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New Dietary Book is Available!!
 Get it here: http://www.demosmedpub.com/book174.html
2004
110 pages
Softcover
ISBN#:1-888799-90-0
1-888799-90-0
Regular Price:$19.95
Discount Price:$16.96
Dietary Supplements and Multiple Sclerosis: A Health Professional's Guide
Allen C. Bowling MD, PhD
Thomas M. Stewart JD, PA-C, MS
There is a relatively high use of complementary and alternative medicine (CAM), especially dietary supplements, among people with multiple sclerosis (MS). Health professionals with CAM information can improve the quality of patient care by guiding patients away from possibly harmful therapies and, if appropriate, towards low-risk, possibly effective therapies.
Dietary Supplements and Multiple Sclerosis is meant to be referred to when people with MS ask a question about a particular dietary supplement. Supplements are arranged in alphabetical order under the most commonly used name. In addition, the index contains a listing of these common names as well as less common names that may be encountered. The main information about the supplements is written in a concise summary form that usually discusses only the MS relevance of the supplement.
The supplements selected for inclusion are those with specific MS relevance, such as those that are known to be used by people with MS, have claimed efficacy for slowing disease progression or relieving MS symptoms, interact with drugs commonly used to treat MS, and potentially worsen MS or its symptoms. Also, supplements are reviewed that are popular in the general population or are known to have serious adverse effects.
ABOUT THE AUTHORS: Allen C. Bowling, MD, PhD, is Medical Director of the Rocky Mountain MS Center. He is also the Director of the Complementary and Alternative Medicine Program based at the center and a Clinical Associate Professor of Neurology at the University of Colorado Health Sciences Center. Dr. Bowling has published numerous articles in clinical and basic science journals. He has presented information and original research on CAM and MS at national and international medical conferences as well as to lay audiences. His work on CAM has received numerous awards.
Thomas M. Stewart, JD, PA-C, MS, is a physician assistant and Associate Director of the Complementary and Alternative Medicine Programs at the Rocky Mountain Multiple Sclerosis Center. With Dr. Bowling, he is involved in developing information related to multiple sclerosis and alternative medicine, and has presented information and original research on CAM and MS nationally to both professional and lay audiences.
Patient Handbook ...
 The Rocky Mountain MS Center Guild is proud to announce the publication of the second edition of the handbook, "Multiple Sclerosis, The Ultimate User Friendly Guide."
To order this revised and updated edition, please mail your request to:
The Rocky Mountain MS Center
Attn: Patient Handbook
701 E Hampden Avenue, Suite 420
Englewood, Colorado 80113.
or click on the book image to read online
 The Rocky Mountain MS Center is pleased to announce the publication of "Alternative Medicine and Multiple Sclerosis," by Allen C. Bowling, M.D., Ph.D.
ISBN#: 1-888799-52-8
Now people with MS can turn to a single source for accurate and unbiased information on a wide range of complementary and alternative medicine (CAM) approaches that can aid both in the management of some MS symptoms and in promoting general health and wellness. In a handy, practical format, this authoritative book offers reliable information on the relevance, safety, and effectiveness of various alternative therapies.
These therapies are organized alphabetically so that readers can readily pinpoint a specific treatment and learn about its origins, merits, and possible uses in MS.
The huge expansion of information available about MS, especially through the Internet,has put the individual with MS in a position to take increasing responsibility for her or his own care. There is thus a need for a comprehensive, readily accessible guide to the present therapeutic options, which will give the inquirer a balanced guide to the relative effectiveness of individual treatments. This books is designed to do just that. Dr. Allen Bowling is one of the co-authors of this book.
The bestselling title is a unique compendium of the most frequently used treatments for multiple sclerosis, an authoritative reference for all physicians, and a factual guide for patients who need information about therapies. This new edition has been extensively revised both in content and format from previous editions. Its organization into sections dealing with the treament of acute exacerbations, disease-modifying therapies, symptom management, and alternative therapies makes the book much more accessible to the reader.
