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Bodybuilding.com Alert

Bodybuilding.com and FDA notified healthcare professionals and patients of a nationwide and international recall of all lots and expiration dates of 65 dietary supplement products that were sold through the Company's website, www.bodybuilding.com.FDA believes that the recalled products contain the following ingredients that are currently classified, or the FDA believes should be classified, as steroids: "Superdrol," "Madol," "Tren," "Androstenedione," and/or "Turinabol." Acute liver injury is known to be a possible harmful effect of using steroid-containing products. In addition, steroids may cause other serious long-term adverse health consequences in men, women, and children. These include shrinkage of the testes and male infertility, masculinization of women, breast enlargement in males, short stature in children, a higher predilection to misuse other drugs and alcohol, adverse effects on blood lipid levels, and increased risk of heart attack, stroke, and death.

Study Suggests That Both Traditional and Simulated Acupuncture Relieve Pain but by Different Mechanisms

Although acupuncture has long been used to treat pain, the underlying cellular and molecular mechanisms are not fully understood. The process appears to involve the brain's ability to produce opioids (pain-reducing chemicals) that bind to neurons in distinct regions of the brain, and the ability of neurons to produce receptors for these endogenous opioids—specifically, mu-opioid receptors (MORs). Recent clinical trials have indicated that both traditional (actual) and simulated (sham/placebo) acupuncture decrease pain, but other studies have suggested that the neural mechanisms involved may be different.

November Is National Alzheimer's Awareness Month

Alzheimer's disease (AD) is an irreversible, progressive brain disease that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks of daily living. Among older people, AD is the most common cause of dementia (a decline in cognitive function that interferes with daily life and activities). However, AD is not a normal part of aging. Although treatment can slow the progression of AD and help manage its symptoms in some people, currently there is no cure for this devastating disease. Scientists are learning more every day, but right now, they still do not know what causes Alzheimer's disease.NCCAM supports studies on Alzheimer's and diseases and conditions related to aging. In one recent NCCAM-funded study, it was found that 240 milligrams per day of the dietary supplement Ginkgo biloba was ineffective in reducing the development of dementia and Alzheimer's disease in older people. Those considering using CAM therapies, should talk to their health care providers to ensure safe and coordinated care.

Director's Message on the Flu

As we are all aware, flu season is upon us. In a typical year, approximately 5 to 20 percent of the population gets the seasonal flu and approximately 36,000 flu-related deaths are reported. This year, we are faced with not only the seasonal flu, but also the novel H1N1 flu virus. This additional virus may cause a more dangerous flu season with more people getting sick, being hospitalized and dying than during a regular flu season. Like seasonal flu, illness in people with H1N1 can vary from mild to severe.

Strategic Plan Request for Input

NCCAM is now seeking stakeholder comments on three "big picture" topics:MissionPriority settingInformation and communicationComments will be accepted through November 19, 2009. More »

Job Opening: Director for the Office of Policy, Planning, and Evaluation

Looking for an exciting opportunity? Come join the nation's medical research agency, where we are making important medical discoveries that improve health and save lives!If you are a knowledgeable and motivated individual, interested in joining a diverse team dedicated to exploring complementary and alternative healing practices, then consider joining the National Center for Complementary and Alternative Medicine (NCCAM), Office of the Director (OD), Office of Policy, Planning and Evaluation (OPPE). Our office is responsible for developing and coordinating science policy and program planning and evaluation for the Center. For more information about the NCCAM, visit our website at www.nccam.nih.gov.

Message from the Director: Symptoms Matter

CAM approaches have sometimes been discounted in popular press as only being helpful for "life's little miseries"—trouble falling asleep, menopausal hot flashes, memory lapses, the need to lose weight, and sexual problems. I'm sure I'm not alone in thinking that these and other "little miseries" have a tremendous impact on one's quality of life and are worth researching.

Study Indicates Cranberry Juice Does Not Interfere with Two Antibiotics Women Take for Recurrent Urinary Tract Infections

About 50 to 60 percent of women are diagnosed with a urinary tract infection (UTI) at least once during their lifetime. Many experience multiple recurrences. Cranberry juice, a popular home remedy for UTI, is often taken along with low-dose antibiotics as a preventive measure. Because little is known about the potential of cranberry juice to interact with drugs, NCCAM-funded researchers at the University of Washington studied cranberry's effects on two antibiotics frequently prescribed for UTI: amoxicillin and cefaclor.

Message from the Director: Spending on CAM

Today, NCCAM and the National Center for Health Statistics at the Centers for Disease Control and Prevention released new information on Americans' spending on CAM. Even in these difficult economic times, Americans are spending almost $34 billion per year on various CAM products and visits to CAM practitioners. By any measure, this is a substantial amount of money. This number, while only 1.5 percent of total health care expenditures, represents about 11.2 percent of all out-of-pocket spending on health care in the United States.

Americans Spent $33.9 Billion Out-of-Pocket on Complementary and Alternative Medicine

Americans spent $33.9 billion out-of-pocket on complementary and alternative medicine (CAM) over the previous 12 months, according to a 2007 government survey. CAM is a group of diverse medical and health care systems, practices, and products such as herbal supplements, meditation, chiropractic, and acupuncture that are not generally considered to be part of conventional medicine. CAM accounts for approximately 1.5 percent of total health care expenditures ($2.2 trillion) and 11.2 percent of total out-of-pocket expenditures (conventional out-of-pocket: $286.6 billion and CAM out-of-pocket: $33.9 billion) on health care in the United States.

Colloidal Silver Products

Colloidal silver consists of tiny silver particles suspended in liquid. Usually marketed as dietary supplements, colloidal silver products have been used for a variety of health purposes—although there is no scientific evidence to support their safety or effectiveness. This fact sheet provides a general overview of colloidal silver products and suggests sources for additional information.Key Points The U.S. Food and Drug Administration (FDA) does not consider colloidal silver to be safe or effective for treating any disease or condition. The FDA and the Federal Trade Commission (FTC) have taken action against a number of colloidal silver companies (including some companies that sell products over the Internet) for making drug-like claims about their products. Colloidal silver can cause many side effects. One example is argyria, a bluish-gray discoloration of the body, which is not treatable or reversible. Tell all your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Red Yeast Rice May Help Patients With High Cholesterol Who Cannot Take Statin Drugs

Doctors often prescribe statin drugs to lower cholesterol levels and reduce the risk of coronary artery disease. These drugs, which interfere with the liver's production of cholesterol, are relatively safe for most people but sometimes can cause muscle problems known as statin-associated myalgia (SAM). Some patients who cannot tolerate statins because of muscle problems use the dietary supplement red yeast rice as a cholesterol-lowering alternative. In light of previous findings that red yeast rice can reduce levels of low-density lipoprotein (LDL, or "bad" cholesterol), researchers from the University of Pennsylvania and Thomas Jefferson University investigated the effects of this supplement in patients with high cholesterol and a history of SAM. The study was funded by the Commonwealth of Pennsylvania, with additional support from NCCAM.

Many Older People Use Both Prescription Drugs and Dietary Supplements

Older adults tend to take a number of different prescription medications, and according to previous studies, they also often use dietary supplements. Because of the potential for adverse interactions between prescription drugs and dietary supplements, it is important to learn as much as possible about the real-life practices of older people—the extent to which they take both prescription drugs and dietary supplements, and what kinds of drugs and supplements are being used. NCCAM-funded researchers recently analyzed the use of prescription drugs and dietary supplements in a sample of 3,070 people aged 75 and older. The data had been gathered during the Gingko for the Evaluation of Memory (GEM) study, a clinical trial that examined the effects of Gingko biloba on the development of dementia.

Young You Weight Loss Products Recalled

Young You Corporation and FDA notified healthcare professionals and consumers that four weight loss dietary supplements sold and marketed by the firm contain an undeclared drug ingredient, Sibutramine.

Recall of Stealth Chocolate, Stealth Vanilla Powdered Dietary Supplement

Vital Pharmaceuticals Inc. and FDA notified healthcare professionals and consumers of a nationwide recall of the powdered dietary supplement, Stealth Chocolate and Stealth Vanilla, because it has the potential to be contaminated with Salmonella.

Omega-3 Supplements: An Introduction

Omega-3 fatty acids are a group of polyunsaturated fatty acids that are important for a number of functions in the body. They are found in foods such as fatty fish and vegetable oils and are also available as dietary supplements. People take omega-3 supplements to improve their health and prevent various diseases. This fact sheet provides a general overview of omega-3 fatty acids—with a focus on dietary supplements—and suggests sources for additional information.

Sleep Disorders and CAM: At a Glance

People who have trouble sleeping may try dietary supplements, relaxation therapies, or other forms of complementary and alternative medicine (CAM) in an effort to fall asleep faster, stay asleep longer, and improve the overall quality of their sleep. This fact sheet provides basic information on sleep disorders and "what the science says" about the effectiveness of CAM practices people use as sleep aids. If you are considering a CAM therapy for sleep problems, this information can help you talk with your health care provider about it.

Chromium Picolinate Does Not Improve Key Features of Metabolic Syndrome in Adults

About 47 million Americans have some form of metabolic syndromea group of conditions that increase the risk of diabetes, heart disease, and related complications. Metabolic syndrome is often characterized by abdominal obesity, impaired fasting glucose (an increase in glucose levels), elevated blood pressure, and high cholesterol and triglycerides. It is also associated with insulin resistance, a condition in which the body cannot use insulin effectively. Previous studies have suggested that chromium picolinate dietary supplements can help people with type 2 diabetes by improving insulin resistance and increasing the bodys sensitivity to insulin. However, its effects on people with a high risk for developing type 2 diabetes, especially those with metabolic syndrome, are largely unknown.

Complementary and Alternative Medicine: Focus on Research and Care May 2009

Low-Back Pain and CAMFour out of five American adults will experience low-back pain (LBP). Many will try CAM therapies to manage their pain. Given the many choices, how can one approach making decisions about CAM use for LBP?Also Featuring: Moving the Economyand Biomedical DiscoveryAhead; Interview: Low-Back Pain and Evidence-Based Care; First Straus Lecture: Acupuncture and Medical Paradigms; and other stories

Zicam Cold Remedy Nasal ProductsWarnings

FDA notified consumers and healthcare professionals to discontinue use of three Zicam Nasal Gel/Nasal Swab products sold over-the-counter as cold remedies because they are associated with the loss of sense of smell that may be long-lasting or permanent. The FDA has received more than 130 reports of loss of sense of smell associated with the use of the three Zicam products. In these reports, many people who experienced a loss of smell said the condition occurred with the first dose; others reported a loss of the sense of smell after multiple uses of the products. People who have experienced a loss of sense of smell or other problems after use of the affected Zicam products should contact their health care professional. The loss of sense of smell can adversely affect a persons quality of life, and can limit the ability to detect the smell of gas or smoke or other signs of danger in the environment.Please use our link about Zicam to read more on these warnings.

A Message from the Director

Considering All PerspectivesRecently, a series of articles appeared in the media that were critical of complementary and alternative medicine (CAM) and how NCCAM directs taxpayer resources to study these modalities. While the articles contained several misconceptions regarding NCCAM's research, they also raised some important concerns that I share. No one likes criticism, but it is important to listen to the critics and look for any threads of truth that can help us fulfill our mission better. While the value of research on CAM interventions will probably continue to be the subject of some controversy, there are many areas of promise in CAM that need to be pursued. NCCAM is committed to this path.

2009 Director's Testimony

Budget Request for FY 2010Before the Senate Subcommittee on Labor-HHS-Education AppropriationsThe President's Fiscal Year 2010 Budget request for the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health includes $127,241,000, which is $1,770,000 more than the comparable FY 2009 appropriation of $125,471,000.

Acupuncture for Pain

Physical pain is a common occurrence for many Americans; in fact, a national survey found that more than one-quarter of U.S. adults had recently experienced some sort of pain lasting more than a day. In addition to conventional treatments, such as over-the-counter and prescription medications, people may try acupuncture in an effort to relieve pain. This fact sheet provides basic information about pain and acupuncture, summarizes scientific research on acupuncture for specific kinds of pain, and suggests sources for additional information.

Study Finds Benefits of Therapeutic Massage for Chronic Neck Pain

Neck pain is a common health problem in the United States. People suffering from neck pain often turn to complementary and alternative medicine (CAM) therapies. Although therapeutic massage is one of the most popular CAM therapies for neck pain, little is known about its effectiveness for this condition.

NIH Workshop on Nonpharmacologic Management of Back Pain

This 1-day workshop will identify clinical research questions related to nonpharmacologic interventions to treat back pain. This information will help inform future research directions.

Como evaluar recursos de salud publicados en Internet

El número de sitios Web que ofrecen recursos relacionados con la salud, incluso información sobre medicina complementaria y alternativa, crece día a día. Si bien muchos sitios de Internet resultan útiles, es posible que algunos presenten información inexacta o engañosa. Al visitar un sitio por primera vez es importante evaluar si es confiable. Esta guía describe algunos aspectos que debe considerar al evaluar estas fuentes.

Acupuncture-Like Treatments Improve Outcomes Compared to Usual Care for Low Back Pain

People suffering from chronic low back pain who received acupuncture or simulated acupuncture treatments fared better than those receiving only conventional care according to a recent study published in the Archives of Internal Medicine. The study highlights central questions about the mechanisms of benefit seen in acupuncture studies."Because of the lack of highly effective medical treatments for chronic low back pain, we were pleased to find that acupuncture-like treatments were helpful for persons suffering from chronic back pain," said Daniel Cherkin, Ph.D. "However, the finding that real acupuncture produced no greater benefit than simulated acupuncture raises important questions about acupuncture's mechanisms of action."

Message from NCCAM's Director

Caution: Using CAM to Prevent the H1N1 FluRecently, the U.S. Food and Drug Administration and the Federal Trade Commission alerted the public to be wary of Internet sites and other promotions for CAM products that claim to diagnose, prevent, mitigate, treat, or cure the 2009 H1N1 influenza virus (swine flu). Such products have not been tested for safety and efficacy. Currently, the only approved medications for this flu virus are Tamiflu (oseltamivir phosphate) and Relenza (zanamivir).

FDA, FTC Warn of Fraudulent Flu Products

FDA, FTC Warn Public of Fraudulent 2009 H1N1 Influenza ProductsOffending web sites and illegal activity targeted for actionThe U.S. Food and Drug Administration and the Federal Trade Commission are alerting the public to be wary of Internet sites and other promotions for products that claim to diagnose, prevent, mitigate, treat or cure the 2009 H1N1 influenza virus. The agencies are also advising operators of offending web sites that they must take prompt action to correct and/or remove promotions of these fraudulent products or face enforcement action.

Job Openings: IT Specialist

If you are a motivated individual with an excellent attention to detail AND you want to play a significant role in a dynamic organization, then consider joining the National Center for Complementary and Alternative Medicine (NCCAM), Office of Administrative Operations (OAO)! Our office provides leadership and direction for NCCAM's business and administrative operations to promote organizational growth, encourage and empower NCCAM's staff, and optimize effective management of the public's investment in CAM research.

