incline Village, CA, Paul Cheney, M.D. and Jay Goldstein, M.D., director of the CFS Institute.

Dr. Peterson comments, “the patients who improved reported diminishing symptoms…and an increase in exercise tolerance.”

Similarly, Dr. Goldstein has found malic acid to be a safe, inexpensive nutritional supplement for CFS symptoms and suggests it should be added to the list of therapeutic approaches. He currently prescribes it for his patients with symptoms associated with CFS, and those diagnosed with FM. He explains,“…it may have a modest effect on fatigue and/or other symptoms.

Fibromyalgia pain may respond within 48 hours, while fatigue may take about two weeks.”

The effectiveness of the supplement has a sound scientific base. Malic acid, a fruit acid extracted from apples and widely used in the food industry, is essential in the formation of ATP, which is our body’s energy source. Malic acid has the ability to allow the body to make ATP more efficiently, even under low oxygen, or hypoxic, conditions. Magnesium is a mineral that is required for over 100 enymatic reactions in the body. Interestingly, many researchers such as Dr. Cheney, have noted that a large percentage of patients are magnesium depleted on an intra-cellular basis (inside the cell). Standard blood tests are not sensitive to intra-cellular magnesium.

In a study published in the May, 1995 edition of the Journal of Rheumatology, the results of FM treatment with malic acid were assessed in terms of pain, tenderness, ability to function, and psychological well-being.

The results showed no therapeutic effects on Fibromyalgia symptoms when malic acid was taken at the dosage of 600mg for twice a day for four weeks.

However, when the dosage of malic acid was increased to 1200mg twice a day there were significant reductions in the pain and tenderness of the Fibromyalgia symptoms. [Treatment of Fibromyalgia syndrome with Super Malic: a randomized, double-blind, placebo-controlled, crossover pilot study. Russell IJ; Michalek JE; Flechas JD; Abraham GE; J Rheumatol, 22(5):953-8 1995 May]

Jorge Flechas, M.D., M.PH., a holistic practitioner in Hendersonville, N.D., has participated in two medical studies that have tested the combination of malic acid and magnesium for Fibromyalgia patients. In these studies, patients reported a significant reduction in pain and tenderness within 48 hours and without any side effects. In his practice, Flechas has used this supplement combination for six years on about 500 Fibromyalgia patients. “I have found the results are positive 90 percent of the time,” he says.

Billie Jay Sahley, Ph.D., a San Antonio nutritional specialist and author of the indepth book, Malic Acid and Magnesium for Fibromyalgia and Chronic Pain Syndrome reports impressive results in Fibromyalgia patients. ‘The sooner malic acid and magnesium are started, the faster patients begin to return to their normal lifestyles,” remarks Sahley. HW

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SAM-e

A supplement called SAM-e could be a new ally in the battle against the pain of osteoarthritis and fibromyalgia and the depression that so often accompanies chronic illness.

Until last spring, hardly anybody in this country had heard of a European supplement called S-adenosylmethionine. But when it hit the market as a natural remedy named SAM-e (pronounced "sammy") it zoomed in a matter of months from an unknown import to one of the top-selling dietary supplements in the country.

With that user-friendly nickname, you almost expect "sammy" pills to be wearing a little smiley face. And no wonder: It’s being touted as a treatment for depression and osteoarthritis (OA) pain (because of regulations, vaguely referenced on labels as "emotional well-being" and "joint health"). Studies suggest it can also help fibromyalgia symptoms and alcoholdamaged livers, and there are claims that it may help with migraine headaches and maybe even Alzheimer’s disease. And it seems to have no serious side effects and no known drug interactions.

These kinds of sweeping claims have a tendency to make doctors wary, says James McKoy, MD, chief of rheumatology at Kaiser Permanente in Honolulu, Hawaii. "Whenever something is promised to be a cure-all for so many diseases, physicians are very skeptical because so many miracle cures usually only benefit the producer and the seller," he says.

"But I think this substance has promise," he adds, and several other doctors agree.

Dr. McKoy says he has some arthritis patients using SAM-e supplements, "and they like it. SAM-e might be one of the most effective alternative supplements for osteoarthritis and fibromyalgia, and I think it is going to prove to be a great alternative for depression," he says.

People particularly like SAM-e supplements because they don’t have the side effects of nonsteroidal anti-inflammatory drugs (NSAIDs), which can cause gastrointestinal damage; or of antidepressants, which can include sexual dysfunction, dry mouth or nausea. It takes a week or so for SAM-e to take effect, which is slower than NSAIDs but about twice as fast as most antidepressant drugs.

Also, SAM-e has shown no signs of drug interaction and so can be taken along with most, if not all, prescription drugs, according to Richard Brown, MD, a New York psychiatrist who has been using SAM-e for years in his practice.

The Science Behind Sam-E
SAM-e, unlike many dietary supplements, arrived in the marketplace with a thorough background of scientific studies and a history of use.

Doctors in Europe have been studying and using SAM-e for more than two decades as a treatment for osteoarthritis and depression. There are dozens of European studies, including controlled clinical trials that show it relieves osteoarthritis pain as well as NSAIDs; and that it works as well as tricyclic antidepressants in improving mood.

In several countries, it’s a prescription drug, says Teodoro Bottiglieri, PhD, a neuropharmacologist at the Baylor University Institute for Metabolic Diseases in Dallas. Bottiglieri, who has been studying SAM-e for some 15 years, also recently co-wrote a book on SAM-e, Stop Depression Now (Putnam Publishing Group, 1999), along with Dr. Brown.

SAM-e is a compound that occurs naturally in all living cells, and is a key player in a process called methylation that affects more than 100 complex biochemical reactions in the human body.

SAM-e helps our bodies make and regulate hormones, cell membranes and the neurotransmitters that affect mood. SAM-e also contributes to the building blocks for cartilage, and is involved in making glutathione, which the liver uses to remove poisons such as alcohol.

Our bodies usually make all the SAM-e we need. But the level of SAM-e decreases as we age, and levels are low in those who are depressed, or who have deficiencies of B vitamins or methionine, says Bottiglieri. Good diet and vitamin B supplements can help our bodies better use SAM-e, but unfortunately they are not going to do much to help people who have low levels of SAM-e, he says.

SAM-e supplements, however, can raise levels of this compound. And while scientists don’t know for certain how taking SAM-e supplements works, science has shown it relieves OA pain and some fibromyalgia symptoms, as well as depression.

Fibromyalgia And Depression
Some doctors are suggesting SAM-e to their patients with fibromyalgia, because antidepressant drugs in small doses are often used to ease fibromyalgia symptoms. In standard-size doses they can also help relieve the depression that frequently accompanies chronic illness.

