DOCSLIB.ORG

Complementary and Alternative Medicine in Back Pain Utilization Report

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Complementary and Alternative Medicine in Back Pain Utilization Report Evidence Report/Technology Assessment Number 177 Complementary and Alternative Medicine in Back Pain Utilization Report Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 http://www.ahrq.gov Contract No. 290-02-0020 Prepared by: McMaster University Evidence-based Practice Center Hamilton, Ontario, Canada EPC Director: Parminder Raina, Ph.D. Principal Investigators: P. Lina Santaguida, B.Sc.PT., Ph.D. Anita Gross, B.Sc.PT., M.Sc. (Clin Epi) Authors: P. Lina Santaguida, B.Sc.PT., Ph.D. Anita Gross, B.Sc.PT., M.Sc. (Clin. Epi.) Jason Busse, D.C., Ph.D. Joel Gagnier, B.A., N.D., Ph.D. Kathryn Walker, B.Sc, B.Ph.E, M.Sc.P.T. Mohit Bhandari, M.D. M.Sc. F.F.C.S.C. Parminder Raina, B.Sc., Ph.D. AHRQ Publication No. 09-E006 February 2009 This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted for which further reproduction is prohibited without the specific permission of copyright holders. Suggested Citation: Santaguida PL, Gross A, Busse J, Gagnier J, Walker K, Bhandari M, Raina P. Evidence Report on Complementary and Alternative Medicine in Back Pain Utilization Report. Evidence Report/Technology Assessment No. 177. (Prepared by the McMaster University Evidence-based Practice Center, under Contract No. 290-02-0020.) AHRQ Publication No.09-E006) Rockville, MD. Agency for Healthcare Research and Quality. February 2009. No investigators have any affiliations or financial involvement (e.g., employment, consultancies, honoraria, stock options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in this report. ii Preface The Agency for Healthcare Research and Quality (AHRQ), through its Evidence-Based Practice Centers (EPCs), sponsors the development of evidence reports and technology assessments to assist public- and private-sector organizations in their efforts to improve the quality of healthcare in the United States. The reports and assessments provide organizations with comprehensive, science-based information on common, costly medical conditions and new health care technologies. The EPCs systematically review the relevant scientific literature on topics assigned to them by AHRQ and conduct additional analyses when appropriate prior to developing their reports and assessments. To bring the broadest range of experts into the development of evidence reports and health technology assessments, AHRQ encourages the EPCs to form partnerships and enter into collaborations with other medical and research organizations. The EPCs work with these partner organizations to ensure that the evidence reports and technology assessments they produce will become building blocks for health care quality improvement projects throughout the Nation. The reports undergo peer review prior to their release. AHRQ expects that the EPC evidence reports and technology assessments will inform individual health plans, providers, and purchasers as well as the healthcare system as a whole by providing important information to help improve health care quality. We welcome comments on this evidence report. They may be sent by mail to the Task Order Officer named below at: Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, or by e-mail to [email protected]. Carolyn M. Clancy, M.D. Beth A. Collins Sharp, R.N., Ph.D. Director Director, EPC Program Agency for Healthcare Research and Quality Agency for Healthcare Research and Quality Jean Slutsky, P.A., M.S.P.H. Margaret Coopey, R.N., M.G.A., M.P.S. Director, Center for Outcomes and Evidence Task Order Officer, EPC Program Agency for Healthcare Research and Quality Agency for Healthcare Research and Quality iii Acknowledgments We thank the representatives of our partner organization, National Center for Complementary and Alternative Medicine (NCCAM). Our thanks go to librarian Maureen Rice for her thorough management of the search terms and methodology. We would like to thank the following people who helped with screening, and the data abstraction for this review: Connie Freeborn, Rob Stevens, Lynda Booker, Solina Yoo, Kathryn Walker, and Mary Gauld. We would also like to thank Mary Gauld, Lynda Booker, and Kathryn Walker for their coordination activities. Our editorial staff, Cecile Royer, Roxanne Cheeseman, and Maureen Rice have provided invaluable input into this document. iv Structured Abstract Objectives: This systematic review was undertaken to evaluate which complementary and alternative medicine (CAM) therapies are being used for persons with back pain in the United States. Data Sources: MEDLINE®, EMBASE®, CINAHL® and Cochrane Central® and a variety of CAM specific databases were searched