FDA Alert - Hydroxycut

FDA Warns Consumers to Stop Using Hydroxycut ProductsDietary Supplements Linked to One Death; Pose Risk of Liver InjuryThe U.S. Food and Drug Administration is warning consumers to immediately stop using Hydroxycut products by Iovate Health Sciences Inc., of Oakville, Ontario and distributed by Iovate Health Sciences USA Inc. of Blasdell, N.Y. Some Hydroxycut products are associated with a number of serious liver injuries. Iovate has agreed to recall Hydroxycut products from the market.

Study Finds Creatine Does Not Enhance Strength-Building Effects of Resistance Training in HIV Patients

Progressive resistance exercise training (known as PRT) can increase muscle mass and preserve physical functioning in people with HIV. In light of evidence that the dietary supplement creatine can enhance PRT-related benefits in athletes and improve muscle function in patients with muscle-wasting conditions, a recent NCCAM-funded study investigated creatine's effects on PRT results in a group of HIV-positive men. The researchers were affiliated with the University of California at San Francisco and Santa Cruz, San Francisco General Hospital, Northern California Institute for Research and Education, the University of Massachusetts, and the University of Thessaly (Greece).

NCCAM Faculty Recruitment through Biomedical Research Core Centers

The purpose of the Biomedical Research Core Centers program is to support the hiring of newly-recruited faculty to develop research projects within the context of Biomedical Core Centers. For this announcement, a Biomedical Core Center is defined as a community of multidisciplinary researchers focusing on areas of biomedical research relevant to NIH, such as centers. These awards are designed to enhance innovative programs of excellence by providing scientific and programmatic support for promising research faculty and their areas of research. Specifically for the purposes of this announcement, Core Center Grants are institutional awards that provide funding to hire, provide appropriate start-up packages, and develop pilot research projects for newly independent investigators, with the goal of augmenting and expanding the institution's community of multidisciplinary researchers focusing on areas of biomedical research relevant to NIH.This initiative is one of several being offered by NCCAM to help fulfill the goals of the American Recovery and Reinvestment Act (ARRA) to help stimulate the economy through support of biomedical and behavioral research. Additional information the Recovery Act and related NIH opportunities is available through the Office of Extramural Research.

Message from NCCAM's Director

For 10 years, NCCAM has been supporting research studies on complementary and alternative medicine (CAM) practices, determining their safety and effectiveness, and reporting the findings to the medical community and to the public. In these 10 years, we have funded more than 2,200 research projects, resulting in more than 3,300 articles published in peer-reviewed medical journals. A paper published in the April 13, 2009 Archives of Internal Medicine exposes a gap in the knowledge and application of CAM research in clinical practice. In sum, approximately one in four clinicians was aware of two major CAM clinical trials. The 1,561 clinicians surveyed included acupuncturists, naturopaths, internists, and rheumatologists.

Two More NCCAM Funding Opportunities Related to the American Recovery and Reinvestment Act (ARRA)

NCCAM has posted the Center's guidelines for Grand Opportunities (GO) Grants. This new program will support projects that address large, specific biomedical and biobehavioral research endeavors that will benefit from significant 2-year funds without the expectation of continued NIH funding beyond two years. The center is also participating in an initiative that supports new faculty recruitments to biomedical core centers (P30 grant). These grants will be institutional awards that provide funding to hire, provide appropriate start-up packages, and develop pilot research projects for newly independent investigators, with the goal of augmenting and expanding the institutions community of multidisciplinary researchers focusing on areas of biomedical research relevant to NIH.

Translating CAM Research Results Into Clinical Practice: Results From a National Survey of Physicians and CAM Providers

In an initial investigation of the potential for information from CAM research to influence clinical practice, a 2007 national survey asked acupuncturists, naturopaths, internists, and rheumatologists about their awareness of CAM clinical trials, their ability to interpret research results, and their use of research evidence in decisionmaking. The survey was conducted by researchers affiliated with the National Institutes of Health, the Mayo Clinic, the University of Chicago, Harvard Medical School, and the University of Massachusetts. The survey focused on awareness of two major NCCAM-funded clinical trials that studied acupuncture or glucosamine/chondroitin for osteoarthritis of the knee.

World Tai Chi and Qi Gong Day Is April 25

What Is Tai Chi?Tai chi (pronounced "tie chee" and also known by some other names and spellings) is a mind-body practice that originated in China as a martial art. A person doing tai chi moves his body slowly and gently, while breathing deeply and meditating (tai chi is sometimes called "moving meditation").What Is Qi Gong?A component of traditional Chinese medicine that combines movement, meditation, and controlled breathing. The intent is to improve blood flow and the flow of qi.

April 7 Council Meeting Public Conference

TeleconferenceApril 7, 20091:00 P.M.1:15 P.M. EST877-719-9799 (toll-free); Passcode: 6064250The first 15 minutes of the teleconference will be monitored by the Premiere Conferencing Operator. People who are calling on this line just listen only when Dr. Briggs speaks. This line will be closed at 1:15 P.M. EST.

NCCAM Investments Related to the American Recovery and Reinvestment Act (ARRA)

NCCAM has posted the Center's guidelines for ARRA Administrative Supplements, ARRA Competitive Revisions, and Recovery Act Funds for Summer Research Opportunities. Information about NCCAM's Challenge Grant Topics is also available.

Acupuncture Shows Possible Effect for Tension Headaches

Headaches affect millions of Americans. According to the National Institute of Neurological Disorders and Stroke, about 45 million Americans suffer from chronic headaches. Tension-type headaches (or tension headaches)—characterized by pain or discomfort from tense or constricted muscles in the head, neck, or scalp—are one of the most common forms of headaches. In most patients, tension headaches occur infrequently and can be treated with over-the-counter pain medicine. However, some people experience these headaches several days per month, or even daily, and may benefit from other treatments.

Grape Seed Extract May Help Neurodegenerative Diseases

Tauopathies—a group of neurodegenerative conditions such as Alzheimer's disease—have been linked to the build-up of "misfolded" tau proteins in the brain. (Tau proteins are associated with microtubules, which help to regulate important cellular processes.) In light of previous studies indicating that grape-derived polyphenols may inhibit protein misfolding, an NCCAM-funded research center at the Mount Sinai School of Medicine recently examined the potential role of a particular grape seed polyphenol extract (GSPE) in preventing and treating tau-associated neurodegenerative disorders.

Message from NCCAM's Director

On February 17, President Obama signed the American Recovery and Reinvestment Act of 2009 (Recovery Act). Funds from the Recovery Act will be invested in the construction and renovation of research and educational facilities, as well as groundbreaking scientific research that will improve the health of our Nation.We appreciate that the President and Congress have recognized both the economic and health impacts of biomedical and behavioral research.The goals of the Recovery Act include: Preserving and creating jobs Promoting economic recovery Increasing economic efficiency by spurring technological advances in science and health.

Complementary and Alternative Medicine: Focus on Research and Care January 2009

Welcome to Our New NewsletterA fresh new design and content that is more focused on research and patient care.Survey Sheds New Light on Adults'—and Children's—Use of CAMA new national survey on Americans' use of CAM and, for the first time, data on children's use of CAM.Also Featuring: Sorting Claims from Facts About CAM; Interview: Cognitive Disorders in Later Life; Children and CAM; Using Dietary Supplements Wisely; and other stories

February Is American Heart Month

Heart disease is the leading cause of death for both men and women in the United States and is a major cause of disability. About 1.2 million people will have a first or recurrent coronary attack. Each year, about 700,000 people die of heart disease. (CDC) NCCAM supports studies on heart disease. Some people at risk for heart disease may try complementary and alternative medicine (CAM) therapies, including dietary supplements. An individual considering using CAM therapy, should talk to their health care providers to ensure safe and coordinated care.

Message from the Director: Public Mission

Yesterday, NCCAM and the National Center for Health Statistics released the results of a survey on the use of complementary and alternative medicine (CAM) in the United States. The report confirms that CAM practices are a frequently used component of Americans health care regimens. Whether people use CAM for chronic health conditions or to prevent disease and maintain wellness, these approaches are a part of health care in America today.

Brain-Imaging Study Explores Analgesic Effect of Acupuncture

Although acupuncture has long been used to relieve pain, scientific understanding of how acupuncture might achieve an analgesic effect is incomplete. Previous research has linked acupuncture's effects to the neuronal networks and opioid (pain response) systems of the brain. In light of these findings, NCCAM-funded researchers at Massachusetts General Hospital recently used two imaging technologies—functional magnetic resonance imaging (fMRI) and positron emission tomography (PET)—to investigate how specific areas of the brain might be involved in acupuncture analgesia.

Green Tea May Help Protect Against Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that affects more than 2.1 million Americans. It is characterized by joint pain, stiffness, inflammation, swelling, and sometimes joint destruction. Nonsteroidal anti-inflammatory drugs are the standard treatment for RA, but their prolonged use is associated with adverse effects and discomfort. Natural plant alternatives like green tea are being investigated for the management of RA. Green tea is the most widely consumed beverage in the world, and its polyphenols (substances rich in antioxidants) possess anti-inflammatory properties.

St. John's Wort Extracts May Help Treat Major Depression

Major depression is a disorder characterized by a depressed mood and/or a loss of interest in nearly all activities consistently for at least 2 weeks. People with major depression may also experience a variety of other symptoms such as loss of appetite, fatigue, sleep disturbance, irritability, difficulty concentrating, and thoughts of death or suicide. Extracts from the herb St. John's wort (Hypericum perforatum) are used in many countries, especially Germany, to treat depression. However, results from clinical trials worldwide have been contradictory, and the effectiveness of St. John's wort for depression is still questionable. Additionally, major depression is often treated with antidepressant drugs, which have only shown modest effects over placebo in clinical trials.

New Statistics on Complementary and Alternative Medicine Use in the United States

Approximately 38 percent of adults in the United States aged 18 years and over and nearly 12 percent of U.S. children aged 17 years and under use some form of complementary and alternative medicine (CAM), according to a new nationwide government survey. This survey marks the first time questions were included on children's use of CAM, which is a group of diverse medical and health care systems, practices, and products such as herbal supplements, meditation, chiropractic, and acupuncture that are not generally considered to be part of conventional medicine. The survey, conducted as part of the 2007 National Health Interview Survey (NHIS), an annual study in which tens of thousands of Americans are interviewed about their health- and illness-related experiences, was developed by the National Center for Complementary and Alternative Medicine (NCCAM), a part of the National Institutes of Health (NIH) and the National Center for Health Statistics (NCHS), a part of the Centers for Disease Control and Prevention (CDC). The survey included questions on 36 types of CAM therapies commonly used in the United States—10 types of provider-based therapies, such as acupuncture and chiropractic, and 26 other therapies that do not require a provider, such as herbal supplements and meditation. "The 2007 NHIS provides the most current, comprehensive, and reliable source of information on Americans' use of CAM," said Josephine P. Briggs, M.D., director of NCCAM. "These statistics confirm that CAM practices are a frequently used component of Americans' health care regimens, and reinforce the need for rigorous research to study the safety and effectiveness of these therapies. The data also point out the need for patients and health care providers to openly discuss CAM use to ensure safe and coordinated care.

Herbs at a Glance Update: Black Cohosh

This fact sheet provides basic information about the black cohosh—common names, uses, potential side effects, and resources for more information. Black cohosh, a member of the buttercup family, is a plant native to North America. It was used in Native American medicine and was a home remedy in 19th-century America.What It Is Used ForBlack cohosh has a history of use for rheumatism (arthritis and muscle pain) but has been used more recently to treat hot flashes, night sweats, vaginal dryness, and other symptoms that can occur during menopause.Black cohosh has also been used for menstrual irregularities and premenstrual syndrome, and to induce labor.

December 1 Is World AIDS Day

AIDS (acquired immunodeficiency syndrome) is caused by the human immunodeficiency virus, or HIV. By killing or damaging cells of the body's immune system, HIV progressively destroys the body's ability to fight infections and certain cancers. These infections are caused by viruses or bacteria that usually do not make healthy people sick.Many people infected with HIV or living with AIDS may be considering the use of complementary and alternative medicine (CAM) to boost their immune system; treat complications of disease; or cope with side effects of conventional medications.

Ginkgo Evaluation of Memory (GEM) Study Fails To Show Benefit in Preventing Dementia in the Elderly

In a study published in the Journal of the American Medical Association, 240 milligrams per day of the dietary supplement Ginkgo biloba was found to be ineffective in reducing the development of dementia and Alzheimer's disease in older people. Researchers led by Steven T. DeKosky, M.D., conducted the trial known as the Ginkgo Evaluation of Memory (GEM) study at four clinical sites over the course of 8 years. GEM is the largest clinical trial ever to evaluate ginkgo's effect on the occurrence of dementia.Press Release—summary of results of the studyQuestions and Answers—detailed background information on the study

Massage Therapy May Ease Pain and Improve Mood in Advanced Cancer Patients

People with advanced cancer often experience pain that causes physical and emotional distress, which leads to a decrease in functional ability and quality of life. Symptom relief is an important part of end-of-life care, and small studies have suggested that massage therapy may benefit people with advanced cancer.In a study funded in part by NCCAM, researchers investigated the benefits of massage versus simple touch therapy (placing both hands on specific body sites) in patients with advanced cancer. This multisite study—conducted at 15 U.S. hospices in the Population-based Palliative Care Research Network—included 380 participants with advanced cancer who were experiencing moderate-to-severe pain. Participants were randomly assigned to receive six 30-minute treatment sessions of either massage or simple touch therapy over a 2-week period.

CAM and Hepatitis C: A Focus on Herbal Supplements

Hepatitis C, a liver disease caused by a virus, is usually chronic (long-lasting), with symptoms ranging from mild (or even none) to severe. Conventional medical treatments are available for hepatitis C; however, some people also try complementary and alternative medicine (CAM) therapies, especially herbal supplements. This fact sheet provides basic information on hepatitis C, summarizes scientific research on the effectiveness and safety of selected supplements, and suggests sources for additional information.Key PointsNo CAM treatment has yet been proven effective for treating hepatitis C or its complications.It is important not to replace conventional medical therapy for hepatitis C with an unproven CAM therapy.Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

November Is American Diabetes Month

There are 23.6 million adults and children in the United States living with diabetes. Conventional medical treatments are available to control diabetes and its complications. However, some people also try complementary and alternative medicine (CAM) therapies, including dietary supplements. An individual considering using CAM therapy, should talk to their health care providers to ensure safe and coordinated care.What is Diabetes?Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

Researchers Investigate Effects of Ginkgo Biloba on Stroke-Related Brain Injury in Mice

Previous animal studies have indicated that an extract from leaves of the Ginkgo biloba tree may protect against stroke-related brain injury. However, the mechanism involved has not been fully understood. In a recent NCCAM-funded study, researchers at Johns Hopkins University investigated whether and how the ginkgo extract Egb761 alters outcomes in mice with brain injury from stroke.

Half of Surveyed Physicians Use Placebo Treatments for Patients

Treating patients with placebos has a long, complicated, and often controversial history. Nonetheless, little is actually known about U.S. physicians' current attitudes toward and use of placebo treatments. A recent national survey of 679 physicians, funded in part by NCCAM, found that about half the physician respondents prescribed placebo treatments on a regular basis. Most (62%) said they think the practice is ethical. The surveyed physicians were internists and rheumatologists—specialties that commonly treat patients with debilitating chronic conditions.