The antidepressant effects of SAM-e are documented in several studies. It’s being prescribed by some psychiatrists to treat depression, particularly for people who haven’t responded to other drugs, or who are reluctant to take prescription antidepressants because of side effects.

"It’s a promising drug," says Maurizio Fava, MD, lead author of a study that shows SAM-e is an effective antidepressant. Dr. Fava is director of the Clinical Depression Research Program at Massachusetts General Hospital, where he uses SAM-e to treat some of his patients.

But there are mixed results in studies of SAM-e for fibromyalgia. In one small European study of fibromyalgia and SAM-e, 200-mg daily injections reduced the number of tender points and improved mood in patients with fibromyalgia. In another, those taking 800 mg of SAM-e in pill form had less pain, fatigue and morning stiffness than patients taking placebo, but no effect on tender points. A third study showed no benefit.

There are also mixed opinions from physicians.

"I think SAM-e is even better for fibromyalgia than for osteoarthritis," says Dr. McKoy, who has several patients using it.

Dr. Brown agrees, saying he finds the supplement more effective than antidepressants for fibromyalgia, and that some of his patients get significant pain relief from taking it.

However, Don Goldenberg, MD, a fibromyalgia specialist and chief of rheumatology at Newton-Wellesley Hospital in the Boston area, says he’s not convinced SAM-e has much to offer people with fibromyalgia. His laboratory began and abandoned a study on SAM-e about eight years ago when it didn’t appear to have any benefit for fibromyalgia patients.

However, Dr. Goldenberg notes that the SAM-e product that was used in the discontinued trial could have been too old and thus not effective. He says he would like to see more studies.

The Downsides and the Bottom Line
However, there are some potential downsides to taking SAM-e. Although it has been used for 20 years, there are no controlled, long-term studies to show what effects might occur in people who take SAM-e daily for years, as they would for either osteoarthritis or fibromyalgia.

Few rheumatologists know enough about SAM-e or its research to be able to advise you. And the appropriate dosage isn’t known: Between 200 and 1,600 mg per day of SAM-e was used in studies, with the highest dosage used for depression.

SAM-e is not a cure: You have to keep taking it to get the effects, and it’s pricey for some: SAM-e costs approximately $60 to $230 per month, depending on the amount taken, and it’s not covered by insurance.

And, as with all supplements, loose regulations mean that there is no guarantee that consumers are getting active ingredients in the products they buy.

However, all agreed SAM-e appears to be safe when it is used short term. Both Bottiglieri and Dr. Brown say it can be taken with most prescription drugs, including antidepressants, under a doctor’s supervision. None of the experts interviewed thought SAM-e had any serious side effects – "except poverty," one scientist said, half-joking about the cost of the supplement.

"We really don’t have enough information to say if it’s effective or not," says Dr. Moskowitz. "But we need to keep an open mind."

Good Advice
If you decide you would like to try SAM-e for OA, fibromyalgia or depression, keep this advice in mind:

  • Don’t try SAM-e without a doctor’s supervision if you are severely depressed. You must be under medical care. If you have bipolar disease (also known as manic-depression), SAM-e could cause a manic episode.

  • Remember to tell your doctor you are planning to try SAM-e, especially if you are taking prescription drugs. And don’t stop any prescribed drugs without checking with your doctor: It can be harmful to stop some medications abruptly.

  • Try to choose a SAM-e product that is stabilized. Look for SAM-e butanedisulfonate on the label. SAM-e loses potency easily, so it has to be carefully packaged in airtight, light-proof containers. Also, tablets should be coated to dissolve in your intestines, not your stomach, or you’ll be wasting some of that expensive substance.

  • Do not take more than 1,600 mg per day of SAM-e. For OA pain, some doctors suggest starting with 800 mg per day, taken in two doses. If you see an improvement in pain or mood symptoms in two weeks, reduce the dosage to 400 mg. But if you don’t see any change, you may want to increase the dosage and try for another two weeks.

  • Consider taking B vitamins – 800 mg of folic acid and 1,000 mg of B12 a day – along with SAM-e, because these vitamins are known to help your body utilize SAM-e.

  • See a doctor about any side effects you experience. He may advise you to stop taking SAM-e or lower your dosage. Side effects are rare, but some people may get a temporary skin irritation or nausea. Nausea may be eased by taking SAM-e with meals.

  • Keep up your regular routine of exercise, and maintain a healthy weight to ease pressure on your joints.

  • Table of Topics

 

Spotlight on SAM-e by Stacey Booth

When news of a supplement comes along that promises to lift depression, ease joint pain, reverse toxicity in the kidneys and, last but not least, bring relief from Fibromyalgia, a likely response may be made up of equal parts hope and skepticism. Yet, is this "too good to be true" attitude of today's consumer necessary? The product with all this promise is SAM-e (pronounce it "sammy"), and it's causing even the skeptics to give it serious attention.

What is SAM-e?

Not a prescription drug or an herb, SAM-e (S-adenosylmethionine) is a synthetic replication of a compound that the body makes naturally from methionine, an amino acid found in protein-rich foods. Used in Europe for over twenty years, SAM-e is just beginning to make national headlines in publications like Newsweek magazine and the Los Angeles Times and in books and on major television networks.

How Does it Work?

The key to understanding the way SAM-e works is by recognizing its role in a process called methylation. Methylation happens a billion times a second throughout the body and is responsible for, among other things, the regulation of brain function, preserving bone health and protecting against heart disease. It helps regulate various hormones and neurotransmitters including serotonin, melatonin, dopamine and adrenaline. During the methylation process a molecule in the body "gives up" a methyl group comprised of four atoms to another molecule, changing both the original molecule and the recipient of the methyl group in the process. "It [SAM-e] is involved in almost everything," says Teodoro Bottiglieri, Ph.D. and co-author of the book, "Stop Depression Now," which discusses his extensive use of SAM-e to treat a number of illnesses.1

How does it ease depression?

There are a few theories. One may be SAM-e's regulation of serotonin and dopamine, which are mood-lifting neurotransmitters. This hypothesis was confirmed in one study where SAM-e was shown to cross the blood-brain barrier. This research further found that the cerebrospinal fluid levels of SAM-e were significantly lower in patients with severe depression, as compared to the control group. Researchers concluded that SAM-e has antidepressant effects.2

Actually, there is little, if any, debate over SAM-e's depression-easing abilities. In fact, SAM-e's ability to lift mood is comparable to that of standard antidepressants, yet without the possible side-effects of headache, stomach upset and sexual dysfunction that prescription drugs often bring.3 Richard Brown, who authored "Stop Depression Now" with Teodoto Bottiglieri and has treated several hundred patients with SAM-e, calls it, "...the best antidepressant I've ever prescribed. I've seen only benefits." 4

Can SAM-e Stop Pain?

