Complimentary and Alternative Medicine

In an effort to take break from the HIV chapter, I started to read about back pain, but then found that fairly dense so I read the CAM chapter so I could cross another one off the list.

CAM encompasses things like herbal remiedies, acupunture, massage, homeopathy, etc. Homeopathy sounded kinda hokey to me since it involves giving things that cause side effects in very dilute doses. It was first proposed by Samuel Hahnemann - and I wonder if he is the namesake behind my medical school. Anyhow, the whole idea is that if a substance causes side effects in a well person, it can be used to cure illness in minuscule amounts. Sounds absurd, but this formed the foundation behind immunization and allergen desensitization. When they mentioned that, I realized that I make use of it myself all the time: with lactose. If I stop drinking milk for more than a week or so, the next time I have it, I get sick. But if I have milk every day, there aren't too many problems.

Other notable facts:
- gingko bilboa prolongs bleeding times
- St. John Wort is notorious for interfering with prescription meds by altering their metabolism
- acupuncture may be able to release endogenous opiods that help with pain control
- laetrile (an extract from apricot seeds) was once though to cure solid tumors, but studies in the 1980s showed no benefit
- Linus Pauling first proposed that vit C could prevent and/or treat the common cold, but high powered studies disproved this theory. In most cases, it does no harm - you pee out excess vit C, but in patients who have iron excess, it can lead to the overproduction of free radicals. Watch out in pts with hemochromatosis or chronic transfusion patients.

Harrison's lists some good website for CAM which include:
- the Natural Medicines Comprehensive Database (www.naturaldatabase.com)
- NIH (http://ods.od.nih.gov) or (http://nccam.nih.gov/health/) or (http://www3.cancer.gov/occam.information/html)



Vitamin/Mineral Goodies:
-vit A deficiency seen in developing world and increases death rate and progression HIV/AIDS
- folic acid reduces neural tube defects in utero (knew this one!)
- folic acid, vit B6, and vit B12 combined may be able to lower homocysteine levels, but doing so has not shown to alter cardiovascular end points.
- vitamine C and E, beta cartotene and zinc combo - could reduce the progression of age-related macular degeneration.


Herbal Goodies:
- Glucosamine and/or chondroitin sulfate: good for osteoarthritis and may slow the narrowing of joint spaces
- gingko bilboa - no proof in improving cognition, but ppl still taking it for Alzheimer's
- saw palmetto - marketed for BPH but no proof it works
- St. John's wort - marketed for depression, but again, no proof
- Echinacea - used to prevent or treat respiratory infections but no clear proof although it does stimulate the immune system in vitro.

Other goodies:
-acupuncture had been shown to work for nausea and osteoarthritis
- biofeedback is helpful for incontinence, headaches, and stroke rehab
- hypnosis is good for pain from minor surgeries, chemo-related nausea, and IBS
- spinal manipulation useful for uncomplicated acute back pain, but has not been shown to be superior to conventional approaches.

I like reading about alternative therapies. Acupuncture is particularly interesting because I worked with a family doc in medical school who spent his Friday afternoons doing acupuncture. It would be kinda neat to do outpatient medicine and acupuncture. He had mentioned that there was course in LA where you could get certified, so it sounds really interesting.