Review of Prostate Cancer Prevention Study Shows No Benefit for Use of Selenium and Vitamin E Supplements

Initial, independent review of study data from the Selenium and Vitamin E Cancer Prevention Trial (SELECT), funded by the National Cancer Institute (NCI) and other institutes that comprise the National Institutes of Health shows that selenium and vitamin E supplements, taken either alone or together, did not prevent prostate cancer. The data also showed two concerning trends: a small but not statistically significant increase in the number of prostate cancer cases among the over 35,000 men age 50 and older in the trial taking only vitamin E and a small, but not statistically significant increase in the number of cases of adult onset diabetes in men taking only selenium. Because this is an early analysis of the data from the study, neither of these findings proves an increased risk from the supplements and both may be due to chance.

Hypnosis May Reduce Hot Flashes in Breast Cancer Survivors

Hot flashes are a problem for many menopausal women and a common side effect of breast cancer treatment. For many breast cancer survivors, vasomotor symptoms result in discomfort, disrupted sleep, anxiety, and decreased quality of life. Hormonal (estrogen) drugs have been used to treat hot flashes, but because estrogens are associated with an increased risk of breast cancer, they usually are avoided by breast cancer survivors. Since nonhormonal treatments do not work for some women and may have adverse effects, new interventions for hot flashes are needed. Previous research has indicated that hypnosis may be a promising alternative.

National Chiropractic Month, October 2008

Chiropractic is a health care approach that focuses on the relationship between the body's structure—mainly the spine—and its functioning. Although practitioners may use a variety of treatment approaches, they primarily perform adjustments to the spine or other parts of the body with the goal of correcting alignment problems and supporting the body's natural ability to heal itself.

New Complementary and Alternative Medicine Research Centers Target Stress-Related Illnesses, Obesity, Cancer, and Other Conditions

The National Institutes of Health's National Center for Complementary and Alternative Medicine (NCCAM) has added four new Centers of Excellence for Research on Complementary and Alternative Medicine (CERCs) to its research centers program. The new centers will add to knowledge about complementary and alternative medicine (CAM) approaches and their potential in treating and preventing diseases and conditions that are common among Americans.In NCCAM's CERC program, highly accomplished researchers across a variety of disciplines apply cutting-edge technology to projects in CAM.

Lifestyle Changes May Affect Cell-Level Processes Related to Disease

Disease risk, progression, and premature mortality—in many types of cancer and in cardiovascular and infectious diseases—have been linked to telomeres, which are protective DNA-protein complexes that keep cells genetically stable. The cellular enzyme telomerase is an important part of the body's maintenance system for these essential complexes. For example, a previous investigation found that increased stress among caregivers of Alzheimer's patients was associated with lower telomerase activity and telomere shortening. In a recent pilot study funded by NCCAM and several other sponsors, researchers at the University of California-San Francisco investigated the effects of lifestyle changes on telomerase levels in 24 men with low-risk prostate cancer.

CAM at the NIH - October 2008

Feature Stories Tips for Talking with Your Health Care ProviderAre you using—or thinking about using—complementary and alternative medicine (CAM)? If so, NCCAM provides some ideas on how to get a conversation started about CAM use when you talk to your health care providers. NCCAM Hosts Meditation WorkshopExperts from a wide range of fields and disciplines who share a common interest in meditation for health purposes met to assess current scientific knowledge and identify areas of opportunity for future research. Meet NACCAM Member Margery Gass, M.D.What are some things that women can do to stay healthy at midlife and beyond? NCCAM National Advisory Council member Margery Gass, M.D., a specialist in women's health, discusses this topic. Happiness and Systematic Mind-Body TrainingWhat do monks, meditation, and music have in common? Dr. Richard Davidson discusses his work on the science of happiness and on systematic training of the mind and body.

Tips for Talking With Your Health Care Providers About CAM

Like many Americans, you may be using or considering some form of complementary and alternative medicine (CAM). If so, it is a good idea to talk with your health care providers about your CAM use. This fact sheet explains why and offers some tips to help you get the conversation started. Key Points Tell your health care providers about all the complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. Be proactive. Don't wait for your health care providers to ask about your CAM use. When you talk with your health care providers about CAM, make the most of the conversation. Bring a list of everything you use, keep a record of the information you receive, and ask questions if something is unclear.

Dietary Supplements Glucosamine and/or Chondroitin Fare No Better than Placebo in Slowing Structural Damage of Knee Osteoarthritis

The dietary supplements glucosamine and chondroitin sulfate, together or alone, appeared to fare no better than placebo in slowing loss of cartilage in osteoarthritis of the knee, researchers from the Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) team report in the October issue of Arthritis & Rheumatism. Interpreting the study results is complicated, however, because participants taking placebo had a smaller loss of cartilage, or joint space width, than predicted. Loss of cartilage, the slippery material that cushions the joints, is a hallmark of osteoarthritis and its loss is typically measured as a reduction in joint space width—the distance between the ends of bones in a joint as seen on an X-ray. "While these results are of interest, we cannot draw definitive conclusions about the utility of glucosamine or chondroitin in reducing joint space width loss, in part because the placebo group fared better than anticipated based on prior research results," said Josephine P. Briggs, M.D., director of the National Center for Complementary and Alternative Medicine, at the National Institutes of Health (NIH), one of the study's funders. "The results of the study provide interesting insights for future research."

Operation False Cure

The FTC today announced a new Web site about bogus cancer cures. The site — www.ftc.gov/curious — tells consumers how to spot and report bogus claims they see online, and urges people with cancer to talk to their treatment team about any products they'd like to try. The site features a video and includes a list of resources on cancer treatments from a variety of agencies within the federal government. Information is provided in English and Spanish. The Federal Trade Commission also announced 11 law enforcement actions challenging deceptive advertising of bogus cancer cures. The FTC charged the companies with making unsupported claims that their products cured or treated one or more types of cancer. In each case, the company is charged with violating the FTC Act, which bars deceptive claims. Some complaints allege that the companies also falsely touted clinical or scientific proof for their products.

New NIH Research Initiative to Test Treatments for Menopausal Symptoms

Clinical Trials to Target Hot Flashes, Night Sweats Women troubled by hot flashes and night sweats during the years around menopause want safe, effective treatment options. A new research initiative from the National Institutes of Health (NIH) will establish a multisite research network to conduct clinical trials of promising treatments for the most common symptoms of the menopausal transition. The initiative Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) is led by the National Institute on Aging in collaboration with the National Center for Complementary and Alternative Medicine, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the Office of Research on Womens Health, all parts of the NIH. The MsFLASH network will be coordinated by principal investigators Andrea Z. LaCroix, Ph.D., and Garnet Anderson, Ph.D., both of the Fred Hutchinson Cancer Research Center in Seattle. The network centers will collectively receive approximately $4.4 million each year of the initiative, which is projected to run for five years. A Press Release from the National Institute on Aging

Message from the Director

As I've had the opportunity to meet with many of our stakeholders over the past 6 months, I have learned a lot. I've gained a greater appreciation of the complexities of studying CAM, the challenges to conducting rigorous research, and the need for setting clear priorities for the years ahead.

September Is Healthy Aging Month

The older population is growing rapidly, and the aging of the "baby boomers," born between 1946 and 1964 (and who begin turning age 65 in 2011), will accelerate this growth. Healthy Aging Month was designed to focus national attention on the positive aspects of growing older. Many older Americans use complementary and alternative medicine (CAM) to improve their health and maintain wellness. The National Center for Complementary and Alternative Medicine (NCCAM) conducts and supports research on many conditions associated with aging and provides information on how to be an informed consumer.

Paying for CAM Treatment

If you are using (or thinking about using), you may have financial questions about paying for treatment. This fact sheet answers some frequently asked questions on this topic. To find out more about any topic or resource that is mentioned. What are some questions to ask about paying for CAM treatment? Some questions to ask a CAM practitioner or his office staff are: What does the first appointment cost? What do followup appointments cost? How many appointments does someone with my condition typically need? Are there any additional costs (such as for tests, equipment, or supplements)? If you have a health insurance plan, some other questions are: Do you accept this insurance? What has your experience been with coverage by this insurance company for my condition? Do I file the claim forms, or do you take care of that? If it would be difficult for you to pay the full fee at each visit, you can ask: Could you arrange a payment plan over time? Do you offer a sliding-scale fee? (Sliding-scale fees are determined by people's income and ability to pay.)

Executive Summary of Meditation for Health Purposes Workshop

The purpose of the meeting was to articulate potential goals and directions for research on the mechanisms and efficacy of meditation practices for a variety of health concerns. Experts from a range of disciplines and with a wide range of involvement in the field of meditation research were asked to critically examine the current state of science on meditation for health, and to identify existing or potential intersections and contributions from their fields to further this area of science. This group developed a set of critical questions and approaches that could better inform future research in this area.

Reiki: An Introduction

Reiki is a healing practice that originated in Japan. Reiki practitioners place their hands lightly on or just above the person receiving treatment, with the goal of facilitating the person's own healing response. In the United States, Reiki is part of complementary and alternative medicine (CAM). This fact sheet provides a general overview of Reiki and suggests sources for additional information. People use Reiki to promote overall health and well-being. Reiki is also used by people who are seeking relief from disease-related symptoms and the side effects of conventional medical treatments. Reiki has historically been practiced as a form of self-care. Increasingly, it is also provided by health care professionals in a variety of clinical settings. People do not need a special background to learn how to perform Reiki. Currently, training and certification for Reiki practitioners are not formally regulated. Scientific research is under way to learn more about how Reiki may work, its possible effects on health, and diseases and conditions for which it may be helpful. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Ayurvedic Medicine: An Introduction

Ayurvedic medicine (also called Ayurveda) is one of the world's oldest medical systems. It originated in India and has evolved there over thousands of years. In the United States, Ayurvedic medicine is considered complementary and alternative medicine (CAM)—more specifically, a CAM whole medical system. Many therapies used in Ayurvedic medicine are also used on their own as CAM—for example, herbs, massage, and specialized diets. This fact sheet provides a general overview of Ayurvedic medicine and suggests sources for additional information. Key Points The aim of Ayurvedic medicine is to integrate and balance the body, mind, and spirit. This is believed to help prevent illness and promote wellness. Ayurvedic medicine uses a variety of products and techniques to cleanse the body and restore balance. Some of these products may be harmful if used improperly or without the direction of a trained practitioner. For example, some herbs can cause side effects or interact with conventional medicines. Before using Ayurvedic treatment, ask about the practitioner's training and experience. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

CAM at the NIH - July 2008

Feature Stories New Campaign Encourages Open Communication About CAM A new campaign from NCCAM, which offers free educational materials, is encouraging dialogue between patients and their health care providers about CAM use. A Walk in the Botanical Research Centers "Garden"Visit the NIH Botanical Research Centers "garden" to find out how Russian tarragon, prunella (self-heal), borage oil, and other botanical and dietary supplement ingredients are being examined to prevent and treat diseases and conditions. CAM and Fibromyalgia: At a GlanceFibromyalgia is a condition involving pain, "tender points" on the body, and fatigue. About nine out of 10 people with this condition use CAM. What is known from science about CAM's effectiveness for fibromyalgia?

CAM and Fibromyalgia: At a Glance

People with chronic health conditions such as fibromyalgia often turn to some form of complementary and alternative medicine (CAM)—a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. This fact sheet provides basic information on fibromyalgia and "what the science says" about the effectiveness of CAM practices that many people with fibromyalgia use. If you are considering a CAM therapy for fibromyalgia, this information can help you talk to your health care provider about it.

CAM and Diabetes: A Focus on Dietary Supplements

Diabetes is a chronic condition affecting millions of Americans. Conventional medical treatments are available to control diabetes and its complications. However, some people also try complementary and alternative medicine (CAM) therapies, including dietary supplements. This fact sheet provides basic information on diabetes (with a focus on type 2), summarizes scientific research on the effectiveness and safety of selected supplements that people with diabetes sometimes use, and suggests sources for additional information. Key Points In general, there is not enough scientific evidence to prove that dietary supplements have substantial benefits for type 2 diabetes or its complications. It is very important not to replace conventional medical therapy for diabetes with an unproven CAM therapy. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Grape Seed Extract May Help Prevent and Treat Alzheimer's

According to the National Institute on Aging (NIA), Alzheimer's disease affects nearly 4.5 million Americans and is the most common form of dementia in the elderly. Alzheimer's disease is an incurable disease with a slow progression beginning with mild memory loss and ending with severe brain damage and death. While no treatment is proven to stop Alzheimer's disease, some conventional drugs may limit symptoms for a short period of time in the early stages of the disease. Emerging research shows a correlation between red wine consumption and reduced risk of Alzheimer's disease-type cognitive decline. Authors of a new NCCAM-funded study in mice found that grape seed-derived polyphenolics—similar to that in red wine—significantly reduced Alzheimer's disease-type cognitive deterioration.

St. John's Wort Shows No Impact on the Symptoms of ADHD

According to the National Institute of Mental Health at NIH, Attention Deficit Hyperactivity Disorder (ADHD) affects 3 to 5 percent of children in the United States and it is one of the most common mental disorders that develop in children. NIMH states that children with ADHD have impaired functioning in multiple settings, including home, school, and in relationships with peers. Children with chronic conditions like ADHD are reported to have higher rates of complementary and alternative medicine use and may turn to dietary and herbal supplements such as St. John's wort. However, according to authors of a new NCCAM-funded study, St. John's wort does not appear to have an impact on the symptoms of ADHD in children and adolescents.

Time To Talk About CAM

The National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health (NIH), has launched Time to Talk, an educational campaign to encourage patients—particularly those age 50 or older—and their health care providers to openly discuss the use of complementary and alternative medicine (CAM). CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine, such as herbal supplements, meditation, naturopathy, and acupuncture. According to a national consumer survey conducted by NCCAM and AARP, almost two-thirds of people age 50 or older are using some form of CAM, yet less than one-third of these CAM users talk about it with their providers. The NCCAM/AARP survey revealed some reasons why this doctor-patient dialogue about CAM does not occur.

Message From The Director

I am now 4 months into this exciting and challenging new job as Director of NCCAM. In this short period, I have been given an excellent orientation to all areas of responsibility of the Center, guided by our terrific staff. I have also had the opportunity to speak with many CAM investigators, practitioners, and thought leaders, and some of our critics as well. I am learning a great deal from these various communities and perspectives. Clinicians have given me a sense of the promise that they see in the CAM approaches to health and wellness. Scientists have discussed the many challenges and knowledge gaps in conducting CAM research as well as the opportunities that are emerging from new research methods. NCCAM staff members have shared with me their expertise and experience in the complexities of oversight of our highly varied research portfolio. And CAM advocates who closely follow our progress have shared their perspective and hopes for NCCAM as well.

International Pharmaceuticals, Ltd. Issues a Voluntary Recall of all Viril-Ity-Power (VIP) Tabs

International Pharmaceuticals, Ltd. is conducting this recall after being informed by representatives of the Food and Drug Administration (FDA) that lab analysis by FDA of a sample from one lot of the product revealed that it contained a potentially harmful undeclared ingredient, hydroxyhomosildenafil. FDA asserts that this ingredient is an analog of sildenafil. Sildenafil is the active chemical ingredient of an FDA-approved drug used for Erectile Dysfunction in men to enhance sexual performance. The use of undeclared chemicals pose a threat to consumers because they may harmfully interact with nitrates found in some prescription drugs (such as nitroglycerin) and may lower blood pressure to dangerous levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take such nitrates. VIP Tabs are sold in retail outlets nationwide and are packaged into 2-capsule blister packs and 8-capsule bottles.

