Alternative therapies for infectious diseases

Definition

The National Center for Complementary and Alternative Medicine (NCCAM) defines “complementary and alternative medicine,” or CAM, as a group of diverse medical and healthcare systems, products, and practices not considered part of conventional medicine. Alternative medicine, or therapy, replaces conventional medicine. Conventional medicine includes osteopathic medicine (practiced by a doctor of osteopathy or D.O.) and allopathic medicine (practiced by a medical doctor or M.D.). Alternative therapy, for example, uses products such as echinacea, zinc, and vitamin C to decrease common cold symptoms.

Complementary medicine, or therapy, differs from alternative medicine in that it is used with, not in place of, conventional medicine; it “complements” conventional therapy. Complementary medicine combines alternative therapy with the care of medical doctors, osteopaths, and associated conventional health professionals such as psychologists, nurses, and radiologists. Complementary therapy includes, for example, using massage or aromatherapy to lessen the discomfort associated with the complications and discomfort of an infectious disease treated earlier with antibiotics and surgical wound debridement.

Tested CAM therapy, which has quality scientific support, and mainstream (conventional) treatment, is known as integrative medicine. Integrative medicine combines the best of CAM and conventional medicine to optimize health and well-being. For example, some individuals may use cranberry products to avoid repeated urinary tract infections after successful treatment of a urinary tract infection with antibiotics.

Major Types of CAM

Five major CAM categories, defined by the National Institutes of Health (NIH), provide a helpful outline for different complementary and alternative optionsalternative medical systems, biological based systems, manipulative and body-based systems, mind-body interventions, and energy therapies. These categories organize alternative and complementary approaches, and this organization guides study and approaches to CAM therapies.

Alternative medical systems. Complete systems of theory and practice and central philosophies define alternative medical systems, such as traditional Chinese medicine (TCM) and Ayurvedic medicine. Multiculturalism and ancient heritage provided by medical systems outside Western conventional care provide attractive alternatives for many people seeking to optimize their health and well-being. TCM and Ayurvedic medicine (in India) are integral to local heritage and culture. TCM and Ayurvedic medicine are mainstream in China and India because of thousands of years of practice in those countries; the practices now coexist with conventional medicine.

The NIH, through NCCAM, analyzes and funds studies of alternative medical systems and procedures to best determine what healthcare approaches have benefit. The NIH has determined that scientific evidence supports needle acupuncture to treat nausea and vomiting associated with chemotherapy and postoperatively. Some infectious disease treatments, such as surgical wound debridement, result in pain and discomfort; these types of problems could be alleviated with acupuncture techniques. More follow-up study can help to develop the effective range of acupuncture as an adjunct to conventional medicine in the treatment of infectious diseases.

Western cultures have developed alternative medical systems that include homeopathic and naturopathic medicine. Homeopathy began in Germany in the late eighteenth century with the work of physician Samuel Christian Hahnemann, and naturopathy started in Europe in the nineteenth century. It was popularized in the United States by the German physician Benedict Lust, who founded the American School of Naturopathy in New York City in the early 1900s. Naturopathy’s healing system shares many principles with conventional medicine, including the principles of first doing no harm and the identification and treatment of disease origins. Major naturopathic tenets involve belief in nature’s healing power, teaching, and disease prevention.

Hahnemann founded homeopathy by selecting therapies based on how closely symptoms produced by remedies matched the symptoms of the disease. He named this the principle of similars. A similar procedure is used in modern vaccine development. Homeopathic practice includes careful examinations of the mental, emotional, and physical aspects of a person’s health and the analysis of distinctive personality and physical traits.

Homeopathy uses dilute liquid and pills. Minute or nonexistent amounts of the original molecules remain after vigorous shaking and multiple dilutions. The contention is that the “memory” of the original molecule impacts surrounding water molecules, and that this essence confers therapeutic properties to the solutions. Most scientific study finds little evidence supporting homeopathy. Skepticism exists in part because nonexistent or minuscule doses are used in homeopathic remedies. Although most analyses do not support homeopathy, NCCAM has identified some studies, laboratory research, and clinical trials supporting homeopathic remedies.

