Cam massumi.mehrdad.michael iaapdc_2017_06_08

Mehrdad Michael Massumi, MD
Massumi Associates
Rockville, MD | Towson, MD
www.Massumi.com
info@Massumi.com
410-825-5905

Disclosure
 Nothing to disclose.
 Mehrdad Michael Massumi, MD is a board-certified specialist in Physical Medicine & Rehabilitation. He is a Fellow of
the American Academy of Physical Medicine and Rehabilitation and a Diplomate of the American Academy of Pain
Management.
 After graduation with honors from the University of Birmingham Medical School (UK) and two years of surgical
residency training at the Washington Hospital Center in Washington, D.C. he undertook and concluded successfully
his residency in Rehabilitation Medicine in Seattle, WA in 1988. He remains active at Harvard Postgraduate Medical
Association.
 Dr. Massumi has been in practice for twenty-eight years in Maryland. He was the founder or director of many
Rehabilitation, Spine and Pain clinics in the Baltimore Metropolitan hospitals. He is a former clinical faculty of the
Department of Rehabilitation Medicine at Johns Hopkins Medical School. He is currently in private practice in
Baltimore and more recently also in Rockville, MD.

Sources & Credits
 United States of America Sources:
 https://nccih.nih.gov/ ( National Center for Complementary and Integrative Health of the
National Institutes of Health)
 www.ncbi.nlm.nih.gov ( National Center for Biotechnology Information )
 www.PubMed.gov ( US National Library of Medicine – NIH)
 https://naturalmedicines.therapeuticresearch.com/ ( Natural Medicines on Therapeutic
Research Center)
 https://ods.od.nih.gov/ (National Institutes of Health Office of Dietary Supplements)
 Fundamentals of Complementary and Alternative Medicine; Marc S Micozzi, MD, Ph.D.; Editor;
Elsevier; 2015; Fifth Edition
 Textbook of Natural Medicine; Joseph E. Pizzorno, ND & Michael T. Murray, ND; Editors;
Elsevier; 2013; Fourth Edition
 www.FAIM.org ( Foundation for Alternative and Integrative Medicine)

Sources and Credits
 Iran Sources
 www.Tandorostan.org( Iranian Traditional Medicine Site )
 www.tim.tums.ac.ir ( Faculty of Traditional Medicine of the Tehran
University of Medical Sciences )
 www.tim.ir ( The Comprehensive Resource for Traditional Medicine in Iran)
 www.medplant.ir ( The Educational & News Resource for Herbal Medicine
in Iran)

Educational Institutions
 https://aanmc.org/ - Association of Accredited Naturopathic Medical Colleges

Educational Institutions - Local
 University of Maryland Center for Integrative Medicine -
http://www.cim.umaryland.edu/
 Maryland University of Integrative Health http://www.muih.edu/
 Complementary and Alternative Medicine Program (CAM Program) at
Georgetown University https://cam.georgetown.edu/

Fundamentals of Complementary and Alternative Medicine, 5e (Fundamentals of Complementary and Integrative Medicine) 5th
Edition
by Marc S. Micozzi MD PhD (Author) - Adjunct Professor / Georgetown University and Formerly the Director – Center for Integrative
Medicine, Thomas Jefferson University Hospital

Textbook of Natural Medicine, 4e 4th Edition
Joseph E. Pizzorno (Author) - President Emeritus, Bastyr University & Chair / Science Board / Bioclinical Naturals
Michael T. Murray (Author) – Director of Product Development and Education / Natural Factors Nutritional Products, Inc.

Purposes / Goals of this Presentation
 Define Complementary and Alternative Medicine (CAM)
 Prevalence and acceptance in society and cost of CAM
 Role of Academia and Government in education, review and oversight
 Utilization and distribution of different modes / applications of CAM
 Pros and Cons of different modes / applications of CAM
 Role of NCCIH and other regulatory bodies in the further development / acceptance of
CM
 Future developments in CAM

Complementary Versus Alternative
Many Americans—more than 30 percent of adults and
about 12 percent of children—use health care
approaches developed outside of mainstream Western,
or conventional, medicine. When describing these
approaches, people often use “alternative” and
“complementary” interchangeably, but the two terms
refer to different concepts:
◾If a non-mainstream practice is used together with
conventional medicine, it’s considered
“complementary.”
◾If a non-mainstream practice is used in place of
conventional medicine, it’s considered “alternative.”
True alternative medicine is uncommon. Most people
who use non-mainstream approaches use them along
with conventional treatments.

