Use of traditional medicine as an alternative cure

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Information from the National Institutes of Health’s National Center for Alternative and Complementary Medicine (NCCAM), World Health Organization, the Arthritis Foundation, and the Center for Disease Control and Prevention

Traditional medicine refers to culturally unique, commonly held practices, approaches, and beliefs incorporating various non-pharmaceutical treatments to treat, diagnose and prevent illnesses.

Various Third World countries in Africa, Asia and Latin America use traditional medicine (TM) to help meet many of their primary health care needs. In industrialized nations, use of traditional medicine is termed “Complementary“ or “Alternative” (CAM) medicine.

TM has become more popular in the industrialized world.

• In China, traditional herbal preparations account for 30%-50% of the total medicinal consumption.
• In Ghana, Mali, Nigeria and Zambia, the first line of treatment for 60% of children with high fever resulting from malaria is the use of herbal medicines at home.
• WHO estimates that in several African countries traditional birth attendants assist in the majority of births.
• In Europe, North America and other industrialized regions, over 50% of the population have used complementary or alternative medicine at least once.
• In San Francisco, London and South Africa, 75% of people living with HIV/AIDS use TM/CAM.
• 70% of the population in Canada have used complementary medicine at least once.
• In Germany, 90% of the population have used a natural remedy at some point in their life. Between 1995 and 2000, the number of doctors who had undergone special training in natural remedy medicine had almost doubled to 10 800.
• In the United States, 158 million of the adult population use complementary medicines and according to the USA Commission for Alternative and Complementary medicines, US $17 billion was spent on traditional remedies in 2000.
• In the United Kingdom, annual expenditure on alternative medicine is US$ 230 million.
• The global market for herbal medicines currently stands at over US $ 60 billion annually and is growing steadily.

Scientific evidence from randomized clinical trials is only present for acupuncture, some herbal medicines and for some of the manual therapies. Further research is needed to ascertain the efficacy and safety of several other practices and medicinal plants.

Unregulated or inappropriate use of traditional medicines and practices can have negative or dangerous effects.

For instance, the herb “Ma Huang” (Ephedra) is traditionally used in China to treat respiratory congestion. In the United States, the herb was marketed as a dietary aid, whose over dosage led to at least a dozen deaths, heart attacks and strokes.

In Belgium, at least 70 people required renal transplant or dialysis for interstitial fibrosis of the kidney after taking a herbal preparation made from the wrong species of plant as slimming treatment.

In addition to patient safety issues, there is the risk that a growing herbal market and its great commercial benefit might pose a threat to biodiversity through the over harvesting of the raw material for herbal medicines and other natural health care products. These practices, if not controlled, may lead to the extinction of endangered species and the destruction of natural habitats and resources.

Another related issue is that at present, the requirements for protection provided under international standards for patent law and by most national conventional patent laws are inadequate to protect traditional knowledge and biodiversity.

Tried and tested methods and products

• 25% of modern medicines are made from plants first used traditionally.
• Acupuncture has been proven effective in relieving postoperative pain, nausea during pregnancy, nausea and vomiting resulting from chemotherapy, and dental pain with extremely low side effects. It can also alleviate anxiety, panic disorders and insomnia.
• Yoga can reduce asthma attacks while Tai Ji techniques can help the elderly reduce their fear of falls.
• TM can also have impact on infectious diseases. For example, the Chinese herbal remedy Artemisia annua, used in China for almost 2000 years has been found to be effective against resistant malaria and could create a breakthrough in preventing almost one million deaths annually, most of them children, from severe malaria.
• In South Africa, the Medical Research Council is conducting studies on the efficacy of the plant Sutherlandia Microphylla in treating AIDS patients. Traditionally used as a tonic, this plant may increase energy, appetite and body mass in people living with HIV.

The World Health Organization launched its first ever comprehensive traditional medicine strategy in 2002. The strategy is designed to assist countries to:

• Develop national policies on the evaluation and regulation of TM/CAM practices; • Create a stronger evidence base on the safety, efficacy and quality of the TAM/CAM products and practices;
• Ensure availability and affordability of TM/CAM including essential herbal medicines;
• Promote therapeutically sound use of TM/CAM by providers and consumers;
• Document traditional medicines and remedies.

