CM NEWS – So now not only acupuncture can control pain, it can also help a mother to have a smooth breast feeding experience.
A group of Swedish scientiests set out to compare acupuncture treatment and care interventions for the relief of inflammatory symptoms of the breast during lactation, and to investigate the relationship between bacteria in the breast milk and clinical signs and symptoms in a randomised, non-blinded, controlled study.
The researchers are from Department of Obstetrics and Gynaecology of Helsingborg Hospital and Faculty of Social and Life Sciences, Karlstad University in Swede.
205 mothers with 210 cases of inflammatory symptoms of the breast during lactation agreed to participate. The mothers were randomly assigned to one of three treatment groups, two of which included acupuncture among the care interventions and one without acupuncture.
All groups were given essential care. Protocols, which included scales for erythema, breast tension and pain, were maintained for each day of contact with the breast feeding clinic. A Severity Index (SI) for each mother and each day was created by adding together the scores on the erythema, breast tension and pain scales. The range of the SI was 0 (least severe) to 19 (most severe).
Significant differences were found in the mean SI scores on contact days 3 and 4 between the non-acupuncture group and the two acupuncture groups. Mothers with less favourable outcomes (6 contact days, n=61) were, at first contact with the midwife, more often given advice on correction of the baby’s attachment to the breast. An obstetrician was called to examine 20% of the mothers, and antibiotic treatment was prescribed for 15% of the study population. The presence of Group B streptococci in the breast milk was related to less favourable outcomes.
“If acupuncture treatment is acceptable to the mother, this, together with care interventions such as correction of breast feeding position and babies’ attachment to the breast, might be a more expedient and less invasive choice of treatment than the use of oxytocin nasal spray,” the researchers wrote.
However, no significant difference was found in numbers of mothers in the treatment groups, with the lowest possible score for severity of symptoms on contact days 3, 4 or 5. No statistically significant differences were found between the treatment groups for number of contact days needed until the mother felt well enough to discontinue contact with the breast feeding clinic or for number of mothers prescribed antibiotics.
The researchers add that midwives, nurses or medical practitioners with specialist competence in breast feeding should be the primary care providers for mothers with inflammatory symptoms of the breast during lactation. The use of antibiotics for inflammatory symptoms of the breast should be closely monitored in order to help the global community reduce resistance development among bacterial pathogens.
InspireHealth release – Vancouver-based InspireHealth – Canada’s leader in integrated cancer care and prevention – today announced that a newly-released U.S. study, which provides evidence that Vitamin D substantially reduces the risk of cancer development, is the most important cancer prevention study ever published.
The study released today by researchers from Creighton University in Nebraska is a double-blind, randomized placebo-controlled trial – the highest standard in medical research, and is being published in the American Journal of Clinical Nutrition.
“The study shows that in women over 55, Vitamin D supplementation may be able to reduce cancer incidence by 60 per cent. That’s a staggering finding,” said Dr. Hal Gunn, M.D., Co-Founder and CEO of InspireHealth. “Translated into numbers, more than 35,000 Canadian women could be saved from getting cancer each year. If Vitamin D is helpful for younger women and men as well – which seems likely based on other evidence – the numbers are even greater. This is remarkable for something as simple as Vitamin D supplementation.”
Physicians at InspireHealth, aware of the growing body of research supporting the use of Vitamin D in recent years, have been prescribing Vitamin D for cancer prevention and treatment for the last 10 years since InspireHealth’s founding in 1997. “Over the last 15 years, there has been a growing body of research showing that Vitamin D plays a very important role in the prevention of cancer of the colon, breast, prostate, lung, stomach, bladder, pancreas, uterus and ovary,” said Dr. Gunn. “This new study proves that link, and demonstrates that Vitamin D supplementation may provide a simple means to prevent the majority of cancer cases.”
“In short, this study clearly indicates for the first time, we may have a simple and effective means to prevent the majority of cancer cases, and put an end to the cancer epidemic that has plagued the western world for the last century,” said Dr. Gunn. “The Vitamin D study is a landmark study in cancer prevention.”