Food for Thought
The 2012 National Health Interview Survey conducted by the National Center for Health
Statistics (The Centers for Disease Control and Prevention) gathered information on
88,962 American adults and 17,321 children. The survey found that 33.2 percent of
adults in the United States aged 18 years and over and 11.6 percent of children age 4 to
17 years used some form of Complementary and Integrative Health (CIH) approach in
the previous 12 months.
Americans spent $30.2 billion out-of-pocket on CIH during the 12 months prior to the
survey. Americans spent $14.7 billion out-of-pocket on visits to complementary
practitioners – almost 30 percent of what they spent out-of-pocket on services by
conventional physicians ($49.6 billion). They spent $12.8 billion out-of-pocket on natural
product supplements – about one-quarter of what they spent out-of-pocket on
prescription drugs ($54.1 billion).

Take Charge of Your Health
◾Be an informed consumer. Find out and consider what scientific
studies have been done on the safety and effectiveness of any
health approach that is recommended to or interests you.
◾Discuss the information and your interests with your health care
providers before making a decision.
◾Choose a complementary health practitioner, such as an
acupuncturist, as carefully as you would choose a conventional
health care provider.
◾Before using any dietary supplement or herbal product, make
sure you find out about potential side effects or interactions with
medications you may be taking.
◾Only use treatments for your condition that have been proven
safe. Do not use a product or practice that has not been proven
to be effective to postpone seeing your health care provider for
your condition.
◾Tell all your health care providers—complementary and
conventional—about all the health approaches you use. Give
them a full picture of what you do to manage your health. This
will help ensure coordinated and safe care.

How can I get reliable information about a
complementary health approach?
◾ Talk with your health care providers.
◾ Visit the NCCIH Web site
www.nccih.nih.gov
◾ Find information from NCCIH on
Facebook www.facebook.com/nih.nccih
Twitter www.twitter.com/nih_nccih
YouTube www.youtube.com/c/nih_nccih
Pinterest www.pinterest.com/nccih
◾Visit your local library or a medical library.

How can I determine whether statements made about the
effectiveness of a complementary health approach are true?
◾Is there scientific evidence (not just personal stories) to back up the statements?
◾What is the source?
◾Does the Federal Government have anything to report about the product or practice?
◾Visit the U.S. Food and Drug Administration (FDA) online at www.fda.gov .
◾Information specifically about dietary supplements can be found on the FDA’s Web site at
www.fda.gov/Food/DietarySupplements/ and on the Web site of the National Institutes of
Health (NIH) Office of Dietary Supplements at www.ods.od.nih.gov
◾Visit the FDA's Web page on recalls and safety alerts at www.fda.gov/Safety/Recalls/
◾Check with the Federal Trade Commission at www.ftc.gov to see if there are any enforcement
actions for deceptive advertising regarding the therapy. Also, visit the site’s Consumer
Information section at www.consumer.ftc.gov
◾How does the provider or manufacturer describe the approach? Beware of terms like
“scientific breakthrough,” “miracle cure,” “secret ingredient,” or “ancient remedy.”
◾If you encounter claims of a “quick fix” that depart from previous research, keep in mind that
science usually advances over time by small steps, slowly building an evidence base.
◾Remember: if it sounds too good to be true—for example, claims that a product or practice
can cure a disease or works for a variety of ailments—it usually is.

Is That Health Web Site Trustworthy?
If you're visiting a health Web site for the first time, these five quick questions can help you decide whether the
site is a helpful resource.
Who? Who runs the Web site? Can you trust them?
What? What does the site say? Do its claims seem too good to be true?
When? When was the information posted or reviewed? Is it up-to-date?
Where? Where did the information come from? Is it based on scientific research?
Why? Why does the site exist? Is it selling something?

I’m interested in an approach that involves seeing a complementary
health practitioner. How do I go about selecting a practitioner?
Your primary health care provider or local hospital may be able to recommend a
complementary health practitioner.
The professional organization for the type of practitioner you’re seeking may have
helpful information, such as licensing and training requirements. Many states have
regulatory agencies or licensing boards for certain types of complementary health
practitioners; they may be able to help you locate practitioners in your area.
Make sure any practitioner you’re considering is willing to work in collaboration with
your other health care providers.

Can I participate in a clinical trial of a
complementary health approach?
NCCIH supports clinical trials on complementary health approaches. These trials are
taking place in many locations, and study participants are needed. To learn more or to
find trials that are recruiting participants, visit NIH Clinical Research Trials and You. The
site includes questions and answers about clinical trials, guidance on how to find clinical
trials through ClinicalTrials.gov, and other resources and stories about the personal
experiences of clinical trial participants.