SAM-e was first given to patients for use in treating depression, but when some of those same patients began to report relief from osteoarthritis joint pain, researchers began to study this second benefit of the product. Over 22,000 arthritis sufferers reported, after only four weeks of treatment, that SAM-e gave comparable results to NSAID pain relievers like ibuprofen.3 The vital distinction is that instead of causing stomach upset like NSAIDs often do, SAM-e may actually protect the stomach lining. Furthermore, animal studies show that SAM-e could help restore damaged cartilage in addition to relieving pain.1 This happens when B-vitamins convert homocysteine into the antioxidant glutathione. This glutathione conversion yields molecules called sulfate groups that actually help to restore cartilage. Proof positive: the Arthritis Foundation recently stated that they were satisfied that SAM-e “provides pain relief.”

Can it Treat Fibromyalgia?

Drs. Brown and Bottiglieri dedicate an entire chapter on SAM-e's positive effects on Fibromyalgia in their book, "Stop Depression Now." They state that depression and soreness, of all of FM's symptoms, are the most stubborn. They are careful to point out that the depression that is common among FM's sufferers is not a symptom of the disease, but often a by-product of living with chronic illness. They support the benefit of SAM-e's non-prescription effects: "...fibromyalgia patients get the best of all worlds--relief from depression and muscle soreness without the side-effects or possible adverse interactions with other medications." 1

They are not alone in their findings. In a study of 47 FM patients treated daily with 200mg of SAM-e intramuscularly and 400mg orally, patients reported significant reduction in tender points, significant improvement in well-being, and significant reduction in the mean scores of the Hamilton Rating Scale for Depression, the Zung SelRating Scale, the Hamilton Rating Scale for Anxiety, and the Lorish and Maisiak's Face Scale. All reported that SAM-e was well-tolerated, with no adverse side effects.5

In another study of 30 patients with FM, Sjogren's Syndrome, or both, the patients were treated with 200mg of SAM-e daily through intramuscular injection. At the end of the four week study, the patients with Sjogren's Syndrome and FM reported a significant reduction in painful areas and tender points. The patients with only Sjogren's Syndrome reported a significant reduction on the Hamilton Rating Scale for Depression. Finally, the patients with FM finished the trial with significant reductions in symptoms of FM, numbers of tender point areas and painful areas, pain severity scores and depression scales.6

Which SAM-e Should I Take and How Much?

Not all SAM-e is created equal and those who wish to make SAM-e a part of their supplementation program should look for two distinctive qualities before purchasing: type and coating. First, full-strength SAM-e is in a form called butanedisulfonate, which should not be confused with tosylate or SAM-e sulfate. Second, look for SAM-e tablets that are enteric coated, meaning that the tablets pass through the acidic environment of the stomach intact, and can be absorbed most efficiently by the body. Lastly, the amounts used in various SAM-e studies vary widely, leaving the consumer confused about effective dosage. The starting dose is 400mg of SAM-e daily on an empty stomach.1

Are There Are Precautions or Warnings About Taking SAM-e?

Even those who have jumped on the SAM-e bandwagon are clear to point out that it is not a "cure" for severe depression and advise consumers to consult with their physician before taking SAM-e (good advice for anyone beginning a new supplementation program).

There is at least one group of people who should avoid SAM-e: those with bi-polar disorder. Commonly called manic depression, these individuals should be aware that SAM-e may induce mania in those with the disorder.

In conclusion

Since the mass availability of SAM-e earlier this year, the buzz has been strong and the research to support it very promising, if not yet iron-clad. As stated above, it's a good idea to consult your physician when beginning any new supplementation program. However, it does appear that for those wishing to lift their mood, soothe painful joints and muscles, and lighten the load of FM's many symptoms, SAM-e is a safe complimentary treatment, nearly without side-effect.

Sources: 1. Brown, Richard, M.D., Bottigileri, Teodoro, Ph.D., Colman, Carol. Stop Depression Now. New York, 1999. 2. J Neurol Neurosurg Psychiatry (England) Dec. 1990, 53 (12) p1096-8. "Cerebrospinal Fluid S-andenosylmethionine in Depression and Dementia: Effects of Treatment with Parenteral and Oral S-andenosylmethionine." 3. Cowley, Geoffrey and Underwood, Anne. "What is SAM-e?" Newsweek, July 5, 1999. 4. Curr. Ther. Res. Clin. Exp. (USA), 1994, 55/7 (797-806). "Primary Fibromyalgia is Responsive to S-adenosylmethionine." 5. Curr. Ther. Res. Clin. Exp. (USA), 1994, 55/6 (699-706). "S-adenosylmethionine in Sjogren's Syndrome and Fibromyalgia."

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Oxygen Therapy Might Ease Pain of Migraine, Cluster Headaches

Description
Two types of oxygen therapy could offer some help for adults who suffer from disabling migraine and cluster headaches. Reviewers
concluded that hyperbaric treatment might give some relief for migraine headache and that oxygen therapy at normal room pressure
might provide similar relief for cluster headache.

Newswise - Two types of oxygen therapy could offer some relief to adults who suffer from disabling migraine and cluster headaches,
according to a new research review from Australia.

Migraine headaches are severely painful and usually occur with other symptoms such as nausea, vomiting and painful sensitivity to light. Cluster headaches cause sharp, burning pain on one side of the head.

Physicians commonly rely on a number of drug therapies to both treat and prevent migraine and cluster headaches, but some also prescribe oxygen therapy. The aim of the systematic review - comprising nine small studies involving 201 participants - was to determine whether inhaling oxygen actually helps.

"We wanted to locate and assess any evidence from randomized trials that oxygen administration was a safe and effective treatment for migraine or cluster headaches," said lead reviewer Michael Bennett, of Diving and Hyperbaric Medicine at Prince of Wales Hospital in Sydney. "We hoped this would assist physicians to make effective treatment decisions in this area."

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international
organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

The Cochrane reviewers examined studies that evaluated normobaric oxygen therapy and hyperbaric oxygen therapy. Normobaric therapy consists of patients inhaling pure oxygen at normal room pressure, and hyperbaric therapy involves patients breathing oxygen at higher pressure in a specially designed chamber.