The researchers, who were originally studying the effects of Vitamin D and calcium on osteoporosis, found that this combination (vitamin D 1,000 IU per day and calcium 1400-1500 mg per day) substantially reduced the incidence of cancer (by 60 per cent) during the four-year period of the study. Researchers found that Vitamin D provided even greater protection when used longer term – a 77 per cent reduction in cancer incidence after one year of Vitamin D use.
Assuming Vitamin D has a similar benefit in all age groups and both genders, this may mean that up to 15,000 cases of cancer in BC alone could be prevented each year, and 123,000 cases in Canada, by simply ensuring that all Canadians take Vitamin D supplements on an ongoing basis.
Baseline and treatment-induced Vitamin D levels were found to be strong predictors of cancer risk in this study, providing further evidence of the value of Vitamin D in cancer prevention.
“It is important that all physicians and Canadians are aware of the results of this study and adequately supplement with Vitamin D”, said Dr. Gunn. “Vitamin D has many other health benefits besides cancer prevention and is important in the promotion and maintenance of optimal health and immune system function.”
“An important challenge in incorporating health-related research into medical practice is that much of this health-related research – such as Vitamin D supplementation, nutrition and exercise – gets ‘lost’ in the medical literature. At InspireHealth, we have created a Research Information System – the first of its kind in the world – that tracks world-wide research on integrative approaches to cancer prevention and treatment, enabling physicians and patients from around the world to access this research free-of-charge simply by logging on to our website at www.InspireHealth.ca,” Dr. Gunn added.
InspireHealth, Canada’s leader in integrative cancer prevention and treatment, was founded to help people with cancer explore the many ways they can support their own health before, during and after cancer treatment. InspireHealth is a non-profit society funded by the Lotte and John Hecht Foundation, the Canadian Cancer Society, the Canadian Breast Cancer Foundation, the Provincial Government and other foundations, corporations and individuals. It has served over 4,000 patients to date and aims to increase that number to 2,000 patients annually by 2012. InspireHealth has working partnerships with the Canadian Cancer Society, the Canadian Breast Cancer Foundation, BC/Yukon Chapter, the BC Cancer Agency, and the BC Foundation for Prostate Research.
Heartwire – A study billed as the first rigorous, randomized trial in the West to test acupuncture against a sham (fake) needle technique to treat hypertension suggests that, performed properly, acupuncture may produce blood-pressure changes on a par with monotherapy in mild to moderate hypertension.
“It’s certainly not like a wonder drug; it’s not a massive effect, but it’s a clear effect,” lead investigator Dr Frank A Flachskampf (Universitätsklinikum Erlangen, Germany) said.
Smaller randomized trials have been performed in China, with mixed results, while one randomized study in the West found no difference in blood-pressure lowering between traditional Chinese acupuncture, standardized acupuncture, and a sham procedure, the authors note. This earlier study did not use ambulatory blood-pressure measurements, believed to be superior to office-based measurements.
Results of their study are published online June 4, 2007 in Circulation.
For the study, 160 outpatients with uncomplicated, mild to moderate hypertension were randomized to six weeks of acupuncture performed by Chinese medicine practitioners, trained in China, or to a sham procedure. In both arms, patients underwent 22 sessions, each 30 minutes in length. By the end of the six weeks, 24-hour ambulatory systolic and diastolic blood pressures were significantly reduced from baseline in the acupuncture-treated patients (5.4 mm Hg and 3.0 mm Hg, respectively), and this change was also significantly different from values in the sham-treated patients, in whom no meaningful changes were seen.
After three and six months, however, the blood-pressure reductions disappeared, leading investigators to conclude that ongoing acupuncture treatments would be required to maintain the blood-pressure reductions.
“The main finding is that for the first time in a reasonably sized but still relatively small randomized study, this establishes beyond a reasonable doubt that acupuncture lowers blood pressure,” Flachskampf commented. “It’s a modest but undeniable effect on both systolic and diastolic blood pressure.”
