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Kenneth R. Pelletier is a clinical professor of medicine at Stanford University’s School of Medicine in Stanford, California, and director of the Complementary and Alternative Medicine Program at Stanford. In this question-and-answer series, Pelletier provides a handy digest of terms commonly used in alternative medicine, such as phytonutrients and antioxidants, while also offering brief explanations of such fields as homeopathy and naturopathy. The effectiveness of acupuncture and herbal medicines, such as echinacea and St. John’s Wort, are also discussed.
Q: Can acupuncture help reduce the craving for cigarettes?
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A: Acupuncture, in combination with the burning of a traditional Chinese herb, moxa, at specific acupuncture points has been demonstrated to be effective in addictions such as cigarettes and tobacco products.
Q: What is a phytonutrient?
A: Phytonutrients are “plant-based” nutrients from the Latin “phyto” for plants. A good example is the naturally occurring estrogens on “phytoestrogens” in soy beans and products.
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Q: What is an antioxidant?
A: An antioxidant is a substance, such as Vitamins C and E, that prevent the cellular damage due to oxygen interacting with cellular metabolism. Although oxygen metabolism is essential to life, the antioxidants diminish excessive activity and damage to the cell.
Q: Does melatonin prevent jet lag?
A: Melatonin can alleviate jet lag. There are a number of complex ways of using melatonin but the best general approach is to ingest no more than 3 mg of melatonin approximately 45 minutes prior to going to sleep in the new time zone.
Q: Is St. John’s Wort effective in treating depression?
A: St. John’s Wort is effective in treating mild to moderate depression. It has been studied in comparison to common antidepressants, such as Prozac, and been found to be equally effective with fewer side effects.
Q: Is Echinacea effective in treating colds and flu?
A: Echinacea can be effective in preventing the onset of cold or flu if taken at the earliest possible onset of the symptoms. Evidence is actually better that Echinacea can shorten the duration, if not prevent altogether, a cold or flu episode.
Q: In homeopathy, what does “Like cures like” mean?
A: In homeopathy, the principle of “like cures like” refers to the use of dilute preparation of a substance that would produce the symptoms of the illness in a healthy person. Using the “like” substance is theorized to provide the body into a healing response to that same illness.
Q: What is Ayurvedic medicine? According to Ayurvedic medicine, what are the three basic life forces, or doshas?
A: Ayurvedic medicine is the indigenous, traditional medicine of India.
According to Ayurveda, there are basic life forces, or “doshas,” that determine a person’s unique constitution. These are the “vata” or air aspect for very energetic people; the “pitta” or fire aspect of aggressive people; and the “kapha” aspect of slow moving, conservative individuals.
Q: What is yin and yang?
A: According to traditional Chinese medicine (TCM), the universe is in constant dynamic interplay between the two forces of “yin” (the male, active, aggressive) and “yang” (the female, passive, receptive) energies, which need to be in balance to achieve individual, environmental, and spiritual balance and harmony.
Q. Are some medical therapies considered experimental in the United States but regarded as mainstream medicine in other countries?
A: Many medical therapies that are considered alternative in the United States are actually conventional medicine in other countries. For example, acupuncture has long been a standard medical procedure in China. In fact, given the populations of China and India, the vast majority of people in the world receive their medical care by interventions considered alternative here in the United States.
Q: What benefits does fasting have?
A: Among the benefits of brief fasting (three to five days) are short-term water weight loss, increased energy, modest long-term weight reduction, possible increased elimination of toxicity, and mood enhancement.
Among the dangers are dehydration, short-term malnutrition, possible arrythmias (which can be life threatening), irritability, light-headedness, fainting due to hypotension, and excessive urination. Any fast of more than one day should be undertaken with clinical supervision and expertise.
Q: What benefits does meditation have?
A: The primary benefit of meditation is relaxation and pain management. It also improves concentration, stimulates the onset of sleep, and reduces blood pressure. While meditating, the meditator experiences enhanced immunity for a brief duration. The meditator also may have an as enhanced response to UV treatment of psoriasis, as well as to treatment of painful menstruation, headache, and many other conditions.
In fact, meditation and relaxation therapies have the best scientific record for helping the broadest array of medical and psychological conditions for the largest number of people. The record for these therapies is better than that for any other complementary and alternative medicine (CAM) interventions.
Q. What is Complementary and Alternative Medicine (CAM)?
A. According to the Cochrane Collaboration, an international research group based in London and dedicated to evidence-based medicine (medical treatments that have undergone objective, rigorous scientific evaluation), CAM is defined as “diagnosis, treatment, and/or prevention which complements conventional medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy, or by diversifying the conceptual framework of medicine.”
Q: What conditions can homeopathic remedies treat effectively?
