RISK AND BENEFITS ALTERNATIVE MEDICAL SYSTEMS/WHOLE MEDICAL

SYSTEMS

Whereas the ancient Greeks postulated that health requires a

balance of vital humors, Asian cultures considered that health
depends on the balance and flow of vital energies through the
body.

• A category that extends beyond a single modality

and refers to an entire system of theory and
practice that developed separately from
conventional medicine.
• Major Eastern whole medical systems include
Traditional Chinese medicine (TCM), Kampo
medicine (Japanese), and Ayurvedic medicine, one
of India's traditional systems of medicine. Major
Western whole medical systems include
homeopathy and naturopathy.

TRADITIONAL CHINESE MEDICINE

CONCEPTS OF CRITICAL ISSUES OF CAM
A. CONCEPTS OF CAM
• Dietary supplements are considered by law as
food.
• Usage of Dietary supplements: a. supply daily
quota of nutrient (RDA) b. Preventive- taken to
prevent developing illnesses.
• Dietary supplements needed in the following in
spite of proper diet (Expert opinion)
✓ Pregnant and lactating women
✓ People with poor appetite
✓ Vegetarians
✓ People who have nutrient deficiency diseases
✓ Persons with illnesses that impair absorption
of nutrients.
• Dietary supplements needed in the following in spite of
proper diet (Expert opinion)
✓ People taking medications that interfere with the
body’s use of specific nutrients.
✓ Patients with prolonged illnesses, extensive
injuries or have undergone surgery.
• Alcohol and Drug Abuse
• Subsets: Herbalism, Acupuncture, Moxibustion,
Tuina, Qi gong, Tai chi
BACKGROUND:
• Ancient China
• TCM practitioners use herbal medicines and
various mind and body practices, such as
acupuncture and tai chi, to treat or prevent health
problems.
• TCM view, the body is a delicate balance of two
opposing and inseparable forces: yin and yang.
✓ yin represents the cold, slow, or passive principle,
while yang represents the hot, excited, or active
principle.
✓ imbalance leads to blockage in the flow of qi (or
vital energy) along pathways known as meridians.

B. CRITICAL ISSUES OF CAM IN MEDICAL PRACTICE

• Clinicians unaware of patient’s usage of CAM
• Potential interaction between CAM and Medical therapy
• Medicinal CAM agents used for anti-inflammatory and
antibiotic effect.
• CAM used in many chronic diseases.
▪ e.g., soy protein useful in cirrhotic patients with CHF
and malnutrition

C. THE DON’T’S IN THE DIETARY SUPPLEMENT

• Don’t take dietary supplements with high concentration
of iron (Hepatic heart deposits)
• Don’t use products that are labeled high potency e.g.,
megadose of vit. C and Calcium carbonate tablets can
cause renal calculi and sandy crystals
• Don’t take mega supplements. supplements unless
monitored by physicians.
• Don’t succumb to random recommendations even if
they were well-meant.
• Don’t diagnose symptoms on your own and treat
yourself using diet supplements.
TRADITIONAL CHINESE MEDICINE - TREATMENTS

HERBALISM

• Chinese herbal medicine uses herbs to improve

health.
• Chinese herbal therapy can come in the form of:
✓ Granules or easy-to-digest capsules.
✓ Teas, liquid extracts and powders.
✓ A traditional formula.
✓ A custom formula that your herbalist creates for
you.

BENEFITS OF CHINESE HERBS

• Allergies.
• Autoimmune disorders.
• Cancer treatment side effects.
• Diarrhea and constipation.
• Digestion issues.
• Infertility.
• Irritable bowel syndrome.
• Immune system regulation.
• Menopause.
• Menstrual or endometriosis pain.
• Persistent fatigue.

CHINESE MATERIA MEDICA

• Standard reference book of information on

medicinal substances that are used in Chinese
herbal medicine.
• Examples:
• Artemisia annua BEN
✓ -controls fevers EFIT
✓ 1970s - extracted the chemical S
artemisinin.
✓ There is a lower concentration of •
artemisinin in herbal preparations than in eopl
the drug products, and there is concern e
that using it alone as a therapy may can
cause resistance. effec
• Tripterygium wilfordii Hook F (Chinese Thunder tivel
God vine) y
✓ treatment of autoimmune and com
inflammatory diseases bine
✓ The first small randomized, placebo- acup
controlled trial of a Thunder God vine unct
extract in the United States showed a ure
significant dose-dependent response in with other treatments.
patients with rheumatoid arthritis. In • Effective acupuncture can help manage chronic
larger, uncontrolled studies, however, pain, migraine, and headaches.
renal, cardiac, hematopoietic, and • Acupuncture carries a low risk of side effects.
reproductive toxicities of Thunder God • It is a flexible form of treatment that can target
vine extracts have been observed. numerous health concerns at once.

