Alternative Medicine Websites / in Windsor!

[Guest guest]

Greetings Listers: Here is some areas that each of you might want to explore on

Alternative Medications. It would seem that these sites plus parts of an

article I have copied might contain information.

Peace and Happy Searching

E. Darwent

altmed.od.nih.gov/

altmed.od.nih.gov/oam/cam/1997/oct/

This Is Medicine? Alternative Medical Web Sites

Author: Harry Goldhagen, SCP Communications, Inc.

Abstract

A large proportion of the US population believes that alternative approaches

to health care are safer and better than so-called Western medicine. This

survey looks at resources on the Web related to alternative medicine, including

herbal therapy, homeopathy, and acupuncture. [infect Med 15(5):309-313, 1998. ©

1998 SCP Communications, Inc.]

Introduction

During my last cold, I can't remember how many people told me to take

echinacea, but there were a lot. The assistant manager at the local health

food store suggested that I take this herb in capsule form ( " It's more

effective

that way " ) along with a dozen other herbs, minerals, vitamins, and a long list

of food supplements to " boost my immune system. " Friends and acquaintances

also prescribed goldenseal and zinc lozenges.

To many lay people, herbal therapy and numerous other types of so-called

alternative medicine are considered first-line treatment for many common

disorders--from arthritis to depression--despite almost no clinical data

supporting their efficacy. An expert panel convened by the National Institutes

of Health (NIH) estimated that 1 of 3 Americans uses some form of complementary

or alternative medicine, including acupuncture, homeopathy, and herbal

medicine.[1] Everything from aromatherapy and ayurvedic medicine to Rolfing and

mental imaging techniques is in vogue across the US.

Even if you are not a great believer in any of these approaches, it would be to

your benefit to at least know what your patients are talking about. For

instance, it would be helpful to know when patients with AIDS are taking herbal

preparations on top of their antiretroviral and prophylactic regimens, since

there is a large potential for many of the herbal remedies to interact with

prescribed medications in unexpected ways. After reviewing these Web sites, you

may not be able to tell your patients which is better, wheat grass juice or

spirulina, but this short list of some of the more informative alternative

medicine sites may come in handy.

Office of Alternative Medicine, NIH

Any serious search of the Web for alternative medicine must start at the

Office of Alternative Medicine (OAM) at the NIH (Fig. 1). The purpose of this

office is to evaluate alternative medicine therapies and determine their

efficacy, a rather difficult task in an area with few clinical trials, no

controlled studies, and different definitions of etiology and cure. In addition

to funding extramural research at leading institutions around the US, the OAM

has collected current references in acupuncture and chronic pain treatments,

downloadable slide presentations about the role of the OAM, and a clearinghouse

of documents related to alternative medicine. The list of frequently asked

questions (FAQs) provides clear definitions of many terms and provides other

useful information for practitioners interested in learning more. There are

links to press releases, and the full text of the consensus

statement on acupuncture can be found on this site. There is also a thorough

classification of alternative medicine approaches and techniques (Table I). (It

is interesting to note that psychotherapy has been recategorized from mainstream

psychiatry to alternative medicine.) Back issues of Complementary & Alternative

Medicine at the NIH, the OAM's quarterly publication (Fig. 2), are available on

the site, along with a search engine.

Herbs and Other Dietary Supplements

Herbs seem to be considered the magic bullets of alternative medicine. Some of

the claims made about herbs are reminiscent of snake oil advertising, promising

to cure or treat a broad variety of " septic " or " toxic " conditions. For example,

a discussion of echinacea from The Natural Planet Web site lists the following

indications: " It has been used by American Indians and herbalists for centuries

as a tea for internal help and externally as a poultice for boils, wounds, and

insect bites. . . . It appears from scientific investigation to have anti-viral

properties as well as antibacterial properties, making it extremely helpful in

lessening the severity and length of colds. Even though it boosts the immune

system and is good for bronchitis, one should not take it for long periods of

time. "

There is no denying that a number of pharmaceuticals were originally discovered

in natural products, from digitalis and aspirin to the most recently

FDA-approved plant derivative, yohimbine (from yohimbe bark, for treating

impotence). It is precisely because so many herbs contain active ingredients in

unknown and variable amounts that their use is so troubling. These drug

substitutes are not controlled by the FDA, their purity and content of active

compounds are widely variable, and the health claims associated with them are

only minimally regulated.

