Alternative Remedies Doctor's Trust

The Latest Word On What's Safe And Effective By Janis Jibrin, R.D.

Chances are, you've at least considered trying an alternative remedy - maybe a supplement to control arthritis or an herb to ease the symptoms of menopause. But how do you know the treatment you choose is safe and effective? For that matter, how does anyone know?

We asked conventionally trained M.D.s, many of them affiliated with leading academic medical institutions, which alternative remedies they regularly recommend in their own practices. According to them, a growing body of research stands behind the success of these alternative treatments. Some say these remedies have been so successful that some patients have been able to discontinue medications for back pain, arthritis and other ailments - or at least lower the dose. * Could one of these remedies be right for you?

Easing Arthritis
No one was more familiar with arthritis pain than Jason Theodosakis, M.D., a physician and assistant professor at the University of Arizona School of Medicine in Tucson. In 1992, a sports injury led to osteoarthritis so severe that he was briefly confined to a wheel chair. Today, "Dr. Theo" enjoys tennis.

His saviors: chondroitin and glucosamine. These compounds, made by the body, help repair cartilage. Taking them as supplements can reduce joint pain and may help build new cartilage, according to a study at Boston University School of Medicine. For most patients, Dr. Theodosakis recommends a daily dose of 1,500 mg of glucosamine and 1,200 mg of chondroitin, along with their medication, for three to five months. If patients improve, they may be able to reduce the dosage of their medicine, under a doctor's supervision.

The treatment worked so well for Dr. Theodosakis that he is now medication free. I'd like to get all my patients off everything as well, he says. This was possible in the case of a 43-year-old nurse, who was an avid runner until osteoarthritis struck her knee. After just three weeks of chondroitin and glucosamine plus regular exercise (in this case, easy stints on a stationary bike), she felt strong enough to cancel knee surgery and stop medications. Two months later, she completed a half marathon. Today, five years later, Dr. Theodosakis says she's still doing well.

There are also options for people with rheumatoid arthritis. Although these patients cannot stop their medication, they may be able to lower the dose with the help of mega - 3 fatty acids, says Dr. Theodosakis. A daily supplement containing 3 to 6 grams of omega -3 fatty acids may ease joint pain and morning stiffness, according to a study from Albany Medical College in Albany, New York.

Healing the Heart
Most people see heart disease and heart surgery as horrible obstacles, says Mehmet Oz, M.D., a heart surgeon and medical director of the Complementary Care Center at Columbia Presbyterian Medical Center in New York City and author of Healing from the Heart. I try to show them the opportunities for growth.

Dr. Oz is referring to the use of self-hypnosis, meditation and yoga - part of his arsenal of alternative treatments to reduce heart-disease risk factors, including high blood pressure. Under self-hypnosis, Dr. Oz's patients listen to calming music and positive messages on tape, such as, You will relax and keep blood pressure down. With these methods, I've had patients reduce their dose of blood pressure medication or even go off it entirely, he says. Japanese research has confirmed that self-hypnosis can lower blood pressure.

As for yoga, research shows that practicing it regularly helps reduce blood pressure and may also lower levels of "bad" LDL cholesterol.

Soothing the Pain
Stress and muscle tension often go hand in hand when it comes to stiff necks, bad backs and headaches. In this culture, we're often rewarded for being in overdrive, even if that means hunching over our computers and disconnecting from our bodies to get the work done, says Sharon Montes, M.D., a family physician at the Complementary Medicine Center for Healing at the University of Maryland in Baltimore. Many people walk around with muscle tension; yet don't even realize it until the pain is overwhelming. Her goal is to help patients manage their stress in healthier ways, including exercise.

People may not want to move because it hurts. But I can usually find something they can do before the pain starts, even if it's walking just one block. We build from there, says Dr. Montes. Her ideal choices: swimming and gentle exercises like yoga or tai chi. In addition, patients may be given biofeedback training, in which wires taped to the body record changes in temperature, muscle tension and heart rate. Patients use this information to learn to relax painful areas.

Acupuncture is another mainstay of Dr. Monte's treatment. Acupuncturists place extremely thin needles at specific points on the body that are associated with pain relief. A review of acupuncture research published in the Archives of Internal Medicine concluded that acupuncture was nearly twice as effective as placebo treatments in relieving back pain.

Relieving Menopausal Symptoms
A mix of conventional and alternative therapies is often effective. Making various treatments available to patients helps them view menopause as a positive experience, says Sarah Ferguson, M.D., an internist at Avenues for Health, a woman's health center in Danville, California. After the change, they wind up with stable, creative energy, unfettered by hormonal swings.

Each case and treatment is different, she says. One variable is whether my patient can, or wants to, take estrogen. Estrogen works best for hot flashes and vaginal dryness, but for some, it's not an option.

One patient of Dr. Ferguson's was reeling from 15 to 20 hot flashes a day, but couldn't take estrogen. Instead, Dr. Ferguson prescribed acupuncture, Chinese herbs, one to two servings of soy foods daily and 1 to 2 tablespoons of ground flaxseed. The estrogen like compounds in these foods not only modestly alleviate hot flashes, but also help reduce high cholesterol. Other patients have been able to ease hot flashes by taking 400 IUs of vitamin E a day.

On occasion, Dr. Ferguson prescribes herbs, including 40 to 60 mg of black cohosh, twice daily. Many studies have shown that this herb can reduce symptoms like hot flashes, night sweats, and nervousness, headaches and heart palpitations.

Calming an Upset Bowel
The cause of irritable bowel syndrome (IBS) and related conditions isn't always obvious. Intestinal disorders take a while to diagnose because there are many possible triggers, says Paul Lebovitz, M.D., a gastroenterologist and medical director at the Allegheny Center for Digestive Health in Pittsburgh. His patients keep a weekly food and symptoms diary to track down links, such as coffee triggering diarrhea. Dr. Lebovitz prescribes drugs if necessary, but tries milder remedies first. One of my patients, a lawyer, has IBS. She would get attacks of diarrhea at the very worst time: on the courtroom floor. And she couldn't take antispasmodic drugs because they sedated her, he says. So Dr. Lebovitz prescribed 0.2 to 0.4 ml of peppermint oil before court, which improved her symptoms. A British research review found that in several studies, peppermint oil reduced IBS symptoms, such as bowel spasms and the feeling of urgency. The lawyer also received biofeedback training, which taught her to relax her colon. In six weeks, she was mildly better, and three months later she was nearly symptom-free.

Want to know more?

Herbal remedies: Contact the Herb Research Foundation at 800-748-2617

Acupuncture: Contact the American Academy of Medical Acupuncture at 323-937-5514

e-help: www.medicalacupuncture.org

Hypnosis: Call International Medical and Dental Hypnotherapy Association™. 248-549-5594. www.infinityinst.com

* Never stop taking medications or begin taking supplements without consulting your doctor.
Source: Woman's Day, June 26, 2001 Article. Alternative Remedies Doctors Trust 06.01