Yarg.
I hate “alternative medicine.” Alternative medicine suggests that the patient has turned their backs on conventional/ Western/boring medicine and has headed out on a fantastical pathway of crystals, oils and unresearched herbals. As a Western medicine practitioner, I respect that my medical care is backed with peer-reviewed articles. I also recognize the validity of Eastern medicine, with its centuries of empiric evidence, and more recently, published data as well. And I heartily embrace complementary medicine—more on that in a bit.
My dislike—nay, hatred—of alternative medicine comes via the deaths of two friends. Early in my gastroenterology career, my roommate, Stephanie, had found a breast lump. After a non-diagnostic needle biopsy of the mass, she elected to “go alternative,” although her medical team strongly encouraged a second biopsy via ultrasound guidance. She drank hot potions of stewed balls of something noxious (that I swear, based on the smell, was manure) and juiced alfalfa and carrots—half our shared refrigerator was full of bags of carrots and sod. I bit my tongue firmly and was ready to offer medical insight and advice when asked—yet she didn’t ask. The end of her story was death by metastatic breast cancer, despite last-ditch efforts of surgery, radiation and chemotherapy.
Another vibrant friend, Sandy, died of “dunno what.” She began to waste away, weakness progressing and eventually rendering her unable to walk and confined to her second-floor bedroom. She continued to see her alternative medicine practitioner, who treated her with oils and crystals, but without any Western medicine testing or evaluation. Was it autoimmune? Cancer? My differential diagnosis without any exam or testing was vast. I visited Sandy with a mutual friend mid-course, and the changes wrought by her illness were shocking. She also died, but I continue my belief that the culprit may have been manageable or curable with the application of science.
However, I have no beef with—and even joyously embrace— complementary medicine. The American Heritage Dictionary defines complementary medicine as “a method of healthcare that combines the therapies and philosophies of conventional medicine with those of alternative medicines, such as acupuncture, herbal medicine, and biofeedback.”
In fact, finding complementary medicine practices that have medical science to support them gives me a head rush. They are a positive action that you as patient might adopt, with little chance of a downside, side effect or complication—and you get to assume some measure of ownership of your health. There are a slew of data-supported complementary practices; here are some of my favorites that you might incorporate into your life as a healthcare professional, or into your patients’ or family’s lives.
Probiotics and Cranberries to Reduce Chronic UTI
Use of probiotics, specifically lactobacillus rhamnosis and lactobacillus reuteri, have been demonstrated in the spinal-cord injury population requiring intermittent catheterization, and in the mainly female recurrent/chronic UTI population, to reduce the bacterial counts (mainly gastrointestinal E. coli), reduce adherence of pathogenic bacteria to the urinary mucosa, reduce recurrent infections, and reduce antibiotic resistance of the pathogenic bacteria.
The data isn’t perfect,1,2,3 but I was moved to go online and put Mom on a daily probiotic of lactobacillus rhamnosus GR-1 and lactobacillus reuteri RC-14 strains for her chronic multidrug-resistant UTI. Oh, and her daily fresh cranberry orange relish that Mom swears by helps too, just as she said. The recipe follows.
Nancy Raymond’s Cranberry Orange Relish Recipe
- 3 cups fresh or frozen cranberries
- 2 navel oranges, washed, unpeeled and quartered
- 1 cup sugar, or less to taste (I prefer about 1/3 cup—it’s easy to add more later)
- 1/2 cup pecans, finely chopped
Add the oranges to a food processor and whiz until they are finely ground to pulp. Add the cranberries and sugar, and pulse until just coarsely ground. Remove to a storage bowl and stir in the pecans. Cover and refrigerate.
Dietary Strawberries for Osteoarthritis of the Knees in Overweight Postmenopausal Women
Yikes. The title says it all.