from 1990 to November 2007. A grey literature search was also undertaken, particularly for clinical practice guidelines (CPG) related to CAM. Review Methods: Standard systematic review methodology was employed. Eligibility criteria included English studies of adults with back pain, and a predefined list of CAM therapies. Results: A total of 103 publications were evaluated; of these 29 did not present CAM therapy use stratified for back pain. There were a total of 65 utilization studies, 43 of which were American. Four publications evaluated the concurrent use of four or more CAM therapies and these suggest that chiropractic/manipulation is the most frequently used modality followed by massage and acupuncture. A limited number of publications evaluated utilization rates within multiple regions of the back and show that CAM was used least for treating the thoracic spine and most for the low back. However, rates of use of massage were similar for neck and lower back regions. Concurrent use of different CAM or conventional therapies was not well reported. From 11 eligible CPG, only one (for electro-acupuncture) provided recommendations for frequency of use for low back pain of all acuity levels. Eighteen cost publications were reviewed and all but one publication (cost-effectiveness) were cost identification studies. There is limited information on the impact of insurance coverage on costs and utilization specific to back pain. Conclusions: There are few studies evaluating the relative utilization of various CAM therapies for back pain. For those studies evaluating utilization of individual CAM therapies, the specific characteristics of the therapy, the providers, and the clinical presentation of the back pain patients were not adequately detailed; nor was the overlap with other CAM or conventional treatments. v Contents Executive Summary........................................................................................................................ 1 Chapter 1. Introduction................................................................................................................. 11 Background............................................................................................................................... 11 What is CAM? ...................................................................................................................... 12 Who Uses CAM? .................................................................................................................. 13 What is CAM use and What are the Behavioral Models Explaining This Use? .................. 13 Evaluating the Methodological Quality of Studies Addressing Utilization of CAM ............... 14 Research Questions................................................................................................................... 15 Chapter 2. Methods...................................................................................................................... 17 Analytic Framework ................................................................................................................. 17 Scope of the Literature Search.............................................................................................. 17 Eligibility Criteria ................................................................................................................. 18 Data Collection and Reliability of Study Selection .............................................................. 23 Quality Criteria ..................................................................................................................... 23 Summarizing the Findings Descriptive and Analytic Approaches....................................... 23 Chapter 3. Results......................................................................................................................... 25 Question 1. What is the Relative Utilization for the Different CAM Therapies?.................... 27 Utilization of CAM, Data not Stratified by Back Pain or Therapy ...................................... 27 Utilization not Stratified by Back Pain Within the United States......................................... 27 Utilization not Stratified by Back Pain Within Other Countries .......................................... 28 Relative use of CAM Therapies............................................................................................ 28 Relative Utilization of CAM Therapies Within the United States ....................................... 29 Relative Utilization of CAM Therapies Outside the United States ...................................... 30 Trends in CAM Utilization ......................................................................................................
