Category Archives: CAM Education

CAM Education, Herbals

The importance of defining the active ingredients in herbal medicines

The Handbook of Clinically Tested Herbal Remedies is an excellent reference source on herbal medicines. Writing in the International Society for Complementary Medicine Research Newsletter (go here and click the volume 2 number 4 issue), the reviewer states that editor Marilyn Barrett and her contributors, “take a rigorous look at both the nature of the herbal evidence base, and how it [the evidence base] is and should be generated.”

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CAM Education, Flavonoids (Soy), Menopause

Use of soy and herbals to treat menopausal symptoms

“More than half of women who treat their symptoms of menopause take soy supplements or herbal products as part or all of their therapy.” states The New York Times, which reported on a recently published article in the journal Menopause.

However, the women in this online survey generally felt illinformed about proper doses and use of herbal products.

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CAM Education, Diabetes Mellitus, Diet-Nutrition, Exercise, Metabolic Syndrome, Stress

A problem endemic to clinical medicine: treating the symptoms, not the cause

Here’s a series of quotes from the October (Volume 12, 2006) editorial in Alternative Therapies in Health and Medicine that I think contrasts the points of view between alternative and mainstream medicine today. Is the alternative perspective too esoteric to be of practical value? Or is the mainstream approach (for chronic diabetes for example) destined to come up short? Or is the answer somewhere in the middle?

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CAM Education

A core curriculum for CAM and allopathic practitioners

The Sixth U.K. House of Lords Science and Technology Report was published in 2000. It covers basic information on CAM. However, the section that interested me was on professional training and education.

Ultimately, the goal for CAM should be its integration into mainstream, allopathic medicine, according to the Report.

OK. But shouldn’t contemporary medicine be integrated into current CAM disciplines, as well? Patients benefit most when all healthcare providers understand the potential and limits of all available treatments.

Here are highlights of the Report’s recommendations on training and education. Again, these recommendations should apply to CAM and mainstream medicine training programs.
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Art, Music, Dance, CAM Education, Chelation, Chiropractic, Osteopathic

The Quick-and-Dirty Guide to Complementary Therapies

In 1995, the American Medical Student Association prepared an introductory guide to complementary medicine.

It is available online at no charge. And it’s still the first place to turn for introductory information on everything from art therapy, to osteopathy, chiropractic, chelation therapy, and more.

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CAM Education, Heart Disease, Herbals, Kidney Disease, Liver Disease, Rosemary, St. John's Wort

Cyclosporine, herbals, and immunosupressive therapy

Cyclosporine (Sandimmune, Neoral) is used to prevent organ rejection following kidney, liver, and heart transplants. It may also be used to treat chronic rejection in patients previously treated with other immunosuppressive agents.

The information in this article should be valuable for people taking cyclosporine for its immunosuppressant effect, and for pharmacists and other healthcare professionals who are monitoring this therapy.

Interactions between cyclosporine and St. John’s wort and rosemary are discussed. In addition, it reviews the purported immunostimulating effects of certain herbals and herbal medicines that are potential nephrotoxins.

Illustration: University of Texas

8/11/06 20:38 JR

CAM Education, Homeopathy

Homeopathic medicine: Bucking the trend

Homeopathy is at odds with two powerful trends in today’s culture: sooner is better than later, and the more the better. First, homeopaths claim that patients need at least one month of active treatment for every year of illness. Second, treatments are undertaken using minute concentrations (1:50,000) of remedies.

Then, there is one more difference from conventional mainstream medicine that poses a problem for practitioners and researchers of homeopathic treatments.

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Ayurveda, CAM Education, Common Cold

Ayurveda: Struggling within itself

It’s easy to be critical of ayurveda ? a “natural healing system” developed in India. The immediate problems, from a Western perspective, include lack of standardization and reported toxicity (particularly lead poisoning).

But there’s more. “The problem lies in the crisis of confidence both within and outside the ayurvedic community, and it is here that the future efforts need to be concentrated in order to effect a revitalization.”

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CAM Education, CAM Politics

Wyeth questions the role of pharmacists to compound HRT

 In April, Wyeth Labs renewed its request (submitted last October) for increased FDA regulation of compounding pharmacies that prepare hormone replacement therapy (HRT). Wyeth markets the HRT called Premarin and asserts that the HRT medicines prepared by compounding pharmacies can pose serious health risks.

