03/07/2017., universities, & medical schools.

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1 03/07/2017 WELCOME TO:, universities, & medical schools. (I started teaching >55 years ago in 1960 and I ve never stopped)

2 Complementary & Alternative Medicine (CAM) Massage Therapy Herbal Medicine Acupuncture Nutrition Therapy what works - what doesn't - and why

3 All kinds of people- with all sorts ofhealth issues issues -areincreasingly considering* Complementary& Alternative Medicineas a potential solution to a problem... *Some thoughtfully, Some more urgently... Any one here like that? What sorts of problems?

4 Coarse Mechanics: While I know what I m going to be talking about today, I haven't anything planned for next week or the weeks thereafter. What I ll be talking about is - UP TO YOU

5 I need you to VOTE for the topics you want to learn about -and-we ll discuss two topics/week starting next week.

6 Complementary & Alternative Medicine (CAM) Massage Therapy Herbal Medicine Acupuncture Nutrition Therapy LET US BEGIN

7 Here are some examples of thehealth health issues people areincreasingly considering Complementary& Alternative Medicinefor as answers for those issues.... nausea headaches diarrhea constipation And, here are the answers

8 Here are some examples of thehealth health issues people areincreasingly considering Complementary& Alternative Medicinefor as answers for those issues.... Especially popular *

9 AND all kinds of people- with all sorts of health solutions -are marketingvarious Complementary& Alternative Medicinemodalities as ways to fix those problems Especially popular * Which one(s) should you pick? Which ones actually work?

10 AND all kinds of people- with all sorts of health solutions -are marketingvarious Complementary& Alternative Medicinemodalities as ways to fix those problems Especially popular * Which one(s) do you pick? Which ones actually work? [ NOTE: * Osteopathy in the U.S. is different than elsewhere SEE Wikipedia ]

11 Some of these therapies are BOGUS.. Some of them WORK. BUT,which is which? That s why the National Center for Complementary & Integrative Health exists. * NCCIH has your back!

12 So What works? What doesn t? * And, Why?

13 And Where can you go to find out? *

14 This class will be over in a few weeks. What will you do then? *

15 This class will be over in a few weeks. What will you do then? The most important thing I can doasateacherinthisclassis- *

16 This class will be over in a few weeks. What will you do then? The most important thing I can doasateacherinthisclassis- NOTanswer your questions, *

17 This class will be over in a few weeks. What will you do then? The most important thing I can doasateacherinthisclassis- NOTanswer your questions, but show you how to find answers to questions on your own. *

18 SO Here is your first set of resources * (NOTE: copies of all PowerPoints will be posted on the course webpage)

19 Material presented here was taken from these and similar web sites: National Center for Complementary & Integrative Health (NCCIH) MUCH, MUCH more on this website in a moment Cochrane.Org Great Britain s highly respected equivalent to the NCCIH Wikipedia medical and related articlespublished there are currently peer-reviewed, updated, and fully referenced by MD s from Cochrane.Org (see above) National Library of Medicine: PubMedCentral (PMC) recent public access research articles (FREE) are available if research is funded by NIH (add public access to your search terms in addition to publication name, key words, etc.) Science-Based Medicine BLOG Maintained by a highly motivated group of MD s who hate faulty logic and medical research poorly done Health News Reviews BLOG A team of journalists who grade health news reported by major news organizations, point out bad reporting and faulty logic, etc. QuackWatch.Org some stuff is dated but still useful Snopes.com Fake News debunking site inc. health news - [alsosee:

20 NCCIH NCCIH one of the National Institutes of Health a look from the A Little History & A Lot of Politics -or - INSIDE Getting timely, accurate information to you - the public - isn t easy

21 A Very Brief History of the NCCIH Tom Harkin (a life-long believer in alternative medicine) was a U.S. Congressman ( ) and a Senator ( ) from Iowa who served on the Agriculture, Nutrition, and Forestry Committee. His committeecreated the Office of Alternative Medicine (OAM) in 1992 in the hope that it would confirm and promote his belief in Alternative Medicine. In 1998, the OAM was incorporated into the National Institutes of Health, to Harkin's chagrin, and renamed the National Center for Complementary & Alternative Medicine (NCCAM). Subsequently, it was renamed the National Center for Complementary and Integrative Health (NCCIH) as alternative medicine does not lend itself to scientific investigation, so research in that area was discontinued. Senator Harkin has been disappointed the NCCAM/NCCIH never confirmed his belief in alternative medicine. It is now one of 21 Institutes & 6 Research Centers at NIH in Bethesda, MD. It s mission is to define, by rigorous research, the usefulness and safety of complementary and integrative health interventions and their roles in improving health and health care.