Biologically based therapies. Biologically based treatments are natural compounds that include herbs, food supplements, and vitamins. Many find the natural aspect of these therapies alluring, but natural products interact with prescription drugs and have side effects, some quite serious. The difference between the regulation of prescription medications and the regulation of herbs, food supplements, and vitamins is important to understand. The approval and marketing of prescription medications require extensive clinical testing and clinical trials. The regulation of dietary supplements resembles the regulation of salt and pepper production more than it resembles the regulation of prescription drugs. Regulation of supplements, and production oversight, varies greatly from the regulation of prescription drugs.

Aromatherapy studies provide scientific evidence supporting beneficial effects. Infections caused by bacteria, viruses, or fungi have been shown to respond positively to various aromatherapies. Fragrant essences, found in plants such as geranium, roman chamomile, lavender, lemon, and cedar wood, are extracted as essential oils from plants in natural ways. Aromatherapy includes inhalation or skin application of these oils. Studies consistently show that pleasant odors improve mood and reduce anxiety. Aromatherapies offer a sense of well-being, calm, and energy.

Many studies document antibacterial effects with the application of the essential oils on skin. Antifungal activity against some vaginal and mouth fungus infections has been demonstrated. Some essential oils have been shown to alleviate problems associated with infections caused by the herpes simplex virus.

Stressed rats in laboratory experiments developed enhanced immune responses when exposed to certain aromas. Aromatherapy is usually thought of as a positive adjustment of the central nervous system, but one study showed that markers of the fragrant aromas are found in the blood. This could mean that aromatherapy agents act like drugs or medications, rather than as adjusters of brain perception. Side effects of aromatherapy include dermatitis and allergies.

Milk thistle seeds are used to treat liver diseases. A strong antioxidant, silymarin, provides the active ingredient for milk thistle. Silymarin regenerates liver tissue, may aid treatments of hepatitis, and may work as adjunctive liver cancer therapy, helping chemotherapeutic agents. More studies will help isolate the therapeutic benefits of silymarin.

Cranberries, a fruit, may help prevent urinary tract infections (UTIs) and reduce Helicobacter pylori stomach infections that cause ulcers. Although some evidence supports using cranberries for UTI prevention, cranberries are not effective treatments for existing UTIs. Cranberries may keep bacteria such as Escherichia coli and H. pylori from adhering to cell walls in the urinary tract and in stomach linings, thus preventing UTIs and stomach ulcers.

Cranberries are found in juices and dietary supplements. Tablets or capsules of cranberry extracts are available as well. The excessive use of cranberry juice extracts or beverages can result in diarrhea or gastrointestinal upset. Although cranberry products may help prevent UTIs, the diagnosis and treatment of UTIs should be done by qualified healthcare personnel. Cranberries may interact with medications affecting the liver or with blood-thinning drugs.

Echinacea is thought to kindle the immune system and prevent or treat colds, the flu, or other infections. NCCAM funded studies that did not support the use of echinacea for colds, but other studies showed that echinacea may be beneficial for both the treatment and the prevention of colds. Echinacea is used as a tea, a pill extract, or as juice. Allergic reactions can occur, particularly among those who have asthma, genetic tendencies to allergic reactions, or allergies to ragweed, marigold, chrysanthemum, and daisy. Echinacea comes from plants in the daisy family.

Goldenseal, sometimes called orangeroot or yellow puccoon, is a plant used for respiratory tract infections and colds. Some cold preparations combine goldenseal with echinacea. Native Americans traditionally use goldenseal for a variety of ailments, including gonorrhea and ulcers. Goldenseal is also used for gastrointestinal infections, vaginal infections, and eye infections. Sore throats and canker sores are treated with goldenseal, too. Little scientific evidence supports the use of goldenseal for any of these infections, but more study may show that an active goldenseal ingredient, berberine, can help with some infections, like those causing diarrhea.

Vitamin C and zinc preparations are often used to treat colds. A primary goal of vitamin C and zinc use is to decrease the duration and perhaps the severity of the illness. No cure exists for colds in either conventional or alternative medicine. Some studies indicate that high doses of zinc may reduce cold duration, and other studies support vitamin C use for cold symptom reduction, but these are not cures for the common cold and lack scientific evidence to support their use.