Here is some historical perspective. Prior to the 1950s, when commercially prepared drugs became widely available, compounding prescriptions to be taken by mouth or inserted rectally was the main function of community pharmacists. In fact, as late as the 1970s (at least in New Jersey), compounding was part of the licensing exam for pharmacists.

In the 1970s, with the advent of total parenteral nutrition, preparation (compounding) of injectables increased by hospital pharmacists. In the 1980s there was a resurgence of compounding in community pharmacies.

In an excellent review, Dr. David Newton states, “Since the early 1990s, most national pharmacy practitioner organizations have asserted compounding is an intrinsic professional practice to be regulated by state boards of pharmacy.” The FDA usually defers to state boards to oversee this practice. Yet, state boards lack inspectors to enforce compounding practice standards, and most boards of pharmacy do not examine the compounding proficiency of their licensure candidates.

The implications of Wyeth’s anticompetitive petition according to the International Association of Compounding Pharmacists, is the “end to the option of prescribing bio-identical hormone replacement therapy for those patients that need it.”

The FDA is reviewing Wyeth’s request.

7/16/06 10:40 JR

CAM Education

When is a side effect not a side effect?

Cultures around the world differ in what is considered a side effect (SE) that is important enough to report to a doctor during treatment or by a researcher during a clinical trial. Here are first-hand examples of what I mean. At the end I’ll explain why these differences are important.

SEs in Germany: The diabetes drug Precose (acarbose) was first tested in Germany, then marketed in Japan, and finally tested and marketed in the U.S. My first experience was in writing articles about Precose for Japanese doctors.

The German data indicated that flatulence was a known SE, but not a major problem. Yet, when it was finally studied and marketed in the U.S., flatulence was so severe that it prevented most people from taking Precose for any length of time.

Frustrated, the U.S. product manager eventually asked his German counterparts why their data never identified flatulence as a serious problem. They answered that in German trials, reported SEs came from patients who completed a study. Well, of course these were patients not bothered by flatulence, and thus the reported incidence was low. It ignored all patients in Germany who discontinued treatment because of SEs, such as flatulence.

SEs in the U.S.: U.S. studies report SEs on all patients who participate even for one dose. Therefore, there is likely to be a discrepancy between what is reported in a U.S. vs. German clinical trial. (My experience goes back more than 10 years, and it is possible that German clinical trial design has changed since then.)

SEs in Japan: My experience in obtaining SE data from Japanese studies is based on experience with photodynamic therapy. At the request of the U.S. Food and Drug Administration, a company sent me to Japan to collect safety data on this treatment. To my surprise, Japanese research reports listed almost no SEs. I later learned that Japanese patients were loath to report SEs to their doctors, because it was a sign of disrespect. Well, semasen goziemas, as Steve Martin used to say.

In a previous post I reported the position of the World Health Organization regarding the safety of herbals. I hope this explains why we should be dubious of this position.

7/14/06 14:18 JR

CAM Education, Meditation

Transcendental meditation in the classroom

David Lynch (The Elephant Man, Twin Peaks, and others) is funding the inclusion of TM in the classroom. The July/August 2006 issue of AARP The Magazine (Yes, I am a member.) reports his foundation has launched or is planning to launch meditation programs in six cities.

According to Mr. Lynch, “In the classroom where meditation is taught, you’d see students much happier, much brighter, eager to learn.”

It sounds like a good idea to me, but when you add new activities to a fixed time period, what is lost? Not reading, writing, and arithmetic, I hope.

7/1/06 10:00 JR

CAM Education, CAM Politics, Herbals

Treating herbal products as medicines in Spain

The latest issue of Functional Foods & Nutraceuticals e-newsletter is out. In it, we learn that Spanish authorities treat herbal products as medicines. They require such products to be withdrawn from the market and to obtain medicinal marketing authorizations.

In contrast to this, the European Commission considers that the absence of adequate procedures to assess the risk to public health that such products allegedly pose is an unjustified barrier to trade.

As a result of complaints from companies that want to market herbals in Spain, the European Commission is pursuing infringement procedures against Spain for hampering the free movement of goods in the market.

6/29/06 21:22 JR