Load more

Recommended publications
  • What Is Commonly Known As Salt -Nacl- Is a Deceivingly Simple
    K. Хуесо, В. Карраско. In sale Salus: соли и соленые болотные угодья Европы для сохранения здоровья УДК 577.151.01 DOI: 10.18101/2306-2363-2017-4-11-25 * IN SALE SALUS: HEALTH PROVISION FROM SALT AND SALINE WETLANDS IN EUROPE © Kortekaas K. Hueso Institute of Saltscapes and Salt Heritage (IPAISAL), Apartado de Correos 50 28450 Collado Mediano, Spain ICAI Higher Technical School of Engineering, Department of Mechanical Engineering, Universidad Pontificia de Comillas Alberto Aguilera 25, Madrid, Spain © Vayá J-F. Carrasco Institute of Saltscapes and Salt Heritage (IPAISAL), Apartado de Correos 50 28450 Collado Mediano, Spain Among the often cited 14,000 uses of salt, many are related to wellness and health. Its different physical-chemical properties allow many health-related applications of salt itself, brine, mother lay and saline muds. Salt can be used as skin rubs or in blocks, for building halochambers; inhaled as aerosols or even ionised by lamps. Brine can be ingested or used for bathing and exercising in it. Mother lay is usually employed as a basis for cosmetics and skin treatments and muds are traditionally applied directly on the skin for similar ailments. Many of these applications have been known since the Antiquity and are still in use today. Some have disappeared or are only known at local scale, while others are growing in popularity, amid the surge of spa and wellness facilities worldwide. The also increasingly popular natural and alternative treatments have included salt-related healing. In this contribution, we will review among others the traditional uses of brine and salt for health provision; the therapeutic and wellness uses of mother lay and mud as a side activity for traditional salinas, some of which have built ad hoc spa and wellness centres; the now widespread phenomenon of salt caves and mines for halotherapy and the historical spas built around saline lakes, now in disuse.
    [Show full text]
  • Patients with Cancer. Is There a Role for Chiropractic? Maria Tsampika Laoudikou, Mchiro1 Peter William Mccarthy, Phd1
    ISSN 0008-3194 (p)/ISSN 1715-6181 (e)/2020/32–42/$2.00/©JCCA 2020 Patients with cancer. Is there a role for chiropractic? Maria Tsampika Laoudikou, MChiro1 Peter William McCarthy, PhD1 People who have a diagnosis of cancer may develop, Comme tout le monde, les personnes atteintes or already have musculoskeletal conditions, just d’un cancer peuvent développer des troubles like any other person. However, discussion about musculosquelettiques, si elles n’en ont pas déjà. En règle potential benefits of chiropractic treatment to this générale, on évite de discuter des éventuels bienfaits des group has generally been avoided related to the fear traitements chiropratiques pour ce groupe de personnes of misrepresentation. We aimed to derive a consensus de peur de faire de fausses déclarations. Nous avons from a group of experienced chiropractors regarding cherché à obtenir un consensus auprès d’un groupe their perception of what chiropractic care offered to de chiropraticiens d’expérience à qui on a demandé patients with cancer. An anonymous, two stage, on- ce qu’ils pensaient des traitements chiropratiques line, Delphi process was performed using experienced administrés aux patients cancéreux. On a mené une chiropractors (n=23: >10 yrs practice experience, who enquête Delphi anonyme, en deux étapes et en ligne, had treated patients with cancer) purposively selected auprès de chiropraticiens d’expérience (n =23 : >10 ans and recruited independently. One opted out of the study, d’exercice, ayant déjà traité des patients atteints d’un 13 actively engaged in two rounds of questions and cancer) choisis et recrutés de manière indépendante. verification; agreeing such patients gained benefit from L’un d’entre eux a abandonné l’étude, 13 ont répondu chiropractic care but use of spinal manipulation was à deux séries de questions et se sont soumis aux not essential.
    [Show full text]
  • Progress of Research of Hyperthermia Integration with TCM in the Treatment of Cancer
    Oncothermia Journal 7:36-42 (2013) Progress of research of hyperthermia integration with TCM in the treatment of cancer Prof. Dr. Clifford L.K. Pang1 (1) Clifford Hospital, 8 Shiguang Road, Panyu, Guangzhou, Guangdong Province, China Corresponding author: cpang@ Oncothermia Journal, June 2013 35 Progress of research of hyperthermia integration with TCM in the treatment of cancer With the development of clinical oncotherapies, integrative treatments have generally been recognized by the Oncology Association. Hyperthermia has proven its effectiveness in the treatment of cancer which is different from surgery, radiotherapy, chemotherapy and biotherapy. Besides integration with the above therapies, using this with TCM is a unique approach. The progress of research of hyperthermia integration with TCM in treating cancer will be presented according to the following six aspects:l 1. The advantages of hyperthermia in the treatment of cancer 2. The advantages of TCM in treating cancer 3. The advantages of hyperthermia in combination with TCM 4. An overview of the implementation of hyperthermia integration with TCM in treating cancer in Clifford Hospital 5. Clinical report of integrative therapy 6. The future of hyperthermia integration with TCM in treating cancer 1. The advantages of hyperthermia in treating cancer 1.1. Hyperthermia is part of the field of Natural Medicine. It targets cancer cells directly, improves the immune system, induces apoptosis of cancer cells, suppresses the formation of cancer vessels, destroys cancer vessels, and relieves pain caused by cancer. At the same time, hyperthermia has demonstrated no damage to normal tissue. 1.2. Hyperthermia can be utilized in conjunction with other cancer therapies and integrated into a comprehensive anti-cancer protocol.