The extent of the blood-pressure reductions are comparable to those seen with ACE-inhibitor monotherapy or aggressive lifestyle changes, including radical salt restrictions, he added.
A “demanding” alternative to drugs
Flachskampf had some caveats, acknowledging that the regular acupuncture sessions used in the study represent a significant time investment: each acupuncture session lasted 30 minutes—not including transportation and administrative time—and took place several times a week. The study subjects were also reasonably healthy, with no other major risk factors and with only mild to moderate hypertension.
“This is clearly something that would probably not work as well with very sick people or people with blood pressure at dangerous levels,” he said. “We cannot easily extrapolate to people, for example, with complicated hypertension who have had a myocardial infarction.”
Flachskampf believes, however, that acupuncture likely represents an attractive option in specific patients, particularly those averse to taking medical therapy who are open to so-called “alternative” medicine.
“This is probably only for people who somehow relate to this spiritually, who say I am profoundly against taking drugs and I’m very fond of Oriental wisdom or things like that,” Flachskampf told heartwire. “I don’t want to make a joke about this, but this certainly needs more compliance than taking two or three pills a day. It’s much more demanding.”
Unlike drugs, acupuncture appeared to have few or no side effects, although two people complained that the needles were painful. “Clearly, many millions of Chinese get acupuncture without any major problems so I think this is really a minor point,” Flachskampf observed.
[Circulation 2007; DOI: 10.1161/CIRCULATIONAHA.106.661140. Flachskampf FA, Gallasch J, Gefeller O, et al. “Randomized trial of acupuncture to lower blood pressure.” ]
Medical News Today – It might not be a bad idea for people with overactive thyroids to supplement their standard treatment with Chinese herbal medicine, a new review suggests. But while some of the studies supported the combination of two types of medicine, the reviewers say the quality of the research was questionable.
“Unfortunately, we cannot find a well-designed and conducted trial at this stage,” said Taixiang Wu, an associate professor at Sichuan University in China.
Hyperthyroidism occurs when the thyroid gland produces too much thyroid hormone, causing problems that can mimic the effects of a shot of adrenalin, said Jeffrey Sandler, M.D., an endocrinologist with Scripps Mercy Hospital and Whittier Institute in San Diego. “It stimulates the heart rate, can raise blood pressure, breaks down muscle and can cause weakness and weight loss.”
Increased thyroid hormone can lead to higher body temperatures and warm, moist skin as well. The cause of hyperthyroidism is typically Graves’ disease, where cells of the immune system work against the thyroid gland.
Hyperthyroidism is most common among women and the drugs used to treat it have been around for about 50 years, Sandler said. In extreme cases, doctors turn to surgery and radiation.
In this new Cochrane Library review, the researchers looked for studies that compared hyperthyroidism patients who took Chinese herbal medicine alone to those who took it in combination with Western treatments.
The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews like this one draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
The reviewers were only able to find 13 relevant studies whose authors were available to interview. The researchers excluded 52 other studies whose authors they could not reach.
According to the reviewers, the 13 studies with 1,770 people were all of “low quality.” Types of herbal treatment varied widely, with 103 different formulations included.
None of the studies analyzed death rates, health-related quality of life or participants’ willingness to follow the regimens. And none used a “double-blinding” approach, in which both researchers and subjects are initially prevented from knowing who’s getting which treatment.
The studies indicated that combinations of Chinese herbal medicines and Western antithyroid drugs might lower relapse rates, reduce side effects and relieve symptoms of hyperthyroidism, but the Chinese treatments didn’t seem to have much of an effect on the functioning of the thyroid itself.
While understanding of hyperthyroidism is a product of modern times, Chinese doctors have presumably been treating patients with the condition for some 2,000 years, said Subhuti Dharmananda, director of the Institute for Traditional Medicine in Portland, Ore. Chinese research focused on specific treatments, however, only goes back to the 1970s and 1980s, he said.