The title has been changed from "Therapeutic Claims in Mulitple Sclerosis" to reflect the major restructuring of this edition and to better describe the range and focus of the content. The authors have included the original data underlying the conclusions reached by the Therapeutic Claims Committee of the International Federation of Multiple Sclerosis Societies, providing for a greater understanding of how those conclusions were reached. The addition of references at the end of each chapter will be especially useful for phsycians and other health care professionals, but will also be of interest to those lay readers who want more detail about the therapies discussed.
You may order by calling (800) 532-8663, e-mailing at: orderdept@demospub.com or through Amazon.com and Barnes and Noble.com
Posters
Published Articles
Summer beckons us with images of easygoing days. But it's a mixed bag. Hot, muggy weather can sap anyone's energy. For people with MS, hot weather often brings additional challenges.
Heat can cause symptoms to appear or make the ones you already have feel worse. It can affect walking, thinking, strength, and energy level.
As many as 60–80% of people with MS have had heat-related symptoms. One theory holds that while damaged nerves may be able to conduct electrical impulses adequately under ideal temperatures, higher temperatures interfere with the process.
Fortunately, the effects of heat are usually temporary. With hot weather on the way, take time to assess your own sensitivity. You may then want to consider some
CAM
, or complementary and alternative medicine strategies.
Cool out
Cooling strategies can improve symptoms for many people. Many are just common sense (fans, air conditioning, cold drinks). A spritzer bottle of water is great to use during exercise. People report that dampened clothes and a fan may give symptomatic relief.
Cool clothes rule
Consider personal cooling garments. Vests, jackets, and neck wraps have pockets for inserting ice packs or refrigerated gels. Cooling suits that circulate fluids, a method called active cooling, are more expensive. Cooling garments may be covered by health insurance and may be tax-deductible.
Research on the active cooling system funded by the National Aeronautics and Space Administration (NASA) showed that lowering core body temperature by only 0.5 degree Fahrenheit could produce small but immediate improvements in walking speed and vision and suggested that there may be long-term benefits as well.
Mind over matter?
There are several
CAM
strategies that don't need a thing. They're in your head, so to speak. Even though there's scant clinical evidence for people with MS, there's little risk involved, so they're worth considering. If nothing else, they might just help you feel more relaxed.
Meditation has been shown to calm the nervous system and has been used to treat such medical conditions as high blood pressure and pain. There are many types, and most include breathing techniques. A basic meditation practice is sitting or lying comfortably, eyes open or closed, and simply focusing on breathing.
Visualization involves creating a mental image. Images such as a waterfall flowing over your body may help you feel more comfortable. Develop an image that you like, and practice bringing it to mind.
These are practices you can call on at any time, any where. But it's best to practice a technique regularly so that you can access it in a pinch. Many health-care professionals have experience in teaching these techniques.
Yoga is cool, too
Certain yoga poses and breathing techniques are said to be "cooling." Yoga practitioners believe that these poses may actually help lower core body temperature. Most gentle or restorative yoga classes are appropriate for people with MS. But many yoga poses are believed to create "heat," so find an instructor experienced in adapting poses for people with special needs.
Listen to yourself
Biofeedback is a non-invasive therapy that teaches people how to regulate mental and bodily functions. It has been used to reduce blood pressure and treat pain. There is some evidence that biofeedback can help people learn to regulate body temperature. However, it has not been studied in people with MS. Since biofeedback can be expensive, consider the lack of evidence before trying this approach.
Choices
When exploring
CAM
, it's important to be aware of the difference between proven evidence resulting from clinical studies and personal opinion based on individual experience. Like so many aspects of MS,
CAM
therapies affect individuals differently. You have to find what works for you.
Acupuncture in MS
Acupuncture is one form of traditional Chinese medicine that is widely used throughout the world. In the
United States
, acupuncture was relatively rare until the early 1970s. Since then, it has grown quickly in popularity, and today, possibly a million Americans use acupuncture yearly. The frequency of acupuncture use among people with MS in the
United States
and
Canada
is not known, but based on two large surveys, it may be higher than in the general population.
The theory
There are major conceptual differences between Western medicine and traditional Chinese medicine. For example, Chinese medical theory does not include the concept of a nervous system. In Western science and medicine, the nervous system is seen as a critical component in understanding and treating many diseases. Furthermore, while “causality” (meaning that process “A” leads to process “B”) is fundamental to many Western concepts, Chinese thought assumes that the world is a web-like array of many interrelated processes that cannot be viewed in isolation or in one-to-one relationships with each other.