    [Show full text]
  • Acupuncture, Chiropractic, Naturopathy, Massage Therapy)
    All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest 500 NE Multnomah St., Suite 100, Portland, OR 97232 ©2019 Kaiser Foundation Health Plan of the Northwest 337643167_LBG_04-19 Oregon PPO Plus® alternative care benefit (acupuncture, chiropractic, naturopathy, massage therapy) This benefit covers self-referred acupuncture, chiropractic, naturopathic, and massage therapy services. You may choose providers from PPO providers or non-participating providers. Choose your benefit maximum, 3 options: Benefit maximum per year (all services combined, all tiers combined) $1,000 / $1,500 / $2,000 Non-Participating PPO Providers Providers (Tier 1) (Tier 2)2 Services You Pay1 Specialty office visit Specialty office visit Acupuncture services cost share cost share Specialty office visit Specialty office visit Chiropractic services cost share cost share Specialty office visit Specialty office visit Naturopathic medicine cost share cost share Massage therapy (12-visit limit) $25 $25 1If added to an HSA-qualified deductible plan, this benefit is subject to the deductible. 2You may need to file a claim for covered services at non-participating providers. Office visits You do not need a referral to make an appointment. There is no claim form to file for services from Tier 1 providers; you pay your copay or coinsurance directly to the provider when you receive care. Once your benefit limit has been reached, you pay 100% of the cost of services for the remainder of the calendar year. PPO provider You may contact Member Services for additional information or visit kp.org/ppoplus/nw for information on locating a PPO provider. Acupuncture services Acupuncturists influence the health of the body by the insertion of very fine needles.
    [Show full text]
  • Huang-Lian Jie-Du Decoction
    Qi et al. Chin Med (2019) 14:57 https://doi.org/10.1186/s13020-019-0277-2 Chinese Medicine REVIEW Open Access Huang-Lian Jie-Du decoction: a review on phytochemical, pharmacological and pharmacokinetic investigations Yiyu Qi1,2,3, Qichun Zhang1,2,3,4* and Huaxu Zhu1,2,3* Abstract Huang-Lian Jie-Du decoction (HLJDD), a famous traditional Chinese prescription constituted by Rhizoma Coptidis, Radix Scutellariae, Cortex Phellodendri and Fructus Gradeniae, has notable characteristics of dissipating heat and detoxi- fcation, interfering with tumors, hepatic diseases, metabolic disorders, infammatory or allergic processes, cerebral diseases and microbial infections. Based on the wide clinical applications, accumulating investigations about HLJDD focused on several aspects: (1) chemical analysis to explore the underlying substrates responsible for the therapeutic efects; (2) further determination of pharmacological actions and the possible mechanisms of the whole prescrip- tion and of those representative ingredients to provide scientifc evidence for traditional clinical applications and to demonstrate the intriguing molecular targets for specifc pathological processes; (3) pharmacokinetic feature studies of single or all components of HLJDD to reveal the chemical basis and synergistic actions contributing to the pharma- cological and clinically therapeutic efects. In this review, we summarized the main achievements of phytochemical, pharmacological and pharmacokinetic profles of HLJDD and its herbal or pharmacologically active chemicals, as well as our understanding which further reveals the signifcance of HLJDD clinically. Keywords: Huang-Lian Jie-Du decoction, Traditional Chinese medicine, Phytochemical, Parmacological, Pharmacokinetic Background exuberant heat, which is transformed from the process Herbal formula, the most popular therapeutic approach of external pathogens entering the internal organs.