Herbs at a Glance Book Now Available

Many people take herbal supplements to boost their immune systems, treat allergy symptoms, prevent a cold—all in an effort to be well and stay healthy. There are hundreds of herbal supplements available in the grocery store or pharmacy or for sale on the Internet. And, there are many claims about their health benefits. How can a consumer decide what's safe or effective? This booklet will give you a basic understanding of some of the most common herbs in popular dietary supplements—their historical uses, what they're used for now, the scientific evidence on their effectiveness, and side effects or cautions for you to consider. To manage your health, you need to be an informed consumer. Learn about herbal supplements and talk with your health care provider about everything you are doing to stay well.

Spinal Manipulation for Low-Back Pain

Low-back pain is a common condition that can be difficult to treat. Spinal manipulationThe application of controlled force to a joint, moving it beyond the normal range of motion in an effort to aid in restoring health. Manipulation may be performed as a part of other therapies or whole medical systems, including chiropractic medicine, massage, and naturopathy. is among the treatment options used by people with low-back pain in attempts to relieve pain and improve functioning. It is performed by chiropractors and other health care professionals such as physical therapists, osteopaths, and some conventional medical doctors. This fact sheet summarizes the current scientific knowledge about the effects of spinal manipulation on low-back pain.

Martin H. Goldrosen, Ph.D., Named Director of NCCAM's Division of Extramural Activities

Martin H. Goldrosen, Ph.D., was recently appointed director of the Division of Extramural Activities at the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health. In announcing Dr. Goldrosen's appointment, Josephine P. Briggs, M.D., NCCAM Director, said "The Division of Extramural Activities is crucial to NCCAM's ability to review and fund high-quality research, as well as coordinate grant management and advisory committee activities. Dr. Goldrosen's experience and his extensive research background make him well-suited for this important work for NCCAM."

Yoga for Health: An Introduction

Yoga is a mind–body practice in complementary and alternative medicine (CAM) with origins in ancient Indian philosophy. The various styles of yoga that people use for health purposes typically combine physical postures, breathing techniques, and meditation or relaxation. This Backgrounder provides a general overview of yoga and suggests sources for more information. Yoga in its full form combines physical postures, breathing exercises, meditation, and a distinct philosophy. Yoga is intended to increase relaxation and balance the mind, body, and the spirit. Early written descriptions of yoga are in Sanskrit, the classical language of India. The word "yoga" comes from the Sanskrit word yuj, which means "yoke or union." It is believed that this describes the union between the mind and the body. The first known text, The Yoga Sutras, was written more than 2,000 years ago, although yoga may have been practiced as early as 5,000 years ago. Yoga was originally developed as a method of discipline and attitudes to help people reach spiritual enlightenment. The Sutras outline eight limbs or foundations of yoga practice that serve as spiritual guidelines.

NIH Yoga Week is May 19–23, 2008

This 5-day series of events will highlight the science and practice of yoga. Participants will not only learn about yoga but also experience it first-hand through stretching and practice. NIH grantees as well as other local and international speakers will explore yoga practice for health. For a schedule of events and additional information visit: does.ors.od.nih.gov/fitness/yogaWeek.htm.

Women's Health Week is May 11–17, 2008

NCCAM provides resources and information on some health issues that affect women, such as menopause, osteoarthritis, and urinary tract infections. We also highlight some of the clinical trials related to women's health issues. Decisions about medical care and treatment should be made in consultation with a health care provider and based on the condition and needs of each person. Discuss information on complementary and alternative medicine (CAM) with your health care provider before making any decisions about treatment or care. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Director's Testimony: Fiscal Year 2009 Budget Request

I am pleased to present the President's Fiscal Year (FY) budget request for the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health. The FY 2009 budget includes $121,695,000, which is $118,000 more than the comparable FY 2008 appropriation of $121,577,000. The public's concept of health is broader than preventing and treating disease. Increasingly, Americans are using strategies that they can employ themselves to improve their health, maintain wellness, and improve quality of life. As part of this participatory approach to health, millions of people are using complementary and alternative medicine (CAM). Many of the leading U.S. medical institutions now offer integrative medicine services. These programs include personalized CAM interventions such as yoga, meditation, massage, and acupuncture. However, we know relatively little about the true potential of CAM to improve health and well being or to preempt disease, or about how best to use most CAM modalities. We also need to understand how CAM practices interact with other therapies and whether they are safe. Given this consumer-driven call for better approaches to improved health and wellness, the medical research community has begun to explore promising CAM approaches and develop the scientific evidence base for CAM modalities that can be integrated as part of comprehensive health care. Using proven scientific methods and rigorous standards, NCCAM is building the research enterprise and the evidence base to better understand CAM. Through scientific investigation, research training programs, and outreach activities, NCCAM's efforts will support the rational integration of proven CAM approaches with conventional medicine.

The Use of Magnets for Pain

Magnets have been used for health purposes for centuries. Static, or permanent, magnets are widely marketed for pain control and are considered part of complementary and alternative medicine. This fact sheet provides an overview of static magnets and summarizes current scientific knowledge about their effects on pain.

Herbal Science International, Inc. Recalls Twelve Dietary Herbal Supplements Nationwide Because of Possible Health Risk Associated with Ephedra, Aristolochic Acid and Human Placenta

FDA has long regarded dietary supplements containing ephedra as potential health hazards because this botanical contains ephedrine alkaloids. Ephedrine alkaloids are adrenaline-like stimulants that can have potentially dangerous effects on the heart. Recent studies have confirmed that ephedrine alkaloids raise blood pressure and otherwise stress the circulatory system, effects that are linked to adverse health effects like heart attacks and strokes. Based on this and other evidence in the scientific literature, FDA issued a rule in February 2004 prohibiting the sale of dietary supplements containing ephedrine alkaloids because they present an unreasonable risk of illness or injury. The company is recalling nine products that contain ephedra, a source of ephedrine alkaloids.

CAM at the NIH - April 2008

NCCAM has a new director, Josephine L. Briggs, M.D. Meet this accomplished researcher and physician, and hear her foremost goal for the upcoming months. It's been 10 years since a groundbreaking NIH conference on acupuncture. What has happened in acupuncture research since then? Where should the field go from here? A recent conference explored these questions. The last thing people need when they are under stress is to get a cold—yet that's what often happens. Is there a scientific connection? A member of NCCAM's Advisory Council talks about some of his work in this area.

Study Sheds Light on the Placebo Effect of Medical Encounters

Researchers have found that a medical encounter may produce its own placebo effects that can bring about significant symptom improvement. The part of the encounter that plays the greatest role in the placebo effect appears to be the physician-patient relationship. In theory, the placebo effect of a medical encounter can be divided into the response to three main components: 1) the assessment and observation, 2) placebo treatment, and 3) patient-physician relationship. This study verified this theory and examined these components of the placebo effect.

Brain Awareness Week is March 10-16, 2008

Brain Awareness Week is an international effort to advance public awareness about the progress and benefits of brain research. The National Center for Complementary and Alternative Medicine is actively involved in brain research, including research on mind-body medicine. Innovative use of imaging technology allows researchers to study the effects of specific CAM therapies on the brain. You can find out more about NCCAM's brain research efforts here.

Pilot Study Provides New Insight on Effect of Ginkgo Extract on Dementia in the Elderly

Overall, in a pilot study of a ginkgo biloba extract for delaying the onset of dementia in the elderly, researchers did not find a reduction in progression to dementia in those using ginkgo versus those using placebo. However, when the researchers took into account participants' adherence to taking the compound, the group that took ginkgo did appear to have a reduced risk of progression and a smaller decline in memory.

Acupuncture Shows Promise in Improving Rates of Pregnancy Following IVF

A review of seven clinical trials of acupuncture given with embryo transfer in women undergoing in vitro fertilization (IVF) suggests that acupuncture may improve rates of pregnancy. An estimated 10 to 15 percent of couples experience reproductive difficulty and seek specialist fertility treatments, such as IVF.

February Is American Heart Month

Heart disease is the leading cause of death in the United States and is a major cause of disability. NCCAM has funded many basic and clinical studies related to heart disease. To ensure safe and coordinated care, people should talk to their health care providers about any CAM therapy that they are currently using or considering.

St. John's Wort and Depression

This fact sheet answers some frequently asked questions about St. John's wort and depression, and summarizes what the science says about its effectiveness and the research being done.

Introduction to Acupuncture

This Backgrounder will provide an introduction to acupuncture as well as resources for more information. Acupuncture is among the oldest healing practices in the world. As part of traditional Chinese medicine (TCM), acupuncture aims to restore and maintain health through the stimulation of specific points on the body.

NCCAM's Advisory Council Welcomes Six New Members

The National Center for Complementary and Alternative Medicine (NCCAM) welcomes six new members to the National Advisory Council for Complementary and Alternative Medicine. The Council serves as the principal advisory body to NCCAM, the lead Federal agency for complementary and alternative medicine research and a component of the National Institutes of Health.

Menopausal Symptoms and CAM

This fact sheet will provide information on menopausal symptoms and complementary and alternative medicine (CAM) based on findings from a 2005 National Institutes of Health State-of-the-Science conference on the management of menopause-related symptoms, as well as resources for more information.

Introduction to Chiropractic

This fact sheet provides basic information about the Chiropractic health care approach that focuses on the relationship between the body's structure-mainly the spine-and its functioning.

FY 2007 Research Awards

The posted table lists research and training grants funded for both new and ongoing research by the National Center for Complementary and Alternative Medicine during Fiscal Year 2007. The list includes the grant number, project title (linked to abstracts on CRISP), principal investigator, institution, and state.

Josephine Briggs, M.D., Named Director of NCCAM

National Institutes of Health (NIH) Director, Elias A. Zerhouni, M.D., today named Josephine P. Briggs, M.D., to be the director of the National Center for Complementary and Alternative Medicine (NCCAM). An accomplished researcher and physician, Dr. Briggs brings a focus on translational research to the study of complementary and alternative medicine (CAM) to help build a fuller understanding of the usefulness and safety of CAM practices.

NCCAM Grantsmanship Workshop

The National Center for Complementary and Alternative Medicine (NCCAM), a component of the National Institutes of Health (NIH), will conduct a 3-day grantsmanship workshop. This workshop will provide researchers, fellows, and graduate students with an in-depth understanding of the NIH grants and review processes, clarify Federal regulations and policies, and highlight areas of special interest and concern. Emphasis will be placed on complementary and alternative medicine (CAM) research. The workshop will include time to interact and discuss research ideas with NCCAM staff. Due to limited space, attendees will be selected through an application process.

CAM at the NIH - Fall 2007

International Team Studies South African Plant for HIV/AIDS Could a plant that is unique to South Africa, and used as a traditional medicine there, be helpful to people with HIV/AIDS? A research team on two continents is working to find out. Also Featuring: Meet NACCAM Member Carlo Calabrese, M.D., M.P.H.; Low Back Pain: NACCAM Symposium; First Transagency Fellow in Cancer CAM

Job Opening: Health Scientist Administrator NCCAM

If you are an exceptionally talented, knowledgeable and motivated individual with excellent knowledge of NIH training and career development programs; have scientific expertise in basic or clinical research that you wish to apply toward advancing the mission of the National Center for Complementary and Alternative Medicine (NCCAM), and ability to work as a member of and provide leadership for a team, within and across groups and organizations, AND you want to play a significant role in a dynamic organization, then consider joining NCCAM's Division of Extramural Research! The Division develops and oversees NCCAM-funded research and research training programs conducted across the country and around the world. The deadline for applications is Friday, January 11, 2008.

Grant Application Notice: NIH Reduces Error Correction Window to Two Business Days

After January 8, the "error correction window" for NIH eSubmission will be the two business days (Mon.–Fri., excluding Federal holidays) that follow the receipt deadline of the Funding Opportunity Announcement.

December 1 Is World AIDS Day

Many people infected with HIV or living with AIDS may be considering the use of complementary and alternative medicine (CAM) to boost their immune system; treat complications of disease; or cope with side effects of conventional medications. This information may be of interest.

Recall of 'True Man Sexual Energy,' 'Energy Max' Dietary Supplements: FDA Press Release

The U.S. Food and Drug Administration requested a recall of True Man Sexual Energy Nutrient Capsules and Energy Max Energy Supplement Men's Formula Capsules, illegal drug products that contain potentially harmful, undeclared ingredients.

New Herbs at a Glance: Noni

This fact sheet provides basic information about noni—common names, uses, potential side effects, and resources for more information. Noni is an evergreen shrub or small tree that grows throughout the tropical regions of the Pacific Ocean, from Southeast Asia to Australia and especially in Polynesia.

New Herbs at a Glance: Soy

This fact sheet provides basic information about soy—uses, potential side effects, and resources for more information. Soy, a plant in the pea family, has been common in Asian diets for thousands of years. It is found in modern American diets as a food or food additive. Soybeans, the high-protein seeds of the soy plant, contain isoflavones-compounds similar to the female hormone estrogen. This fact sheet highlights what is known about soy when used by adults for health purposes.

New Herbs at a Glance: Thunder God Vine

This fact sheet provides basic information about the herb thunder god vine—common names, uses, potential side effects, and resources for more information. Thunder god vine has been used in China for health purposes for more than 400 years.

November Is American Diabetes Month

Nearly 21 million adults and children in the United States are living with diabetes. Some people with diabetes may be considering the use of complementary and alternative medicine (CAM) to either treat their diabetes or its complications. This information may be of interest.

NCCAM Education Grant Program Focus of Academic Medicine Journal Issue

With millions of Americans including complementary and alternative medicine (CAM) in their health care, and as CAM therapies become increasingly available as a result of consumer demand, it is critical that conventional health care professionals be familiar with the most commonly used forms of CAM. The October 2007 issue of the journal Academic Medicine, published by the American Association of Medical Colleges, highlights the results of 15 Education Project Grants funded by NCCAM.

NCCAM Image Gallery

The Image Gallery contains high quality digital photographs available from the National Center for Complementary and Alternative Medicine (NCCAM).

October is National Breast Cancer Awareness Month

While there are no proven CAM treatments for cancer, CAM may be useful to relieve the side effects of treatment and to improve quality of life. NCCAM has a number of resources available for breast cancer patients considering complementary and alternative medicine (CAM).Please visit our site to learn more.

New Herbs at a Glance: Hoodia

Hoodia is a flowering, cactus-like plant native to the Kalahari Desert in southern Africa. Today, hoodia is marketed as an appetite suppressant for weight loss. This fact sheet provides basic information about the herb hoodia—common names, uses, potential side effects, and resources for more information.

New Herbs at a Glance: European Elder

Today, elderberry and elder flower are used for flu, colds, fevers, constipation, and sinus infections. This fact sheet provides basic information about European elder—common names, uses, potential side effects, and resources for more information.

New Herbs at a Glance: Chamomile

Two types of chamomile are used for health conditions: German chamomile and Roman chamomile. This fact sheet provides basic information about the herb chamomile—common names, uses, potential side effects, and resources for more information.