Should hyperthyroidism patients consider combining Chinese and Western medicine? “At this point, there is no wisdom available one way or the other,” Dharmananda said. “My recommendation to people is that if they are drawn to using Chinese medicine as part of their therapy, that they find a good practitioner in their area and undertake a program of treatment to see if it helps.”
He added, “It is possible that Chinese medicine can, for example, alleviate some of the symptoms of hyperthyroidism or help maintain good health after modern treatment for the disease.”
As for the current Western treatment, “we do pretty well with what’s currently available and standard,” Sandler said.
Regarding alternative treatments, “the problem is that when you’re dealing with a disease where it’s important to have the right dosage of medication,” Sandler said. Indeed, the proper dose of one thyroid medication can range from 50 to 1,200 milligrams depending on the person, he said
“Things like herbal medicines and supplements are not reliably predictable, and the doses may vary from batch to batch or manufacturer to manufacturer,” Sandler said. “You’re dealing with a situation where there isn’t a great deal of control.”
The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.
Zen XX, et al. Chinese herbal medicines for hyperthyroidism. (Review). Cochrane Database of Systematic Reviews 2007, Issue 2.
CM NEWS – Daily use of ginseng or ginkgo biloba supplements at the recommended doses, or the combination of both supplements, are unlikely to alter the pharmacokinetics of most drugs, a study has found.
Recent findings that the widely-used herbal supplement Saint John’s wort could dramatically affect the absorption and metabolism of many prescription and non-prescription drugs raised concerns that other popular herbal supplements might cause similar changes, thus significantly altering drugs’ therapeutic or toxic effects.
What, for example, about ginseng and ginkgo biloba, two of the most widely used herbal supplements? Ginseng and gingkgo biloba are commonlyly used in traditional Chinese medicine.
What are the effects of ginseng? In Chinese medicine, ginseng (Panax ginseng C.A. Meyer) has long been used as a general tonic or an adaptogen to promote longevity and enhance bodily functions. It has also been claimed to be effective in combating stress, fatigue, oxidants, cancer and diabetes mellitus. Most of the pharmacological actions of ginseng are attributed to one type of its constituents, namely the ginsenosides.
Panax qinsenq & Panax quinquefolium are two species of the ginseng plant. The herb grows to a height of about 60 centimeters (around two feet) and belongs to the Araliaceae family.
The plant grows very slowly and requires a cool shady climate. It grows best in China, Korea, and Japan. Ginseng also grows wild in some parts of North America. Indeed, it has been said that the best type is the wild type with roots which are several years old.
The Asian form is the Panax qinsenq, the American variety is the quinquefolium type. Both have many similar properties, but the Chinese version is more useful for a winter tonic because of its warming nature and the American variety is useful for a summer tonic because it has a more yin or cooling nature
There is an entirely different plant called Eleutherococcus senticosus which, although a botanical cousin of ginseng is often sold as “Siberian Ginseng”. It has some similar properties to ginseng.
Korean ginseng is considered by many folks to be the “best”. The most potent ginseng is considered by some to be that which is grown in South Korea, especially in the Kunsan and Kaesong provinces.
Speaking on May 1 at Experimental Biology 2007, University of Kansas Medical Center scientist Dr. Gregory Reed reports a study that found daily use of ginseng or ginkgo biloba supplements at the recommended doses, or the combination of both supplements, are unlikely to alter the pharmacokinetics – by which drugs are absorbed, distributed, metabolized, and eliminated by the body – of the majority of prescription or over-the counter drugs. Dr. Reed’s presentation was part of the scientific program of the American Society for Pharmacology and Experimental Therapeutics.
The research team, led by Dr. Reed and the late Dr. Aryeh Hurwitz, recruited 72 healthy non-smoking adults (31 men and 41 women, ages 20 to 59) who were not taking any prescription drugs or dietary supplements. The participants were given a “cocktail” of five drugs, each drug in the cocktail chosen because it provides a measure of the activity of a key drug metabolism pathway. Taken together, the five drugs in the cocktail provide measurements of the pathways that determine the pharmacokinetics of over 90% of prescription drugs. The scientists then measured the presence of these drugs or their metabolites in each subject’s blood and urine in order to establish a baseline for how each individual absorbed and metabolized the different prescription drugs in the absence of herbal supplements.