A: According to well-designed scientific studies, homeopathy appears to be effective at treating the following conditions:
- * respiratory infections
- * hay fever
- * peripheral circulation disorders
- * pain and trauma
- * swelling due to trauma or surgery
It is also a helpful aid in returning normal gastrointestinal function after bowel surgery. In addition, some evidence indicates that homeopathy may be helpful for depression, otitis in children, and diarrhea.
Studies have shown that homeopathy is not effective at treating plantar warts or osteoarthritis or at preventing flu or conjunctivitis.
Q: How does hypnosis work? Does it have medical applications?
A: Hypnosis is a state of focused attention similar to deep relaxation. The exact mechanism of the state of hypnosis remains unknown. Either under the direction of a clinician/hypnotist or through self-hypnosis, an individual can learn to focus on specific inner sensations that are positive while withdrawing the attention from negative internal sensations or thoughts, such as pain and anxiety.
Hypnosis is used in medicine to help patients achieve self-control over conditions such as drug and cigarette addiction, acute and chronic pain, and an array of psychological conditions, including sleep onset insomnia and depression.
Q. What is the difference between a Doctor of Osteopathy (D.O.) and a Doctor of Medicine (M.D.)?
A. Doctors of Medicine (M.D.s) and Doctors of Osteopathy (D.O.s) receive virtually identical training, and both are equally licensed in all 50 states. In their medical practice, D.O.s generally place a greater emphasis on manipulating the muscles and skeleton than M.D.s do. D.O.s also tend to emphasize herbal medicines and methods that influence the biological energy fields in the body.
To learn more about the differences between these two types of physicians, review Encarta’s article on Medicine. The American Medical Association promotes professionalism in medicine and sets standards for medical education, practice, and ethics. The American Osteopathic Association advances the philosophy and science of osteopathic medicine through research and education.
Q: What is Mind-Body Medicine?
A: Mind-body medicine focuses on the interaction between the mind and physical responses in the body. Emotions such as stress or depression can have a debilitating affect on health, affecting the body’s ability to fight off disease. Likewise, a chronic disease can affect mental outlook, causing emotional ills such as stress, depression, or loneliness. The scientific name for this type of medicine is psychoneuroimmunology, in which psycho refers to the mind, neuro refers to the brain and nervous system, and immunology refers to the body’s response to infections.
Mind-body medicine uses therapies that help improve both mental and physical well-being. Therapies may be used to help boost the body’s infection-fighting abilities. These therapies include meditation, visual imagery, and group support that improves mental outlook while diminishing anger, pessimism, or anxiety. Mind-body medicine may use placebos, drugs that contain no active ingredients. Placebos can provide patients with a positive psychological effect, which in turn results in lessened disease symptoms. Healing techniques from other cultures, such as acupuncture, yoga, and herbal medicines, may also be used.
Q. In acupuncture, what is moxibustion?
A. Moxibustion is an acupuncture procedure that uses a dried herb, commonly known as moxa or mugwort. This herb is burned so that the heat from the herb is transferred to specific points on the body to tonify (increase the energy) along the body’s meridians (lines of subtle energy that flow on the surface of the body). Like acupuncture, moxibustion activates a patient’s natural power to heal.
Q: What is naturopathy? What type of therapy does it use? How are naturopaths trained?
A: It should be noted that naturopathy is not the same as homeopathy. Naturopathy is a clinical specialty that emphasizes the use of natural products in both prevention and treatment of disease. It is founded on six basic principles:
- * Nature has the power to heal
- * Treat the whole person
- * First, “do no harm”
- * Identify and treat the cause of the disease
- * Prevention is as important as cure
- * Doctors should be teachers
Naturopathic doctors (NDs) use many forms of therapy including therapeutic diets, fasting, herbal supplements, hydrotherapy, psychotherapy, stress management, massage and other physical manipulation therapies, and homeopathy. In certain states NDs can perform minor surgeries and prescribe specific conventional medicines such as antibiotics.
Naturopathy appears to be effective in treating the following:
- * asthma
- * osteoarthritis
- * cardiovascular disease (CHD)
- * hypertension
- * benign prostatic hypertrophy
- * diabetes mellitus
- * irritable bowel syndrome (IBS)
- * premenstrual syndrome (PMS)
- * vaginitis
- * eczema
It is also effective for other chronic and acute conditions, and in promoting weight loss.
Naturopaths do treat cancer and usually work in conjunction with conventional oncologists. ND approaches with cancer patients include fasting, therapeutic diet, hydrotherapy, herbal medicine, and stress management. Despite clinical cases claiming efficacy, there is no research clearly demonstrating naturopathy to be effective in any form of cancer treatment.