New Herbs at a Glance: Bitter Orange

The bitter orange tree is native to eastern Africa and tropical Asia. Today, it is grown throughout the Mediterranean region and elsewhere, including California and Florida. Bitter orange oil is used in foods, cosmetics, and aromatherapyA therapy in which the scent of essential oils from flowers, herbs, and trees is inhaled to promote health and well-being. products. This fact sheet provides basic information about bitter orange—common names, uses, potential side effects, and resources for more information.

Warning of Red Yeast Rice Products for High Cholesterol

The FDA is warning consumers not to buy or eat three red yeast rice products promoted and sold on Web sites.

FY 2008 Budget Request

On June 22, Ruth L. Kirschstein, M.D., Acting Director NCCAM, presented the President's Fiscal Year (FY) 2008 budget request of $121,699,000 for the National Center for Complementary and Alternative Medicine NCCAM) to the Senate Subcommittee on Labor-HHS-Education Appropriations.

FDA Issues Dietary Supplements Final Rule

The U.S. Food and Drug Administration today announced a final rule establishing regulations to require current good manufacturing practices (cGMP) for dietary supplements. The rule ensures that dietary supplements are produced in a quality manner, do not contain contaminants or impurities, and are accurately labeled. "This rule helps to ensure the quality of dietary supplements so that consumers can be confident that the products they purchase contain what is on the label," said Commissioner of Food and Drugs Andrew C. von Eschenbach, M.D. "In addition, as a result of recent amendments to the Federal Food, Drug, and Cosmetic Act, by the end of the year, industry will be required to report all serious dietary supplement related adverse events to FDA."

CAM Use in Children

Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. As with adults, a wide range of CAM therapies are used in children, including herbs and dietary supplements, massage, acupuncture, chiropractic care, naturopathy, and homeopathy. This fact sheet includes issues to consider and resources for more information when making decisions about CAM use and children.

New Herbs at a Glance: Astragalus

Native to China, astragalus has been used for centuries in traditional Chinese medicine. In the United States, the herb gained popularity in the 1980s. This fact sheet provides basic information about the herb's common names, uses, potential side effects, and resources for more information.

CAM at the NIH: Focus on Complementary and Alternative Medicine

NCCAM's Centers of Excellence: Focusing on the Big—and (Very) Small—PictureWhat do Chinese herbal formulas, mindfulness meditation, electromagnetic beams, and the supplements alpha-lipoic acid and gamma tocopherol have in common? They are among CAM treatments being studied in depth at eight NCCAM-supported research centers.In Memoriam: Stephen E. Straus, M.D.Stephen E. Straus, M.D., founding Director of the National Center for Complementary and Alternative Medicine (NCCAM), died of brain cancer on May 14, 2007. He was 60.

In Memoriam: Stephen E. Straus, M.D., First Director of NIH's National Center for Complementary and Alternative Medicine and Internationally Recognized Physician-Scientist

Stephen E. Straus, M.D., 60, the first director of the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH), died of brain cancer May 14, 2007, at his home in Potomac, Maryland."As NCCAM's first Director, Dr. Straus articulated an uncompromising and compelling agenda for scientific research and research training that engendered broad interest and collaboration," noted Elias A. Zerhouni, M.D., Director of the National Institutes of Health. "His success stemmed from the fact that he understood that the commitment to help patients had to be constantly evolving in order to meet their needs. The NIH has lost a great leader and an outstanding scientist. Most of all, we have lost a dear friend."

Integrative Medicine Consult Service Established at the NIH Clinical Center

The National Center for Complementary and Alternative Medicine (NCCAM) has established an Integrative Medicine Consult Service at the National Institutes of Health (NIH) Clinical Center, the world's largest hospital devoted to research. This service will provide physicians, nurses, and other members of the Clinical Center health care team the ability to discuss complementary and alternative medicine (CAM) therapies with knowledgeable medical staff from the consult service and learn how various CAM practices might complement or interact with a patient's care as a research participant at the Clinical Center.

May is National High Blood Pressure Education Month

Nearly 1 in 3 American adults has high blood pressure, or hypertension. If it is not found and treated, the condition can cause major health problems such as stroke, heart disease, eye problems, or kidney failure. Your doctor can tell you how to prevent and control high blood pressure. NCCAM is studying complementary and alternative medicine (CAM) for this condition—such as mindfulness-based stress reduction. Be sure to tell your doctor about any CAM therapies you are considering, including herbal or dietary supplements. Ask your health care providers about its safety, effectiveness, and possible interactions with medications (both prescription and nonprescription).

An Introduction to Naturopathy

Naturopathy, also called naturopathic medicine, is a whole medical system—one of the systems of healing and beliefs that have evolved over time in different cultures and parts of the world. Naturopathy is rooted in health care approaches that were popular in Europe, especially in Germany, in the 19th century, but it also includes therapies (both ancient and modern) from other traditions. In naturopathy, the emphasis is on supporting health rather than combating disease.

April is Irritable Bowel Syndrome Awareness Month

As many as 20 percent of the adult population, or one in five Americans, has symptoms of irritable bowel syndrome (IBS), making it one of the most common disorders diagnosed by doctors. In an effort to bring attention to the symptoms and difficulties associated with the disorder, April has been designated as IBS Awareness Month. The National Center for Complementary and Alternative Medicine conducts and supports research on many types of diseases and disorders, including IBS. Researchers are studying the effects of acupuncture and the placebo effect on pain caused by IBS. The results have not been published yet.

Grape Seed Extract: Herbs at a Glance

This fact sheet provides basic information about grape seed extract—uses, potential side effects, and resources for more information. The grape seeds used to produce this extract are generally obtained from wine manufacturers.

Lavender: Herbs at a Glance

This fact sheet provides basic information about the herb lavender—common names, uses, potential side effects, and resources for more information. Lavender is native to the Mediterranean region. It was used in ancient Egypt as part of the process for mummifying bodies. Lavender's use as a bath additive originated in Persia, Greece, and Rome. The herb's name comes from the Latin lavare, which means "to wash."

Study compares year-long effectiveness of four weight-loss plans

The very low carbohydrate diet known as the Atkins diet may contribute to greater weight loss than higher carbohydrate plans without negative effects such as increased cholesterol. Christopher Gardner, Ph.D., and colleagues at Stanford University conducted an NCCAM-funded study of 311 pre-menopausal women, all of whom were overweight or obese. Each woman was randomly assigned to one of four diets.

Brain Awareness Week (March 12-18, 2007)

Brain Awareness Week is an international effort to advance public awareness about the progress and benefits of brain research.

Turmeric: Herbs at a Glance

This fact sheet provides basic information about the herb turmeric—common names, uses, potential side effects, and resources for more information. Turmeric, a shrub related to ginger, is grown throughout India, other parts of Asia, and Africa. Known for its warm, bitter taste and golden color, turmeric is commonly used in fabric dyes and foods such as curry powders, mustards, and cheeses. It should not be confused with Javanese turmeric.

Peppermint Oil: Herbs at a Glance

This fact sheet provides basic information about peppermint oil—uses, potential side effects, and resources for more information. The herb peppermint, a cross between two types of mint (water mint and spearmint), grows throughout Europe and North America. Peppermint is often used to flavor foods, and the leaves can be used fresh or dried in teas.

Fenugreek: Herbs at a Glance

This fact sheet provides basic information about the herb fenugreek—common names, uses, potential side effects, and resources for more information. The first recorded use of fenugreek is described on an ancient Egyptian papyrus dated to 1500 B.C. Fenugreek seed is commonly used in cooking.

Job Opening: Director, Office of Policy, Planning, and Evaluation, NCCAM

This position is located in the Office of Policy, Planning and Evaluation (OPPE), National Center for Complementary and Alternative Medicine (NCCAM). NCCAM is dedicated to exploring complementary and alternative healing practices in the context of rigorous science, training complementary and alternative medicine researchers, and disseminating authoritative information to the public and professionals. OPPE is responsible for the science policy, programmatic analyses, program planning, and legislative liaison activities of the Center.

Job Opening: Director of NCCAM

There is much to be done to understand the safety and efficacy of the myriad of CAM therapies used by Americans each year. The NCCAM Director is the leader of the Nation's primary organization for exploring complementary and alternative medicine (CAM) practices in the context of rigorous science, training CAM researchers, and disseminating information to the public and professionals. The incumbent will have the opportunity to build upon a foundation of research that encompasses basic to clinical studies; to attract leading researchers from academic medicine to bring state of the art approaches to studying CAM; and to build a research infrastructure within the CAM community. The incumbent will chart a course for the future of CAM research that will, ultimately, facilitate the integration of proven CAM approaches with conventional health care.

Winter CAM at the NIH Newsletter

Feature stories: Survey: Older Americans' Discussion of CAM with DoctorsFindings from a new survey, conducted by AARP in collaboration with NCCAM, on older Americans' use of CAM and their discussions of CAM with their physicians.Thinking About CAM Therapies for Young PeopleCan CAM therapies be helpful to children? Are they safe? Here are some general points to consider in addressing these questions.

Yohimbe: Herbs at a Glance

This fact sheet provides basic information about the herb yohimbe—common names, uses, potential side effects, and resources for more information. The yohimbe tree is a tall evergreen that is native to western Africa. The bark of the tree contains a chemical called yohimbine. The amount of yohimbine in dietary supplements may vary; some yohimbe products have been found to contain very little yohimbine. However, a standardized form of yohimbine—yohimbine hydrochloride—is available as a prescription medicine that has been studied and used for the treatment of erectile dysfunction.

February is American Heart Month

NCCAM is involved in research related to heart health…Clinical TrialsChelation Therapy Study—A large national study of an alternative treatment— chelation therapy and vitamin therapy—for people with heart diseaseExamples of Recently Published Studies:Transcendental meditation and quality of life of African Americans with congestive heart failure Tea consumption and risk of ventricular arrhythmias among patients hospitalized with acute myocardial infarction

AARP/NCCAM Report on Older Americans

Do Americans age 50 and older discuss the use of complementary and alternative medicine (CAM) with their physicians? In spring 2006, AARP and NCCAM partnered on a survey to help answer this question. The consumer survey found that among the 1,559 adults surveyed age 50+ nearly two out of three reported using some form of CAM, yet only one in three of those who have used CAM said they have discussed it with their physicians.

An Introduction to Probiotics

Probiotics are live microorganisms (in most cases, bacteria) that are similar to beneficial microorganisms found in the human gut. They are also called "friendly bacteria" or "good bacteria." Probiotics are available to consumers mainly in the form of dietary supplements and foods. They can be used as complementary and alternative medicine (CAM)

Self-Hypnosis Beneficial for Women Undergoing Breast Biopsy

An NCCAM-funded trial found that women who used self-hypnosis during a type of core needle breast biopsy experienced anxiety relief and reduced pain when compared with standard care. A large core needle breast biopsy is usually an outpatient procedure that limits the use of anesthetic. Women having this procedure often experience anxiety because of the possibility of a cancer diagnosis in addition to the anxiety that patients typically experience during a medical procedure.

Twenty-Sixth NACCAM Meeting, February 2, 2007

The draft agenda is available for the twenty-sixth NACCAM meeting, scheduled for February 2, 2007. NACCAM is charged with the responsibility of advising, consulting with, and making recommendations to the Director, NCCAM, on matters relating to the research activities and functions of the Center. The role and responsibilities of the council members include secondary review of grant applications in light of NCCAM scientific program priorities and program balance.

New Herbs at a Glance: Aloe Vera, Cat's Claw, Chasteberry, and More.

NCCAM has published eight new Herbs at a Glance fact sheets: Aloe Vera, Cat's Claw, Chasteberry, Ephedra, Evening Primrose Oil, Feverfew, Goldenseal, and Hawthorn. Herbs at a Glance is a series of fact sheets that provides basic information about specific herbs or botanicals—common names, uses, potential side effects, and resources for more information.

Herbal Supplement Fails To Relieve Hot Flashes

The herbal supplement black cohosh, whether used alone or with other botanicals, did not relieve hot flashes in women in the Herbal Alternatives (HALT) for Menopause Study. HALT, co-funded by NCCAM and the National Institute on Aging, did find that women using menopausal hormone therapy received significant relief from their hot flashes and night sweats.

NCCAM-Funded Research for FY 2006

This lists research and training grants funded for both new and ongoing research by the National Center for Complementary and Alternative Medicine during Fiscal Year 2006. The list includes the grant number, project title (linked to abstracts on CRISP), principal investigator, institution, and state.

CAM at the NIH, Fall 2006

Stephen E. Straus, M.D., first Director of the National Center for Complementary and Alternative Medicine (NCCAM), stepped down from his position on November 7, 2006, for health reasons. Dr. Straus plans to continue his scientific work at the National Institutes of Health (NIH) as Senior Advisor to the NIH Director. Tools That Are Transforming Discovery in CAM The National Institutes of Health (NIH) is the nation's medical research agency—making important medical discoveries that improve health and save lives. NIH-supported scientists study ways to prevent disease, as well as the causes, treatments, and cures for common and rare diseases. The National Center for Complementary and Alternative Medicine (NCCAM), as a part of NIH, shares in these goals.

Paying for CAM Treatment

If you are using (or thinking about using) complementary and alternative medicine (CAM), you may have financial questions about paying for treatment. This fact sheet answers some frequently asked questions on this topic.

Stephen E. Straus, M.D., Becomes Senior Advisor to NIH Director

On November 7, 2006, Stephen E. Straus M.D., Director of the National Center for Complementary and Alternative Medicine (NCCAM), stepped down from his leadership of the Center for health reasons. Straus will become Senior Advisor to National Institutes of Health (NIH) Director Elias A. Zerhouni, M.D.

NCCAM and The Bernard Osher Foundation Announce New Career Development Award

The National Center for Complementary and Alternative Medicine (NCCAM) today announced a prestigious career development award designed to diminish the barriers that prevent complementary and alternative medicine (CAM) clinicians from exploring a career in research. NCCAM, a part of the National Institutes of Health (NIH), created this award in partnership with The Bernard Osher Foundation through a grant to the Foundation for the National Institutes of Health.

Developing Probiotics as Foods and Drugs

This workshop will review the state of the science supporting clinical applications of probiotics in promoting and sustaining health and in the management of disease conditions. It will also explore how the current regulatory status of probiotics, which are marketed mostly as foods and dietary supplements in the United States, impacts the clinical evaluation of probiotics. Limitations and gaps in the current body of evidence, as well as scientific and regulatory hurdles, will be identified and recommendations will be provided regarding areas in need of future support. NIH is one of the cosponsors of the workshop.

Natural Products: Challenges and Opportunities, Distinguished Lectures

Ram Sasisekharan, Ph.D.Professor of Biological EngineeringMassachusetts Institute of TechnologyOctober 25, 2006 at 11 a.m.Complex carbohydrates called glycans coat the surface of every cell in our bodies, but only recently have scientists been able to probe the structure of these compounds to understand their biological function and how they might be used to prevent or arrest disease. Dr. Ram Sasisekharan and his multidisciplinary team of researchers at MIT have developed a technique for rapidly sequencing these glycans, revealing their structure for the first time. They have discovered that glycans play a key role in the communications between cells that cause cells to divide, migrate and die. Dr. Sasisekharan and his team are pursuing ways to use glycans for diagnostic purposes and to develop alternative carbohydrate-based therapies for a variety of diseases including cancer. Ginseng, heparin and chondroitin have been the focus of recent studies. Please plan to attend and learn more about this new and promising area of research.