At present, WHO is supporting clinical studies on antimalarials in three African countries; the studies are revealing good potential for herbal antimalarials.

Other collaboration is taking place with Burkina Faso, the Democratic Republic of the Congo, Ghana, Mali, Nigeria, Kenya, Uganda, and Zimbabwe in the research and evaluation of herbal treatments for HIV/ AIDS, malaria, sickle cell anaemia and Diabetes Mellitus.

In Tanzania, WHO, in collaboration with China, is providing technical support to the government for the production of antimalarials derived from the Chinese herb Artemisia annua. Local production of the medicine will bring the price of one dose down from US $6 or $7 to a more affordable $2.

In 2003, WHO support has so far facilitated the development and introduction of traditional and alternative health care curricula in seven tertiary education institutions in the Philippines.

Training workshops on the use of traditional medicines for selected diseases and disorders have also been organized in China, Mongolia and Vietnam.

Over one-third of the population in developing countries lack access to essential medicines. The provision of safe and effective TM/CAM therapies could become a critical tool to increase access to health care.

While China, the Democratic People’s Republic of Korea, the Republic of Korea and Vietnam have fully integrated traditional medicine into their health care systems, many countries are yet to collect and integrate standardized evidence on this type of health care.

70 countries have a national regulation on herbal medicines but the legislative control of medicinal plants has not evolved around a structured model. This is because medicinal products or herbs are defined differently in different countries and diverse approaches have been adopted with regard to licensing, dispensing, manufacturing and trading.

The limited scientific evidence about TM/CAM’s safety and efficacy as well as other considerations make it important for governments to:

• Formulate national policy and regulation for the proper use of TM/CAM and its integration into national health care systems in line with the provisions of the WHO strategies on Traditional Medicines;
• Establish regulatory mechanisms to control the safety and quality of products and of TM/CAM practice;
• Create awareness about safe and effective TM/CAM therapies among the public and consumers;
• Cultivate and conserve medicinal plants to ensure their sustainable use.

An "alternative" therapy is a treatment that is used in place of traditional medicine. A "complementary" therapy is a treatment that is used as a supplement to traditional medicine. Alternative and complementary medicines have become increasingly popular in recent years. According to the National Institutes of Health’s National Center for Alternative and Complementary Medicine (NCCAM), Americans spent more than $27 billion on alternative or complementary therapies in 1997. This is more than all out-of-pocket hospital costs combined for 1997 (out-of pocket costs are costs the patient may pay in addition to the costs covered by his or her health insurance or health plan).

While anecdotal evidence reveals that many alternative or complementary medicines may be beneficial to patients, extensive research is still needed to determine whether non-traditional medicines are truly effective. Therefore, most physicians recommend that patients who use non-traditional medicines use them only as supplements to traditional treatment options that have been scientifically proven to be effective. Currently, there is no scientific evidence that non-traditional therapies can cure arthritis.

That is not to say that complementary medicines are not viable options for some patients. When used in conjunction with traditional medicines, some complementary therapies may be very beneficial to the physical or psychological well-being of a patient. There have been studies that show that non-traditional medicines can help alleviate the symptoms of cancer or ease the side effects of traditional therapies. For example, Chinese herbs have been shown to help arthritis and acupuncture has been shown to reduce arthritis pain.

However, it is important for patients to realize that not all alternative or complementary medicines are safe. Patients who are considering non-traditional medicines should thoroughly investigate the therapy and consult with their physicians or alternative medicine practitioners to make sure the therapy is safe and will not interact with other medicines they may be taking.

The National Institutes of Health recommends that patients ask the following questions when considering an alternative or complementary therapy:

• What benefits can be expected from this therapy?
• What are the risks associated with this therapy?
• Do the known benefits outweigh the risks?
• What side effects can be expected?
• Will the therapy interfere with conventional treatment?
• Will the therapy be covered by health insurance?