NCCIH Clearinghouse
The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health
approaches, including publications and searches of Federal databases of scientific and medical
literature. The Clearinghouse does not provide medical advice, treatment recommendations, or
referrals to practitioners.
Toll-free in the U.S.:
1-888-644-6226
TTY (for deaf and hard-of-hearing callers):
1-866-464-3615
Web site:
nccih.nih.gov
E-mail:
info@nccih.nih.gov

Office of Dietary Supplements (ODS), National Institutes of Health (NIH)
ODS seeks to strengthen knowledge and understanding of dietary supplements by
evaluating scientific information, supporting research, sharing research results, and
educating the public. Its resources include publications (such as Dietary Supplements:
What You Need to Know), fact sheets on a variety of specific supplement ingredients
and products (such as vitamin D and multivitamin/mineral supplements), and the
PubMed Dietary Supplement Subset.
Web site:
ods.od.nih.gov
E-mail:
ods@nih.gov

MedlinePlus
To provide resources that help answer health questions, MedlinePlus (a
service of the National Library of Medicine) brings together authoritative
information from the National Institutes of Health as well as other
Government agencies and health-related organizations.
Web site:
www.medlineplus.gov

NIH Clinical Research Trials and You
The National Institutes of Health (NIH) has created a Web site, NIH Clinical
Research Trials and You, to help people learn about clinical trials, why they
matter, and how to participate. The site includes questions and answers
about clinical trials, guidance on how to find clinical trials through
ClinicalTrials.gov and other resources, and stories about the personal
experiences of clinical trial participants. Clinical trials are necessary to find
better ways to prevent, diagnose, and treat diseases.
Web site:
www.nih.gov/health/clinicaltrials/

PubMed®
A service of the National Library of Medicine, PubMed® contains publication information
and (in most cases) brief summaries of articles from scientific and medical journals. For
guidance from NCCIH on using PubMed, see How To Find Information About
Complementary Health Approaches on PubMed.
Web site:
www.ncbi.nlm.nih.gov/pubmed

U.S. Food and Drug Administration (FDA)
The FDA oversees the safety of many products, such as foods, medicines, dietary
supplements, medical devices, and cosmetics. See its Web page on Dietary
Supplements.
1-888-463-6332
Web site:
www.fda.gov

Federal Trade Commission (FTC)
The FTC is the Federal agency charged with protecting the public against unfair and
deceptive business practices. A key area of its work is the regulation of advertising
(except for prescription drugs and medical devices).
1-877-382-4357
Web site:
www.ftc.gov

Western ‘Allopathic’ Medicine
 Immunology
 Hematology
 Oncology
 Cardiology
 Dermatology
 Gastroenterology
 Ear, Nose and Throat
 Endocrinology
 Ophthalmology
 Gynecology
 Infertility
 Nephrology
 Laryngology
 Pulmonary
 Neurology
 Obstetrics
 Orthopedic
 Otology
 Pediatrics
 Urology

Alternative and Complementary Methods
 Acupuncture
 Massage
 Hydrotherapy
 Juice Therapy
 Ayurveda
 Sound/Music Therapy
 Relaxation/Meditation
 Vitamin/Mineral Therapy
 Aromatherapy
 Imagery/Visualization
 Herbal Remedies
 Dark Field Microscopy
 Naturopathic Med
 Energy Healing
 Movement Education
 Reflexology
 Flower Remedy
 Homeopathy
 Iridology
 Frequency Healing

Not subject of much discussion in our talk today – Each topic requiring
its own independent hour of talk
 Osteopathy
 Chiropractic
 Reflexology / Yoga
 Biophysics: Electricity, Light, Magnetism & Sound
 Energy Medicine
 Mind-Body Therapies: Prayer, Religion, Spirituality, Creative & Expressive Arts Therapies, Vitalism
 Sufism & Healing in the Middle East
 Ethnomedicine & Shamanism
 Native North American Healing
 Central & South American Healing
 Latin American Curanderismo
 African Healing and Traditional African Medicine Man
 Magico-Religious and Neo-Shamanism
 Tibetan Medicine
 Ayurveda, Siddha and Unani Medicine

Contemporary Naturopathic Medicine
 Principles:
 The healing power of Nature ( Vis medicatrix naturae)
 First do no harm ( Primum non nocere)
 Find the cause ( Tolle causam)
 Treat the whole person ( Holism)
 Preventive Medicine

