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| C. A. M. |
| ALTERNITIVE |
| MEDICINE |
| Complementary and Alternative Medicine in MS by Allen C. Bowling, MD, PhD, Rocky Mountain MS Center COMPLEMENTARY AND ALTERNATIVE MEDICINE In the United States, there is growing interest in what has become known as �alternative medicine,� especially among people with chronic diseases such as multiple sclerosis (MS). The use of unconventional therapies may be �complementary� (used in combination with conventional medicine) or �alternative� (used instead of conventional medicine). A broad term that includes both of these approaches is �complementary and alternative medicine,� or �CAM.� Recent studies indicate that 50�60% of people with MS use some form of CAM. Popular CAM therapies include diets, dietary supplements, acupuncture, meditation, massage, and yoga. Approximately 90% of people with MS who use CAM also use conventional medicine. In other words, CAM is usually used in a complementary manner by people with MS. Unfortunately, MS patients often withhold information about their CAM use from their physicians. Physicians often lack understanding about the use of CAM, and accurate information about CAM that is relevant to the treatment of MS is difficult to find. To address these gaps, the CAM Program was developed at the Rocky Mountain MS Center. This bulletin is based on information compiled from this source. COMPLEMENTARY AND ALTERNATIVE THERAPIES Herbal Medicine Herbal therapy is one of the most accessible forms of CAM. Since herbs are not under strict FDA regulation, they should be used with caution. There are several important principles about herbal therapy: Herbs are often used as drugs. Herbs contain many different compounds, some of which may be toxic or interact with other drugs. Herbs may contain compounds that have not been identified or characterized, and may be different from those on the label. The quality and composition of herbal preparations are variable. Herbs should only be used for a short time, for benign, self-limited conditions. Herbs should be avoided in women who are pregnant or breastfeeding, people with multiple medical problems or taking multiple medications, and children. Herbal preparations that may be effective include cranberry tablets for the prevention of urinary tract infections and psyllium for constipation (FDA approved). Valerian may be effective for insomnia. St. John�s wort has long been widely used in Europe for the treatment of depression. While it may have an antidepressant effect, the strength of this effect and the full range of toxicity have not been established. In an effort to clarify these issues, a multi-center placebo-controlled clinical trial was conducted at Vanderbilt University. Results of this study indicated that St. John�s wort is not effective for moderate or severe depression. A three-year, multi-site, clinical trial coordinated by Duke University and funded by the National Institutes of Health confirmed that St. John�s wort is no more effective than placebo for moderately severe depression. In separate studies, St. John�s wort has been found to interact with an antiviral medication for HIV infection called indinavir, and with cyclosporine, a drug used to prevent rejection of organ transplants. St. John�s wort may also interfere with the effectiveness of oral contraceptives and medications for heart disease, seizures, and certain cancers. Certain herbs might worsen MS or interact with medications. MS patients should use care with herbs that may have immune-stimulating properties, including alfalfa, astragalus, echinacea, garlic, and Asian ginseng. Patients who have fatigue or take sedating medications, such as lioresal (Baclofen�), tizanidine (Zanaflex�), and diazepam (Valium�), should be careful about using potentially sedating herbs, which include chamomile, Asian and Siberian ginseng, goldenseal, kava kava, stinging nettle, passionflower, sage, St. John�s wort, and valerian. Steroid side effects may be worsened by some herbs, including aloe, bayberry, Asian ginseng, and licorice. Herbs sometimes recommended for MS that may cause serious side effects include chaparral, comfrey, lobelia, and yohimbe. HYPE OR HOPE? Does CAM use in MS provide hope or is it simply meaningless hype? The answer is �both.� Some therapies have produced promising results, others are excessively promoted but ineffective or unsafe, and a large number have yet to be studied carefully in people with MS. This large variability in the possible effectiveness of different therapies is the cause for much of the confusion and controversy in CAM. Improving the way in which CAM is used involves increasing communication between people with MS and health care professionals, providing accurate CAM information to people with MS, and conducting reliable studies to determine which therapies are effective. |
| I DO NOT SUPPORT OR INDORCE C.A.M. THERAPY. THIS IS FOR INFORMATION PURPOSE ONLY!! PLEASE CONSULT YOUR DOCTOR BEFORE USING ANY TYPE OF ALTERNITIVE MEDICINE INCLUDING VITAMINS... |
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