There are very few rigorous, placebo-controlled, clinical trials (RCTs) of naturopathy, and therefore the scientific basis for the clinical efficacy of naturopathy is weak. However, there is an extensive clinical case report basis for ND practices.
Given this lack of general research in naturopathy and the fact that scientific journals generally publish fewer “negative outcome” studies (in which the intervention does not work), there is a virtual absence of any scientific documentation and research of what does not work in naturopathic medicine.
Naturopathic physicians receive training leading to a Naturopathic Doctor (ND) degree. Overall, the training is similar to conventional medical training in the basic biomedical sciences but has a greater emphasis on herbal and other natural therapies. In some states, such as Washington, naturopaths can prescribe certain conventional medications such as antibiotics. In other states, such as Connecticut, NDs are recognized as primary care providers, while states such as California do not license NDs to practice.
Q. What is the National Center for Complementary and Alternative Medicine (NCCAM)?
A. The National Center for Complementary and Alternative Medicine (NCCAM), established within the National Institutes of Health (NIH), has the objective of researching a vast array of alternative medicine interventions to determine their safety and efficacy. NCCAM defines complementary and alternative medicine as “those treatments and health-care practices not taught widely in medical schools, not generally used in hospitals, and not usually reimbursed by medical insurance companies.… Some approaches are consistent with physiological principles of Western medicine, while others constitute healing systems with a different origin. While some therapies are far outside the realm of accepted Western medical theory and practice, others are becoming established in mainstream medicine.”
Q. Do practitioners of acupuncture use only needles in their treatments?
A. Practitioners of acupuncture use various needles in their treatment as well as massage, herbal remedies, and considerable psychological and emotional counseling.
Q. Can acupuncture relieve the pain caused by rheumatoid arthritis?
A. According to the National Institutes of Health, there is good scientific evidence that acupuncture can have a positive effect on rheumatoid arthritis. Acupuncture has also been found effective in treating over 15 common medical conditions, including fibromyalgia, carpal tunnel syndrome, headache, and asthma.
Q. What conditions can Reiki therapy treat?
A. Reiki is a form of massage and subtle biological energy manipulation. There is some preliminary evidence that Reiki may relieve the pain of neurological damage caused by diabetes mellitus. Ongoing research is investigating if Reiki can help patients make a faster recovery from open-heart surgery.
Q. Do any medical schools in the United States teach alternative medicine therapies?
A. Over half of the approximately 144 medical schools in the United States that offer degrees in medicine (M.D.) or osteopathy (D.O.) teach courses in alternative medicine and/or courses on specific complementary and alternative medicine (CAM) practices, such as acupuncture.
For more information about medical schools offering medical degrees, the Association of American Medical Colleges offers a listing of medical schools by their location. The American Osteopathic Association also provides a list of its medical schools offering doctor of osteopathy (D.O.) degrees.
Q: What do chiropractors do? What conditions do they treat?
A: Chiropractic medicine is an approach that is derived from the Greek roots “cheir,” meaning hand, and “praxis,” meaning practice, and was formulated by the founder of chiropractic, Daniel David Palmer, to mean “done by hand.” The emphasis in chiropractic is on the use of physical manipulation or adjustments to correct misalignment of the spinal vertebrae and other musculoskeletal joints to improve the function of the related organs and musculature.
The main treatments used by chiropractic physicians are adjustments, or physical manipulation of the musculoskeletal system. Chiropractors also use heat and/or cold therapy, immobilization (with splints, for example), hydrotherapy, ultrasound, and massage.
Chiropractic treatments can help lower back and neck pain, as well as general musculoskeletal pain. It is less certain if they help headaches.
Chiropractic interventions are generally not effective for hypertension, immune function stimulation, enuresis or bed-wetting, chronic asthma, infant colic, and otitis media in children.
Chiropractic physicians receive training in the basic biomedical sciences but with a greater emphasis on the spine and musculoskeletal system. Training occurs at an accredited school of chiropractic medicine over a period of four years and leads to the DC (Doctor of Chiropractic) degree. Chiropractic physicians are licensed to practice in every state in the United States, and chiropractic is one of the alternative medicine therapies most commonly used by the general public.
Q: What is reflexology? What conditions can it effectively treat?
A: Reflexology is a form of massage that focuses on certain “trigger” or “reflex” points in the muscles and tendons. Through a focused massage at these trigger points, the reflexology therapist releases physical tension and psychological issues that arise.
Although there is virtually no research on reflexology per se, many conditions respond well to massage therapies, including general pain, musculoskeletal trauma, and low back pain. Massage therapies are also helpful for rehabilitation, lymph node drainage (post-mastectomy), general relaxation, and general psychological well-being.
There are no studies demonstrating any conditions for which reflexology is not effective.
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