Different viruses cause colds and influenza. No vaccine or conventional antibiotic exists to treat or prevent these viral infections. Many vitamins, minerals, herbs, and other compounds, such as honey, peppermint, selenium, or ginseng, are used in an attempt to fill in this treatment and prevention gap. Elderberries and elder flowers are used for flu, colds, sinus infections, and fevers. With the possible exception of echinacea, zinc, and vitamin C, the various other remedies do not have much scientific support for their use, particularly in children. Handwashing prevents the spread of cold and flu viruses, and frequent handwashing, particularly in cold and flu seasons, provides a reasonable approach to cold and flu prevention.

Manipulative and body-based methods. Manipulation or movement of body parts characterizes these therapeutic techniques. Massage therapy is helpful for stress relief and the discomfort experienced with many chronic conditions, including acquired immunodeficiency syndrome (AIDS) and recurrent hepatitis. Trager bodywork, Rolfing, reflexology, the Alexander and Bowen techniques, the Feldenkrais method, and chiropractic or osteopathic manipulations are some of the therapies and techniques in this category. Popular in the United States, chiropractic and massage therapy appointments represent one-half of all visits to CAM practitioners in the United States.

Bones, joints, muscles, and the circulatory and lymphatic systems are often the focus of these body-based therapies. An emphasis on the interdependence of body parts, body self-regulation, and the “laying on of hands” are desirable methods for people seeking relief from health problems and for those trying to optimize individual health.

Mind-body interventions. A variety of processes in this category, such as meditation, prayer, group support, and self-hypnosis, enhance overall well-being. Creative channels tapped in music, art, dance, and writing improve interaction between the mind and physical symptoms.

Self-hypnosis is a mind-body intervention that improves self-confidence and fosters positive attitudes. Self-hypnotic positive attitudes and autosuggestions can enhance pain relief, help manage stress, improve immune response, and improve diseases like asthma and arthritis. Focused concentration and a willingness to follow one’s own instructions are important parts of successful self-hypnosis. A personal mantra, such as “My confidence grows daily because I am getting better,” can help focus one’s thoughts.

Energy therapies. Energy therapies claim that manipulating energy fields enhances well-being. Scientific proof of these energy fields is lacking, and these energy fields have not been sufficiently measured in controlled scientific studies. Biofield therapies, such as therapeutic touch and Reiki, purportedly change energy fields surrounding the body to enhance wellness and health. Practitioners of these types of therapies claim that biofields change by applying forces on, in, or through these energy fields. Bioelectromagnetic therapies use electromagnetic fields, including direct-current and alternating-current fields. Pulsed and magnetic electromagnetic fields also are used in these alternative therapies.

Impact

Sick persons want to optimize their health and get better, and persons who are well want to stay healthy. To do so, one should consult conventional healthcare providers, including allopathic and osteopathic providers, about individual healthcare issues. No substitute exists for the advice and medical expertise of primary care providers, and decisions about treatment or care options should be discussed with these providers.

Conventional healthcare is an important part of any healthcare plan, but people who seek out and use CAM therapies want to maintain health and optimize disease defense mechanisms. Most CAM users do not reject conventional healthcare; they simply want to enhance their overall well-being. Typical CAM users are inquisitive and educate themselves on the various aspects of illness or disease prevention. CAM users are often health enthusiasts, in much the same way that exercisers study various options for optimal physical fitness.

Critical thinking skills are important when using alternative therapies for infectious diseases. CAM therapies should be discussed with one’s conventional healthcare provider. Critical thinking helps decipher the many options available and helps discern whether a therapy is helpful or harmful. Integrative medicine incorporates the best CAM with indicated alternative or complementary treatments. Some scientific studies have been completed on CAM treatments, but more scientific studies are needed to uncover potentially helpful alternative treatments.

Optimal wellness techniques meld scientific-based medical care with the best of CAM. Integrative medical systems often involve more personal responsibility for individual wellness. More responsibility engenders a healthier lifestyle, enabling better choices. CAM users have many options available. The challenge is sorting out what is best for an individual and how to best develop a healthy lifestyle. More study and knowledge of healthy mechanisms enables successful health preservation and the ability to prevent and treat infectious disease processes when they occur.

Bibliography

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