Acupuncture, and traditional Chinese medicine generally, is based on a complex theory of body functioning that involves a flow of energy, or “qi”, through 14 main pathways, or “meridians”, in the body. There is also a balance of opposites known as “yin” and “yang”. According to traditional Chinese medicine, disease states are thought to be a consequence of disrupted energy flow and/or imbalances.
Attempts have been made by scientists to explain some of the pain-relieving effects of acupuncture in Western terms. It has been hypothesized that acupuncture may work by altering the levels of chemical messengers in the body. Specifically, acupuncture may release “opioids” that decrease pain. Other hypotheses propose that acupuncture decreases stress or acts as a placebo. (Improvement occurs because the patient strongly believes the treatment is beneficial.)
In one study using a special type of magnetic resonance imaging (MRI), acupuncture at certain sites produced changes in brain activity. These changes, some of which occurred in pain-relevant brain regions, were present during the time in which the pain-relieving effects were present.
In the end, it may be found that multiple processes are involved in acupuncture’s pain-relieving effects—or that current Western biological concepts are insufficient to explain the processes.
The procedure
Acupuncture refers to a group of procedures that involve stimulating specific locations on the skin. Most often, this involves the insertion of thin, solid, metallic needles into points on the body’s “meridians”. It is believed that this alters the flow of energy and thereby produces improvement. There are approximately 400 acupuncture points, but usually only four to twelve points are used in a single session.
Other methods for stimulating the skin are also used. The acupuncture points can be stimulated by:
finger pressure, which is known as acupressure or, in
Japan
, shiatsu.
small heated cups placed on the points (“cupping”).
electroacupuncture, which uses electrically stimulated needles.
“moxibustion” in which smoldering fibers of an herb (Asian mugwort or “moxa”) are placed on the points, or used to heat needles after insertion.
Studies in MS
Few clinical studies have been conducted to assess acupuncture effectiveness in people with MS. One preliminary study was recently conducted in
Canada
to evaluate whether acupuncture might improve bladder function in people with MS. This well designed but small study (involving 41 people) suggested that bladder urgency and incontinence might be improved through the use of acupuncture. However, the effect varied depending on the particular acupuncturist performing the procedure.
Several other reported trials of acupuncture in MS involved very small numbers of people and were not well designed. It is difficult to draw any conclusions based on those studies.
Two large surveys—one in the
United States
and one in
Canada
—have been conducted involving people with MS and acupuncture. Although the results of surveys are not as convincing as those from clinical trials, they are an important method for generating ideas for further research. The preliminary findings of both studies are similar. In each, 20–25% of the respondents who said they have MS had tried acupuncture, and 10–15% of those who tried it indicated that they planned to continue using it. In both surveys, pain, spasticity, and numbness or tingling were among the symptoms most frequently reported to be improved. Other symptoms that were frequently reported to be improved by acupuncture included fatigue, depression, anxiety, and bowel or bladder function.
Studies in people without MS
A large number of studies have assessed acupuncture for other medical conditions. To evaluate these studies in an objective manner, the National Institutes of Health (NIH), created a 12-member panel in 1997. Based on research data and clinical experience, the panel concluded that acupuncture is a reasonable treatment option for stroke rehabilitation, headaches, and pain (including facial pain, low back pain, and neck pain). Other studies suggested there were acupuncture-related improvements in anxiety, depression, dizziness, and urinary difficulties.
It is important to remember that people in these studies did not have MS. It cannot be assumed that these same effects would be experienced by people who do have MS.
Effects on the immune system
It is important for people with MS to ask if acupuncture has an effect on the immune system, since inflammation and MS attacks are associated with certain overactive immune functions. At this time, however, the issue is not well understood. Studies focusing on acupuncture’s effects on the immune system have been done in people with several forms of cancer and rheumatoid arthritis. Acupuncture has been associated variously with stimulating, inhibiting, and having no effect at all on the immune system. Due to these mixed results, further studies are needed.