ACUPUNCTURE USES:

• A technique in which practitioners stimulate
specific points on the body—most often by
inserting thin needles through the skin.
• Studies suggest that acupuncture stimulates the
RISK/COMPLICATIONS:
release of the body’s natural painkillers and affects
areas in the brain involved in processing pain;
however, some trials suggest that real acupuncture
and sham acupuncture are equally effective,
indicating a placebo effect.
• Seeks to release the flow of the body's vital energy
or "chi" by stimulating points along 14 energy
pathways.
• low back pain, neck pain, osteoarthritis (OA), knee
pain, headache, migraine, peripheral neuropathy,
nausea, rheumatoid arthritis, fatigue, tendinopathy
• Bleeding, bruising, and soreness may occur at the
insertion sites.
• Unsterilized needles may lead to infection.
• In rare cases, a needle may break and damage an
internal organ.
 ACUPRESSURE MOXIBUSTION
What is it? Acupuncturists use hair-thin
needles as a method of • Form of therapy that entails the burning of mugwort
stimulation for different leaves. This is a small, spongy herb that is believed to
meridians, or acupoints, in enhance healing with acupuncture.
order to help heal the body • Purpose is to strengthen the blood, stimulate the flow
How does it help promote it is said to be the most of Qi or energy, and maintain good health.
healing? effective treatment when • traditionally – for colds
working with various • direct or indirect
ailments because of its
ability to facilitate a better
flow of energy in comparison
to other methods.
Acupuncture is commonly
integrated with traditional
Western medicine or
chiropractic methods in
order to help patients
achieve optimum results.
What are the pros? Patients are working with a
skilled professional for their
treatment.
There are actual medical
diagnoses involved
What are the cons? Patients should be prepared
DIRECT
for costlier sessions,
meaning that some patients
• Scarring Moxibustion – proper size of moxa cone placed
may be limited in their ability
directly on point; local place is desired to be burnt,
to continue sessions in the
blistered, and left with a scar when healed.
long run.
What are the costs? The average acupuncture ✓ Applied for: asthma, chronic digestive
treatment costs about $100 disease.
or more • Non-scarring Moxibustion – applied for chronic
deficiency of coldness.

ACUPUNCTURE INDIRECT
What is it? A cupressure uses firm
pressure from hands, wrists, • Salt
and elbows in order to target • Aconite
and stimulate different • Garlic
meridians, or acupoints. • Ginger
How does it help promote The firm pressure that is
healing applied during acupressure,
which is similar to a Shiatsu
massage, helps to stimulate
endorphins, or the “feel
good” hormones; this helps
when it comes to increasing
blood flow and oxygen
throughout the body, relaxing
the muscles, decreasing
pain and promoting healing.
In addition to relieving pain,
acupressure works to
rebalance the body by
strengthening the immune
system and reducing existing
stress and tension. BENEFITS:
What are the pros? Low to no-cost if using self-
healing. • therapy for chronic kidney disease, Hot flashes,
Ulcerative colitis. Breech Birth
Patients’ ability to receive
treatments on a daily basis USES:
rather than weekly
What are the cons? Patients need time and • Back pain, Arthritis, Headaches, Migraines, Muscle
research to understand the stiffness, Tendonitis, Ulcers, Fatigue, Infertility,
basics of acupressure Menstrual cramps, Cancer, Digestive problems
methods, acupoint locations
throughout the body, and RISK/COMPLICATIONS
Chinese medical theory.
• Toxic reactions to mugwort, Nausea and vomiting,
What are the costs? Low to no cost if self-treated
Coughing from the smoke, Dark skin patches, Fetal
distress if you’re pregnant, Premature birth, Basal cell
ACUPUNCTURE: FUNDED REASEARCH carcinoma or a type of skin cancer.

