Jan 8, 2024 nguoi vietbai Uncategorized 0

I.     FREQUENTLY USED/RECOMMENDED CAM THERAPIES

  1. Menopause and perimenopausal symptoms
    1. B complex vitamins
      1. Usual dose 50 to 300 mg daily
      2. Indications for use
        1. Stress/depression
        2. Water retention

 

  1. Toxicity/adverse effects
    1. None known
  2. Vitamin C (L-ascorbic acid)
    1. Usual dose to total 1,000 to 2,000 mg daily from diet and supplements
    2. Properties and indications for use
      1. Free radical scavenger/antioxidant
      2. Linked with raising levels of high-density lipoprotein (HDL) and lowering levels of low-density lipoprotein (LDL)
  • Helps in maintaining the integrity of bone structures
  1. Helps in maintaining healthy connective tissues
  2. Required for the biosynthesis of collagen, L-carnitine, and some neurotransmitters
  3. Thought to play an important role in the prevention of cancer, cardiovascular disease, age-related macular degeneration, cataracts, and the common cold
  1. Foods containing substantial levels of vitamin C
    1. Citrus fruits and fruit juices
    2. Vegetables
  • Fortified grains and cereals
  1. Toxicity/adverse effects
    1. Low toxicity
    2. Increased doses (over 2,000 mg daily) may be associated with intestinal gas and loose
  • With a history of gastric reflux or other stomach/intestinal issues, buffered vitamin C may be better
  1. Large doses may play a role in the formation of kidney
  2. Use with caution and medical supervision if history of compromised kidney
  1. Vitamin D
    1. Recommended dosages
      1. Usual daily dose 600 to 800 international units (IU) (changing as researchers and clinicians study the role of vitamin D)2
      2. Vitamin D at 400 IU per day for women younger than age 70
  • Vitamin D at 600 IU daily for women older than age 70; for women with darker skin, 1,000 IU daily as well as for elders without sun exposure
  1. Serum levels of 25-hydroxyvitamin D in the range of 20 to 30 mg are sufficient for bone
  2. Vitamin D intake should not be more than 4,000 IU daily without consultation with a health care
  1. Indications for use
    1. Osteoporosis—increase mineral absorption, bone mineral- ization
    2. The role of vitamin D in providing protection from falls, cancer, and possibly autoimmune diseases continues to be

 

  1. Vitamin E
    1. Usual daily dose 400 to 800 IU; may be used up to 1,200 IU safely
    2. Indications for use
      1. Hot flashes
      2. Cardiovascular prevention (remains controversial), poor circulation
  • Atrophic vaginitis
  1. Toxicity/adverse effects
    1. Use with caution if patient on high blood pressure medica- tion (may decrease blood pressure).
    2. Use with caution or not at all if patient is on anticoagulant
  • Using more than recommended dose can result in nausea, flatulence, diarrhea, heart palpitations, fainting (all reversible with dose decrease).
  1. Calcium
    1. Usual daily dose in divided doses 1,000 to 2,500 mg; should be used in conjunction with vitamin D to aid in bone remineralization
      1. Adolescents should be taking 1,000 to 2,500 mg daily, preferably from a diet rich in
      2. Pregnant women 19 to 50 should be taking 1,000 to 2,500 mg
  • Breastfeeding women 19 to 50 should be taking 1,000 to 2,500 mg
  1. Women up to age 50 should be taking 1,200 to 2,000 mg
  2. After age 50, women should be taking 1,200 to 2,000 mg
  3. Remember, calcium should be taken in divided
  • Women should be advised not to take more than 2,500 mg per day from diet and supplements unless advised by a
  1. Indications for use
    1. Osteoporosis (prevention and treatment)—provides reinte- gration of calcium into bones
    2. Hypertension—aids in contraction and expansion of heart muscle
  2. Toxicity/adverse effects
    1. Calcium has no known toxic effects in doses 2,000 mg or less (caution in use of antacids as calcium supplements; in addition to calcium, many of these products contain alumi- num, which interferes with calcium absorption).
    2. Too much calcium from supplements may increase the risk of kidney stones and possibly heart
  • Calcium can interfere with thyroid

Separating calcium supplements and thyroid medication by at least 4 hours is recommended.