Significant Advances in Dietary Supplement Research Released in Annual Bibliography (2005)

The Office of Dietary Supplements at the National Institutes of Health announces the release of the 2005 issue of the Annual Bibliography of Significant Advances in Dietary Supplement Research. This seventh issue of the Bibliography includes abstracts of 25 noteworthy dietary supplement research papers published in 2005, as judged by an international team of reviewers.

Over 1.6 million Americans Use CAM for Insomnia or Trouble Sleeping

A recent analysis of national survey data reveals that over 1.6 million American adults use some form of complementary and alternative medicine (CAM) to treat insomnia or trouble sleeping according to scientists at the National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health. The data came from the 2002 National Health Interview Survey (NHIS) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention.

Massage Therapy as CAM

Massage therapy is a practice that dates back thousands of years. There are many types of massage therapy; all involve manipulating the muscles and other soft tissues of the body. In the United States, massage therapy is sometimes part of conventional medicine

CAM at the NIH, Summer 2006

International Research Conference Highlights Progress, New DirectionsIn May, more than 600 people from 22 countries gathered at the 2006 North American Research Conference on Complementary and Integrative Medicine. Read about the research findings and perspectives shared on the rich diversity of CAM and integrative medicine. Getting To Know "Friendly Bacteria"Probiotics, also known as "friendly bacteria" or "good bacteria," are found in certain foods and supplements. Find out more about these products and the evidence on their health benefits.

Advisory Council Meeting, September 8

The public is welcome to attend the open session of the upcoming meeting of the National Advisory Council for Complementary and Alternative Medicine (NACCAM). The meeting will be held in Rockville, Maryland on September 8, 2006

Job Opening: International Health Program Specialist, GS 12/13

International Health Program Specialist-NCCAM Deadline: August 22, 2006

Red Clover: Herbs at a Glance

This fact sheet provides basic information about the herb red clover—common names, uses, potential side effects, and resources for more information. Like peas and beans, red clover belongs to the family of plants called legumes. Red clover contains phytoestrogens—compounds similar to the female hormone estrogen.

Licorice Root: Herbs at a Glance

This fact sheet provides basic information about licorice root—common names, uses, potential side effects, and resources for more information. Most licorice is grown in Greece, Turkey, and Asia. Licorice contains a compound called glycyrrhizin (or glycyrrhizic acid). Licorice root has been used as a dietary supplement for stomach ulcers, bronchitis, and sore throat, as well as infections caused by viruses, such as hepatitis.

FDA Warns Consumers and Health Care Providers Not to Use Bismacine, also known as Chromacine

The U.S. Food & Drug Administration (FDA) is warning consumers and health care providers not to use a product called "bismacine," also known as chromacine. The FDA is investigating one report of a death and several reports of injury related to the administration of bismacine.

FDA Warning: Dietary Supplements Used for Sexual Enhancement

FDA Warns Consumers About Dangerous Ingredients in "Dietary Supplements" Promoted for Sexual Enhancement The U.S. Food and Drug Administration (FDA) is warning consumers not to purchase or consume Zimaxx, Libidus, Neophase, Nasutra, Vigor-25, Actra-Rx, or 4EVERON. These products are promoted and sold on web sites as "dietary supplements" for treating erectile dysfunction (ED) and enhancing sexual performance, but they are in fact illegal drugs that contain potentially harmful undeclared ingredients. These products have not been approved by FDA, and there is no guarantee of their safety and effectiveness, or of the purity of their ingredients. FDA advises consumers who have used any of these products to discontinue use and to consult their health care provider. FDA encourages anyone experiencing ED to seek guidance from a health care provider before purchasing a product to treat this medical condition. "These products threaten the public health because they contain undeclared chemicals that are similar or identical to the active ingredients used in several FDA-approved prescription drug products. This risk is even more serious because consumers may not know that these ingredients can interact with medications and dangerously lower their blood pressure," said Dr. Steven Galson, Director of FDA's Center for Drug Evaluation and Research.

New SF424 and PHS 398 Electronic Forms

NOT-OD-06-078 : Grants.gov and NIH/AHRQ recently have made changes to the standard SF424 (R&R) and agency-specific PHS 398 electronic form components used for the electronic submission of grant applications. The forms changes provide greater consistency between forms and align the forms with current policy.

Spring Issue: CAM at the NIH Newsletter

Glucosamine and Chondroitin Sulfate Study Results Announced Glucosamine and chondroitin sulfate are two popular CAM therapies for arthritis. Read about the results of one of NCCAM's largest studies, on the use of these supplements to treat the pain of knee osteoarthritis. The Irresistible Treat That Might Help Resistance Many people enjoy dark chocolate for its taste. Could it have health benefits, too, for insulin resistance—a silent condition that increases one's chances of developing diabetes and heart disease?

DCRC Applicants Conference Call

NCCAM will hold a conference call on Thursday, July 6, 2006, from 2 to 3 pm ET to clarify issues specific to multi-PI applications submitted in response to the Developmental Centers for Research on CAM (DCRC) initiatives. During the call, NCCAM staff will review relevant forms and issues and answer applicants' questions. Please register for the call by sending an e-mail to nccamdcrcinfo@mail.nih.gov. We will send you a call-in phone number and passcode to confirm.

Miller Named Director of Office of Policy, Planning, and Evaluation

Heather G. Miller, Ph.D., M.F.S., was selected as Director for the Office of Policy, Planning, and Evaluation within the National Center for Complementary and Alternative Medicine (NCCAM), at the National Institutes of Health (NIH). Dr. Miller will serve as senior advisor to NCCAM's director on science, science policy, and other strategic issues, as well as oversee the planning, evaluation, and reporting activities for the Center.

Five New Members on the Advisory Council

The National Center for Complementary and Alternative Medicine (NCCAM) welcomes five new members to the National Advisory Council for Complementary and Alternative Medicine (NACCAM). The Council serves as the principal advisory body to NCCAM, a component of the National Institutes of Health within the Department of Health and Human Services. The Council, which meets three times a year, is composed of physicians, scientists, licensed alternative and complementary medicine practitioners, and representatives of the public who contribute their time and expertise over a 4-year term. Council members offer advice and recommendations on the prioritization, conduct, and support of complementary and alternative medicine research, including research training and disseminating health information derived from NCCAM's research.

Job Opening: Scientific Director/Clinical Director

The National Center for Complementary and Alternative Medicine (NCCAM) seeks an accomplished, innovative neuroscientist and clinician to fill three pivotal roles: as Scientific Director and Clinical Director of its Intramural Research Program (IRP) and as Senior Investigator responsible for developing a new research program in mind-body medicine. This individual will report to the NCCAM Director and will be a member of the NCCAM leadership.

Job Opening: Grants Management Specialist

The National Center for Complementary and Alternative Medicine is seeking a Senior Grants Management specialist to serve as a resource to staff associated with grants management related issues. NCCAM is dedicated to exploring complementary and alternative healing practices in the context of rigorous science, training complementary and alternative medicine researchers, and disseminating authoritative information to the public and professionals.

Tai Chi for Health Purposes

Tai chi (pronounced "tie chee" and also known by some other names and spellings) is a mind-body practice that originated in China as a martial art. A person doing tai chi moves his body slowly and gently, while breathing deeply and meditating (tai chi is sometimes called "moving meditation"). Many practitioners believe that tai chi helps the flow throughout the body of a proposed vital energy called qi (pronounced "chee," it means "air," "puff," or "power"). In the United States, tai chi for health purposes is part of complementary and alternative medicine, or CAM. This Backgrounder provides a general overview of tai chi and suggests some resources you can use to find more information.

eCAM: A Closer Look at Clinical Analyses

Novel Diagnosis of Lyme Disease: Potential for CAM Intervention

Lyme disease (LD) is the most common tick-borne disease in the northern hemisphere, producing a wide range of disabling effects on multiple human targets, including the skin, the nervous system, the joints and the heart. Insufficient clinical diagnostic methods, the necessity for prompt antibiotic treatment along with the pervasive nature of infection impel the development and establishment of new clinical diagnostic tools with increased accuracy, sensitivity and specificity. The goal of this article is 4-fold: (i) to detail LD infection and pathology, (ii) to review prevalent diagnostic methods, emphasizing inherent problems, (iii) to introduce the usage of in vivo induced antigen technology (IVIAT) in clinical diagnostics and (iv) to underscore the relevance of a novel comprehensive LD diagnostic approach to practitioners of Complementary and Alternative Medicine (CAM). Utilization of this analytical method will increase the accuracy of the diagnostic process and abridge the time to treatment, with antibiotics, herbal medicines and nutritional supplements, resulting in improved quality of care and disease prognosis.

Cost Effectiveness of Natural Health Products: A Systematic Review of Randomized Clinical Trials

Health care spending in North America is consuming an ever-increasing share of Gross Domestic Product (GDP). A large proportion of alternative health care is consumed in the form of natural health products (NHPs). The question of whether or not NHPs may provide a cost-effective choice in the treatment of disease is important for patients, physicians and policy makers. The objective of this study was to conduct a systematic review of the literature in order to find, appraise and summarize high-quality studies that explore the cost effectiveness of NHPs as compared to conventional medicine. The following databases were searched independently in duplicate from inception to January 1, 2006: EMBASE, MEDLINE, CINAHL, BioethicsLine, Wilson General Science abstracts, EconLit, Cochrane Library, ABI/Inform and SciSearch. To be included in the review, trials had to be randomized, assessed for some measure of cost effectiveness and include the use of NHPs as defined by the Natural Health Products Directorate. Studies dealing with diseases due to malnutrition were excluded from appraisal. The pooled searches unveiled nine articles that fit the inclusion/exclusion criteria. The conditions assessed by the studies included three on postoperative complications, two on cardiovascular disease, two on gastrointestinal disorders, one on critically ill patients and one on urinary tract infections. Heterogeneity between the studies was too great to allow for meta-analysis of the results. The use of NHPs shows evidence of cost effectiveness in relation to postoperative surgery but not with respect to the other conditions assessed. In conclusion, NHPs may be of use in preventing complications associated with surgery. The cost effectiveness of some NHPs is encouraging in certain areas but needs confirmation from further research.

Ten Years Evidence-based High-Tech Acupuncture-A Short Review of Centrally Measured Effects (Part II)

The assessment of acupuncture-induced effects on brain function is crucial. Ultrasound-assisted brain function monitoring and bioelectrical methods as well as near infrared spectroscopic procedures and functional magnetic resonance investigations form the basis for the latest scientific examination methods for acupuncture research. The laserneedle acupuncture, which was examined scientifically for the first time in Graz, represents a new painless and non-invasive acupuncture method. In this way, individual combinations of acupuncture points can be stimulated simultaneously according to traditional Chinese medicine. In the context of double-blind studies, effects in the brain could be demonstrated in a reproducible manner for the first time. This second part of the short review article summarizes some of the centrally measured effects of acupuncture obtained at the Medical University of Graz within the last 10 years.

The Methyltetrahydro-{beta}-Carbolines in Maca (Lepidium meyenii)

Maca, a plant native to the Peruvian highlands, contains (1R,3S)-1-methyl-1,2,3,4-tetrahydro-β-carboline-3-carboxylic acid (MTCA). The family of the tetrahydro-β-carbolines has been associated with both biologically helpful and harmful compounds. We present evidence that MTCA is a natural constituent of Maca, and on consumption no toxicity is found. This suggests that, when consumed as multi-component, MTCA may loose its adversity as drug action.

Ficus racemosa Stem Bark Extract: A Potent Antioxidant and a Probable Natural Radioprotector

Ethanol extract (FRE) and water extract (FRW) of Ficus racemosa (family: Moraceae) were subjected to free radical scavenging both by steady state and time resolved methods such as nanosecond pulse radiolysis and stopped-flow spectrophotometric analyses. FRE exhibited significantly higher steady state antioxidant activity than FRW. FRE exhibited concentration dependent DPPH, ABTS•–, hydroxyl radical and superoxide radical scavenging and inhibition of lipid peroxidation with IC50 comparable with tested standard compounds. In vitro radioprotective potential of FRE was studied using micronucleus assay in irradiated Chinese hamster lung fibroblast cells (V79). Pretreatment with different doses of FRE 1h prior to 2 Gy -radiation resulted in a significant (P < 0.001) decrease in the percentage of micronucleated binuclear V79 cells. Maximum radioprotection was observed at 20 µg/ml of FRE. The radioprotection was found to be significant (P < 0.01) when cells were treated with optimum dose of FRE (20 µg/ml) 1 h prior to 0.5, 1, 2, 3 and 4 Gy -irradiation compared to the respective radiation controls. The cytokinesis-block proliferative index indicated that FRE does not alter radiation induced cell cycle delay. Based on all these results we conclude that the ethanol extract of F. racemosa acts as a potent antioxidant and a probable radioprotector.

Modified Wendan Decoction can Attenuate Neurotoxic Action Associated with Alzheimer's Disease

We observed the effect of modified Wendan decoction (modified Wen-Dan-Tang) on a cellular model of Alzheimer's disease. Amyloid beta (Aβ) 25–35 segment neurotoxin was employed to induce a PC12 cellular model of Alzheimer's disease. After modified Wendan decoction was fed to rats, the serum containing medicine was prepared and changes in cell morphology observed. Cell mortality and survival rate was examined by trypan blue stain assay and MTT method and caspase-3 expression was detected by western blot, while cell apoptosis was examined by flow cytometry. Cell morphology of prepared serum group was better than that of controls, and cell survival rate in prepared serum group was higher than that in control (P < 0.01 or P < 0.05). Cell mortality, caspase-3 expression and apoptosis rate in prepared serum group were lower than that in control (P < 0.01 or P < 0.05). We conclude that Modified Wendan Decoction can attenuate the neurotoxicity of Aβ 25–35 and rescue neurons via suppressing apoptotic process.

Phytic Acid Exposure Alters AflatoxinB1-induced Reproductive and Oxidative Toxicity in Albino Rats (Rattus norvegicus)

The increased use of feed in Egypt's aquaculture and animal industries raises concerns about the possible presence of mycotoxins in feedstuffs. The use of alternative medicine, such as botanicals and nutritional supplements, has become popular with inflammatory cases. The present study aimed to testify the role played by phytic acid (IP6) in enhancing the reproductive and oxidative toxicity induced in aflatoxinB1 (AFB1) treated white male albino rats (Rattus norvegicus) throughout treatment and withdrawal periods. One hundred and twenty white male albino rats were grouped into four groups. Group 1, was injected with 300 µg kg–1 body wt of AFB1 once every 3 days for 15 days and left uninjected for another 15 days to study the withdrawal effect. Group 2, was injected with 300 µg kg–1 body wt of AFB1 once every 3 days for 15 days and treated simultaneously with IP6 daily for another 15 days. Group 3, was treated daily with IP6 (40 mg kg–1 body wt) for 15 days and with no treatment for other 15 days. Group 4, injected with equivalent volume of sterile phosphate buffer saline solution as a control group. Sera were taken at the experimental intervals and assayed for testosterone hormone, follicular-stimulating hormone (FSH) and luteinizing hormone (LH) to determine the toxicological impact of AFB1 and the possibility of amelioration by phytic acid on the reproductive performance of the studied animal. The effects of AFB1 treatment on the absolute and relative weight of testis as well as its histopathologic effect on the testis and the possibility of amelioration by IP6 treatment were evaluated. The activities of enzymatic and non-enzymatic anti-oxidants, in addition to lipid peroxidation were measured in the testis’ homogenate of AFB1-treated rats. A decrease in sex hormone levels, an increase in testicular lipid peroxidation product levels and a significant decrease in testicular glutathione content, catalase and total peroxidase and superoxide dismutase activities were recorded. The histopathologic alterations revealed a degeneration and highly mitotic division within the spermatogenic nuclei, in addition to some karyomegaly and nuclear pyknosis. It is concluded that the reduction in the toxicity of free radicals by phytic acid might be responsible for the protective influence observed.