Risks and side effects
In general, acupuncture is a very well tolerated procedure, especially when performed by a well-trained acupuncturist. The NIH panel that evaluated acupuncture stated, “The occurrence of adverse events … has been documented to be extremely low.” The panel concluded that acupuncture was, “remarkably safe with fewer side effects than many well-established therapies.”
Over a 20-year time period, only 216 serious acupuncture complications have been reported worldwide. Serious complications, such as puncturing a lung, were associated with acupuncturists who were poorly trained.
There are other rare risks. To avoid hepatitis or AIDS, sterile disposable needles should be used. People with heart valves that are damaged or prosthetic should probably not be treated with acupuncture to avoid the risk of infection. People who take blood-thinning medication (warfarin or Coumadin ®
) may occasionally experience bruising or, more rarely, bleeding complications. Electroacupuncture may produce heart rhythm abnormalities in people with pacemakers, and the fumes from moxibustion may worsen breathing in people with asthma.
Practical information
Acupuncture is usually done once or twice weekly. Sessions typically cost $45–$100. The length of time required for a course of treatment varies. If a beneficial response occurs, it should usually be noted after six to ten sessions. The length of a complete course of treatment depends on the specific symptoms and the underlying disease. For MS and other chronic diseases, a longer treatment course may be necessary.
In the
United States
, there are approximately 10,000 licensed acupuncturists. There are 3,000 acupuncturists who have M.D. or D.O. training. Organizations that can be helpful in obtaining information about acupuncture and locating a trained acupuncturist include:
American
Academy
of Medical Acupuncture
www.medicalacupuncture.org
800-521-2262
The
American
Academy
of Acupuncture and Oriental Medicine
1925 West County Road
B2
Roseville
,
MN
55113
www.aaaom.org
651-631-0204
National Certification Commission for Acupuncture and Oriental Medicine
11 Canal Center Plaza, Suite 300
Alexandria, VA 22314
www.nccaom.org
703-548-9004
Acupuncture combined with other Asian therapies
Traditional Chinese medicine includes Chinese herbal medicine, qi gong, lifestyle advice, t’ai chi and exercise, as well as acupuncture.
There are several important considerations regarding Chinese herbal medicine or, indeed, any type of herbal therapy. Chinese herbal medicine involves treatment with complex mixtures of many different herbs. There may be significant variability in the quality and composition of these preparations. Some chemical compounds in the herbs may be toxic or may interact with prescription medications. The safety of these herbal preparations in people with MS has never been extensively studied.
It is known that some of the herbs used in herbal medicine stimulate the immune system, which, theoretically, may be harmful to people with MS. Some of these potentially harmful, immune-stimulating herbs include: Asian ginseng (Panax ginseng), dong quai (Angelica sinensis), astragalus (Astragalus membranaceus), coix, Epimedium sagittatum, reishi mushroom (Ganoderma lucidum), shiitake mushroom (Lentinus edodes), Acanthopanax obovatus, Artemisia myriantha, Artemisia annua, Salvia Miltiorrhiza, Sophora flavescens, green tea, and licorice.
Asian patent medicine is a form of herbal medicine that typically includes herbs along with minerals and animal parts. Several studies indicate that Asian patent medicine may contain toxic ingredients. One study found that approximately one-third of these preparations contained Western prescription drugs (including diazepam [Valium ®], steroids, and prescription asthma medications). Dangerous metals, including arsenic, mercury, lead, and cadmium, have also been found.
While acupuncture is very low risk when properly performed, there are many uncertainties and some clear risks associated with Chinese herbal medicine. Asian patent medicine, should be avoided due to the possible presence of toxic contaminants.
Conclusion
Whether acupuncture is a good choice for people with MS is difficult to evaluate from a scientific perspective. It may be that acupuncture is helpful for certain MS-related symptoms, including pain, spasticity, numbness and tingling, certain urinary symptoms, or depression. However, these symptoms, especially depression, should not be treated by acupuncture alone.
If acupuncture is used, it should only be used in addition to conventional medicine, in consultation with your physician or other licensed health-care professional.
While acupuncture may be a reasonable option to manage some MS symptoms, in conjunction with conventional medicine, there is no evidence to suggest that acupuncture can decrease the frequency of MS exacerbations or the progression of disability.
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