However, in Schell’s elegant, double-blind crossover study, participants drank either faux strawberry milkshakes or those made with freeze-dried strawberries (equivalent to about a pound of berries daily) for 12 weeks, with a two-week washout period. The results showed significant decrease of serum biomarkers of inflammation and cartilage degradation [interleukin (IL)-6, IL-1β, and matrix metalloproteinase (MMP)-3] after daily strawberry ingestion. Eating strawberries didn’t just improve labs; the berries also significantly reduced constant, intermittent and total pain and improved a quality-of-life assessment score (HAQ-DI).
Some studies suggest that strawberries reduce the proinflammatory and glucose surge effect when acutely taken with a non-nutritious meal and can downgrade the histologic grade of dysplastic esophageal lesions, which your Barrett’s patients might like to hear.4,5
Yup, I’m enjoying my daily berries, be they fresh, frozen, or freeze-dried from Trader Joe’s. Nope, no untoward side effects so far. (Hint: they’re strawberries.)
Boswellia (Frankincense) for Knee and Hip Pain as an Alternate NSAID
Here’s a particular favorite: Boswellia serrata, an extract from the frankincense plant, is an anti-inflammatory that works via a different pathway that the standard NSAIAs. It’s slow in onset (don’t expect the rapid relief you can achieve with a dose of ibuprofen); it seems to reach efficacy in about five to seven days, in my personal experience. As it follows a different pathway, it doesn’t cause the gastrointestinal irritation and ulcers common with other anti-inflammatories.
Studies show efficacy pain relief in knee and hip osteoarthritis,6,7,8 and it’s been trialed for pancreatitis and for treatment-induced swelling by irradiation of brain tumors, among other inflammatory processes. In the osteoarthritis studies, they reported a reduction in C-reactive protein, and in radiographs, improved knee joint gap and reduced osteophytes.
Researchers believe it may have efficacy in a plethora of chronic diseases, which raises a major red flag for me: “chronic diseases like arthritis, diabetes, asthma, cancer, inflammatory bowel disease, Parkinson’s disease, [and] Alzheimer’s.” This gets a little Middle Earth to me, as in “One Ring to rule them all, One Ring to find them, One Ring to bring them all, and in the darkness bind them” (JRR Tolkien). A worrisome overpromise, in my opinion.
When I suggest the use for arthritis pain and stiffness, target dosage is 600 milligrams daily, and I suggest initial trial use for a month. It is difficult to determine the absence of discomfort, so at the end of month one, I recommend stopping the Boswellia. In most, the missing discomfort is uncovered after several days of abstinence. Useful information for your arthritis-ridden ulcer patients, no?
Turmeric for Ulcerative Colitis Maintenance of Remission
I’m passionate about this complementary move, not only for my erstwhile patients, but also because a family member was recently diagnosed with ulcerative colitis. I frequently suggested to my patients that turmeric had a studied beneficial effect on their colitis course. In this recent meta-analysis of seven turmeric studies, combining use of curcumin with mesalamine in mild-to-moderate UC yields both a superior clinical and endoscopic response.9 Yes, it actually works “for realz.”
Their analysis was:
- Odds ratio (OR) for clinical remission with curcumin was 2.9
- OR for a clinical response with curcumin was 6
- OR for an endoscopic response and/or remission with curcumin was 2.3
Yes, that’s makes success about two to three times more likely for your patients, no matter how you’ve defined success.
Type 2 Diabetes and the Vegan Diet
Although the vegan diet is rich in high-fiber carbohydrates, this whole-food, plant-based diet is now widely understood to prevent, treat and even reverse Type 2 diabetes.10 And the complications, cardiac and renal disease and diabetic neuropathy all also improve with a vegan diet.
Why wouldn’t you offer this information and the support to make this choice for your diabetics?
There are uncountable others—it’s worth going to Dr. Google to see what’s the buzz, and then into PubMed and entering your disease du jour and seeing what complementary agents have been studied. If you feel moved to add some complementary medicine to your practice or your life, peruse the medical literature yourself and weigh the risks and benefits. For me, the risks (usually a modest expense) versus the benefits (somewhat soft data, but data nonetheless) make complementary medicine worth trying.
After all, what’s the alternative?
For article references, visit www.EndoProMag.com.