    [Show full text]
  • Medical Balneology; Recent Global Developments
    Medical Balneology; recent global developments Müfit Zeki Karagülle, MD, PhD XXV (XXIX) Zjazd Balneologiczny Balneological Congress of the Polish Association of Balneology and Physical Medicine 10-13 September 2015, Polańczyk Balneology/ISMHBalneology/ISMH goesgoes globalglobal IntensifiedIntensified andand enrichedenriched globalglobal scientificscientific researchresearch inin BalneologyBalneology • Balneological articles published in peer reviewed international journals has been continually increasing since last decade • The authors from countries like Brazil, Japan, China, Taiwan, South Korea and India are publishing more in addition to classical European balneological countries like France, Italy, Spain, Germany, Austria • The contribution to this development from eastern European countries like Poland, Romania, Bulgaria, Greece, Serbia and Turkey is also increasing. ResearchResearch methodology;methodology; betterbetter qualityquality We comprehensively searched data bases for randomized controlled trials (RCTs) published in English between July 2005 and December 2013. By using JADAD calculation we evaluated also the quality of the RCTs evaluating balneotherapy and spa therapy for the treatment of low back. RandomizedRandomized controlledcontrolled trialstrials JadadJadad scores,scores, journalsjournals andand impactimpact factorsfactors Jadad Journal Author, (year) Journal quality impact treatment score factor Balogh et al. (2005) ForschendeKomplementärmedizin/Research in 1 1,279 Balneotherapy Complementary Medicine Leibetseder et al. ForschendeKomplementärmedizin/Research in 0 1,279 (2007) Spa therapy Complementary Medicine Demirel et al. (2008) Journal of Back and Musculoskeletal 2 0,613 Spa therapy Rehabilitation Kulisch et al. (2009) Journal of Rehabilitation Medicine 5 2,134 Spa therapy Doğan et al. (2011) Southern Medical Journal 1 0,915 Spa therapy Kesiktaş et al. (2012) Rheumatology International 3 2,214 Spa therapy Tefner et al. (2012) Rheumatology International 3 2,214 Balneotherapy Gremeaux et al.
    [Show full text]
  • Complementary and Alternative Medicine
    Complementary and Alternative Medicine Policy Number: Original Effective Date: MM.12.013 01/01/2014 Line(s) of Business: Current Effective Date: HMO; PPO 11/17/2017 Section: Miscellaneous Place(s) of Service: Outpatient I. Description Complementary and alternative medicine (CAM), also called non-traditional medicine, is a group of diverse medical and healthcare systems, practices and products that are not typically considered to be a part of traditional Western medicine (i.e., conventional medicine). This policy addresses services performed by CAM providers such as naturopaths, chiropractors and acupuncturists. Complementary medicine generally refers to using a non-traditional approach together with conventional medicine. Alternative medicine refers to using a non-traditional approach in place of conventional medicine. Various CAM assessments and therapies are supported by some degree of scientific evidence and are intended to reduce disease-based symptoms and to improve health outcomes. However, due to a lack of well-designed scientific studies and/or peer reviewed literature many CAM therapies have not been shown to improve health outcomes over conventional therapies. II. Criteria/Guidelines A CAM service or procedure is covered (subject to Limitations and Administrative Guidelines) when all of the following criteria are met: A. It meets the definition of medical necessity as specified in Hawaii Revised Statutes (HRS) Section 432: 1. It is for the purpose of treating a medical condition. 2. It is the most appropriate delivery or level of service, considering potential benefits and harms to the patient; 3. It is known to be effective in improving health outcomes; provided that: a. Effectiveness is determined first by scientific evidence; b.