• If acupuncture can reduce the frequency of hot flashes CUPPING

associated with menopause
• stimulate the flow of qi, the vital energy or “life force.”
• Whether acupuncture can reduce pain and discomfort
• cup is applied to the skin and the pressure in the cup is
that may accompany chemotherapy
reduced (either by heat or suction) in order to draw and
• Objectively determining if actual acupuncture is more
hold skin and superficial muscles inside the cup.
effective than simulated acupuncture or usual care for
• one of the best deep-tissue therapies available and it is
pain relief, and (if so) by how much.
frequently used after acupuncture, bloodletting, or
plum blossom treatment.
• cups – glass, bamboo, earthenware, metal, silicone
 10 TYPES OF DIFFERENT CUPPING METHODS TUINA VS. OTHER TYPE OF MASSAGE

• weak/light cupping • Thai massage: As with tuina massage, Thai massage

• medium cupping aims to remove blockages and correct imbalances in
• strong cupping the body’s energy flow.
• moving cupping • Shiatsu massage: Practitioners use this type of
• needle cupping massage to treat a range of chronic health problems
• moxa/hot linked to stress and pain.
• needle cupping • Sports massage: This aims to help manage
• empty/flash cupping musculoskeletal health issues.
• full/bleeding cupping • Swedish massage: Similar to tuina, Swedish massage
• herbal cupping aims to improve relaxation and circulation, but it is a
• water cupping much gentler form of massage.

BENEFITS

• Main benefit is providing relaxation and bringing an

overall feeling of balance; an also reduce pain; help
reduce insomnia, headaches, and stress.

USE:

• Musculoskeletal disorders, such as frozen shoulder

syndrome, herniated disk syndrome, and whiplash
Circulatory system disorders, such as hypertension and
an irregular heartbeat
• Respiratory system disorders, such as asthma and
chronic bronchitis
• Digestive system disorders, such as gallbladder
inflammation and stomach ulcers
BENEFITS: • Reproductive system disorders, such as menstrual
irregularities and sexual dysfunction
• Reduces pain and inflammation.
• Decreases muscle tightness. RISK/COMPLICATION
• Improves blood flow.
• discomfort during or after a session. Slight bruising is
• Increases range of motion. possible.
USE: QI GONG AND TAI CHI
• Arthritis, including rheumatoid arthritis; Back pain, • Qigong pronounced “chi gong,” - Involves using
neck pain, knee pain and shoulder pain; Asthma and exercises to optimize energy within the body, mind, and
other breathing issues; Carpal tunnel syndrome.; spirit, with the goal of improving and maintaining health
Gastrointestinal (GI) disorders like irritable bowel and well-being.
disease (IBD); Headaches and migraines; High blood
• Tai chi - "meditation in motion," also called
pressure (hypertension)
"medication in motion" There is growing evidence that
RISK/COMPLICATIONS this mind-body practice, which originated in China as a
martial art, has value in treating or preventing many
• Bruising. health problems.
• Burns from heated cups.
TAI CHI VS. QI GONG
• Fatigue.
• Headaches. TAI CHI QI GONG
• Muscle tension or soreness. • martial art • a system of wellness
• Nausea. • meditative • “to cultivate or
• Skin infections, itching or scarring. movement practice is enhance the inherent
undertaken “to elicit functional (energetic)
TUINA functional balance essence of the
internally for healing, human being.”
• Ancient form of massage that focuses on balancing a stress neutralization, • less emphasis on
person’s energy. Practitioners use various techniques, longevity, and form. The practice is
including kneading, pressing, rolling, and stretching. personal tranquility.” less rigid and more of
• more complex a free-form art form.
TECHNIQUES
• requires considerably • Ancient practice that
• The rolling method: This focuses on soft tissue more discipline focuses on breath
techniques to address joint injuries and muscle • work on mindful awareness
movement and
sprains.
balance
• The one-finger pushing method: This uses
acupressure techniques with the aim of treating
internal disease. KAMPO MEDICINE
• The Nei Gung method: This method involves exercises
that generate Nei Gong qi — energy work that starts BACKGROUND:
inside the body and works outward — and specific
• Japan
massage methods to revitalize depleted energy
• ‘Kampo’ – which literally means “method from the
systems.
Han period (206 BC to 220 AD) of ancient China.”
• The bone setting methods: This focuses on
✓ refers to its origin from ancient China.
manipulation methods to realign the musculoskeletal
✓ The basic therapeutic handbook for the
system and may be useful for people with joint injuries
application of herbal prescriptions was the
and nerve pain.
Shang han lun. During the Edo-period from
1600 onwards, the specific Japanese
characteristics of Kampo took shape
 TCM VS. KAMPO WHAT THE SCIENCE SAYS ABOUT THE EFFECTIVENESS OF
AYURVEDIC MEDICINE
TRADITIONAL CHINESE KAMPO THERAPY
MEDICINE • Results from a 2013 clinical trial compared two
• TCM emphasizes the • Japanese Kampo Ayurvedic formulations of plant extracts against the
traditional concepts favors diagnostic natural product glucosamine sulfate and the drug
of East Asian natural methods that directly celecoxib in 440 people with knee osteoarthritis. All
philosophy, such as relate the symptoms four products provided similar reductions in pain and
Yin and Yang and the to the therapy, improvements in function.
theory of the five bypassing
• A preliminary and small NCCIH-funded 2011 pilot study
elements. speculative
concepts. with 43 people found that conventional and Ayurvedic
treatments for rheumatoid arthritis were similarly
effective. The conventional drug tested was
WHAT IS KAMPO MADE FROM methotrexate and the Ayurvedic treatment included 40
herbal compounds.
• Japanese kampo is made from natural ingredients— • Outcomes from a small short-term clinical trial with 89
mainly plants, sometimes with minerals and animal men and women suggested that a formulation of five
products included. Some of the core plant ingredients Ayurvedic herbs may help people with type 2 diabetes.
include: However, other researchers said inadequate study
• Ginger designs haven’t allowed researchers to develop firm
• Cinnamon conclusions about Ayurveda for diabetes.
• Licorice • Turmeric, an herb often used in Ayurvedic preparations,
• Medicinal mushrooms (no, not *those* ones) may help with ulcerative colitis, but the two studies
• Ginseng reporting this were small—one, published in 2005,
• Pinellia (*you may not be able to import kampo included 10 people while the other, published in 2006,
containing this into the USA) had 89.
• Perilla • Some Ayurvedic preparations include metals, minerals,
• Magnolia bark or gems. The U.S. Food and Drug Administration warns
that the presence of metals in some Ayurvedic
AYURVEDIC MEDICINE products makes them potentially harmful.
• also called Ayurveda • A 2015 published survey of people who use Ayurvedic
preparations showed that 40 percent had elevated
• is one of the world’s oldest medical systems.
blood levels of lead, and some had elevated blood
• originated in India more than 3,000 years ago and
levels of mercury. About one in four of the supplements
remains one of the country’s traditional health care
tested had high levels of lead and almost half of them
systems
had high levels of mercury.
KEY CONCEPTS OF AYURVEDIC MEDICINE • A 2015 case report published in the Center for Disease
Control’s Morbidity and Mortality Weekly Report linked
• universal interconnectedness (among people, their elevated blood lead levels in a 64-year-old woman with
health, and the universe) Ayurvedic preparations purchased on the Internet.
• the body’s constitution (prakriti) and life forces (dosha) • Although rare, Ayurvedic products may cause arsenic
• which are often compared to the biologic humors of the poisoning.
ancient Greek system.
HOMEOPATHY
VATA DOSHA
• Homeopathy, also known as homeopathic medicine, is
• It controls very basic body functions, like how cells an alternative medical system that was developed in
divide. It also controls your mind, breathing, blood flow, Germany more than 200 years ago.
heart function, and ability to get rid of waste through • medical system based on the belief that the body can
your intestines. Things that can disrupt it include eating cure itself.
again too soon after a meal, fear, grief, and staying up
too late. TWO UNCONVENTIONAL THEORIES OF HOMEOPATHY
• main life force – develop conditions like anxiety,
• “like cures like”—the notion that a diseasecan be cured
asthma, heart disease, skin problems, and rheumatoid
by a substance that produces similar symptoms in
arthritis.
healthy people
PITTA DOSHA • “law of minimum dose”—the notion that the lower the
dose of the medication, the greater its effectiveness.
• This energy controls your digestion, metabolism (how • Homeopathy - Samuel Christian Friedrich Hahnemann
well you break down foods), and certain hormones that in 1797
are linked to your appetite. • Greek terms, homios (“similar”) and pathos (“suffering”
• Things that can disrupt it are eating sour or spicy foods or “sickness”)
and spending too much time in the sun. • Philosophy of health and a formal system of diagnosis
• main life force – develop conditions like Crohn’s and drug therapeutics that aim to stimulate the body’s
disease, heart disease, high blood pressure, and natural healing capabilities.
infections. • The fundamental law that homeopathy is based on is
the law of similars or “like is cured by like,” which may
KAPHA DOSHA
be translated to similia similibus curentur in Latin.
• This life force controls muscle growth, body strength • Homeopathy states that one may cure a disease by
and stability, weight, and your immune system. using a substance that causes certain symptoms in
• You can disrupt it by sleeping during the day, eating too order to cure the disease causing those same
many sweet foods, and eating or drinking things that symptoms.
contain too much salt or water.
HOMEOPATHIC REMEDIES
• main life energy - develop asthma and other breathing
disorders, cancer, diabetes, nausea after eating, and • FDA allows homeopathic remedies that meet certain
obesity. conditions to be marketed without agency preapproval.
For example, homeopathic remedies must contain
active ingredients that are listed in the Homeopathic
Pharmacopeia of the United States (HPUS).
USES: • Traditional naturopaths, also known simply as
“naturopaths,” may receive training in a variety of ways.
• Allergies • Training programs vary in length and content and are
• Migraines not accredited by organizations recognized for
• Depression accreditation purposes by the U.S. Department of
• Chronic fatigue syndrome Education.
• Rheumatoid arthritis • Traditional naturopaths are often not eligible for
• Irritable bowel syndrome licensing.
• Premenstrual syndrome
• It can also be used for minor issues like bruises, PHILIPPINE SETTING
scrapes, toothaches, headaches, nausea, coughs, and
How To Become a Certified Practitioner (Education and
colds.
Training)
PHILIPPINE SETTING
Candidates for Certified Naturopaths must:
How To Become a Certified Practitioner (Education and
• have completed the prescribed Naturopathy course in a
Training)
learning institution accredited by the PITAHC NCC for
Candidates for Certified Homeopath are qualified if: Naturopathy. This refers to no less than 1,500 hours,
including no less than 400 hours of supervised clinical
• The practitioner has completed the prescribed training or equivalent.
Homeopathy course from PITAHC Accredited Learning • have satisfactorily passed the corresponding
institution. Naturopathic Certification Examination
• No less than 3600 – 4800 student/teacher contact • be a holder of a valid Certificate of Registration duly
hours or Bachelor’s Degree in Science, Majoring in issued by the PITAHC National Certification Committee
Homeopathy for Naturopathy