 

  1. Foods rich in calcium
    1. Fortified orange juice
    2. Milk, yogurt, and other dairy products
  • Firm tofu
  1. Canned salmon/sardines with bones
  1. Essential fatty acids (EFAs) omega 3, omega 6, and omega Omega 3 and omega 6 are polyunsaturated fats and cannot be manufactured in the body. Omega 9 fatty acids are from a family of monosaturated fats that can be manufactured by the body but are additionally beneficial when found in food.
    1. Types of omega 3 fatty acids
      1. EPA (eicosapentaenoic acid)—found in fish sources such as herring, bluefish, and sardines
      2. DHA (docosahexaenoic acid)—found in fish in fish sources as for EPA
  • ALA (alpha-linolenic acid)—found in plant sources such as walnuts, flaxseed, and soybeans
  1. Types of omega 6 fatty acids
    1. GLA (gamma-linolenic acid)—found in plant sources, almost exclusively from the borage plant
  2. Types of omega 9 fatty acids
    1. Oleic acid—found in canola, olive, sunflower oils; nuts; avocados; and olives
  3. Indications for use of omega 3 fatty acids
    1. Omega 3 fatty acids have been shown to be helpful in
      1. Lessening stiffness and pain in joints; may boost the effects of anti-inflammatory medications
      2. Lowering elevated triglyceride levels
      3. Currently studied regarding the anti-inflammatory process of asthma
      4. Current studies are suggesting a positive effect on mental health status, not in the role of a primary treatment, but in combination with therapy and psychotherapeutic
      5. Research is suggesting a protective effect against the memory loss of Alzheimer’s
    2. Sources of omega 3 fatty acids
      1. Wild fish, such as anchovies, bluefish, herring, mackerel, sardines, tuna
      2. Walnuts, flaxseed, flaxseed oil, soybean oil
    3. Indications for use of omega 6 fatty acids
      1. Omega 6 fatty acids have been shown to be powerful in decreasing the chronic inflammation of
        1. Eczema
        2. Asthma
        3. Rheumatoid arthritis
        4. Atherosclerosis

 

  1. Diabetes
  2. Obesity
  3. Potentially mood instability associated with psychiatric conditions
  1. Sources of omega 6 fatty acids (GLA)
    1. Almost exclusively from the borage plant
    2. Other omega 6 fatty acids, not GLA, can be found  in corn oil, soybean oil, poultry, and eggs. These should be consumed in smaller
  2. Indications for use of omega 9 fatty acids
    1. Research has shown omega 9 fatty acids increase HDL and decrease LDL and help to decrease plaque formation in
    2. Cooking oils  high  in  omega  9  EFAs,  such   as   canola and sunflower, are excellent replacements for partially hydrogenated cooking
  • May provide a protective benefit against metabolic syndrome
  1. Recommended dosages of combined omega oils
    1. According to the U.S. Department of Agriculture 2010 Dietary Guidelines for Americans the recommendation is a daily intake of combined omega 3 fatty acids (EPA and DHA) of 7 to 1.6 g/d and omega 6 fatty acids 7 to 16 g/d depending on age and gender.
    2. Recommended dosages for specific conditions may be found at mayoclinic.org/drugs-supplements/omega– 3-fatty-acids-fish-oil-alpha-linolenic-acid/background/ hrb-20059372
  2. Toxicity/adverse effects
  3. No known adverse effects
  1. CoǪ10 (ubiquinone)
    1. Usual recommended  daily  dose  within  a  range  of  60  to 400 mg/day
    2. Indications for use
      1. The name ubiquinone is appropriate because CoǪ10 is found everywhere in the body; a powerful antioxidant, it stimulates the immune system, increases tissue oxygenation, and has vital anti-aging
    3. Toxicity/adverse effects
      1. No known adverse effects
    4. Black cohosh (Cimicifuga racemosa), derived from a plant in the buttercup family, does not act like an estrogen but is now thought to behave similarly to serotonin in the brain, acting to relieve feelings of depression and regulating body temperature.
      1. Usual daily dosage—consult individual preparation
        1. Counsel women that therapeutic effects generally begin after 2 weeks and that maximum effects are usually seen within 8 weeks.