    [Show full text]
  • Learn More About Chiropractic
    The Chiropractic Approach tion of health. Spinal integrity is an important factor in promoting healing through chiropractic and is achieved to Health Care without surgery or drugs. Doctors of Chiropractic (DCs) are licensed health care professionals concerned with the diagnosis, treatment Chiropractic Care and prevention of neuromusculoskeletal disorders, and the effects of these disorders on the nervous system and is Unique general health. Chiropractic care involves manipulation/adjustment of the joints (spine or extremity) and associated therapy DCs use natural and conservative methods of treatment to promote spinal integrity. DCs manipulate/treat the and respect the human body’s ability to heal itself. DCs joint dysfunction (subluxation) by using the hands, or a treat the biomechanics, structure, and function of the handheld instrument. DCs diagnose injuries and neuro- spine, and its effects on the muscle and nerve systems, musculoskeletal disorders, and treat individuals for pain, and take into account the role played by the proper func- such as headaches, joint pain, neck pain, low-back pain tion of these systems in the preservation and restora- and sciatica. DCs also treat osteoarthritis, carpal tunnel syndrome, tendonitis, sprains and strains, and a variety of other non-neuromusculoskeletal conditions. Chiropractic Education Candidates must complete a minimum of three years of college-level courses prior to entering chiropractic school. Completion of a Doctor of Chiropractic degree requires four to five years of professional coursework. The education of a chiropractor is similar in total class- room hours to that of a medical doctor. An average of 4,822 hours is required in chiropractic schools, com- pared with 4,667 hours in medical schools.
    [Show full text]
  • National Center for Complementary and Alternative Medicine (NCCAM)
    NCCAM NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE Address: Mission: National Center for Complementary Created by Congress in 1998, the National Center for Complementary and and Alternative Medicine Alternative Medicine (NCCAM) is dedicated to exploring complementary National Institutes of Health and alternative healing practices in the context of rigorous science, training Building 31, Room 2B11 complementary and alternative medicine (CAM) researchers, and dissemi- 31 Center Drive, MSC 2182 nating authoritative information to the public and professionals. To achieve Bethesda, MD 20892-2182 these goals, NCCAM supports basic and clinical research, issues training and Web site: http://nccam.nih.gov career development awards, and sponsors outreach activities, with the goal of enabling integration of scientifically proven complementary and alternative Director: practices with conventional medicine. Stephen E. Straus, M.D. (301) 435-6826 (phone) (301) 402-6549 (fax) Selective Achievements and Initiatives: Email: [email protected] Stemming the Obesity Epidemic: NCCAM, as a partner in the obesity research agenda developed by the National Institutes of Health (NIH), sup- Legislative Contact: ports studies to evaluate the safety and efficacy of popular, but unsubstantiat- Melinda D. Haskins ed, dietary approaches to obesity and its many complications. In 2003, the (301) 594-9097 (phone) Center’s investment in this area yielded results, when the findings of a one- (301) 480-0087 (fax) year, multi-center trial regarding the apparent beneficial short-term effects of E-Mail: [email protected] the low carbohydrate (Atkins) diet on weight loss and risk factors for cardio- vascular disease were published in the New England Journal of Medicine.
    [Show full text]
  • Menu of Services
    Menu of Services Chuan Spa at The Langham, Chicago Welcome to Chuan Spa. Here you will find an oasis of tranquility in the heart of Chicago. The soothing setting inspires contemplation and introspection as you embark upon a journey designed to balance the mind, body and soul. In Chinese, Chuan means flowing water. As the source of life, water represents the re-birth and re-balancing of our whole being. Your Chuan Spa journey begins once you pass through our Moon Gate. Like entering a secret garden where one feels a spirit of rejuvenation, your wellness journey nurtures, heals and restores. Chuan Bathing Ritual Before your treatment, embark on a natural water journey – Transition to our Experience Shower to awaken your spirit the Chuan Bathing Ritual. Located within each gender separate with invigorating aromatherapies. Then enter our Oriental changing room lays a series of rooms designed to reinvigorate Steam Room where you will be greeted by the soothing scent the body’s reaction to hot and cold stimuli to create deeper of Chamomile. Linger longer on one of the ergonomically- dimensions of relaxation, health and well-being. designed relaxation recliners radiating soft warmth directly on This ritual begins with an aromatic sensory and moderate heat your body to create a sense of harmony. experience in the Herbal Sauna allowing the heat to loosen and With your mind and body now in equilibrium, you are a step soothe tightened, congested muscles and the herbs to open closer to rediscovering your source. the respiratory system. For more intense heat, relax in the Salt Stone Sauna which releases negative ions to create a fresh, clean, bacteria-free environment.