Five studies compared hyperbaric versus sham (placebo) therapy for migraine; two compared hyperbaric versus sham therapy for cluster headache; and two investigated the use of normobaric therapy for cluster headache. Length of treatment varied with each study.

Three studies reported the number of patients who had significant relief from their migraines within 40 to 45 minutes of hyperbaric
therapy. Although the studies did not specify each patients' response to treatment, they reported a significant increase in the proportion of patients who had relief with hyperbaric oxygen compared to sham therapy.

For cluster headaches, two studies (69 patients) found a significantly greater proportion of patients had relief of their
headaches after 15 minutes of normobaric compared to sham therapy.

The reviewers concluded that hyperbaric treatment might give some relief for migraine headache and that normobaric therapy might
provide similar relief for cluster headache, but there is no evidence that these therapies will prevent future attacks.

"We believe that hyperbaric oxygen is also a reasonable measure for migraineurs who have not responded to other measures to treat an acute attack," Bennett said. "However, the poor availability of hyperbaric chambers makes this an option only in a minority of health facilities. Most physicians treating headaches will continue to rely on established and emerging pharmacological options for treating and preventing acute attacks."

Estimates indicate that 6 percent to 7 percent of men and 15 percent to 18 percent of women suffer from severe migraine headaches, and cluster headaches effect about 0.2 percent of the population.

John Kirchner, M.D., of the Kirchner Headache Clinic in Omaha, Neb., has treated thousands of patients suffering from a variety of
headaches, including migraine and cluster, and said he does not include oxygen therapy in his patients' treatment plans.

"This [oxygen therapy] would not be practical as the headache comes on fast and does not last long," he said. "So there would not be time to get the patient to the chamber."

Kirchner's treatment for migraine includes avoiding triggers, taking preventive and symptomatic medications and undergoing behavior modification.

Bennett MH, et al. Normobaric and hyperbaric oxygen therapy for migraine and cluster headache. Cochrane Database of Systematic
Reviews 2008, Issue 3.

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.

© 2008 Newswise.  All Rights Reserved.

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Straight Talk About Herbal Supplements

A new Web site by Memorial Sloan-Kettering Cancer Center discusses their safety, effectiveness.  By Jennifer Thomas HealthScoutNews Reporter

If you have high blood pressure, did you know you probably shouldn't take ginseng?

Or that St. John's wort can interfere with chemotherapy?

Or that garlic capsules and gingko biloba can hinder blood coagulation, a potentially major problem if you had to undergo surgery?

A new Web site created by experts at Memorial Sloan-Kettering Cancer Center in New York City provides up-to-date information on the safety and efficacy of 135 of the most popular herbal remedies and dietary supplements, from bee pollen to shark cartilage and skullcap to milk thistle.

Each entry includes a summary and a critique of all the known medical studies on the supplement, as well as a link to the original research on the National Institutes of Health's Medline.

In the past decade, use of alternative treatments has skyrocketed, says Barrie Cassileth, chief of integrative medicine at Memorial Sloan-Kettering, who started the site. "But until now there was no easy access to current, comprehensive information about these agents," she adds.

Research is under way around the globe to scientifically document the effects of hundreds of herbs and other dietary supplements.

Some studies have proven that certain natural substances do have benefits, though in nearly all cases research is mixed. The element zinc, for example, has shown promise in lessening the duration of a cold by making it difficult for the rhinovirus to replicate. And some research shows St. Johns wort can help ease depression.

But that means the converse is also true -- herbs can be dangerous.

"Herbs are powerful, biologically active products that do have important biological effects," Cassileth says. "Those effects can be useful at some times and harmful under other circumstances."

"Herbs should not be used in a casual fashion because they are serious medicines," she adds.

For instance, ginseng can cause low blood sugar in diabetics. And valerian and kava can lessen the effectiveness of prescription drugs by interfering with the liver's ability to process the medicines, Cassileth says.

Another thing to keep in mind: While much is known about the effects of herbs on the body, much more is not known.

Dietary supplements are not regulated by the U.S. Food and Drug Administration, or any government agency. That means the potency in one bottle of St. Johns wort, for example, can -- and often does -- vary dramatically from that in another bottle, Cassileth says.

And you can't even be sure you're getting St. Johns Wort.

"Anybody can put anything on a bottle and put it on a health food store shelf," she says. "Some of the herbal remedies have virtually none of what is assumed to be the active ingredient, some have much higher levels and some are contaminated with other substances."

On the new Web site, the 135 supplements are listed in alphabetical order by scientific name. The common name is below it. (Acanthopanax Senticosus is better known as ginseng. Allium Sativun is better known as garlic).

Each entry includes the brand names the herb is sold under, its purported uses, its chemical properties, and what's known about how the herb works on the body.

Each entry also includes a summary and a critique of all the known published medical studies, instances of adverse reactions, and warnings about potentially dangerous drug interactions.

Each critique is fully cited and linked to Medline, so that doctors or patients can retrieve the original research and read further if they wish.

The site will be continually updated, Cassileth says. In a few weeks, Cassileth and her colleagues are planning to launch a second Web site that will be less technical and more easily understood by patients.

Dr. David Rosenthal, past president of the American Cancer Society, endorses the Web site.

"This resource is an invaluable tool for both doctors and patients looking for comprehensive information about dietary supplements," Rosenthal says.

More information To visit the Sloan-Kettering site, click here. For more on herbal medicine, visit the National Institutes of Health.

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Herbs And Drugs: Never Mix, Never Worry Source: Tufts University Health & Nutrition Letter

Dr. Dean. I’ve discussed the dangers of taking ginkgo with aspirin. It can increase your risk of a stroke, but this isn’t mentioned on product labels. MY COMMENTS - This would also apply to Ibuprofen.)

In fact, ginkgo shouldn’t be used with any anticoagulant drugs or with vitamin E, according to a nutrition newsletter from Tufts University. The reason is ginkgo acts as a blood thinner and taking it with other blood-thinning agents can put you at-risk for excessive bleeding or even stroke.

Shouldn’t manufacturers be required to mention the adverse effects of mixing some herbs and drugs? Ginkgo isn’t the only one you have to be careful with. Echinacea is an immune stimulant commonly used to ward off colds, but it shouldn’t be mixed with corticosteroids, which work to suppress the immune system.

Here are some other examples of herbs and medicines that shouldn’t go together:

--Echinacea Might counteract immune-suppressant drugs such as glucocorticoids taken for lupus and rheumatoid arthritis. Might increase side effects of methotrexate.

--Evening Primrose oil Can counteract the effects of anti-convulsant drugs.

--Fish oil: May increase effects of blood-thinning drugs and herbs.