22 U.S. Govt. NCCIH

23 U.S. Government Quick Review

24 U.S. Govt.

25 U.S. Govt.

26 U.S. Govt.

27 U.S. Govt.

28 U.S. Govt.

29 U.S. Govt.

30 U.S. Govt. Various corporations lobby Congress to protect their interests

31 U.S. Govt.

32 U.S. Govt.

33 Ways Medicine NCCIH Can Be Practiced a look from the (the field of medicine is broader than most people realize and there is more than one kind of medical care) INSIDE

34 The Five Major Philosophies/ Schools of Medical Thought in the United States: Allopathic Medicine: a system of care that combats diseases by using remedies (drugs, surgery, etc.) that produce effects that are different from or incompatible with (i.e.- interferes with/ cures ) the pathologic condition/disease being treated*.

35 The Five Major Philosophies/ Schools of Medical Thought in the United States: Allopathic Medicine: a system of care that combats diseases by using remedies (drugs, surgery, etc.) that produce effects that are different from or incompatible with (i.e.- interferes with/ cures ) the pathologic condition/disease being treated*. Chiropractic Medicine: a system of care which holds disease results primarily from a lack of normal nerve function and which requires manipulation and the specific adjustment of body structures (i.e.- the spinal column) to restore normal function

36 The Five Major Philosophies/ Schools of Medical Thought in the United States: Allopathic Medicine: a system of care that combats diseases by using remedies (drugs, surgery, etc.) that produce effects that are different from or incompatible with (i.e.- interferes with/ cures ) the pathologic condition/disease being treated*. Chiropractic Medicine: a system of care which holds disease results primarily from a lack of normal nerve function and which requires manipulation and the specific adjustment of body structures (as the spinal column) to restore normal function Homeopathic Medicine:a system of care that treats a disease by the administration of minute doses of a remedy /foreign agent that will, in larger amounts, produce in a healthy person symptoms similar to those of the disease. (i.e.- like cures like ).

37 The Five Major Philosophies/ Schools of Medical Thought in the United States: Allopathic Medicine: a system of care that combats diseases by using remedies (drugs, surgery, etc.) that produce effects that are different from or incompatible with (i.e.- interferes with/ cures ) the pathologic condition/disease being treated*. Chiropractic Medicine: a system of care which holds disease results primarily from a lack of normal nerve function and which requires manipulation and the specific adjustment of body structures (as the spinal column) to restore normal function Homeopathic Medicine:a system of care that treats a disease by the administration of minute doses of a remedy /foreign agent that will, in larger amounts, produce in a healthy person symptoms similar to those of the disease. (i.e.- like cures like ). Naturopathic Medicine: a system of care that avoids all drugs and surgery and emphasizes the use of natural agents (air, water, and herbs) and means such as tissue manipulation/massage and electrotherapy to heal that part of the body responsible for the symptoms seen after which the problem then resolves.

38 The Five Major Philosophies/ Schools of Medical Thought in the United States: Allopathic Medicine: a system of care that combats diseases by using remedies (drugs, surgery, etc.) that produce effects that are different from or incompatible with (i.e.- interferes with/ cures ) the pathologic condition/disease being treated. Chiropractic Medicine: a system of care which holds disease results primarily from a lack of normal nerve function and which requires manipulation and the specific adjustment of body structures (as the spinal column) to restore normal function Homeopathic Medicine:a system of care that treats a disease by the administration of minute doses of a remedy /foreign agent that will, in larger amounts, produce in a healthy person symptoms similar to those of the disease. (i.e.- like cures like ). Naturopathic Medicine: a system of care that avoids all drugs and surgery and emphasizes the use of natural agents (air, water, and herbs) and means such as tissue manipulation/massage and electrotherapy to heal that part of the body responsible for the symptoms seen after which the problem then resolves. Osteopathic Medicine(as currently practiced in the U.S. sort of an MD & a DC in one) a system of care based on a theory diseases may be due, at least in part, to a loss of structural integrity which may be restored by manipulation of the parts involved while other diseases may require drugs, surgery, etc. What philosophy/school of thought does the doctor do you go to subscribe to?

