Transcript 14. Complementary and Alternative Medicine

Complementary and
Alternative Medicine,
Dietary Supplements, and
Medications
CAM- every where you look
Complementary and Alternative
Medicine (CAM)
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Complementary and alternative medicine
• A group of diverse medical and health care
systems, practices, and products
• Not considered part of conventional medicine
• Some scientific evidence exists regarding CAM
therapies
• For most, questions of safety and efficacy
persist
Complementary medicine is used together with
conventional medicine. Alternative medicine is
used in place of conventional medicine.
Integrative or Holistic Medicine
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Integrative combines mainstream medical
therapies and CAM therapies for which
there is some high-quality scientific
evidence of safety and effectiveness.
“Healing-oriented medicine that takes account of
the whole person (body, mind, and spirit),
including all aspects of lifestyle. It emphasizes
the therapeutic relationship and makes use of all
appropriate therapies, both conventional and
alternative.”
http://nccam.nih.gov/health/whatiscam/
http://www.integrativemedicine.arizona.edu/about2.html
Major Classes of CAM
Enhance the
mind’s capacity
to affect bodily
function and
symptoms
Alternative
medical
systems
Homeopathic
Naturopathic
Traditional
Chinese and
Ayurvedic
treatments
Mind-body
interventions
Chiropractice
Osteopathy
Massage
Biologically
-based
therapies
Dietary supp
Herbs
Foods
Vitamins
Natural
substances
Manipulative
& body-based
methods
Energy
therapies
Biofield therapy
Bioelectromagnetic
therapy
http://nccam.nih.gov/
CAM Treatments Commonly
Thought Effective in Pediatrics
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Effectiveness
uncertain
• Acupuncture for asthma
• Acupuncture for hay
fever
• Acupuncture for
rheumatoid arthritis
• Chromium for diabetes
• Echinacea for common
cold
• prevention or treatment
• Evening primrose for
eczema
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Effectiveness unlikely
• Acupuncture for body
weight reduction
• Acupuncture for
smoking cessation
• Flower remedies for
anxiety
• Homeopathy for anxiety
• Spinal manipulation for
asthma
• Spinal manipulation for
infantile colic
Biologically Based Practices
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Includes: botanicals, animal-derived
extracts, vitamins, minerals, fatty
acids, amino acids, proteins, whole
diets, and functional foods
• Dietary supplements are a subset
of biologically based practices
Energy Medicine
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Veritable - energy that can be
measured
• Includes sound, visible light, magnetism
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Putative – energy that has yet to be
measured
• human beings are infused with a subtle
form of energy
• Includes qi (ki in Japanese); doshas;
prana, homeopathic resonance
Energy Medicine - Acupuncture
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Few complications
Scientific evidence?
• post chemotherapy
• management of nausea
• pain relief
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NIH Consensus Statement (1997)
Manipulative and Body-Based
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Structures and systems of the body,
including the bones and joints, the
soft tissues, and the circulatory and
lymphatic systems
• Includes chiropractic manipulation,
massage therapy, reflexology,
rolfing, Alexander technique,
Feldenkrais method
Mind-Body Medicine
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Interactions among the brain,
mind, body, and behavior
The ways in which emotional, mental,
social, spiritual, and behavioral factors
can directly affect health
• Includes relaxation, hypnosis, visual imagery,
meditation, yoga, biofeedback, tai chi, group
support, and spirituality
Other CAM Therapies
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Aromatherapy
Colonic Irrigation
Therapeutic Touch
EDTA Chelation
Cupping
Primordial Sound Meditation
Dietary Supplements
RUN THE WHOLE GAMUT!!!
vitamins- C, E.
minerals- Ca, Se
amino acids-lysine
fats- fish oil
hormones- DHEA
herbs- ginseng
phytochemicals-garlic
etc
FDA Regulations Protect
Consumers
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FDA regulates: Drugs are highly
regulated by FDA
Vitamins & minerals regulated as
foods
Supplements are considered safe
until demonstrated to be hazardous
by FDA
Herbals & botanicals totally
unregulated
Who Benefits?