--Folic acid: Interferes with methotrexate; ask your doctor how to take it.

--Ginseng: Don’t mix with coumadin (warfarin) because the herb can reverse the drug’s effects.

--G.L.A.: May increase effects of blood-thinning drugs and herbs.

--Garlic Can increase effects of blood-thinning drugs and herbs.

--Ginger: Can increase NSAID side effects and effects of blood-thinning drugs and herbs

--Ginkgo: May increase effects of blood-thinning drugs and herbs.

--Ginseng    May increase effects of blood-thinning drugs, estrogens and glucocorticoids; shouldn’t be used by those with diabetes; may interact with MAO inhibitors.

--Kava Kava: Don’t mix with alcohol, anti-Parkinson’s medications, antipsychotics, sedatives, sleeping pills. The reason is kava can add to the effects of drugs that depress the central nervous system, causing oversedation as well as tremors, muscle spasms or abnormal movements.

--Natural licorice: Don’t mix with blood pressure medication because of the risk of counteracting the effects of the drugs treating hypertension.

--Magnesium: May interact with blood pressure medications.

--St. John’s Wort: Don’t mix with antidepressants. Studies raise concerns of adverse side effects from the interaction. May enhance effects of narcotics, alcohol, and antidepressants; increase risk of sunburn; interfere with iron absorption.

--Valerian: Don’t use with alcohol, sedatives or sleeping pills because it may result in extreme drowsiness.

--Zinc:Can interfere with glucocorticoids and other immunosuppressing drugs. 

There was one case where a 70-year-old man taking aspirin regularly after heart surgery began using ginkgo biloba twice a day and started bleeding in his eye. After quitting the herb, the bleeding stopped.

If mixing herbs and certain drugs causes adverse effects, shouldn’t we be aware of this? I think herbal supplement labels should include these warnings.

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Chinese Herbal Medicines May Contain Modern Drugs By Richard Woodman

LONDON (Reuters Health) - Chinese herbal medicines may sometimes work--and may sometimes cause serious harm--because they are adulterated with synthetic drugs, a British research group said on Tuesday.

The Bandolier organization, which specializes in reviewing healthcare studies, said Chinese herbal medicines were becoming more popular and there was even evidence that some might work.

"One of the problems, though, is that these herbal medicines are not standardized, and usually contain many ingredients. A review tells us that some of those ingredients can be synthetic drugs, responsible both for good effects, and for serious harm."The review, published on Bandolier's Web site (http://www.jr2.ox.ac.uk/bandolier/whatnew.html), found that a wide range of adulterants were used, including steroids, nonsteroidal anti-inflammatory drugs, anticonvulsants, benzodiazepines, hypoglycemic agents and even Viagra.

While it was not clear what proportion of remedies contained adulterants, analysis of 2,600 samples in Taiwan showed that 24% contained at least one synthetic medicine. In the US it was 7%.

Case reports showed that two or more adulterants were present in 14 of 15 Chinese herbal medicines."There was one death reported in these reports, and at least six potentially life-threatening events," the organization said.

"Suspicion of adulteration was based not only on adverse effects, but suspiciously good efficacy. Chinese herbal medicines may work because of the adulterants," according to the review.

It warned of the potential for adverse events, especially when other treatments were being prescribed at the same time.  Last Updated: 2002-11-05 10:00:40 -0400 (Reuters Health)

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Herbal medication: potential for adverse interactions with analgesic drugs. Abebe W. Department of Oral Biology and Maxillofacial Pathology, School of Dentistry, Medical College of Georgia, Augusta, GA, USA.

The use of herbal supplements in the US has increased dramatically in recent years. These products are not regulated by the Food and Drug Administration (FDA) with the same scrutiny as conventional drugs. Patients who use herbal supplements often do so in conjunction with conventional drugs. This article is a review of potential adverse interactions between some of the commonly used herbal supplements and analgesic drugs. Non-steroidal anti-inflammatory drugs (NSAIDs), particularly aspirin, have the potential to interact with herbal supplements that are known to possess antiplatelet activity (ginkgo, garlic, ginger, bilberry, dong quai, feverfew, ginseng, turmeric, meadowsweet and willow), with those containing coumarin (chamomile, motherworth, horse chestnut, fenugreek and red clover) and with tamarind, enhancing the risk of bleeding. Acetaminophen may also interact with ginkgo and possibly with at least some of the above herbs to increase the risk of bleeding. Further, the incidences of hepatotoxicity and nephrotoxicity may be augmented by acetaminophen when concomitantly used with the potentially hepatotoxic herbs Echinacea and kava, and with herbs containing salicylate (willow, meadowsweet), respectively. The concomitant use of opioid analgesics with the sedative herbal supplements, valerian, kava and chamomile, may lead to increased central nervous system (CNS) depression. The analgesic effect of opioids may also be inhibited by ginseng. It is suggested that health-care professionals should be more aware of the potential adverse interactions between herbal supplements and analgesic drugs, and take appropriate precautionary measures to avoid their possible occurrences. However, as most of the interaction information available is based on individual case reports, animal studies and in vitro data, further research is needed to confirm and assess the clinical significance of these potential interactions.

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Study Shows Cannabis Spray Helps Ease Chronic Pain

Updated: Mon, Sep 03 10:28 AM EDT By Patricia Reaney

GLASGOW, Scotland (Reuters) - A cannabis spray used under the tongue helps to relieve the suffering of multiple sclerosis patients and people suffering from chronic pain, a British doctor said Monday.

The spray contains extracts from the drug and allows doctors to control dosage effectively and measure the effects.

So far the results have been encouraging.

"We are finding it is useful for a lot of patients," Dr. William Notcutt of James Paget Hospital in Great Yarmouth in eastern England
told a science conference in Glasgow.

An estimated one person in 12 experience chronic pain.

Notcutt tested the spray, which was developed and supplied by the British company GW Pharmaceuticals, in patients with experience of cannabis and in others who were not familiar with the drug.

The spray totally relieved pain in some patients while it helped others get a good night's sleep, which Notcutt said is a blessed
event for many chronic pain sufferers.

In addition to providing valuable information about the effectiveness of the drug in easing chronic pain, Notcutt told the British
Association for the Advancement of Science Conference that the study was also providing data on the best dosage and side effects.

"We need much more basic information on how to use this," he said.

Although the use of cannabis is illegal in most countries, patients with diseases such as cancer and multiple sclerosis have been
lobbying to use cannabis for medicinal purposes.

Only three patients out of the 23 in the two groups said they received no benefit from the spray. Side effects included a high
level of euphoria, or "high," panic attacks and fainting.