39 The Five Major Philosophies/ Schools of Medical Thought in the United States: Allopathic Medicine MD: a system of care that combats diseases by using remedies (drugs, surgery, etc.) that produce effects that are different from or incompatible with (i.e.- interferes with/ cures ) the pathologic condition/disease being treated*. Chiropractic Medicine DC: a system of care holding disease results primarily from a lack of normal nerve function and which requires manipulation and the specific adjustment of body structures (as the spinal column) to restore normal function Homeopathic Medicine PhD:a system of care that treats a disease by the administrationof minute doses of a remedy that would, in larger amounts, produce in a healthy person, symptoms similar to those of the disease. (i.e.- like cures like ). Naturopathic Medicine ND: a system of care that avoids all drugs and surgery and emphasizes the use of natural agents (air, water, and herbs) and means such as tissue manipulation/massage and electrotherapy to heal that part of the body responsible for the symptoms seen after which the problem then resolves. Osteopathic Medicine DO(as currently practiced in the U.S. sort of an MD & a DC in one) a system of care based on a theory diseases may be due, at least in part, to a loss of structural integrity which may be restored by manipulation of the parts involved while other diseases may require drugs, surgery, etc*. What philosophy/school of thought does the doctor do you go to subscribe to? (* we will notget into allied health professions nurses, therapists, technicians, assistants, aides, etc.)

40 NCCIH NCCIH -and And the Kind of Medical a look from the Practices It Studies INSIDE

41 OLD NEW What s the Difference?

42 Thoughts BEFORE NCCIH risk vs. evidence Brain Surgery Worked largely independently of each other [they don t refer to MD s & MD s don t refer to them] There is LOTS Accepted of evidence, /Proven it will work. Let s Medical proceed! Practices ALL RESEARCH There is some evidence, it may/may not work. If not... NO RESEARCH We NO RESEARCH need no evidence /research. Werely on tradition. Family Practice Extensive [Needed For High- Risk Procedures] Little [Needed For Low- Risk Procedures] From Scientific Research that something will work No Research No Research ( anecdotal evidence only)

43 OLD NCCAM Brain Surgery [will work with open minded MD s & MD s refer to them & vice versa] [they don t refer to MD s & MD s don t refer to them] Family Practice Proven Medical Practices (not studied by NCCAM) Extensive Needed For High- Risk Procedures NCCAM research to determine its validity Little Needed For Low- Risk Procedures From Scientific Research Developed before the advent of the scientific method. NOinterest by its practionersin research* No Research *It s been around for 100 s of years. If it ain t broke, don t fix it.

44 NEW NCCIH [will work with open minded MD s & MD s refer to them & vice versa] [they don t refer to MD s & MD s don t refer to them] Accepted /Proven Medical Practices Overlap = Integrative Healthcare Dumped by NIH NCCAMNCCIH NCCIH due to lack of interest by alt med side; but, we ll talk about it. Extensive For High-Risk Procedures Experimental Evidence via The Scientific Method Little For Low-Risk Procedures From Scientific Research No Research

45 NEW NCCIH [will work with open minded MD s & MD s refer to them & vice versa] [they don t refer to MD s & MD s don t refer to them] Accepted /Proven Medical Practices e.g.- chamomile as a pre-op tranquilizer -or - acupuncture to reduce post-op op nausea/vomiting Dumped by NIH NCCAMNCCIH NCCIH due to lack of interest by alt med side; but, we ll talk about it. Extensive For High-Risk Procedures Experimental Evidence via The Scientific Method Little For Low-Risk Procedures From Scientific Research No Research

46 NCCIHCIH NCCIH one of the six Research Research Centers at the National Institutes of Health a look from the An Overview of What It Does INSIDE

47 So, what sort of information is at (it s F R E E) also below

48 Safe Use of Complementary Health Products & Practices If you use both Rx meds AND herbal meds, check here every time you start or change an Rx medor an Herbal Med ALSO -

49 SEARCH PRODUCTS BY NAME AT -

50 SEARCH PRODUCTS BY NAME AT Cialisan an Rx med ( more complete info when first listed ) - - Common side effects of Cialis include flushing (redness or warmth of the face, neck, or chest), headaches, stomach upset, diarrhea, flu-like symptoms (such as stuffy nose, sneezing, or sore throat), memory problems, muscle - (back) pain, nausea, low blood pressure, blurred vision, changes in color vision, abnormal ejaculation, and priapism(prolonged/painful erections). Most clinicians consider priapism a medical emergency-it can result in impotence, sexual dysfunction and/or penile infection.

51 SEARCH PRODUCTS BY NAME AT Cialis( ( more complete info when first listed ) How can you avoid buying potentially harmful products that make it to retail stores?

