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August, 2008 - VOL. 7, NO. 4  August, 2008
The Path Ahead: How Do We Get Better?
Joseph Pizzorno, ND
When I first became involved with natural medicine, entering National College of Naturopathic Medicine as a student in 1971, I found not just a lack of science but an antipathy towards science. The political bodies of conventional medicine had effectively helped along the demise of non-conventional medical professions by asserting that they were “unscientific.” This lead to a distrust of science on the part of alternative practitioners and to the belief by many that science was only for MDs and not relevant to natural medicine. Many would assert to me that they knew natural medicine was effective since it had centuries-long traditions of use and their patients got better. It was not uncommon to hear, “There is no need for research; and anyway it would just be used to discredit natural therapies.” My response was (and still is), “How do you know that the therapies you use actually help your patients? After all, the placebo effect is very strong. Your ability to convey to patients your confidence in the efficacy of your therapies is a powerful inducer of the placebo effect. Worse, without realizing it, you may be using a treatment that is not only ineffective but actually hindering your patient’s ability to heal. The only way to know is to objectively measure.”
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August, 2008 - VOL. 7, NO. 4  August, 2008
Industry News and Insights: Balancing the Scales for Drug-Herb Interactions . . . and more
John Weeks
Reframing the Debate on Drug-Herb Interactions Herbs and natural products are typically viewed by consumers and practitioners of “alternative medicine” as having fewer adverse effects than conventional pharmaceuticals. Thus, it has been an irony of their migration into the medical mainstream that the principal dialogue around natural medicines relates to their potentially detrimental outcomes, particularly when they are used concurrently with conventional pharmacy. Concern about drug-herb interactions has prompted numerous investigations and publications. An early entrant into serving this need for information was the Interactions software database developed with a multidisciplinary team led by Mitchell Stargrove, ND, LAc, and published in 2000. This year, Stargrove, with a co-author team that includes a medical doctor and an herbalist, brought some useful balance to the drug-herb dialogue. In a forward to the authoritative 930-page Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies (MosbyElsevier, 2008), Tieraona Lowdog, MD, chair of the United States Pharmacopeia Dietary Supplements Information Expert Committee, notes, “With the primary emphasis [for herbs and nutrients] on adverse interactions, the topic of beneficial interactions has received little attention.” Lowdog then goes on to assert that “An integrative approach would utilize therapies that reduce or mitigate the adverse effects of medications deemed necessary for the patient whenever possible.” In other words, while beneficial interactions of herbs and nutrients with drugs are as important to note as adverse ones, a doctor’s main goal should be to pursue strategies that limit the need for more-powerful pharmaceuticals that may have significant adverse effects.
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August, 2008 - VOL. 7, NO. 4  August, 2008
Is There Still a Place for Normal Birth?
Bethany Hays, MD
The cesarean birth rate in the United States has reached an all-time high of more than 30%. It is projected that by the end of 2007, 1 in 3 babies will be born by cesarean section. In other words, one-third of women will undergo major surgery for a process that is supposed to be normal, not pathological. Could Mother Nature be so inept that she intended 1 in 3 births to require this kind of intervention? Is there any good reason to worry about this climbing surgical birth rate? What about the continued use of episiotomy and forceps in vaginal births? Or would it be more appropriate to celebrate what modern medicine can do to prevent maternal and neonatal harm? This article explores these questions.
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August, 2008 - VOL. 7, NO. 4  August, 2008
Apoptosis of Human Breast Carcinoma MCF-7 Cells Induced by Chinese Herbal Shenghe Powder and Correlated With Alterations in P53, Survivin, and BCL2
Xuejun Li, ND;  Jianhua Wang, ND;  Yuesheng Xia, ND
Objective: To investigate the effects of the Chinese herbal formula Shenghe powder (SHP) on the proliferation and apoptosis of human breast carcinoma MCF-7 cells. Methods: Expression of survivin, BCL2, and P53 proteins was measured by immunoblot analysis. The proliferation inhibition rate of MCF-7 cells was analyzed by 3-(4,5-methylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide(MTT) assay. Flow cytometry was performed to detect SHP-induced apoptosis. Results: SHP inhibited proliferation of human breast carcinoma MCF-7 cells with an IC50 value of 4.1mg/L and induced apoptosis of MCF-7 cells in a time- and dose-dependent manner. During the induction of apoptosis, expression of BCL2 and survivin were decreased, and expression of P53 was increased, significantly. Conclusions: The study suggests that SHP can induce apoptosis of MCF-7 cells, which may be associated with modulations in the expressions of P53, survivin, and BCL2 family proteins.
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August, 2008 - VOL. 7, NO. 4  August, 2008
Self-Administered EFT (Emotional Freedom Techniques) in Individuals With Fibromyalgia: A Randomized Trial
Gunilla Brattberg, MD
The aim of this study was to investigate whether self-administered EFT (Emotional Freedom Techniques) leads to reduced pain perception, increased acceptance and coping ability, and better health-related quality of life in individuals with fibromyalgia. Thus 86 women, diagnosed with fibromyalgia and on sick leave for at least 3 months, were randomly assigned to a treatment group or a wait-listed group. For those in the treatment group, an 8-week EFT treatment program was administered via the Internet. Upon completion of the program, statistically significant improvements were observed in the intervention group (n=26) in comparison with the wait-listed group (n=36) for variables such as pain, anxiety, depression, vitality, social function, mental health, performance problems involving work or other activities due to physical as well as emotional reasons, and stress symptoms. In addition, pain catastrophizing measures, such as rumination, magnification, and helplessness, were significantly reduced, and activity level was significantly increased in the treatment group compared to the wait-listed group. However, no difference in pain willingness between the groups was observed. The number needed to treat (NNT) regarding recovering from anxiety was 3. NNT for depression was 4. Self-administered EFT seems to be a good complement to other treatments and rehabilitation programs. The sample size was small and the dropout rate was high. Therefore the surprisingly good results have to be interpreted with caution. However, it would be of interest to further study this simple and easily accessible self-administered treatment method, which can even be taught over the Internet.