Notcutt refused to be drawn on whether his research would provide further support to those seeking to legalese cannabis.

"Our goal has been to return people to an active life," he said, adding that one patient had returned to work and others had resumed
driving.

GW Pharmaceuticals, set up in 1997, operates under licenses from the British Home Office (interior ministry) to cultivate, possess and supply cannabis for medical research.

It grows cannabis in secure, computer-controlled glasshouses in southern England. The plants used in the trials were grown to
maximize the benefits of cannabinoids, the active ingredient in cannabis.

Notcutt said the use of cannabis extracts for pain could pave the way for the drug to be used for other conditions including rheumatoid arthritis, surgical premedication, epilepsy and eating disorders.

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Peppermint for I.B.S.?

Peppermint ( Mentha x piperita ), a popular flavoring for gum, toothpaste, and tea, also serves as a calming agent to soothe an an upset stomach or to aid in digestion. Because it has a calming and numbing effect, it has been used to treat headaches, skin irritations, anxiety associated with depression, nausea, diarrhea, menstrual cramps, and flatulence. It is also widely used to treat symptoms of the common cold. These and other conditions for which peppermint may be beneficial are listed below.

Indigestion
Peppermint calms the muscles of the stomach and improves the flow of bile, which the body uses to digest fats. As a result, food passes through the stomach more quickly. It is important to know, however, if your symptoms of indigestion are related to a condition called gastoesophageal reflux disease or GERD, peppermint should not be used – see Precautions.

Flatulence/Bloating
Peppermint relaxes the muscles that allow the body to rid itself of painful digestive gas.

Irritable Bowel Syndrome (IBS)
A number of studies have shown the beneficial effects of enteric-coated peppermint capsules for treating symptoms of IBS, such as pain, bloating, gas, and diarrhea. (Enteric-coated capsules keep the oil from being released in the stomach, which can lead to heartburn and indigestion.) A recent study comparing enteric-coated peppermint oil capsules to placebo in children with IBS found that after 2 weeks, 75% of those treated had reduced symptoms. This is in keeping with an earlier study of adults in which 79% of participants receiving peppermint experienced a relief in the severity of pain.

Menstrual Cramps
Peppermint has the potential to influence menstrual periods and, because it relaxes muscles, may help to relieve painful cramps.

Gallstones
Peppermint oil may help the body break down gallstones.

Viruses
Peppermint oil has exhibited antiviral properties against a number of infectious agents, including herpes.

Itching and Skin Irritations
Peppermint, when applied topically, has a soothing and cooling effect on skin irritations caused by hives, poison ivy, or poison oak.

Tension Headache
Research has shown that peppermint applied to the forehead and temples compares favorably with acetaminophen (a commonly used over the counter medication) in terms of its ability to reduce headache symptoms.

Colds and Flu
Peppermint and its main active agent, menthol, are effective decongestants. Because menthol thins mucus, it is also a good expectorant, meaning that it helps loosen and breaks up coughs with phlegm. It is soothing and calming for sore throats (pharyngitis) and dry coughs as well.

Plant Description

Peppermint plants grow to about two feet tall. They bloom from July through August, sprouting tiny purple flowers in whorls and terminal spikes. Simple, toothed, and fragrant leaves grow opposite the flowers. Peppermint is native to Europe and Asia, is naturalized to North America, and grows wild in moist, temperate areas. Some varieties are indigenous to South Africa, South America, and Australia.

What's It Made Of?

Peppermint preparations start with the leaves and flowering tops of the plant. These contain a volatile oil, peppermint's primary active component, menthol.

Available Forms

Peppermint tea is prepared from dried leaves of the plant. Such teas are widely available commercially.

Peppermint spirit (tincture) in an alcoholic solution containing 10% peppermint oil and 1% peppermint leaf extract. A tincture can be prepared by adding 1 part peppermint oil to 9 parts pure grain alcohol.

Enteric-coated capsules, which are specially coated to allow the capsule to pass through the stomach and into the intestine (0.2 mL of peppermint oil per capsule)

Creams or ointments (should contain 1% to 16% menthol)

How to Take It

Pediatric

For digestion and upset stomach: 1 to 2 mL peppermint glycerite per day

Adult

Peppermint tea soothes an upset stomach and can aid digestion. It can be prepared using the infusion method of pouring boiling water over the herb and then steeping for 3 to 5 minutes. Use 1 to 2 tsp of dried peppermint leaf to 8 oz of hot water.

  • Irritable bowel syndrome: Take 1 to 2 coated capsules three times per day between meals.

  • Gallstones: Take 1 to 2 enteric-coated capsules three times per day between meals.

  • Itching and skin irritations: Apply menthol, the active ingredient in peppermint, in a cream or ointment form no more than three to four times per day.

  • Tension headaches: Using a tincture of 10% peppermint oil to 90% ethanol, lightly coat the forehead and allow the tincture to evaporate.

    Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a practitioner knowledgeable in the field of botanical medicine.

Peppermint tea is generally a safe way to soothe an upset stomach. However, peppermint should not be used by those with gastoesophageal reflux disease (GERD -- a condition in which stomach acids back up into the esophagus) even though some of the symptoms include indigestion and heartburn. This is because peppermint can relax the sphincter between the stomach and esophagus, allowing stomach acids to flow back into the esophagus. (The sphincter is the muscle that separates the esophagus from the stomach.) By relaxing the sphincter, peppermint may actually worsen the symptoms of heartburn and indigestion.

Pregnant or nursing mothers should drink peppermint tea only in moderation and those with a history of miscarriage should not use peppermint at all while pregnant.

Rare negative reactions to enteric-coated peppermint oil capsules may include skin rash, slowed heart rate, and muscle tremors.

Menthol or peppermint oil applied to the skin can cause contact dermatitis or other type of rash, including, possibly hives. Some have described hot flashes from the oil. It should be kept away from the eyes and other mucus membranes and should not be inhaled by or applied to the face of an infant or small child. Peppermint oil should be diluted and taken in very small amounts, since it can cause negative reactions such as those listed above, cramping and diarrhea, as well as, rarely drowsiness, tremor, muscle pain, slowed heart rate, and, in severe cases of overdose, coma. Pure menthol is poisonous and should never be taken internally. It is important not to confuse oil and tincture preparations.

Possible Interactions

5-Fluorouracil for Cancer
In an animal study, topical peppermint oil increased the absorption of 5-fluorouracil, a medication used to treat cancer that was also applied topically. It is too early to draw conclusions about the applicability of these findings to people. Therefore, it would be wise to avoid applying peppermint oil topically when using other topical medications for cancer.

