It Comes Natural - Understanding Natural and Integrative Medicine


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What should I expect when visiting a Naturopathic Doctor?

And in no case do these identities overlap with the medical approach to health taken by Functional Medicine. Treatment is focused on considering that the mind, spirit and body are all interconnected in respect to health. It is felt that by evaluating the physical, emotional and spiritual contributions to health, the whole body is brought into a state if coherence. I feel that the term holistic has too broad of an application to root itself in a defined identity.

The problem is not that these different therapies have no value, in many cases each of these categories may be greatly beneficial to an individual seeking a greater state of health.

Naturopathic Medicine: What It Is, Benefits, Risks

In fact, sometimes the lines between natural and synthetic can be blurred; some of our best symptom-based allopathic therapies are influenced by a very natural means. Is this a natural medicine? Vincent van Gogh used foxglove, and twice painted his friend Dr. Gachet holding the plant in his hand. An interesting side note: overdose with digitalis causes lights to give an eerie halo around objects. Certainly optimal health depends on a greater exposure to what we know are natural products rather than those that are not found in nature.

These actions are similar to pharmaceutical products, many of which have been developed from herbs and plants, yet other actions are unheard of within a conventional medicine paradigm. For example, adaptogenic herbs are thought to increase resistance to stress and support the adrenal glands, whereas bitters are used to detoxify the liver; these concepts within herbal medicine are organ-supportive and aim to maintain wellness and optimal functioning of specific tissues and organs, thereby preventing disease and enhancing recovery from illness.

As previously mentioned, most of the current information about cancer-fighting activities of medicinal plants and supplements comes from preclinical studies see Table These studies indicate potential benefits but cannot serve as evidence of these effects in humans. A relatively small number of clinical trials have been published, but they tend to involve few subjects or have methodologic issues. More well-designed large-scale clinical trials are needed to ascertain the benefits and effective dosages of herbal medicines and other natural health products in humans.

The lack of standardization of herbal and other CAM products, either sold to consumers or used in research, poses yet another problem. There can be significant variation in the composition of an herbal medicine depending upon the part of the plant or the extraction method used. Herbal medicines, in particular, are inherently difficult to standardize.

A medicinal plant contains many biologically active compounds that can act synergistically, additively, or antagonistically. Concentrations of different compounds may vary depending on the growing conditions and handling. Frequently, individual active compounds are isolated from medicinal plants and their properties are investigated. This practice allows researchers to characterize the biological activities of these individual compounds in vitro and in vivo.

It also makes it possible for the results to be replicated by other laboratories or aggregated with other research results in meta-analyses or systematic reviews. This practice of isolating individual active compounds, however, may be difficult and expensive. Translating this evidence to the whole plant, which is often available in over-the-counter formulations, is difficult and precludes informed consultations regarding the possible effects of herbal medicine.

An often-cited example is the effect of St. A primary concern during cancer treatment focuses on the effect of natural products on chemotherapy effectiveness. A number of herbal medicines have been shown to modulate the activity of the CYP system, which is responsible for metabolism of a large number of prescription medications, including many chemotherapeutic drugs Block et al.

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The inducers of CYP enzymes may cause the chemotherapeutic agents to be metabolized more quickly, thus resulting in a lower therapeutic effect or a treatment failure. Conversely, the inhibitors of the CYP system may slow down the metabolic clearance of some chemotherapeutic drugs and consequently increase the toxicity of treatment.

Garlic, ginseng, echinacea, and soy were shown to inhibit several CYP isoenzymes in preclinical studies, but human pharmacokinetic studies were either not performed or did not produce measurable changes of chemotherapeutic agents in the blood levels Hardy, ; Lee, Some herbal medicines may reverse the action of chemotherapeutic drugs and other medications. A number of medicinal herbs also have anticoagulant activity e.

Finally, there is a concern that taking herbs with strong antioxidant activity may result in protection of tumor cells from oxidative damage during conventional radio- or chemotherapy, leading to treatment failure or a higher likelihood of cancer recurrence Hardy, According to Cheng et al. On a positive note, preclinical studies indicate that herbal medicines can "increase the sensitivity of cancer cells to chemotherapeutic drugs, improve survival rates, enhance tumor response to chemotherapeutic drugs, and reduce toxicity of cancer chemotherapy" Cheng et al.