Candidates for Certified Medical Candidates for Certified Medical Naturopath must be:
Homeopath/Homotoxicologist are qualified if:
• a licensed physician of good moral character • a
• they are a licensed physician of good moral character. graduate who has served not less than 1000 hours,
• they have completed 2330-3100 hours of including no fewer than 400 hours of supervised clinical
student/teacher contact and home study time or training in Naturopathy for Physicians as a technique
equivalent in a 1–2-year full time or 3–4-year part time for clinical work with:
course in Homeopathy and or Homotoxicology for • 500 hours (450-600 hours) of Basic Principles and
Physicians as a technique for clinical work with: Theories
• 500 hours (450-600 hours of Basic principles and • 500 hours (415-550 hours) of clinical preceptorship
theories
• 1050-1200 hours of home study
• 500 hours (415-550 hours) of clinical preceptorship
practice
• at least 415-550 hours Individual clinical practice
covering 140 homeopathy clients/patients.
• 50 CME units
• Certificate of attendance

NATUROPATHY

• also called naturopathic medicine

• is a medical system that has evolved from a
combination of traditional practices and health care
approaches popular in Europe during the 19th century.

PITAHC

• distinct method of healing that follows a philosophical

perspective, which recognizes the inherent ability of all
living beings to self-regulate and self-heal.
• Naturopathic approaches in health care support and
enhance the body’s own ability to heal itself through
natural remedies. This modality embraces the use of
therapy, herbs, massage, acupuncture, exercise, and
nutritional counseling.

WHAT DO NATUROPATHIC PRACTITIONER DO

• Dietary and lifestyle changes

• Stress reduction
• Herbs and other dietary supplements
• Homeopathy
• Manipulative therapies
• Exercise therapy
• Practitioner-guided detoxification
• Psychotherapy and counseling.

LICENSURE

Naturopathic physicians generally complete a 4- year, graduate-

level program at one of the North American naturopathic
medical schools accredited by the Council on Naturopathic
Medical Education, an organization recognized for accreditation
purposes by the U.S. Department of Education