Supporting Research

Abdullah D, Ping QN, Liu G. Enhancing effect of essential oils on the penetration of 5-fluorouracil through rat skin. Yao Hsueh Hsueh Pao . 1996;31(3):214–221.

Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs . Newton, MA: Integrative Medicine Communications; 2000:297-303.

Briggs CJ, Briggs GL. Herbal products in depression therapy. CPJ/RPC. November 1998;40-44.

Brinker F. Herb Contraindications and Drug Interactions . Sandy, Oregon: Eclectic medical Publications. 1998:111, 173-175.

Dew MJ, Evans BK, Rhodes J. Peppermint oil for the irritable bowel syndrome: a multicentre trial. Br J Clin Pract . 1984;(11–12):394, 398.

Gobel H, Schmidt G, Soyka D. Effect of peppermint and eucalyptus oil preparations on neurophysiological and experimental algesimetric headache parameters. Cephalalgia . 1994;14(3):228-234.

Hills J. The mechanism of action of peppermint oil on gastrointestinal smooth muscle. Gastroenterology . 1991;101:55–65.

Kline RM, Kline JJ, Di Palma J, Barbero GJ. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children. J Pediatr . 2001;138(1):125-128.

Koch TR. Peppermint oil and irritable bowel syndrome. Am J Gastroenterol . 1998;93:2304–2305.

Liu JH, Chen GH, Yeh HZ, Huang CK, Poon SK. Enteric-coated peppermint-oil capsules in the treatment of irritable bowel syndrome: a prospective, randomized trial.

J Gastroenterol. 1997;32(6):765-768.

Pittler MH, Ernst E. Peppermint oil for irritable bowel syndrome: a critical review and meta-analysis. Am J Gastroenterol . 1998;93(7):1131–1135.

Pizzorno JE, Murray MT. Textbook of Natural Medicine . New York: Churchill Livingstone; 1999:827-829, 1361-1362, 1558.

Robbers JE, Tyler VE. Herbs of Choice: The Therapeutic Use of Phytomedicinals . New York, NY: The Haworth Herbal Press; 1999: 67-68.

Woolf A. Essential oil poisoning. Clinical Toxicology . 1999;37(6):721-727.

Review Date: 4/1/2002

Reviewed By: Participants in the review process include: Steven Dentali, PhD (April 1999), Senior Director of Botanical Science, Rexall Sundown, Boca Raton, FL; Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh (Pediatric Dosing section February 2001), Johnson Drugs, Natick, MA; Steven Ottariono, RPh (Pediatric Dosing section February 2001), Veteran's Administrative Hospital, Londonderry, NH; R. Lynn Shumake, PD, Director, Alternative Medicine Apothecary, Blue Mountain Apothecary & Healing Arts, University of Maryland Medical Center, Glenwood, MD; Tom Wolfe, P.AHG (March 1999), Smile Herb Shop, College Park, MD. All interaction sections have also been reviewed by a team of experts including Joseph Lamb, MD (July 2000), The Integrative Medicine Works, Alexandria, VA;Enrico Liva, ND, RPh (August 2000), Vital Nutrients, Middletown, CT; Brian T Sanderoff, PD, BS in Pharmacy (March 2000), Clinical Assistant Professor, University of Maryland School of Pharmacy; President, Your Prescription for Health, Owings Mills, MD; Ira Zunin, MD, MPH, MBA (July 2000), President and Chairman, Hawaii State Consortium for Integrative Medicine, Honolulu, HI.

Table of Topics


Peppermint oil for irritable bowel syndrome: a critical review and metaanalysis.

Pittler MH, Ernst E.Department of Complementary Medicine, Postgraduate Medical School, University of Exeter, United Kingdom.

OBJECTIVE: Peppermint oil is the major constituent of several over-the-counter remedies for symptoms of irritable bowel syndrome (IBS). As the etiology of IBS is not known and treatment is symptomatic, there is a ready market for such products. However, evidence to support their use is sparse. The aim of this study was to review the clinical trials of extracts of peppermint (Mentha X piperita L.) as a symptomatic treatment for IBS. METHODS: Computerized literature searches were performed to identify all randomized controlled trials of peppermint oil for IBS. Databases included Medline, Embase, Biosis, CISCOM, and the Cochrane Library. There were no restrictions on the language of publication. Data were extracted in a standardized, predefined fashion, independently by both authors. Five double blind, randomized, controlled trials were entered into a metaanalysis. RESULTS: Eight randomized, controlled trials were located. Collectively they indicate that peppermint oil could be efficacious for symptom relief in IBS. A metaanalysis of five placebo-controlled, double blind trials seems to support this notion. In view of the methodological flaws associated with most studies, no definitive judgment about efficacy can be given. CONCLUSION: The role of peppermint oil in the symptomatic treatment of IBS has so far not been established beyond reasonable doubt. Well designed and carefully executed studies are needed to clarify the issue.

PMID: 9672344 [PubMed - indexed for MEDLINE]

Table of Topics

Peppermint oil Overview

Peppermint oil and capsules have not been studied as extensively as other treatments for I.B.S. We will list what we learn in order to help you make an informed decision on your own health care. The information offered below is a combination of study items and antedotal information.

Peppermint oil relieves pain and bloating by relaxing the bowel muscles.

Peppermint oil is available in capsule form. You can obtain a prescription from your doctor or buy it OTC (over-the-counter) under the name Colpermin.

Two known studies state that peppermint oil was better than a placebo in relieving I.B.S. symptoms.

Only enteric capsules should be taken to avoid irritation to the mouth, esophagus and stomach.

Three out of ten people taking the capsules reported nausea, heartburn and blurred vision.

Table of Topics


Peppermint Oil May Relieve Digestive Symptoms, Headaches  CME/CE

News Author: Laurie Barclay, MD
CME Author: Charles Vega, MD, FAAFP Release Date: April 13, 2007; Reviewed and Renewed: April 15, 2008; Valid for credit through April 15, 2009

Credits Available Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™ for physicians;
Family Physicians - up to 0.25 AAFP Prescribed credit(s) for physicians;
Nurses - 0.25 nursing contact hours (0.25 contact hours are in the area of pharmacology)


Laurie Barclay, MD
Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

Charles P. Vega, MD
Disclosure: Charles Vega, MD, FAAFP, has disclosed that he has received grants for educational activities from Pfizer.

April 13, 2007 — Peppermint oil is effective in treating digestive disorders and other conditions including headaches, although high dosages may cause adverse effects, according to the results of a review reported in the April 1 issue of American Family Physician.