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August, 2008 - VOL. 7, NO. 4  August, 2008
Natural Treatments for Allergic Rhinitis
Alan Gaby, MD
Allergic rhinitis is a common condition that causes nasal congestion, rhinorrhea, postnasal drip, sneezing, fatigue, and other symptoms. Conventional treatment includes avoidance of symptom-evoking allergens, desensitization therapy, and administration of various medications that suppress the symptoms. There is evidence that, for some patients with allergic rhinitis, dietary modifications and nutritional supplements are beneficial. Treatments that may be effective include identification and avoidance of allergenic foods and supplementation with vitamin C, magnesium, vitamin E, pantothenic acid, hesperidin chalcone sodium, and probiotics. In selected cases, treatment with thyroid hormone appears to be useful, and glutathione administered by aerosol also shows promise. In contrast to conventional medications, these "natural" treatment approaches are generally free of side effects.
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August, 2008 - VOL. 7, NO. 4  August, 2008
A Protocol for Diabetes Comanagement
Cindy Breed, ND;  Marty Ross, MD
In the fall of 1996, a landmark project integrating naturopathic and family medicine began at the Community Health Centers of King County (CHCKC) in Kent, Washington. Originally, this project was a collaborative effort between CHCKC and Bastyr University (Kenmore, Washington), with funding provided through Seattle and King County Public Health. To assure the best delivery of this integrated care, comanagement protocols for a variety of illnesses were created by naturopathic and conventional medical providers at the clinic. What is most notable is that naturopathic care is the first approach and, if needed, conventional care is added. This article presents a version of the original diabetes mellitus type 2 protocol created at that time that was based on both American Diabetes Association guidelines and evidence-based natural medicine.1-78 The article itself is an adaptation from one previously published in the first issue of IMCJ (Integrative Medicine 1.1;Dec 2002/Jan 2003:22-28).
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August, 2008 - VOL. 7, NO. 4  August, 2008
Green Medicine Tips: Workplace Stress and Health: Creating a Supportive Work Environment
Nina Fry, MA;  Joel Kreisberg, DC
When asking the question “What determines health?” it is important to note that social factors can be powerful determinants of health status. The workplace environment and workplace stress, specifically, have been found to have significant impacts on health. Stress from the workplace has been clearly associated with greater propensities for health risk factors including obesity, smoking, reduced leisure time and physical activity, more baseline illness, and higher blood pressure.1-3 An understanding of these correlations is necessary for any effort to bring sustainable approaches to healthcare. Factors Impacting Workplace Stress Demand and Control It is not simply work demands placed on an employee that cause stress; rather, it is the combination of high demand and low control. This combination can predict higher rates of absence at work from physical and mental illness.4, 5
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August, 2008 - VOL. 7, NO. 4  August, 2008
ViewPoints: Healing for Patient and for Doctor: An Interview With Esther Konigsberg, MD
Andrea McCloud, MFA
Esther Konigsberg, MD, is the founder, owner, and medical director of the Family Practice Centre of Integrative Health and Healing in Burlington, Ontario, Canada, which she opened in 2003. She obtained her Bachelor of Science in 1980 from McGill University, in Montreal, Quebec, Canada, and her Medical Degree in 1983 from McMaster University in Hamilton, Ontario, Canada. Since then she has studied extensively with world leaders, including Deepak Chopra, MD; David Simon, MD; John Demartini, DC; and Andrew Weil, MD, on health, healing, and spirituality. Dr Konigsberg is a graduate of the Associate Fellowship Program of Integrative Medicine at the University of Arizona in Tucson and is currently an assistant clinical professor there. She is also the curriculum consultant for Complementary and Alternative Medicine at McMaster’s medical school and is on the steering committee for the Consortium of Academic Health Centers for Integrative Medicine. Dr Konigsberg is also a partner of Integrative Medicine Associates, a consulting service for North American integrative medicine centers. She has written numerous magazine and newspaper articles on health and healing and is a contributing author to the book Inspiring Breakthrough Secrets to Live Your Dreams, published in 2001 by Aviva Publishing.
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August, 2008 - VOL. 7, NO. 4  August, 2008
BackTalk: Student Union
Bill Benda, MD
To advocate for our students, to provide every assistance at our command, is not an option—it is a mandate, commensurate with the mandate to feed, clothe, and educate our biological offspring. A rather unusual event took place in March of 2005—one of those inauspicious incidents that appears a bit mundane on the surface but eventually reveals itself as a pivot point of cultural consequence. Specifically, a group of 3 intrepid naturopathic medical students attended the annual convention of the American Medical Student Association (AMSA) in Washington, District of Columbia, to lobby for full membership rights within that allopathically oriented organization. Before we delve into the aftermath of such a grandiloquent gesture, a little history for the uninformed: AMSA, a quite powerful student organization founded more than a half-century ago, is currently the oldest and largest independent association of physicians in training in the United States, boasting a membership of over 68 000 conventional medical students, premedical students, interns, and residents. The Naturopathic Medical Student Association (NMSA), on the other hand, was created in August of 2005 from the remains of prior attempts at pedagogical unity and currently consists of approximately 450 students from the 6 ND schools in the US and Canada. Unlike AMSA, the NMSA has no real power. But it is driven by students with an unreal passion to affect the future of healthcare in this country.
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