The FDA Home Page has a number of articles on dietary supplements, including a

brief but to-the-point overview; discussions about a few specific products that

have made the news in recent years because of serious side effects (including

ephedrine, DHEA, melatonin, and L-tryptophan); some FDA warnings about specific

products; and laws and regulations related to supplements. Unfortunately, the

FDA does not analyze or regulate the composition of dietary supplements,

although certain health claims must meet FDA rules and language requirements or

bear the following phrases: " This statement has not been evaluated by the FDA.

This product is not intended to diagnose, treat, cure, or prevent any disease. "

(Reminiscent of those psychic advisors who claim that their advice is for

" entertainment purposes only. " )

Most of the sites on the Web that discuss herbal treatments are either amateur

attempts consisting primarily of links to other sites or self-promotional

infomercials " for one or another herbal distributor. A site with the most

thorough descriptions of the hundreds of herbs and nutrients that are prescribed

in this form of medicine is the Natural Health and Longevity Resource Center. In

the Herbal Library you can find the full text for many books on herbology,

including indications and contraindications, toxicity information, and even

clinical forms. This site also contains a massive list of alternative medicine

Web sites, from Acupuncture.com to Yoga for HIV/AIDS, as well as discussion

groups, mailing lists, and, surprisingly, more conventional medical information

sources such as Reuters Health and Health Watch Web Site. If you are interested

in an alternative medicine topic not covered in this article, this is the place

to start searching.

One of the more attractive and somewhat balanced sites is Algy's Herb Page.

Some of the articles actually discuss the potential risks of using herbs,

including lists of poisonous and unsafe herbs. However, be prepared for a very

slow-loading site.

A listing of 30 commonly used herbs, with rather thorough descriptions of

supposed indications, can be found at KC Web--everything from alfalfa ( " useful

in the treatment of urinary tract infections " ) and cat's claw ( " boosts the

immune system " ) to feverfew (an aspirin substitute) and goldenseal ( " primarily

used to treat congestion and soothe inflammatory conditions of the mucous

membrane [sic] that line the respiratory, gastrointestinal, and digestive

tracts " ). KC Web also has similar information related to vitamins and other

nutritional supplements.

One site that I found fascinating is the Miavax site. Miavax is a homeopathic

concoction that is designed to treat " arthritis, fatigue, asthma, allergies,

digestive disorders, nervous disorders, infertility, acne, heartburn, hiatal

hernia, Lyme disease, candida, or general pain, " and to eliminate the " root

causes " of these diseases, including " parasites, bacteria, viruses, fungus,

miasm [sic], vaccination toxins, or toxins in general. " The list of ingredients

is certainly exhaustive (Table II). I was glad to see that echinacea was

included, since I felt another cold coming on during my research for this

article. A bottle of 120 tablets of Miavax (good for 30 days) cost $46 plus

shipping and handling, or $45 per bottle if 2 or more bottles are ordered.

Homeopathy

The art of homeopathy " is a therapeutic system of healing that uses plants,

animals, and mineral products in very small doses to stimulate a sick person's

natural defenses, " according to the authors at homeopath.com. The guiding

principle of homeopathy is " like cures like " or the " law of similars, " by using

substances in vanishingly small quantities that, in larger doses, induce

symptoms similar to those being treated. Supposedly, the substances, when

administered in these dilute forms, work with the body's " natural healing

process " rather than against it. Although I could not find the reference in

Medline, I believe the Amazing Randi, that magician-turned-exposer of con

artists, once participated in a controversial exposé of homeopathic drugs for

Nature magazine.

One very well-produced electronic journal is Homeopathy Online. This attractive

journal (Fig. 3), although published somewhat erratically, appears to cover

serious topics in a thorough, thoughtful way, with review articles, case

reviews, materia medica, and online discussions. Issue 5, published in January,

focuses on war and trauma; previous issues had themes of women's health (issue

4) and sequential therapy (issue 3). I reached Homeopathy Online through the

Homeopathy Home Page, a site from the UK that " aims to provide links to every

related resource available. " The creators of this list certainly seem to have

covered just about every

useful homeopathy-related Web site in the world, including the complete

translated text of Dr. Hahnemann's Organon of Medicine, the founding book of

homeopathy. (I learned from this site that homeopathy was founded by Dr.