"The medicinal use of peppermint and other mint plants probably dates back to the herbal pharmacopoeia of ancient Greece, where peppermint leaf traditionally was used internally as a digestive aid and for management of gallbladder disease; it also was used in inhaled form for upper respiratory symptoms and cough," write Benjamin Kligler, MD, MPH, from the Albert Einstein College of Medicine of Yeshiva University in New York, and Sapna Chaudhary, DO, from the Beth Israel Continuum Center for Health and Healing in New York. "Peppermint oil, which is extracted from the stem, leaves, and flowers of the plant, has become popular as a treatment for a variety of conditions, including irritable bowel syndrome (IBS), headache, and non-ulcer dyspepsia."

Specific applications of note are as follows:

  • Peppermint leaf and oil have a long history of use for digestive disorders.

  • Enteric-coated peppermint oil is a safe alternative to effectively reduce some IBS symptoms, recent evidence suggests, although some evidence is conflicting (evidence rating, B).

  • Peppermint oil combined with caraway oil appears moderately effective in treating nonulcer dyspepsia (evidence rating, B).

  • Peppermint oil applied topically may effectively treat tension headache (evidence rating, B).

  • Peppermint oil has relaxant effects on smooth muscle. When given via enema, it has been shown to be modestly effective in relieving colonic spasm in patients undergoing barium enemas (evidence rating, B).

Although peppermint oil is well tolerated at the commonly recommended dosage, it may cause significant adverse effects at higher dosages. Common adverse effects include allergic reactions, heartburn, perianal burning, blurred vision, nausea, and vomiting. Interstitial nephritis and acute renal failure are rare.

Because peppermint oil may inhibit the cytochrome P450 1A2 system, it may interact with drugs metabolized via this system.

Peppermint oil is contraindicated in patients with hiatal hernia, severe gastroesophageal reflux, and gallbladder disorders and should be used with caution in pregnant and lactating women.

The recommended dosage is 0.2 to 0.4 mL of peppermint oil 3 times daily in enteric-coated capsules for adults, and 0.1 to 0.2 mL of peppermint oil 3 times daily for children older than 8 years.

Cost is approximately $24 to $32 for a 1-month supply.

"Peppermint oil should not be used internally or on or near the face in infants and young children because of its potential to cause bronchospasm, tongue spasms, and, possibly, respiratory arrest," the authors conclude. "However, the amount of peppermint in over-the-counter medications, topical preparations, and herbal teas is likely safe in pregnant and lactating women and in young children."

The authors have disclosed no relevant financial relationships.

Am Fam Physician. 2007;75:1027-1030.

Clinical Context

Peppermint has been used as a medicinal substance for thousands of years. Most modern preparations of peppermint use its oil, which usually is provided with an enteric coating to prevent gastroesophageal reflux. This oil contains menthol, menthone, cineol, and other oils, and there is evidence that this combination of compounds can relax gastrointestinal smooth muscle as well as lower esophageal sphincter pressure.

Peppermint oil has been used to treat not only gastrointestinal complaints but also headache. The current article reviews the efficacy and safety of peppermint oil for these indications.

Study Highlights

  • Peppermint oil appears to be mildly effective in reducing symptoms of IBS, particularly flatulence, abdominal pain, and distension, in adults. However, there has been significant heterogeneity among research into this subject.

  • A study of children between the ages of 8 and 17 years who had IBS found that peppermint oil was more effective than placebo in reducing the severity of abdominal pain.

  • 2 trials have demonstrated that treatment with peppermint oil reduced the risk for gastrointestinal spasm during barium enema, with peppermint associated with up to a 3-fold increase vs placebo in the rate of having a procedure free of spasm.

  • The combination of 90 mg of peppermint oil plus 50 mg of caraway oil has been demonstrated to reduce symptoms of nonulcer dyspepsia, including fullness, bloating, and spasm. This combination should be used cautiously for patients with dyspepsia, as peppermint oil may promote gastroesophageal reflux.

  • 2 studies have delineated the efficacy of topical peppermint oil in tension headache. In 1 study, a combination of peppermint and ethanol was superior to placebo in terms of analgesia. Another trial demonstrated that topical peppermint oil was similar to acetaminophen in terms of treatment efficacy.

  • The therapeutic dosage in most trials of peppermint oil and IBS was 0.2 to 0.4 mL taken 3 times daily in enteric-coated capsules. The 1 trial examining its use for childhood IBS used a dosage of 0.1 mL of peppermint oil 3 times daily for children weighing less than 45 kg.

  • Peppermint oil can be toxic in overdose, leading to interstitial nephritis and acute renal failure. Because it may promote gallstone formation, it should not be used in patients with cholelithiasis or cholecystitis. Peppermint oil also may trigger menstruation and should not be used during pregnancy.

  • The most common adverse events associated with peppermint oil include allergic reactions, heartburn, perianal burning, blurred vision, nausea, and vomiting. Peppermint oil may inhibit the cytochrome P450 1A2 system.

Pearls for Practice

  • Peppermint oil contains menthol, menthone, and cineol and may work by relaxing smooth muscle in the gastrointestinal tract. Peppermint oil also may reduce lower esophageal sphincter pressure and therefore usually is supplied with enteric coating.

  • Peppermint oil offers mild efficacy for symptoms of IBS and may improve colonic spasm associated with barium enema. Topical formulations of peppermint oil may improve tension headache.

    Table of Topics

Acupuncture/Hypnosis for Chronic Pediatric Pain

A Phase I Study on the Feasibility and Acceptability of an Acupuncture/Hypnosis Intervention for Chronic Pediatric Pain. Journal of Pain and Symptom Management , Volume 24 , Issue 4 , Pages 437 - 446 L . Zeltzer

Abstract: The purpose of the present study was to conduct a Phase I investigation examining the feasibility and acceptability of a complementary and alternative medicine (CAM) package combining acupuncture and hypnosis for chronic pediatric pain. Thirty-three sequentially referred children (21 girls) aged 6–18 years were offered 6 weekly sessions consisting of individually tailored acupuncture treatment together with a 20-minute hypnosis session (conducted while the needles were in place). Parent and child ratings of pain and pain-related interferences in functioning, as well as child ratings of anxiety and depression, were obtained at pre- and post-treatment. The treatment was highly acceptable (only 2 patients refused; = 90% completed treatment) and there were no adverse effects. Both parents and children reported significant improvements in children's pain and interference following treatment. Children's anticipatory anxiety declined significantly across treatment sessions. Our results support the feasibility and acceptability of a combined acupuncture/hypnosis intervention for chronic pediatric pain.

Table of Topics

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