Crocus Sativus L. (Saffron) Extract and its Active Constituents (Crocin and Safranal) on Ischemia-Reperfusion in Rat Skeletal Muscle

Saffron and its constituents have been shown to decrease ischemia-reperfusion (I/R) injury in kidney or brain tissues. In this study, the effects of saffron ethanolic extract and its constituents, crocin and safranal, were evaluated in skeletal muscle during I/R injury. Hind limb ischemia was induced using clamping the common femoral artery and vein. After 2 h ischemia, the clamp of the femoral vessels of animals was taken off and the animal underwent 1h reperfusion. Muscle injuries were evaluated by recording of the electromyographic (EMG) potentials and performing some biochemical analysis including thiobarbituric acid reactive substances (TBARS), total sulfhydryl (SH) groups and antioxidant capacity of muscle (using FRAP assay). The ethanolic extract of saffron (5, 20 and 80 mg kg–1), crocin (50, 200 and 400 mg kg–1), safranal (0.1, 0.25 and 0.5 ml kg–1) and normal saline (10 ml kg–1) were administered intraperitoneally 1 h prior reperfusion. The average peak-to-peak amplitude during I/R was significantly increased in extract, crocin and safranal groups in comparison with control-ischemic group. Following saffron, crocin and safranal administration, the total SH contents and antioxidant capacity were elevated in muscle flap. The MDA level was declined significantly in test groups. It is concluded that saffron extract and its constituents show a protective effect against lower limb I/R in rat.

Evaluation of the Wound-healing Activity of Ethanolic Extract of Morinda citrifolia L. Leaf

Morinda citrifolia L. (noni) is one of the most important traditional Polynesian medicinal plants. The primary indigenous use of this plant appears to be of the leaves, as a topical treatment for wound healing. The ethanol extract of noni leaves (150 mg kg–1 day–1) was used to evaluate the wound-healing activity on rats, using excision and dead space wound models. Animals were randomly divided into two groups of six for each model. Test group animals in each model were treated with the ethanol extract of noni orally by mixing in drinking water and the control group animals were maintained with plain drinking water. Healing was assessed by the rate of wound contraction, time until complete epithelialization, granulation tissue weight and hydoxyproline content. On day 11, the extract-treated animals exhibited 71% reduction in the wound area when compared with controls which exhibited 57%. The granulation tissue weight and hydroxyproline content in the dead space wounds were also increased significantly in noni-treated animals compared with controls (P < 0.002). Enhanced wound contraction, decreased epithelialization time, increased hydroxyproline content and histological characteristics suggest that noni leaf extract may have therapeutic benefits in wound healing.

Improvement of Experimentally Induced Hepatic and Renal Disorders in Rats using Lactic Acid Bacteria-fermented Soybean Extract (BiofermenticsTM)

The effects of lactic acid bacteria-fermented soybean extract (BiofermenticsTM; BF) on experimental models of hepatic and renal disorders were investigated in vivo and in vitro. In rat, hepatitis induced by feeding of deoxycholic acid (DCA, 0.5 wt/wt, n = 6) or intraperitoneal injection of d-galactosamine (GMN, 500 mg/body wt, n = 6), the increase in serum AST (aspartate aminotransferase) and ALT (alanine aminotransferase) levels were inhibited significantly (P < 0.05) by feeding a diet containing 5% dried BF. Moreover, the BF-administered rat group showed lower concentrations of blood urea nitrogen and a larger amount of urine as compared with values in the control group. Pretreatment of primary cell cultures of rat hepatic and renal cells with BF prior to exposure to dichromate (K2Cr2O7) resulted in a marked decrease of dichromate-induced cytotoxicity as evaluated by the leakage of lactate dehydrogenase The levels of dichromate-induced lipid peroxidation, as monitored by malondialdehyde formation, were also reduced by pretreatment of hepatocytes with BF. These results suggest that BF may play a role in hepatic and renal disorders, and may be useful for maintaining health in humans as well.

Evaluating Complementary Therapies for Canine Osteoarthritis Part I: Green-lipped Mussel (Perna canaliculus)

A green-lipped mussel (GLM) preparation was evaluated in a randomized, double-controlled and double-blinded clinical trial. It was hypothesized that the treatment effect would be less than that of the positive control (carprofen) but more than that of the negative control (placebo). Forty-five dogs with chronic pain and a radiographic diagnosis of osteoarthritis that were randomly allocated into one of three groups completed the study. All dogs were fed the test products or placebo for 8 weeks. The dogs were evaluated four times, at 4-week intervals. Six different variables were assessed: veterinary-assessed mobility index, two force plate variables, owner-evaluated chronic pain index and pain as well as locomotion visual analogue scales (VASs). Intake of extra carprofen was also evaluated. A chi-squared and a Mann–Whitney test were used to determine significance between groups. When changed to dichotomous variables, there were more dogs in the GLM than in the placebo group that improved, according to veterinary-assessed mobility, owner-evaluated chronic pain index and pain VAS (P = 0.031, P = 0.025, P = 0.011, respectively). For the same three, the odds ratio and their confidence interval were over one. The extent of improvement was significantly different between the GLM and the control in veterinary-assessed mobility (P = 0.012) and pain VAS (P = 0.004). In conclusion, GLM alleviated chronic orthopedic pain in dogs although it was not as effective as carprofen. As no side-effects were detected, GLM may be beneficial in dogs e.g. when non-steroidal anti-inflammatory drugs cannot be used.

Hangekobokuto (Banxia-houpo-tang), a Kampo Medicine that Treats Functional Dyspepsia

Although abdominal bloating is one of the most bothersome symptoms experienced by patients with functional dyspepsia (FD), therapeutic drugs to relieve abdominal bloating have not been established. We investigated the Kampo (Chinese herbal) medicine, Hangekobokuto (Banxia-houpo-tang, HKT) for patients with FD from the standpoint of bowel gas retention. The bowel gas volume calculated from a plain abdominal radiogram (gas volume score, GVS) in FD patients was significantly higher than that in healthy subjects. Two week administration of HKT in the FD patients showed a significant decrease of GVS. Furthermore, gastrointestinal symptoms, especially symptoms of abdominal pain, indigestion and constipation, all of which are closely related to abdominal bloating, improved significantly in FD patients after the administration of HKT. These results suggest that HKT improves abdominal bloating accompanied by the reduction of bowel gas in FD patients.

How Far Can Ki-energy Reach?--A Hypothetical Mechanism for the Generation and Transmission of Ki-energy

‘Ki-energy’, which can be enhanced through the practice of Nishino Breathing Method, was reported to have beneficial health effects. Although Ki-energy can play an important role in complementary and alternative medicine (CAM), as yet it is unknown how Ki-energy is generated, transmitted through air and received by another individual. We previously proposed that Ki-energy may include near-infrared radiation, and that the wavelength was between 800 and 2700 nm. Since Ki-energy is reflected by a mirror, we believe that the ‘Ki-beam’ has a small divergence angle. It can also be guided in a desired direction. The acrylic mirror reflection experiment suggests that the wavelength may be between 800 and 1600 nm. Using a linear variable interference filter, we found that Ki-energy may have a peak around 1000 nm. We have also observed that ‘sensitive’ practitioners responded to Ki sent from a distance of 100 m. All of these results suggest that (i) Ki-energy can be guided as a directional ‘beam’ with a small divergence angle; (ii) the beam can be reflected by a mirror and (iii) Ki-energy may have a specific wavelength. Since these properties are characteristics of the laser radiation, we propose a quantum physics-based mechanism of ‘Light Amplification by the Stimulated Emission of Radiation’ (i.e. LASER) for the generation of Ki-energy. Volunteers responded to Ki even with a blindfold. This suggests that the skin must be detecting Ki-energy. We propose that the detector at the skin level may also have the stimulated emission mechanism, which amplifies the weak incident infrared radiation.

Effective Application of Knowledge Management in Evidence-based Chinese Medicine: A Case Study

Chinese medicine (CM) practice, as a knowledge-based industry, has not embraced knowledge management (KM) techniques widely. However, KM may facilitate the adaptation and promotion of evidence-based CM. A KM framework was introduced to its activities in evidence-based CM through the development of a CM portal. A codification strategy was used to codify and store knowledge systematically in a database. Several approaches were developed and implemented to address specific needs for CM such as centralizing the information, encouraging collective efforts, promoting integration of explicit and tacit knowledge, and developing a flexible technology and support system. Following the established KM framework, the RMIT Chinese Medicine Portal (www.chinese-medicine.com.au) was built up with four major components: organizational knowledge, knowledge workers, KM processes and information technology. Knowledge on Chinese herbs was classified into core, advanced and innovative categories, which involved the development of the monograph template. A working group was organized including CM, pharmacology and information technology professionals to implement this proposal with following sequential development stages: knowledge creation/acquisition, storage/organization, distribution and application. User interface and web language were also defined and accomplished. This case study demonstrates the applicability of KM in evidence-based CM through a multidisciplinary collaboration, such as, an effective collaboration between CM and information technology. The study also shows the potential of KM application in other disciplines of complementary and alternative medicine.

Turo (Qi Dance) Training Attenuates Psychological Symptoms and Sympathetic Activation Induced by Mental Stress in Healthy Women

Vagal withdrawal and sympathetic overactivity accompany various types of stress. Qi training is reported to reduce sympathetic hyper-reactivity in a stressful situation. Turo, which is a type of dance that uses the Meridian Qi System, may reduce the psychological symptoms induced by an imbalance of the autonomic nervous system (ANS). We observed whether Turo training alters psychopathological and psychological symptoms using the Symptom Checklist 90-Revision (SCL-90-R) and examined whether it attenuates the stress response to mental stress in healthy adolescent females using the power spectrum analysis of heart rate variability (HRV). Twenty-one subjects received Turo training and 27 subjects were trained with mimicking movements. The SCL-90-R was measured before and after the 2-month training period. Heart rate (HR), total power (TP) and the LF/HF ratio of HRV were compared between the Turo and control groups during and after mental stress. The somatization and hostility subscales of the SCL-90-R of the Turo group were significantly lower than those of the control group after 2 months. The increases in HR and the LF/HF ratio of HRV induced by the stress test were significantly lower in the Turo group than in the control group. The TP of the Turo group was significantly higher than that of the control group. The psychological symptoms and sympathetic activation induced by the artificial stress were significantly reduced by the Turo training. These findings suggest that Turo training can play a critical role in attenuating psychological symptoms and stress-induced sympathetic activation.

Brief Homeopathic Pathogenetic Experimentation: A Unique Educational Tool in Brazil

In homeopathy, many difficulties are encountered in understanding theoretical presuppositions because they represent different paradigms from those of hegemonic science. In our medical school, we developed a brief homeopathic pathogenetic experimentation course to be added as curricular content and a didactic method in homeopathic disciplines to add practical experience to the theoretical approach of homeopathic presuppositions. In accordance with the premises laid out by Hahnemann, the father of homeopathy, brief pathogenetic experimentation was offered on a voluntary basis for students who were free of chronic diseases and who had not regularly used medication in the last 3 months. The clinical test, either crossed or sequential (randomized and blind), was used as a study model. Single weekly doses of a homeopathic medicine of 30 cH or placebo were taken by participants during 4 weeks after which crossover of the experimented substances took place for another 4 weeks. Polycrest medicines were used so that symptoms developed by the participants could be compared to those described in Homeopathic Materia Medica. Thirty-three of the 50 students who studied homeopathy as an elective discipline over the last 4 years at the School of Medicine of the University of São Paulo (FMUSP) participated. Participants described symptoms according to specific methodology including many comments with peculiar characteristics and notable idiosyncrasies. All these students endorsed the course because it contributed to their understanding of how dynamized substances produced symptoms in healthy participants as well as the cure of symptoms according to the casual similitude principle. Brief homeopathic pathogenetic experimentation proved to be an effective method to observe the idiosyncratic manifestations of human individuality based on qualitative methodology, thus building a basis of understanding of homeopathy.

Summary of the American College for Advancement in Medicine November 2007 Conference on Integrative Medicine: Advancing Science and Clinical Practice

Use of complementary and alternative medicine: a survey in Turkish gastroenterology patients.

Background: The study examined complementary and alternative medicine (CAM) usage by patients attending a Turkish gastroenterology outpatient clinic. Methods: The survey was conducted on 216 patients presenting with gastrointestinal problems during their first visit to the clinic using a 31 item, self-report questionnaire between May and October 2005. Data included information on patient demographics and their gastrointestinal symptoms, as well as items to identify CAM use and patient satisfaction with these therapies. Results: Seventy-nine patients (36.6%) reported using one or more forms of CAM. The most commonly used therapy was herbal therapy, usually taken as a tea or infusion. These were used by 27 people (29%) in this subgroup. Common indicators for their use were epigastric pain, constipation, bloating and dyspepsia or indigestion. CAM use among upper GI patients was marginally higher than lower GI patients (41.8% versus 41.2%), but the highest usage was amongst patients with liver disease where 53.8% reported using one or more CAM therapy. About half of the patients learned about CAM from their relatives or friends, with more women than men using the therapies (p < 0.05). Clinical characteristics such as diagnosis, duration of symptoms and prior surgical intervention did not differ between users and non-users of CAM therapies. Multivariate analysis showed that being female and higher educational status were positively associated with CAM usage (p < 0.05). Conclusion: CAM usage in our sample of gastrointestinal patients was lower than that described in other countries and other chronic disease groups. This could be due to their low perceived efficacy, or the relatively transient duration of symptoms experienced by the sample. Healthcare professionals need however, to be aware of CAM usage in order to educate patients appropriately about possible adverse effects or drug-interactions.