The 72 individuals next were randomly assigned to one of four groups. For four weeks, the first group received a ginseng supplement and a placebo for ginkgo biloba; the second received ginkgo biloba and a placebo for ginseng; the third received both ginseng and ginkgo biloba supplements; and the fourth received placebos for both supplements. The prescription drug cocktail was again administered and blood and urine samples taken in order to determine the absorption and metabolism of these drugs in the presence of either or both of the herbal supplements.
What is gingko biloba used for? According to gingko’s fact sheet provided by the National Centre for Complementary and Alternative Medicine:
- Ginkgo seeds have been used in traditional Chinese medicine for thousands of years, and cooked seeds are occasionally eaten. More recently, ginkgo leaf extract has been used to treat a variety of ailments and conditions, including asthma, bronchitis, fatigue, and tinnitus (ringing in the ears).
- Today, people use ginkgo leaf extracts hoping to improve memory; to treat or help prevent Alzheimer’s disease and other types of dementia; to decrease intermittent claudication (leg pain caused by narrowing arteries); and to treat sexual dysfunction, multiple sclerosis, tinnitus, and other health conditions.
The science behind it: Numerous studies of ginkgo have been done for a variety of conditions. Some promising results have been seen for Alzheimer’s disease/dementia, intermittent claudication, and tinnitus among others, but larger, well-designed research studies are needed.
- Some smaller studies for memory enhancement have had promising results, but a trial sponsored by the National Institute on Aging of more than 200 healthy adults over age 60 found that ginkgo taken for 6 weeks did not improve memory.
- NCCAM is conducting a large clinical trial of ginkgo with more than 3,000 volunteers. The aim is to see if the herb prevents the onset of dementia and, specifically, Alzheimer’s disease; slows cognitive decline and functional disability (for example, inability to prepare meals); reduces the incidence of cardiovascular disease; and decreases the rate of premature death.
- Ginkgo is also being studied by NCCAM for asthma, symptoms of multiple sclerosis, vascular function (intermittent claudication), cognitive decline, sexual dysfunction due to antidepressants, and insulin resistance. NCCAM is also looking at potential interactions between ginkgo and prescription drugs.
In this study, the scientists found no significant differences between those who received one, both, or none of the ginseng and ginkgo biloba supplements in how their bodies absorbed or metabolized any of the five prescription drugs.
This suggests, says Dr. Reed, that neither ginseng nor ginkgo biloba will affect the pharmacokinetics of the majority of prescription or over-the counter drugs.
He does note, however, that the team did not investigate any possible effects of the herbal supplements on pharmacodynamic interactions: the way drugs produce desired therapeutic effects or cause adverse side effects. The possibility of these pharmacodynamic, as opposed to pharmacokinetic, interactions remains to be investigated.
Studies in Dr. Reed’s laboratory continue with an examination of the effects of Saint John’s wort on pharmacokinetics of prescription and non prescription drugs and the role of an individual’s genetic makeup in determining the magnitude of the herbal supplement’s effects. This work was supported by the National Center for Complementary and Alternative Medicine of the National Institutes of Health.
Boston University release — Researchers at Boston University School of Medicine (BUSM) and McLean Hospital have found that practicing yoga may elevate brain gamma-aminobutyric (GABA) levels, the brain’s primary inhibitory neurotransmitter.
The findings, which appear in the May issue of the Journal of Alternative and Complementary Medicine, suggest that the practice of yoga be explored as a possible treatment for depression and anxiety, disorders associated with low GABA levels. Read more
June 5, 2007
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Science Daily — Herbal agents could be used to treat inflammatory bladder diseases, according to a preliminary study that looked at the ability of green tea to protect bladder cells from inflammation. Read more