In contrast, negative pharmacokinetic interactions between specific herbs and anticancer drugs have been identified, raising questions about the safety of use during cancer treatment and the effect on tumor survival, although the complexity of effects requires further illumination. Most cancer patients who choose to take herbs and supplements do so in order to achieve some measure of control over their treatment. They believe that herbal medicines will augment the ability of the body to fight cancer, prevent its recurrence, and alleviate the side effects of conventional treatment Ben-Arye et al.

In fact, many medicinal herbs were experimentally shown to possess the above-mentioned activities in vitro and in vivo and may potentially improve cancer treatment outcomes. Table 2 presents the evidence of biological activities pertinent to cancer treatment for 14 herbal medicines most commonly used by cancer patients. It also lists potential uses of these medicines in cancer therapy as well as possible side effects and drug interactions. As noted in Table 1, a number of herbs have demonstrated benefits in alleviating specific symptoms associated with cancer treatment or improving the overall quality of life.

Herbal use may also decrease chemotherapy and radiation toxicity, although the exact mechanism and effects of these powerful antioxidants remain unclear Baatout et al. Some herbs have also shown the ability to directly affect the growth and spread of cancer or improve tumor response to conventional therapies Hardy, They do so through a variety of mechanisms, including antioxidant protection of DNA, induction of apoptosis of cancer cells, stimulation of the immune system, and inhibition of cyclo-oxygenase, inflammation and angiogenesis Ferrari, Finally, the third important potential benefit of herbal medicines for cancer patients is the prevention or postponement of cancer recurrence Treasure, ; Wargovich et al.

Nicole Nisly, MD Holistic Medicine

Often the same biologically active compounds exhibit several of these activities, thus acting at multiple levels of cancer prevention and treatment at the same time. In spite of all the purported benefits of herbal medicines in cancer, it is important to exercise caution when selecting and using herbal preparations during or after conventional cancer treatment.

There is a belief among users of herbal medicines that these preparations are inherently safer than pharmaceuticals because they are "natural" and that they are effective over a wide range of doses. Because of these beliefs, patients often choose to self-medicate with herbal preparations, sometimes concurrently with conventional medications and without informing their physicians.

What is Integrative Medicine?

This practice can be dangerous, especially for cancer patients. Just like conventional medications, herbal preparations can produce undesirable side effects such as allergic reactions, gastrointestinal symptoms, and shifts in blood values. While the majority of the herbs reviewed in this article do not exhibit direct toxicity, others utilized by cancer patients have been found to be potentially harmful. Thus, mistletoe is administered by injection, which has an improved safety profile Kim et al.

Finally, the herbal medicines can interact with other medications taken by a patient.

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Rigorous scientific evaluation of the safety and effectiveness of herbal therapies, alone and with concurrent chemotherapy, as well as determination of optimal dosages and mechanisms of action are necessary before they can be recommended for cancer patients. As with herbs, there are innumerable products available to consumers in the United States, including vitamins, minerals, and many other natural compounds that can be used for self-care to prevent and treat illness, manage symptoms, improve mood, and enhance quality of life.


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Safe, appropriate, and effective use therefore requires that consumers and health-care providers are informed and proactive in self-care strategies using natural products. Vitamin and supplement use has varied widely over time, with noted fluctuations in popularity over the past decade. Whereas previous survey data examined use of megavitamins, this information was not queried in more current NHIS surveys.

What is IM/IH?

Since the number of vitamins and supplements is so vast, a discussion of selected products is presented in place of a review table. The authors acknowledge that this discussion is limited and refer the reader to the Natural Standard Database for a comprehensive review of natural health products Natural Standard, Use of high-dose vitamin A during cancer treatment remains highly controversial, with the possibility of toxicity. Beta-carotene supplementation has been noted to increase the risk of lung cancer among smokers Goodman et al.

