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What is CAM
Complementary/integrative- generally
refers to using a non-mainstream
approach ________ ______conventional
medicine
Alternative- refers to using a nonmainstream approach
________conventional medicine
True alternative medicine is not common
Integrative Medicine
Combines mainstream medicine with CAM
It is the growing trend among providers
and healthcare systems
The scientific evidence is limited but
growing- a lack of reliable data makes it
difficult for people to make informed
decisions about integrative care
What is CAM?
According to the Office of Dietary (ODS)
Supplements
Dietary supplements and Herbals are the
most commonly used CAM products.
Consumer spending on dietary supplements
and herbals far exceeds research dollars
Consumer Spending in 2007 $34 Billion
Homeopathy
Comes from two Greek words
-homoios(similar)
-pathos(suffering or disease)
Based on like cures like or the law of
similars
If a substance produces the symptoms of an
illness in large doses, the same substance
can cure it in very small doses
Homeopathy
The more dilute a homeopathic medicine
is, the greater the potency
The efficacy of these medicines is
believed to depend on the dilution factor
and the vigorous shaking (succussion)that is performed with each dilution
Homeopathy
Typically used to treat existing illness
An exception: Oscillococcinumhomeopathic preparation derived from
wild duck heart and liver- used to prevent
and treat influenza
Regulations
FDA regulates homeopathic medicines as
products recognized in the official United
States Pharmacopoeia (USP),
Homeopathic Pharmacopoeia of the
United States (HPUS), or National
Formulary (NF)
Safety/Evidence
Evidenced has not been demonstrated in
clinical trials
Cochrane Database of Systematic
Reviews suggest effects are similar to
placebo
For most products, toxicity is low-due to
extreme dilute nature
Naturopathy
A philosophy of life and an approach to
living that encourages lifestyles and
therapies as close to nature as possible
Focuses on building health than treating
disease
Naturopathy
Nutritional counseling and support are
major components of treatments
Use therapeutic manipulation of muscles,
bones, and spine
Use hypnotherapy, biofeedback therapiesaid in psychological wellbeing
Methods- considered to be safer than
conventional drugs
Examples of herbs
Monascus purpureus fungus- found in red
yeast rice- a natural source of lovastatin
Syzygium claviflorum- class of drugs
called maturation inhibitors in clinical trials
for HIV
Acupuncture TCM
Acupuncture is regarded as more of a
Supportive treatment
Cupping- Use rapid skin pinching at
points in the back to break up congestion
and stimulate circulation
Moxibustion- burning of dried moxa, either
near or on the skin
Acupuncture TCM
Meditation and martial arts are also used
in TCM
Tai chi is practiced for improved balance,
coordination, and relaxation and over wellbeing.
Feng Shui are of arranging furniture to
increase health and prosperity
Safety
Acupuncture: avoid in patients with heart
disease, diabetes, seizures, infections,
bleeding disorders, or neurologic
disorders or patients on antithrombotic
drugs
Cupping and moxibustion may leave
temporary discoloration or even scars
Be careful with herbs! Ma huang or
Chiropractic Care
Chiropractic focuses on the relationship
between spinal structure and body
function mediated by the nervous system
Comes from the Greek words cheir(hand)
and praxis (practice)
Spinal manipulation or adjustment does
not define the profession: also provide
advice on diet, exercise, physician therapy
and rehab
Chiropractic
Diagnosis includes X-ray, computed
tomography, magnetic resonance imaging,
electrical current, and ultrasound therapy.
Thermography may also be used with ice
packs and heat packs.
More than 100 chiropractic and spinal
manipulative adjusting techniques may be
employed.
Chiropractic Care
Chiropractic is now one of the largest and
best-established professions of CAM in
the US.
The safety of chiropractic is controversial.
Adverse effects include arterial dissection,
myelopathy, vertebral disc extrusion and
epidural hematoma.
Ayurveda
Ayurveda originated in India more than
5000 years ago is the worlds oldest
system of natural medicine
Ayurveda means the science of life
The goal of Ayurveda is to achieve optimal
health on physical, psychological, and
spiritual levels.
Ayurveda Technique
Vital energy (prana) is the basis of all life
and healing
Prana circulates throughout the human
body and is governed by:
-earth
-air
-fire
-water
-ether
Ayurveda Technique
The regulation of ______ as a form of
therapy is central
Important principle- there is nothing in the
world that is not a food or medicine
Foods and herbs described for energy
properties rather than chemical properties
Also believe there are certain time periods
to consume food that correspond to nature
Herbs and spices are used: turmeric and
cumin
Safety
Ayurvedic herbs- depends on which herbs
and the preparations of the product
Therapeutic levels of sildenafil (Viagra)
have been found in aphrodisiac products
Found to have contaminants such as
arsenic, mercury, and zinc- 12 cases of
lead poisoning in US in early 2000s
Products with USP seals of approval of
quality should not contain unacceptable
levels of metals
Massage
Soft tissue manipulation has been
practiced for thousands of years.
Massage is the fifth most common CAM
therapy in the US.
It is safe and does help lower blood
pressure.
Dr. Oz
Oprah
Mens Health
Womens Health
Is it government sponsored?
Is it sponsored by a national organization?
Is it sponsored by the investors?
Asks or pays
Meet certain criteria
Collect fee
Tailor the information for your needs
References
Office of Dietary Supplements, National
Institutes of Health
http://ods.od.nih.gov/Research/Annual_Bib
liographies.aspx
Top research from peer reviewed journals
published annually
References
National center for Complementary and
Alternative Medicine (NCCAM)
http://nccam.nih.gov/
-up to date literature on NCCAM funded
studies on CAM therapies
References
ConsumerLab.com,LLC
http://www.consumerlab.com/index.asp
Independent testing and information on
nutrition products
References
HerbMed
http://www.herbmed.org
Online herbal database
Links to categorized summaries of
research studies
Contains information on the use of 30
herbs
References
Natural Standard
http://www.naturalstandard.com/
- Tertiary resource on dietary supplements
and herbals
- Has summaries on the available literature
and evidence on natural products
References
Vickers, A, Zollman C. ABC of
complementary medicine. Massage
therapies. BMJ. 1999;319(719):1254-7
Merrell WC, Shalts E. Homeopathy:what
does the best evidence tell us? Med J
Aust. 2010;192:458-60
Sutian s, Zhang J, Louise W. New
exploration and understanding of TCM.Am
J Chin Med. 2009;37-411-26