 

  1. Indications for use
    1. Hot flashes
    2. Fatigue
  • Irritability
  1. Night sweats
  2. Headaches
  3. Insomnia
  • Heart palpitations
  1. Toxicity/adverse effects
    1. Low incidence of adverse effects with moderate dose
      1. Avoid during pregnancy and lactation
      2. Avoid use in women with aspirin sensitivity because it contains salicylates
      3. Avoid in women with liver problems, including a history of hepatitis
    2. Overdose of black cohosh may cause nausea, vomiting, dizziness, and nervous system and visual disturbances
  2. Ginkgo biloba medicinal preparations are made from extracts of the leaves of the
    1. Usual daily dosage—consult preparation directions
    2. Indications for use
      1. Circulation
      2. Cognitive impairment, forgetfulness
  • Cold hands and feet
  1. Antitoxin/anti-inflammatory
  1. Toxicity/adverse effects
    1. Headaches
    2. Nausea
  • Heart palpitations
  1. Dizziness
  2. Allergic skin reactions
  3. Do not use if taking aspirin, anticoagulants, or prior to
  • Do not use if patient has a history of seizure
  1. John’s wort (derived from the wild flowering plant Hypericum perforatum)
    1. Usual daily dose—300 mg (range in clinical trials has indicated a dosage of 900 mg daily in three divided doses)
    2. Conditions
      1. Depression, anxiety, mood swings, sleep disorders, smoking cessation
    3. Toxicity/adverse effects
      1. May alter liver enzyme function in processing  some drugs, including HIV medications, digoxin, warfarin, oral contraceptives, antidepressants
      2. Because of numerous interactions, women should check with all their care providers prior to using
    4. Adverse reactions include
      1. Dry mouth
      2. Nausea
      3. Change in bowel habits
      4. Photosensitivity
      5. Fatigue
      6. Dizziness
      7. Insomnia
      8. Headache
  2. Ginseng
    1. There are three kinds of ginseng: Asian (Chinese or Korean), American, and Siberian. The first two are authentic ginseng. Siberian ginseng is not; however, it looks similar and has similar effects on the
      1. Usual daily dose 100 to 400 mg—varies with origin and preparation
    2. Indications for use (It is advised to limit use to 3 months consecutively, then take a 3-month break before )
      1. Stress
      2. Fatigue
      3. Loss of libido
      4. Memory problems
      5. Vaginal dryness—ginseng has a direct estrogenic
  1. Toxicity/adverse effects
    1. Central nervous system symptoms, headache, agitation, confusion, drowsiness
    2. Gastrointestinal problems; vomiting, abdominal pain
    3. Lowered blood pressure
    4. Should not be used by women with
      1. Inflammatory bowel disease
      2. Multiple sclerosis
      3. Rheumatoid arthritis and systemic lupus
      4. Allergic rhinitis, asthma, or eczema
      5. A risk for cancers associated with or affected by hormones
    5. Severe side effects can include
      1. Rash/hives
      2. Itching
      3. Difficulty breathing
      4. Tightness in chest
      5. Swelling of mouth, lips, tongue, face
      6. Vaginal bleeding
  2. Dietary phytoestrogens are naturally found in These compounds may produce effects similar to estrogen; they are found in cereal, legumes, and grasses.
    1. Three main groups of phytoestrogens: isoflavones, lignans, and coumestans
    2. Isoflavones are found in soy, garbanzo beans, and other They may be consumed in the form of soy, miso, tofu, alfalfa, and peanuts.
    3. Lignans are found in seed oils such as flaxseed and sesame seeds as well as in cereals (rye, wheat, oats, barley); cruciferous vegetables (broccoli, cabbage); and some fruits (apricots, strawberries).
  • Coumestans are found in red clover, sunflower seeds, and bean
  1. Phytoestrogens are thought to be helpful in minimizing hot flashes, maintaining bone density, and lowering cholesterol, LDLs, and
  2. Natural progesterones manufactured from wild yams: Patients should be discouraged from using OTC preparations of topical progestins for their progesterone imbalance because there is no standardized Replacement hormones are usually synthesized.
  1. Melatonin
    1. Found in many plant sources, including, but not limited to
      1. Feverfew
      2. Bananas, cherries, grapes, and tomatoes
  • Rice and corn
  1. Olives
  1. Mechanism of action
    1. Acts as a free radical scavenger and wide-spectrum antioxi- dant with an inflammatory effect
  2. Indications for use
    1. Sleep disorders—by acting to help synchronize the body clock
  3. Recommended dosages
    1. Sleep disorders
      1. Difficulty falling asleep—melatonin 5 mg, 3 to 4 hours before bedtime for at least 4 weeks
      2. Difficulty  staying    asleep—a    controlled-release    dose 2 hours before bedtime
    2. Toxicity/ adverse reactions
      1. Depression
      2. Dizziness
  • Excessive daytime somnolence
  1. Headache
  2. Nausea
  1. Avoid driving after ingestion of melatonin
  1. Other modalities
    1. Relaxation techniques
    2. Biofeedback
    3. Meditation
    4. Tai chi and qigong