Signs of toxicity include dry, itchy, scaling, and cracking skin, desquamation, dry lips, anorexia, headache, psychiatric changes, cerebral edema, bone and joint pain, and osteoporosis Natural Standard, Vitamin E, a fat-soluble vitamin that exists in eight different forms and may be natural or synthetic, has been studied for many different health conditions, including cancer and cardiovascular disease. Conflicting data about its anticoagulants Table 3.

According to the Natural Standard Database , vitamins A, C, and E have unclear or conflicting scientific evidence grade C , except for strong evidence grade A for vitamin A with regard to treatment of acute promyelocytic leukemia; selenium has also been graded as having good scientific evidence related to prostate cancer prevention grade B.

Vitamin D is critical to calcium and magnesium absorption in the body, thus protecting against osteoporosis, hypertension, some cancers, and autoimmune diseases. Of importance is the consideration of the type of vitamin D used and whether it is provided through food sources or as a supplement. Research has focused on vitamin D3, noting the toxicity of vitamin D2. Lycopene, another powerful antioxidant, has received much attention lately because of study findings indicating a possible preventative effect in cancer and chronic illness.

A natural substance found in foods such as tomatoes, lycopene supplements are available for over-the-counter purchase; however, most epidemiologic studies that indicate a reduced incidence of cancer, cardiovascular disease, and other disorders used food products rather than supplements. Research is also needed to distinguish effects of lycopene found in food products as compared with lycopene supplementation on cancer prevention, treatment, and recurrence Natural Standard, Essential fatty acids are considered anti-inflammatory supplements that support cardiovascular health; they are also used as mood stabilizers for individuals with attention deficit disorder, bipolar depression, seizures, mood imbalance, and psychotic disorders.

Fish oil supplementation has also been found to increase response rate to chemotherapy in patients with advanced non—small cell lung cancer without increasing toxicity as compared with standard care, and it may increase survival Murphy et al. Essential fatty acids may also reduce toxic side effects of some medications and were found to reduce pain associated with rheumatoid arthritis due to its anti-inflammatory effects Ruggiero et al.


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Effects on cancer prevention remain unclear MacLean et al. Essential fatty acids have an anticoagulant effect and should be avoided with blood-thinning medications and herbs. Use of EFAs may also increase fasting blood sugar and the need for increased diabetic management medication Natural Standard, SAM-e S-adenosyl-L-methionine , defined as a methyl group donor for many chemical reactions in the body, is primarily produced in the liver. SAM-e supplementation has been used for depression and psychiatric illness, premenstrual disorder, osteoarthritis, liver, and musculoskeletal problems, demonstrating antioxidant, anti-inflammatory, and analgesic effects Natural Standard, Carney, Toone, and Reynolds noted that SAM-e crosses the blood-brain barrier and "is involved in several central enzyme pathways relating to transmethylation and folate and monoamine metabolism as well as in membrane function and neuro-transmission" p.

Melatonin, a neurohormone produced by the pineal gland, is involved in sleep regulation and continues to be studied for effects on tumor growth and regulation. Melatonin is rated as having good to strong scientific evidence grades A and B to support its use for jet lag, insomnia, and other sleep disorders in individuals of different ages Natural Standard, At recommended doses, melatonin is regarded as safe for short-term use Buscemi et al. Melatonin has been used orally as a supplement during cancer treatment as well as topically in studies on melanoma Slominski et al.

Tryptophan and 5-HTP 5-hydroxytryptophan are supplements that are also used to promote sleep and improve sleep quality although scientific evidence is still unclear, with more studies needed. As a precursor to serotonin, 5-HTP has also been used for treatment of stress, anxiety, panic attacks, pain, depression, and obesity Birdsall, ; Rothman, ; Weeks, Tryptophan, a precursor to 5-HTP, was recently allowed back on the US market after being banned for over a decade due to serious side effects eosinophilia myalgia syndrome that were subsequently attributed to a contaminant discovered in tryptophan supplements.

Side effects include gastrointestinal discomfort and nausea, which are minimized by using enteric-coated capsules. Glutamine is a nonessential amino acid that continues to be examined for its preventative effects during cancer treatment, specifically with regard to mucositis.

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