    [Show full text]
  • A Pilot and Feasibility Study on the Effects of Naturopathic Botanical and Dietary Interventions on Sex Steroid Hormone Metabolism in Premenopausal Women
    1601 A Pilot and Feasibility Study on the Effects of Naturopathic Botanical and Dietary Interventions on Sex Steroid Hormone Metabolism in Premenopausal Women Heather Greenlee,1 Charlotte Atkinson,2 Frank Z. Stanczyk,3 and Johanna W. Lampe2 1Mailman School of Public Health, Columbia University, New York, New York; 2Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington; and 3Keck School of Medicine, University of Southern California, Los Angeles, California Abstract Naturopathic physicians commonly make dietary and/or insulin-like growth factor-I, insulin-like growth factor dietary supplement recommendations for breast cancer binding protein-3, and leptin). Serum samples collected prevention. This placebo-controlled, parallel-arm, pilot during the mid-luteal phase of cycles 1 and 5 were analyzed study tested the effects of two naturopathic interventions for total estradiol, free estradiol, and sex hormone-binding over five menstrual cycles on sex steroid hormones and globulin. Urine samples collected during the late follicular metabolic markers in 40 healthy premenopausal women. phase of cycles 1 and 5 were analyzed for 2-hydroxyestrone The intervention arms were as follows: combination and 16A-hydroxyestrone. During the early follicular phase, botanical supplement (Curcuma longa, Cynara scolymus, compared with placebo, the botanical supplement decreased Rosmarinus officinalis, Schisandra chinensis, Silybum mar- dehydroepiandrosterone (À13.2%; P = 0.02), dehydroepian- inum, and Taraxacum officinalis; n = 15), dietary changes drosterone-sulfate (À14.6%; P = 0.07), androstenedione (3 servings/d crucifers or dark leafy greens, 30 g/d fiber, 1-2 (À8.6%; P = 0.05), and estrone-sulfate (À12.0%; P = 0.08). liters/d water, and limiting caffeine and alcohol consump- No other trends or statistically significant changes were tion to 1 serving each/wk; n = 10), and placebo (n = 15).
    [Show full text]
  • Detoxification Protocol
    Dr. Joel Cone/Dr. Alexis Dobson www.diagnosticnaturalmedicine.com (512) 577-7234 Detoxification Protocol Periodic detoxification makes sense in keeping your body as fine tuned and healthy as possible. We know many disease states, including heart disease, cancer, and chronic inflammatory disease states have a strong correlation with diet, lifestyle, and environmental factors. There are many different cleanse ideas, but if we start with the knowledge of the anatomy and physiology of the body we can make the best approach to a detoxification process possible. We know that there are several systems by which toxins and waste products are eliminated through the body. By having knowledge of these systems we can increase our ability to aggressively detoxify our body. There are four major detoxification systems our body uses. The first is the respiratory system which eliminates gaseous waste products such as carbon dioxide, a waste by product of glucose metabolism. Another system is the integumentary system, in which lactic acid and various other wastes are removed. We also use the digestive system, especially the hepatobiliary system to remove some cholesterol, bile secretions, and other toxins bound in bile. The liver is also the primary congugator of metabolic toxins into water soluble products which can be sent to the kidney for removal. The remaining system is the renal system, in which the kidney removed nitrogenous wastes, including urea, ammonia, creatinine, and other drug metabolites from the body. I have also added the lymphatic and circulatory system as an elimination component, as they play a crucial role in the mobilization of compounds that need to be removed from the body.
    [Show full text]