 

  1. Yoga
  2. Acupuncture

This technique can help the body regain homeostasis, thus making it better able to adapt to change without increasing stress.

  1. Ayurvedic and Chinese herbals may also be There are several preparations on the market. Although readily available OTC, women should be advised to consult with an ayurvedic or Chinese medicine provider prior to using.
  2. Homeopathic remedies are based on the premise that the body has the capacity to heal Formulas are compounded that use minute quantities of an agent to trigger the body’s innate capacity to heal. Preparations specific to a symptom can be found in health food stores for self-treatment. Homeopathic practitioners are also available to work with a patient to customize preparations to fit the person’s symptoms.
  1. Premenstrual syndrome
    1. B complex vitamins
      1. Usual dose 50 to 300 mg/d; best taken with food
      2. Symptoms
        1. Stress/depression
        2. Water retention (especially B6)
      3. Toxicity/adverse effects
        1. When taken on an empty stomach, can cause nausea
        2. When taken late in day, can cause restlessness and dreams
      4. Vitamin B6—usual dose 100 to 200 mg/d
      5. Magnesium—usual dose 200 to 400 mg/d
      6. Vitamin E—usual dose 400 to 600 mg/d may help to relieve breast tenderness
      7. EFAs—also helpful with dysmenorrhea
        1. Usual daily dose—as indicated on individual preparation/no daily optimum dose
        2. Conditions
          1. Help to reduce depression, irritability, cramps, nausea, bloat- ing, and Correct balance of EFAs is essential for the rebuilding and production of new cells—decreases inflammation, moderates hormone imbalance.
        3. Licorice (Glycyrrhiza glabra)
          1. Usual daily dose varies with preparation
          2. Conditions addressed—lowers estrogen and increases proges- terone; helps in irritability, mood swings; stimulates adrenal glands
          3. Toxicities—should not be used by women with kidney problems, high blood pressure; patients taking potassium; can increase water retention. Not advisable for use in persons who are on low-salt diets or persons taking diuretics, corticoid treatments, cardiac glycosides, or medications for

 

  1. Black cohosh (Cimicifuga racemosa)
    1. Usual daily dosage—as indicated on individual preparation
    2. Conditions
      1. Nervousness/anxiety
      2. Irritability
  • Sleep disturbances
  1. Depressive moods
  2. Headache
  3. Mood swings
  1. Evening primrose oil—from the oil of the primrose plant/closely related to EFAs
    1. Usual daily dosage—as indicated on individual preparation
    2. Conditions addressed
      1. Vasomotor symptoms
      2. Cyclical breast tenderness
    3. Toxicities
      1. Should not be used by women with seizure disorders
    4. Depression
      1. Depression is a serious condition, and the use of alternative medications has not been proven to be effective. Any alternative method should be used with extreme caution and only with the guidance of an experienced
      2. However, alternative methods may be added to traditional medi- cine, including
        1. Acupuncture
        2. Aroma therapy
        3. Biofeedback
        4. Meditation
        5. Relaxation therapy
        6. Yoga
        7. Dietary supplements
          1. Essential fatty acids
          2. B complex vitamins; B6 is especially helpful

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