Traditional eye medicine use by newly presenting ophthalmic patients to a teaching hospital in South-eastern Nigeria: socio-demographic and clinical correlates

Background: This study set out to determine the incidence, socio-demographic, and clinical correlates of Traditional Eye Medicine (TEM) use in a population of newly presenting ophthalmic outpatients attending a tertiary eye care centre in south-eastern Nigeria. Methods: In a comparative cross-sectional survey at the eye clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, between August 2004 - July 2006, all newly presenting ophthalmic outpatients were recruited. Participants' socio-demographic and clinical data and profile of TEM use were obtained from history and examination of each participant and entered into a pretested questionnaire and proforma. Participants were subsequently categorized into TEM- users and non-users; intra-group analysis yielded proportions, frequencies, and percentages while chi-square test was used for inter-group comparisons at P = 0.01, df = 1. Results: Of the 2,542 (males, 48.1%; females, 51.9%) participants, 149 (5.9%) (males, 45%; females, 55%) used TEM for their current eye disease. The TEMs used were chemical substances (57.7%), plant products (37.7%), and animal products (4.7%). They were more often prescribed by non-traditional (66.4%) than traditional (36.9%) medicine practitioners. TEMs were used on account of vision loss (58.5%), ocular itching (25.4%) and eye discharge (3.8%). Reported efficacy from previous users (67.1%) and belief in potency (28.2%) were the main reasons for using TEM. Civil servants (20.1%), farmers (17.7%), and traders (14.1%) were the leading users of TEM. TEM use was significantly associated with younger age (p < 0.01), being married (p < 0.01), rural residence (p < 0.01), ocular anterior segment disease (p < 0.01), delayed presentation (p < 0.01), low presenting visual acuity (p < 0.01), and co-morbid chronic medical disease (p < 0.01), but not with gender (p = 0.157), and educational status (p = 0.115). Conclusion: The incidence of TEM use among new ophthalmic outpatients at UNTH is low. The reasons for TEM use are amenable to positive change through enhanced delivery of promotive, preventive, and curative public eye care services. This has implications for eye care planners and implementers. To reverse the trend, we suggest strengthening of eye care programmes, even distribution of eye care resources, active collaboration with orthodox eye care providers and traditional medical practitioners, and intensification of research efforts into the pharmacology of TEMs.

Dietary supplementation by older adults in southern China: a hospital outpatient clinic study

Background: There has been little knowledge about dietary supplementation by the Chinese elderly. The aim of this cross-sectional study was to investigate the usage of dietary supplements by older adults in southern China. Methods: A total of 600 community-dwelling older adults were recruited from the outpatient clinics of three major hospitals in Foshan city between July 2007 and July 2008. Face-to-face interviews of participants were conducted to obtain information on demographics, lifestyle and dietary supplements use. Frequency and duration of usage were recorded for six categories of dietary supplements. Results: Among the 446 consented participants (241 men and 205 women) who were over 55 years of age, 19.1% consumed one or more types of dietary supplements. The prevalence of usage was significantly higher (p = 0.008) for females (24.4%) than for males (14.5%). Dietary supplements were more likely to be consumed by non-smokers (p = 0.021) and those with hyperlipidemia (p = 0.003). The most popular supplement among users was calcium (53%). The majority (71%) of the users consumed supplements on a regular basis at one or more times per day, with an average duration of 2.95 (SD 4.80) years. Conclusion: The overall prevalence of dietary supplementation in this older Chinese population was considerably lower than those in other Asia-Pacific countries.

Evaluation and implications of natural product use in preoperative patients: a retrospective review

Background: Medication Reconciliation and Medication Safety are two themes emphasized in a variety of healthcare organizations. As a result, health care facilities have established methods for obtaining a patient's medication history. However, these methods may vary among institutions or even among the health care professionals in a single institution, and studies have shown that patients are reluctant to disclose their complementary and alternative medicine use to any health care professional. This lack of disclosure is important in surgical patients because of potential herbal interactions with medications and drugs used during the surgical procedure; and the potential for adverse reactions including effects on coagulation, blood pressure, sedation, electrolytes or diuresis. Therefore, the objectives of this study are to identify patterns of natural product use, to identify potential complications among patients scheduled for surgery, to improve existing medication reconciliation efforts, and to develop discontinuation guidelines for the use of these products prior to surgery. Methods: A retrospective review of surgery patients presenting to the Anesthesia Preoperative Evaluation Clinic (APEC) at the University of Kansas Hospital was conducted to identify the prevalence of natural product use. The following data was collected: patient age; gender; allergy information; date of medication history; number of days prior to surgery; source of medication history; credentials of person obtaining the history; number and name of prescription medications, over-the-counter medications and natural products; and natural product dosage. Following the collection of data and analysis of the most common natural products used, possible complications and interactions were identified, and a protocol regarding the pre-operative use of natural products was developed and implemented. Results: Approximately one-fourth of patients seen in the APEC indicated the use of natural products. Patients taking natural products were significantly older, were more likely to undergo cardiac or chest surgery, and were more likely to be taking more prescription and non-prescription medications (all p < 0.001). Conclusion: Based on the results of this study, it is concluded that there is a need for established guidelines regarding discontinuation of selected natural products prior to surgery and further education is needed concerning the perioperative implications of natural products.

Justification for the use of Ocimum gratissimum L in herbal medicine and its interaction with disc antibiotics.

Background: The ethanolic extract of the leaves of Ocimium gratisimum L. (Lamiaceae), used in traditional medicine for the treatment of several ailments such as urinary tract, wound, skin and gastrointestinal infections, was evaluated for its antibacterial properties against four clinical bacteria isolates namely: Escherichia coli, Proteus mirabilis, Staphylococcus aureus and Pseudomonas aeruginosa and the antifungal properties using a clinical isolate of Candida albicans. A typed bacterium of Escherichia coli ATCC 11775 and another typed fungal strain of Candida albicans (ATCC 90028) were also included. The study also intended to verify if the concomitant administration of conventional antibiotics with Ocimium gratisimum which is normally taken as food (spice) will negatively affect its activity. Methods: The agar diffusion method was used to test the in vitro activity of the plant extract. The interaction of the plant extract with some disc antibiotics namely: ciprofloxacin, septrin, streptomycin, ampicillin, nystatin and ketoconazole was tested using the agar overlay inoculum susceptibility disc method. Phytochemical analysis of the extract was performed following established methods. Results: The extract showed good but varying in vitro activities against all the isolates tested. While ampicillin showed synergistic interaction with the plant extract against clinical isolates of E. coli and P. mirabilis, septrin was synergistic against the clinical isolate of E. coli only. Similarly, the activity of the extract against C. albicans isolate was synergistic with ketoconazole and nystatin. Conclusion: The study has validated the folkloric use of O. gratissimum in traditional medicinal practice and goes further to show that the use of this plant material as food spice may not really threaten the efficacy of some conventional antibiotics that may have been taken concomitantly with it as is the popular belief in the practice of herbal medicine in local/rural communities of many countries in the world.

Anti-inflammatory properties of Salograviolide A purified from Lebanese plant Centaurea ainetensis

Background: Anti-inflammatory activities of medicinal plants have largely been attributed to their content of sesquiterpene lactones (SLs). SLs are predominantly found in the sunflower family Asteraceae and have been isolated from many plants of this family, particularly Centaurea. The anti-inflammatory activities of extract of Centaurea ainetensis, a Lebanese endemic plant, and the isolated active molecule were assessed for their potential ant-inflammatory activities. Methods: Plant extract from Centaurea ainetensis, and the isolated active ingredient Salograviolide A (SA), a sesquiterpene lactones guaianolide, were used for the study. Western blotting and electrophoretic mobility shift assays were used to test the effects of the plant extract and SA on interleukin-1 (IL-1) induced increase in cyclooxygenase-2 (COX-2) levels and in nuclear factor-κB (NF-κB) translocation in an intestinal epithelial cell (IEC) of inflammation. Their effects on inflammation score and cytokine levels were also studied in an iodoacetoamide-induced rat model of inflammation. Results: Plant extract and SA were shown to reverse the effects observed by IL-1 on COX-2 levels and NF-κB translocation in IEC. SA decreased the level of inflammatory cytokines and the level of inflammation in the animal model. Conclusion: These findings suggest that SA may be useful in the development of natural therapies for inflammatory diseases.

Termite usage associated with antibiotic therapy: Enhancement of aminoglycoside antibiotic activity by natural products of Nasutitermes corniger (Motschulsky 1855)

Background: Several species from Insecta are used as remedies. Among these species, the termite Nasutitermes corniger is commonly used in traditional medicine in Northeast Brazil. The present work tests the modifying antibiotic activity of Nasutitermes corniger, a termite used in folk medicine in Northeastern region of Brazil. Methods: Chlorpromazine and decocts of N. corniger were collected from two different plant species used in the traditional medicine were tested for their antimicrobial activity against strains of Escherichia coli resistant to aminoglycosides. The growth of two bacterial strains of E. coli was tested using decocts and chlorpromazine alone or associeted with aminogycosides. Results: The MIC and MBC values were ≥1024 μg/ml for both strains of E. coli assayed. A significant synergism was observed between both decocts and chlorpromazine when assyed with neomycin. This synergism with neomycin indicates the involvement of an efflux system in the resistance to this aminoglycoside. Conclusion: Therefore it is suggested that natural products from N. corniger could be used as a source of zoo-derived natural products with modifying antibiotic activity to aminoglycosides, being a new weapon against the bacterial resistance to antibiotics.

The antibacterial properties of Malaysian tualang honey against wound and enteric microorganisms in comparison to manuka honey

Background: Antibiotic resistance of bacteria is on the rise, thus the discovery of alternative therapeutic agents is urgently needed. Honey possesses therapeutic potential, including wound healing properties and antimicrobial activity. Although the antimicrobial activity of honey has been effectively established against an extensive spectrum of microorganisms, it differs depending on the type of honey. To date, no extensive studies of the antibacterial properties of tualang (Koompassia excelsa) honey on wound and enteric microorganisms have been conducted. The objectives of this study were to conduct such studies and to compare the antibacterial activity of tualang honey with that of manuka honey. Methods: Using a broth dilution method, the antibacterial activity of tualang honey against 13 wound and enteric microorganisms was determined; manuka honey was used as the control. Different concentrations of honey [6.25-25% (w/v)] were tested against each type of microorganism. Briefly, two-fold dilutions of honey solutions were tested to determine the minimum inhibitory concentration (MIC) against each type of microorganism, followed by more assays within a narrower dilution range to obtain more precise MIC values. MICs were determined by both visual inspection and spectrophotometric assay at 620 nm. Minimum bactericidal concentration (MBC) also was determined by culturing on blood agar plates. Results: By visual inspection, the MICs of tualang honey ranged from 8.75% to 25% compared to manuka honey (8.75-20%). Spectrophotometric readings of at least 95% inhibition yielded MIC values ranging between 10% and 25% for both types of honey. The lowest MBC for tualang honey was 20%, whereas that for manuka honey was 11.25% for the microorganisms tested. The lowest MIC value (8.75%) for both types of honey was against Stenotrophomonas maltophilia. Tualang honey had a lower MIC (11.25%) against Acinetobacter baumannii compared to manuka honey (12.5%). Conclusion: Tualang honey exhibited variable activities against different microorganisms, but they were within the same range as those for manuka honey. This result suggests that tualang honey could potentially be used as an alternative therapeutic agent against certain microorganisms, particularly A. baumannii and S. maltophilia.

Exploring integrative medicine for back and neck pain - a pragmatic randomised clinical pilot trial

Background: A model for integrative medicine (IM) adapted to Swedish primary care was previously developed. The aim of this study was to explore the feasibility of a pragmatic randomised clinical trial to investigate the effectiveness of the IM model versus conventional primary care in the management of patients with non-specific back/neck pain. Specific objectives included the exploration of recruitment and retention rates, patient and care characteristics, clinical differences and effect sizes between groups, selected outcome measures and power calculations to inform the basis of a full-scale trial. Methods: Eighty patients with back/neck pain of at least two weeks duration were randomised to the two types of care. Outcome measures were standardised health related quality of life (the eight domains of SF-36) complemented by a set of exploratory "IM tailored" outcomes targeting self-rated disability, stress and well-being (0-10 scales); days in pain (0-14); and the use of analgesics and health care over the last two weeks (yes/no). Data on clinical management were derived from medical records. Outcome changes from baseline to follow-up after 16 weeks were used to explore the differences between the groups. Results: Seventy-five percent (80/107) of screened patients in general practice were eligible and feasible to enrol into the trial. Eighty-two percent (36/44) of the integrative and 75% (27/36) of the conventional care group completed follow-up after 16 weeks. Most patients had back/neck pain of at least three months duration. Conventional care typically comprised advice and prescription of analgesics, occasionally complemented with sick leave or a written referral to physiotherapy. IM care generally integrated seven treatment sessions from two different types of complementary therapies with conventional care over ten weeks. The study was underpowered to detect any statistically significant differences between the groups. One SF-36 domain showed a clinically relevant difference between groups that was also supported by a small distribution based effect size, i.e. vitality (-7.3 points, Cohen's d -0.34) which was in favour of IM. There was a clinical trend between groups showing that IM contributed to less use of prescription and non-prescription analgesics (-11.7 and - 9.7 percent units respectively) compared to conventional care. Exploring clinically relevant differences and the SF-36 as the basis for a main outcome measure showed that the sample sizes needed per arm to adequately power a full-scale trial depended on the target domain, i.e. ranging from 60 (vitality) to 339 (role emotion). Conclusion: This pilot study investigated the implementation of IM in the primary care management of non-specific back and neck pain. Recruiting patients and implementing IM in routine clinical practice was feasible. The results warrant further exploration into different perspectives and relevant combinations of outcome measures including the use of health resources, drugs and cost-effectiveness to help understand the relevance of IM in primary care. Future research should prioritise larger scale studies considering variability, pain duration and small to moderate treatment effects.Trial registrationClinical trials NCT00565942

Knowledge, attitudes and practices regarding gemstone therapeutics in a selected adult population in Pakistan

Background: Gemstones have been in use as part of alternative and complementary medicine for years. However, our understanding of the perceived healing powers of gemstones is limited. An extensive literature search revealed that there is a dearth of validated information on this subject. This study was therefore undertaken to explore the various aspects of the knowledge, attitudes, and practices of the public towards gemstone therapeutics. Methods: A survey was performed in the Community Health Centre of a tertiary care teaching hospital in Pakistan. Data collection was done via a face-to-face interview based on a structured, pre-tested questionnaire. Participants included all willing persons between 18–75 years of age approached prior to their appointments at the Community Health Centre. Results: The survey response rate was 86% (400/465). More than half (63%) of the study population was aware of the use of gemstone therapy. One hundred fifty-six individuals believed that gemstone use impacts health. Of this group, 39% believed that gemstone use increases physical strength. 62% believed that gemstone use is based on superstitious beliefs, whereas 28% opined that it is based on religious beliefs. 38% had used gemstones therapeutics formerly, while 24% were current users. Multiple logistic regression analysis revealed that age status and education status were significant (p < 0.05) independent predictors for both awareness of gemstone therapy and the belief that gemstone use impacts health. The elderly (aged 51–61) were 5.9-times more likely to believe that gemstones had an impact on health than the younger population (aged 18–28 years). (Adjusted Odd's Ratio = 5.9 [95% Confidence Interval = 2.9–11.9]). Conclusion: More than half of our sample population is aware of the use of the gemstones for their various effects. Willingness to use gemstones is associated with the beliefs about the impact of gemstone therapy on health. Friends and family seem to be the major role players influencing people's willingness to use gemstones. CAM modalities should be recognized and considered as an important therapeutic option. We feel that gemstone therapy is a relatively unexplored area and more studies should, therefore, be conducted to gather more validated information on the subject.