Those at risk for developing
nutritional deficiencies only!
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People with vit, mineral deficiency
Vegans- vit D, B12
Pregnant women- folate
Elderly persons- B12/folate
People at risk of osteoporosis- Ca,
vit D
People at risk of losing blood- Fe
People on restricted diets- vit,
minerals
Hormones
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HGH
EPO
BHCG
Steroids
Human Growth Hormone
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Normally secreted by the pituitary
Normal function of GH is growth and
development of every body system,
including bone and muscle
Can be stimulated by propanolol,
vasopressin, clonidine, and levodopa
Synthetic growth hormone
Side Effects:
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Acromegaly (may be irreversible)
Peripheral Neuropathy
Coronary Artery Disease
Cardiomyopathy
Diabetes, Hypothyroidism, arthritis
No available urine test available, but
banned by NCAA and IOC
Erythropoietin
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Hormone released by the kidneys in
response to low Hct
Stimulates RBC production from
bone marrow
Has recently been manufactured by
recombinant DNA technique
Can increase Hct in renal patients by
up to 35%, lasting up to 7 months
Used most by cyclists
Blood Doping
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Induced Erythrocythemia: An
increase in Hb following reinfusion of
an athlete’s blood
Goal: to increase the oxygencarrying capacity of Hb
Has been used as far back as 1947
1984: seven US Olympic cyclists
guilty
Banned by IOC in 1985
Anabolic Steroids
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The ultimate ergogenic aid aka
“Juice”
Creates the Superhuman Athlete
Testosterone derivatives (cholesterol)
Produced in the adrenal/ testes
Anabolic/Androgenic
Steroids
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Anabolism - Constructive
Catabolism - Destructive
Anabolic effects : inc. skeletal mm
mass
anticatabolism
Androgenic effects: secondary
sexual characteristics - pubic hair,
genital size
No Pure Anabolic Steroids
Desired Effects:
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Increase in strength
Increase in weight
Increase in aggressiveness
Increased capability of sustaining
repetitive, high intensity workouts
Enhanced performance
Specific Side Effects
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Women
(Virilzation):
• Clitoril
enlargement,
Deepening of
voice, Male
pattern baldness,
dec. breast size,
libido
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Children:
• premature closure
of growth plate in
long bones & thus
“Prohormones”
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Androstenedione
DHEA
Androstenediol
Norandrostenedione
Norandrostendiol
Effects:
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Benefits: Same as Testosterone
• Increased energy
• Enhanced recovery and growth from
exercise
• heightened sexual arousal and function
• greater sense of well-being
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Plasma levels of testosterone
increased from 140% to 330% of
normal levels after 50mg and 100mg
doses
SE’s : Same as Testosterone
Banned by IOC, NCAA, NFL
Stimulants
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Caffeine
Amphetamines
Cocaine
Ephedrine
Amino Acids
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Creatine
L-Carnitine
Choline
Inosine
HMB (B-OH-BMethylbutyrate)
Amino Acids
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Essential amino acids: found in a
balanced diet
Recommended protein intake: 0.8
g /kg/day
Athletes may benefit from up to
1.4 -2.4 g/kg/day
Most beneficial for athletes on a
poor diet, or vegetarians
In endurance athletes, up to 10%
of energy expenditure is from
protein breakdown
Creatine
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Methylguanidine-acetic acid - made
from glycine, arginine & methionine
Estimated Daily requirement: 2gms
Available in meats and fish (1/2 EDR)
Sold as Creatine Monohydrate
Stored in Skeletal MM
2000 NCAA banned distribution in
training rooms
Antioxidants
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Vitamins E & C
potential damage from free oxygen
radicals produced by lipid
peroxidation in exercise
exercise performance is not
improved
Herbs
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Ginseng
Yohimbe
Tribulus Terresteris
Ma haung