MDs bone up on remedies once scorned

Julie Deardorff
http://www.chicagotribune.com

Tagging along with the holidays come ailments that challenge most Western doctors: stress, back and joint pain, head colds, heart attacks, anxiety, depression, upset stomachs and insomnia.

Is it time to try acupuncture, hypnosis, meditation, guided imagery and massage?

Surprisingly, even the most conservative mainstream research hospitals now answer “yes!”

Twenty years ago, the mind-body connection was largely dismissed by U.S. doctors as a wacky concept in healing. Today it’s a staple of integrative medicine, the discipline that blends complementary and alternative medicine (CAM) with conventional treatments and places more emphasis on treating the whole person.

About 75 percent of medical schools now have some CAM courses in the curriculum, and the Consortium of Academic Health Centers for Integrative Medicine includes 39 academic health centers, including the Mayo Clinic plus Harvard, Stanford, Columbia, Duke and Yale Universities.

To help doctors catch up on the growing body of evidence-based research on CAM therapies, the University of Chicago’s Tang Center for Herbal Medicine Research and the Mayo Clinic last weekend co-hosted the annual Conference on Complementary and Alternative Medicine.

The encouraging thing is that CAM treatments require self-care,” said Brent Bauer, director of the Complementary and Integrative Medicine Program at the Mayo Clinic. “It’s a supplement to what the doctor is doing; the patient is working together with the doctor in a partnership. This is not ‘Let’s wait till it breaks and then fix it.'” The three-day seminar, which drew more than 250 doctors, nurses and other health practitioners to Chicago’s Drake Hotel, focused on herbal, food and dietary supplements and CAM therapies for common medical conditions, including obesity, stress and heart disease.

Here are some highlights:

Weight loss

CAM treatments are popular weight-loss options, but only chitosan, chromium, conjugated linoleic acid (CLA) and calcium have shown positive effects, and these were modest, said Todd Brown, a specialist in endocrine and metabolic diseases at Johns Hopkins University. There is no data on the cactus Hoodia gordonii.

Heart disease

A Mediterranean-style diet is the best eating plan for patients with coronary heart disease. It includes fruits and vegetables, at least two servings of fish per week, the use of liquid vegetable oils, such as flaxseed, and a decreased intake of saturated fat, said Matthew Sorrentino, a non-invasive preventive cardiologist at the University of Chicago. A Mediterranean diet in conjunction with statin therapy has been shown to be more effective than statin therapy alone.

If you have had heart trouble, supplement your diet with omega-3 fatty acids, Sorrentino said. Though more evidence is needed for the optimal dose, the American Heart Association recommends getting 1 gram of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day, either by eating fatty fish such as salmon, mackerel, herring and trout or taking fish-oil supplements. (Shoot for 180 milligrams of EPA and 120 milligrams of DHA). If the supplement causes fish burps, try freezing the capsules, Sorrentino said.

Irritable-bowel syndrome

Doctors have long considered irritable-bowel syndrome to be a non-inflammatory disease, but “that’s wrong,” said Gerald Mullin, director of Integrative Gastrointestinal Nutrition at the Johns Hopkins Hospital, who adds that stress is the trigger for many gut diseases. Mullin suggests a combination treatment approach including exercise, probiotics, some herbs (including peppermint oil, but watch out for reflux) and ginger. Mind-body approaches, including yoga, meditation, hypnosis and behavioral therapy, are backed by the strongest data. Melatonin and herbs such as valerian, lemon balm and camomile can cut down on stress and should be considered. “It would also help to have a better attitude and not be so angry at the world,” Mullin said.

Stress

Doctors should respect stress and its link to illness, said Brent Bauer, director of the Complementary and Integrative Medicine Program at the Mayo Clinic. Up to 80 percent of the doctor visits in the U.S. are triggered by a stress-related illness, but several CAM therapies have good efficacy and low risk, including yoga, acupuncture, massage, spirituality, meditation and music therapy and hypnotism.

“Hypnotism has gotten a bad rap, but when you look at the data, it’s actually pretty good,” he said.

Smoking cessation

Hypnotism also is worth considering if you’re trying to quit smoking before Illinois’ ban takes effect in January. Meanwhile, Mayo Clinic researchers are looking at whether chocolate enriched with theanine, an amino acid commonly found in tea, can help people break the habit. Another study will examine whether paced-breathing meditation can be used as adjunct therapy for smoking cessation. Studies have shown that taking just six long breaths per minute has a positive physiological effect.

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Do they work?

These are some alternative remedies doctors are looking at closely.

WEIGHT LOSS

Chitosan, chromium, conjugated linoleic acid and calcium

HEART DISEASE

A Mediterranean-style diet

IRRITABLE-BOWEL SYNDROME

Exercise, probiotics, peppermint oil and ginger

STRESS

Yoga, acupuncture, massage, spirituality, meditation, music therapy and hypnotism

SMOKING CESSATION

Hypnotism, chocolate, paced-breathing meditation
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