Types of Alternative/Complementary Therapies

Mind-Body/Spiritual: These therapies often focus on the emotional and psychological aspects of a patient’s health. Studies have shown that stress levels and emotional outlooks can impact an arthritis patient’s health. Examples of mind-body or spiritual therapies include hypnosis, breathing techniques, dance, music, art therapy, poetry, prayer, and meditation. Many of these therapies originated in ancient Eastern cultures.

Oriental Medicine: This category of medicine focuses on maintaining a balancing the body’s energies: the "yin" and the "yang." It attempts to accomplish this balance by restoring the body’s natural energy flow, called the qi (pronounced "chee").

Examples of oriental medicine include:

• Acupuncture: stimulating pressure points with needles.
• Acupressure: massage technique of pressure points.
• Moxibustion: heat therapy
• Qi Gong: applying finger pressure to acupuncture points. Qi Gong involves using breathing techniques and medication to strengthen the qi (the body’s natural immunity).
• Reiki ("Universal Life Energy"): involves channeling spiritual energy through the practitioner to help heal the body.

Ayurveda: This is India's traditional system of medicine. Ayurvedic means "science of life" and its system equally emphasizes the body, mind, and spirit to help restore harmony to the patient. Examples of Ayuvedic medicine include special diets, exercise, meditation, herbs, massage, exposure to sunlight, and controlled breathing.

Homeopathy: This Western therapy is based on the idea that a patient could be treated by using small doses of a medicine that produces the same symptoms as the patient’s illness. Supporters of homeopathy believe that diluted extracts from herbs, minerals, or animal substances can be potent remedies for illnesses and diseases.

Naturopathy: This therapy takes a natural approach to healing. Supporters of naturopathy see disease as an alteration of processes that can be healed naturally through diet, herbal remedies, exercise, homeopathy, massage, spinal and soft tissue manipulation, hydrotherapy (use of water to promote healing), counseling, light therapy, and other techniques. Some naturopaths practice Oriental medicine, including acupuncture.

Aromatherapy: This therapy was originally used in ancient Egypt and India and has become increasingly common in the United States since the early 1980s. Aromatherapy uses special scented oils to treat physical and emotional problems. The oils may be inhaled or applied topically to the skin, sometimes in the form of massage. Types of oils used during aromatherapy include eucalyptus, lavender, rosemary, and thyme. Aromatherapy is usually given by certified aromatherapists.

Biological therapies (vitamins, minerals, and herbs): This category of therapies involves the use of vitamins, minerals, or herbal supplements and is often used in conjunction with traditional therapies in cancer patients. An herb is a plant or an extract from the non-woody portion of a plant (the stems, leaves, flowers, etc.). Plant chemicals (called phytochemicals) are substances derived from plants that may have an effect on the body. In fact, many modern, traditional drugs were discovered from plants

Vitamins and minerals can help strengthen the body’s immune system. The main antioxidant vitamins are vitamin A, vitamin C, and vitamin E. In addition, deficiencies of vitamin B1 (thiamin), vitamin B2 (riboflavin), vitamin B5 (pantotheniec acid) and vitamin B12 can decrease white blood cell function. Some preliminary studies have shown that vitamins may help reduce the ill effects of arthritis.

Herbs and herbal supplements have also become more commonly used among arthritis patients in recent years. Herbal remedies may consist of single or multiple herbal mixtures. Currently, there is little scientific research on the effectiveness of herbs on arthritis. Still, some people find that taking herbal supplements is helpful for their arthritis. However, patients considering herbal diets should talk to their physicians since some herbs may interfere with other therapies or may be harmful if proper dosages are not followed.

Note, shark cartilage capsules became a popular alternative/complementary arthritis therapy after the book, Sharks Don’t Get Cancer by William Lance, was first published in 1993. A new study shows that shark cartilage does not have any effect on arthritis.

This section outlined a few of the common schools of alternative and complementary medicine. There are many more therapies available. Although research on non-traditional medicine is limited at this time, many physicians are beginning to embrace some complementary medicines as useful supplements to traditional arthritis treatment in selected cases. People interested in learning more about alternative and complementary therapies should speak with their physicians or alternative medicine practitioners.

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