52 When Shopping - The safest products to ( or maybe the least unsafe ) buy are CERTIFIED WARNING: While standards of these labs aren t as rigorousas FDA standards, they re still important as the FDA doesn t routinely testotc supplements. What 'USP Verified' and Other Supplement Seals Mean Where do initial test samples come from? Purchased in stores. Provided by the manufacturer. Provided by the manufacturer. Provided by the manufacturer. How often are samples retested or spot-check? Once per / yearusing samples from stores. Once / year using samples from the manufacturer. One to six times / year using samples from stores. Twice / year using samples from stores. Do manufacturers pay for certification? [ potential conflict of interest ] YES YES YES YES Are there any products they won t test? If they won t test, should you buy? Products containing ingredients known to be unsafe. Products marketed for weight loss or sexual enhancement. Products containing unsafe ingredients and products for erectile dysfunction, weight loss, or sports. Products containing unsafe ingredients or not recognized as dietary ingredients by the FDA.

53 The safest products to ( or maybe the least unsafe ) buy are CERTIFIED WARNING: While standards of these labs aren t as rigorousas FDA standards, they re still important as the FDA doesn t routinely testotc supplements. What 'USP Verified' and Other Supplement Seals Mean Where do initial test samples come from? Purchased in stores. Provided by the manufacturer. Provided by the manufacturer. Provided by the manufacturer. How often are samples retested or spot-check? Once per / year using samples from stores. Once / year using samples from the manufacturer. One to six times / year using samples from stores. Twice / year using samples from stores. Should you buy/use something that isn t CERTIFIED? Are there any products they won t test? If they won t test, should you buy? Products containing ingredients known to be unsafe. Products marketed for weight loss or sexual enhancement. Products containing unsafe ingredients and products for erectile dysfunction, weight loss, or sports. Products containing unsafe ingredients or not recognized as dietary ingredients by the FDA.

54 So, what s at - see below So you can understand what is going on

55 Know the Science- On this page you'll find tools to help you better understand scientific topics that relate to health research so you can be discerning about what you hear as well as make informed decisions about your health. Know More (ARTICLES) Finding and Evaluating Online Resources on Complementary Health Approaches How To Find Information About Complementary Health (PubMed) Understanding Risk: What Do Those Headlines Really Mean?(NIA) Understanding Medical Words(NLM) Frequently Asked Questions About Clinical Research(NHGRI) Beware of Health Scams(NIA) About Clinical Effectiveness Research(NLM) Understand Research Results(NLM) Why Do Researchers Do Different Kinds of Studies?(NIH) (317KB PDF) Understanding Clinical Studies(NIH)

56 SUBSCRIBE!!! its FREE

57 MOST RECENT ISSUE - FEB 17

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61 Who do you go to if you want to learn about herbal products: -a website promoting a product you found in an on-line ad? notagoodood plan -a WalMart minimum wage earning/dropout shelf-stocker? stocker? notagoodood plan Multi-Vitamins Herbal Products (NOTE: pharmacists don t order the stuff stocked on store shelves; so, don t ask them)

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63 Herbs at a Glance: Herbal Products Widely Used in the U.S. Discussed in Depth National Center for Complementary & Integrative Health (NCCIH) Acai Aloe Vera Asian Ginseng Astragalus Bilberry Bitter Orange Black Cohosh Bromelain Butterbur Cat's Claw Chamomile Chasteberry Cinnamon Cranberry Dandelion Echinacea Ephedra European Elder European Mistletoe Evening Primrose Fenugreek Feverfew Flaxseed Garcinia Cambogia Garlic Ginger Ginko Goldenseal Let s look at - Grape Seed Green Tea Hawthorne Hoodia A Chinese Restaurant Favorite Horse Chestnut Kava Lavender Licorice Root Milk Thistle Noni Passion Flower Peppermint Oil Pomegranate Red Clover Rhodiola Sage Saw Palmetto Soy St. John s Wort Tea Tree Oil Thunder God Vine Turmeric Valerian Yohimbe

64 Green, black, and oolong teas all come from Camellia sinensis, but are produced using different methods. For green tea, fresh leaves are lightlysteamed. Tea has been used for medicinal purposes in China and Japan for 1000 s ofyears. It is used as a beverage or dietary supplement. Proponents say it improves mental alertness, relieves digestive symptoms and headaches, and promotes weight loss. Green tea and its extracts, such as EGCG, are studied for possible protective effects against heart disease and cancer. How Much Do WeKnow? Though many studies have been done, definite conclusions cannot yet be reached on whether green tea is helpful for most of the purposes for which it istouted.

65 Other GOOD resources on the topic of herbal medicines Should You Take Dietary Supplements? - Vitamins, Minerals, Botanicals, and More(NIH) Botanical Dietary Supplements (NIH) - FDA Alerts and Advisories (FDA) MedlinePlus: Herbs and Supplements Herbal Health Products and Supplements (Am Acad Family Practice) familydoctor.org Nutrition and Healthy Eating Life Style Mayo Clinic Some herbal supplements can have dangerous interactions with heart medications.

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