Hahnemann, a German chemist, during the first half of the 1800s.) The

Reference Library at this site has at least 16 different books on various

homeopathic topics, most in full text. There is also a list of recent research

papers in the medical press, from journals such as The Lancet, The British

Medical Journal, Pediatrics, and The British Journal of Clinical Pharmacology,

with ratings of whether homeopathic treatment was positive or negative. Any

search of homeopathic resources should begin at the Homeopathy Home Page.

One quite beautiful site is the Alchemilla Journal (Fig. 4). Sponsored by the

Hahnemann Academy of North America, this site covers not only homeopathy but

also alchemy, astrology, and other ancient forms of medicine. Unfortunately, it

does not present much in the way of educational material; rather, it tries to

sell books about homeopathy. In fact, one needs to be wary of randomly

discovered homeopathic sites, since most of the ones I found through standard

search engines like Lycos either sold books or advertised the services of a

homeopathic practitioner.

Figure 4. (click image to zoom) Alchemilla Journal homepage.

[www.alchemilla.com/]

Acupuncture

Acupuncture is an ancient healing system with origins in China, Japan, and

other parts of Eastern Asia. According to the British Acupuncture Council, " The

practise of acupuncture is thought to have begun with the discovery that the

stimulation of specific areas on the skin affects the functioning of certain

organs of the body. It has evolved into a system of medicine that restores and

maintains health by the insertion of fine needles into acupuncture points just

beneath the body surface. These points are in very specific locations and lie on

channels of energy. Moxibustion, the warming of acupuncture points through the

use of smouldering herbs, is often used as a supplement, and the needles may

also be stimulated using a small electric current. "

Of all the alternative approaches to medicine, acupuncture has been studied

the most. A quick search of Medline for 1995-1998 found 227 papers in English

with the word acupuncture in the title, with topics ranging from nonallergic

rhinitis and chronic pain syndromes to osteoarthritis and gastroptosis.

Acupuncture.com (Fig. 5) is a good first stop for information. On this site is

a

basic list of FAQs, basic information about acupuncture, a listing of

acupuncturists around the world, resources for practitioners and students, and

recently added discussion groups and news sections. One paper on this site,

entitled " Some Thoughts on Efficacy Beyond the Placebo Effect, " by Ted Kaptchuk,

OMD (Associate Director of the Center for Alternative Medicine Research at

Harvard Medical School), provides some interesting perspectives that can help

the standard practitioner understand this approach to treatment as well as the

nature of clinical trials in alternative medicine. (I must admit that I disagree

with the author, who believes that " satisfaction surveys " and " performance

efficacy " trials are more accurate than placebo-controlled clinical trials for

determining the efficacy of

acupuncture.) The list of research on this site related to acupuncture is

extensive but quite variable, with everything from herbal formulas for anemia

and chronic fatigue to reports of clinical trials from the general medical

literature.

Figure 5. (click image to zoom) Acupuncture.com homepage. [Acupuncture.com/]

The Acupuncture Home Page, a British Web site created and maintained by the

Foundation for Traditional Chinese Medicine, also has some basic information

about the practice of acupuncture. The page listing conditions that acupuncture

treats has a surprisingly extensive list of disorders, including upper

respiratory tract infections, toothache and other disorders of the mouth,

gastrointestinal syndromes, eye diseases, and many neurologic and

musculoskeletal disorders. The resource list at this site is useful although

aimed more at the British clinician.

Summary

Alternative medicine is more than just a passing fad. A large proportion of the

US population believes that alternative approaches to health care are safer,

better, " healthier, " better for the environment, and, overall, the preferred

method for healing compared with standard " Western " medicine. Clinicians need to

know about these alternative systems, at the least to understand what their

patients are talking about.

Acknowledgments

Thanks to T. Sinnott IV, MD, and the members of the Infectious Diseases

Department at Tampa General Hospital for valuable comments during a talk on this

subject.

About the Author

Mr. Goldhagen is Managing Editor of INFECTIONS in MEDICINE. He is currently

feeling much better since his last cold.