Alternative and Complementary Medicine Dr Monem Alshok 21\5\2016 The CAM Domains Biologically Based Therapies Using substances found in nature, such as herbs, foods, and vitamins. • Herbalism, Nutritional Counseling and Folk Medicine Aromatherapy “involves the use of essential oils (extracts or essences) from flowers, herbs, and trees to promote health and well-being.” CAM Modalities Now in Mainstream Medicine Codeine for pain Digitalis for heart failure Ipecac for poisoning Quinine for malaria Aspirin for fever Behavioral therapy for headache Hypnosis for smoking cessation Low fat, low cholesterol diets Exercise for diabetes Support groups for breast Ca Herbs When a plants or products made from them , can have a powerful impact on our bodies and when plants are used for such effects rather than as food , they are called Herbs Dietary Supplements: Definition Product intended to supplement the diet Contains one or more of the following: Vitamin Mineral Herb or other botanical (not tobacco) Amino acid Any other dietary substance For oral intake as a concentrate, metabolite, extract, constituent, or combination Challenges of Herbal Medicines & Adverse effects Safety is assumed, not proven e.g Cabbage causes goiter ,some plants are poisonous ( Herb Tea ) Lack of product standardization Contamination with drugs, heavy metals Allergic reactions Inherent toxicity Interactions with drugs Replacing proven therapies Useful Herbal Products Echinacea Saw Palmetto Ginkgo Milk Thistle Ginger Chamomile Fever Few St. John’s Wort Hawthorn Soy Kava Black cohosh Green tea Cranberry Yohimbe Valerian Garlic immune stimulant BPH circulation liver nausea indigestion migraine mild/mod depression heart/circulation menopause symptoms anxiolytic menopause symptoms stimulant (antioxidant) UTI prevention erectile dysfunction Sleep Disorders Hyperlipidemia Probiotics: definitions World Health Organization: “live microorganisms which when administered in adequate amounts confer a health benefit on the host” A bacterial strain that: Survives the stomach acid and bile Adheres to intestinal lining Grows and establishes temporary residence in the intestines Imparts health benefits R Fuller. Probiotics: The Scientific Basis. London: Chapman and Halls. 1992 Probiotics Lactobacillus sp. reuteri casei ramnosus acidophilus Streptococcus sp. Bifidobacterium sp. infantis lactis longum breve bifidum Sacharomyces boulardii (non-human) Prebiotics: Sources, Side effects: Sources: breastmilk, barley, bran and whole grains, legumes, such as beans; vegetables such as leeks, onions, asparagus, greens such as chicory, spinach, fruits such as bananas, berries Doses: 1 – 2 grams daily (adults) Side effects: flatulence, diarrhea, allergies Probiotics Colonization at birth Similar to maternal species Specific organisms vary by age in first year Become established by 1 year In children and adults, “Successful” treatment with probiotics leads to temporary colonization only Probiotics: proposed mechanisms Adherence and subsequent stimulation of gut immune system Up-regulation of mucin gene Enhance secretory IgA Maintain normal macrophage function Competition for essential nutrients Production of antimicrobial factors Provide favorable environment for growth of other beneficial bacteria Production of short-chain fatty acids with anti-inflammatory properties Case A 13 year old recently diagnosed with osteogenic sarcoma says she’s having trouble sleeping. She doesn’t want any more meds. Valerian ( Root of Nardin ) Herbs Herbs Action African plum BPH Fenugreek seed Sexual stimulant for female , increase milk and breast size Garlic & onion IHD , lipids , platelets& protection against GIT cancers Pumkin oil Antiworms & BPH Rocket oil Body tonics for men Aloe Vera oil Topically for sunburn & psoriasis & orally as laxative Chamomile Dyspepsia , tension , immunity St. John Wort Depression Gripe Water Traditionally – dill extract ± bicarbonate (Woodard’s™), ± alcohol; Dill, fennel and caraway are spasmolytics Some include ginger, fennel (Baby’s Bliss™), chamomile, cinnamon and other herbs (Wellements™) Ginger for Nausea Numerous RCTs suggest benefits of ginger in preventing and treating nausea Irritable bowel syndrome (IBS) A 17 year old with a diagnosed by your partner as having irritable bowel syndrome says he read on the Internet that peppermint might help him. Should he eat more candy? What’s the evidence? IBS - Peppermint Peppermint (Mentha piperita); primary ingredient, 29% - 48% menthol Uses: many digestive complaints, including colic, flatulence, diarrhea, dyspepsia, indigestion, nausea and vomiting Relaxes smooth muscle and slows GI transit Fiber for constipation It depends (dried fruit anyone?) Fiber is safe if taken with sufficient water; no intestinal obstruction; no allergies Bran Psyllium (Plantago. ovata and P. psyllium) Flax seeds also contain lignans and omega three fatty acids Side effects: flatulence, abdominal pain, diarrhea, dyspepsia, nausea Herbal remedies for stress-related abdominal pain Chamomile (Matricaria recutita) recommended by Peter Rabbit’s mother Contains flavonoids, antiinflammatories, spasmolytic compounds Listed on formularies of 25+ countries Approved by German Commission E to treat abdominal spasms and inflammatory diseases of the GI tract May combine with fennel, peppermint, lemon balm Side effects: allergies Licorice: Glycyrrhiza glabra Contains: glycyrrhizin, glycyrrhizic acid, polyphenols, and polysaccharides TCM ulcer remedy; newer HepC? Inhibits 11 beta-hydroxysteroid dehydrogenase + other enzymes involved in the metabolism of corticosteroids. → increased cortisol levels Anti-inflammatory and mineralocorticoid effects (BP, edema) Bromelain An enzyme derived from the stem of pinapple plant ( Ananos Comosus) may help reduce swelling & inflammation Cranberries juice Used to acidify urine and seems to make a more difficult for bacteria to stick to bladder wall Herbs used to immune system Black seed Echinacea Herbs Anise , Yansoon Sage , Thyme Z, Rosemary Ginger Chamomille بابوننك