Unifying theory: Healing power of nature and therapeutic order
 Re-establish the basis for health:
 Remove obstacles to healing
 Establish a healthy environment
 Address inborn susceptibility
 Stimulate the Vis medicatrix naturae
 Tonify and nourish weakened systems
 Correct deficiencies in structural integrity
 Prescribe specific substances and modalities for specific conditions and biochemical pathways ( e.g.
botanicals, nutrients, acupuncture, homeopathy, hydrotherapy, counseling)
 Prescribe pharmaceutical substances
 Use radiation, chemotherapy and surgery

Traditional Chinese Medicine
 Dietary therapy
 Acupuncture - insertion of sterile needles into specific
points on the body in order to control the flow of chi,
or life energy
 Moxibustion – burning an herb, called moxa, over
acupuncture and other points
 Herbal medicine
 Qigong

Acupuncture
 Goal:
 Restore balance and harmony within the individual
 And between the individual and the environment
 Balancing the energies of the meridians and the body

What will TCM do for you?
 Used to treat any physical condition or emotional
problem.
 Historically been effective for chronic conditions that
Western medicine is unable to reverse, such as:
 Heart disease
 Arthritis
 Menopausal and Menstrual problems
 Sinusitis
 Allergies
 Known to treat chronic fatigue and fibromyalgia.

Massage
 Types:
 Swedish
 Clinical
 Deep tissue massage
 Neuromuscular Therapy
 Trigger point Therapy
 Myotherapy

Massage
Muscles and soft tissues are pressed, rubbed and
manipulated.
 Massage breaks the cycle in which the nervous system
stimulates muscles to contract causing pain.
 Muscles relax and lengthen
 Pain relieving oxygen and blood floods the muscles
 The process of “touch” also is relaxing and therapeutic

Hydrotherapy
 Water is applied to the body to stimulate and redirect
the flow of blood and lymph. This nourishes cells and
promotes regeneration of the tissues.
 Heat causes the arteries and veins to expand and bring
in blood and lymph.
 Cold make the arteries and veins constrict, pushing
blood and lymph away.
 This in-and-out movement of blood and lymph brings
fresh oxygen and nutrients and helps removes toxins and
waste.

Hydrotherapy
 Techniques:
 Showers
 Baths
 Water-soaked towels
 Water-soaked sheets
 Ie: Shower – alternate the hot and cold water along
the spine to stimulate the nervous system and improve
circulation to the abdomen, lungs and heart.

Vet application
www.glendorahydrotherapy.com.uk

Juice Therapy
 Juice Fasting
 Detoxifier
 Helps identify food sensitivities
 Increases the nutrient density of our diets
 Not for everyone
 Dangerous for diabetics and hypoglycemics
 Lacks fiber
 Juice Fasting can be beneficial, but it is still best to eat
the fruits, vegetables and whole grains.

Juice Therapy
Used for 5000 years in Ayurvedic Medicine
 Stimulate digestion
 Bolster the immune system
 Eliminate toxins
 Heal infections
 Create a nutritional foundation to heal the body

Ayurvedic Medicine
 Originated in India
 Combines many modalities:
 Diet
 Herbs
 Massage
 Purification
 Exercise
 Music Therapy
 Aromatherapy
 Color Therapy
 Meditation
 Yoga
 Astrology

How does Ayurvedic Medicine work?
 Dosha
 Vata
 Pitta
 Kapha
 Element
 Space and Air
 Fire and Water
 Earth and Water
Everything in nature is composed of 5 elements in 3 doshas:

How does Ayurvedic Medicine work?
 Disease is caused by an excess in one of the elements
 Treatment restores balance by decreasing excessive
elements and increasing deficient elements.
 Illnesses are based on stress and unhappiness
 Treatment such as meditation aims to relieve stress and
restore clarity of purpose.
 Historical uses:
 Diabetes, arthritis, anemia, allergies, immune issues

Sound and Music Therapy
 Used in Traditional Cultures for thousands of years.
 Music Therapy:
 Prescribed by board-certified music therapists
 Western European Classical music
 Effecting positive changes:
 Psychological
 Physical
 Cognitive
 Social
 Sound Therapy
 Rhythmic drumming and chanting
 Higher level of balance and self-healing

Sound and Music Therapy
 Used in cases of:
 Stress related health issues
 Muscle pain
 Tension Headaches
 High Blood Pressure
 Insomnia
 Depression
 Anxiety
 Fatigue

Sound Therapy
www.pet-scene.com

Relaxation and Meditation
 Goal:
 Induce a calm, rested state of body and mind that
relieves stress and tension.
 Methods:
 Deep breathing
 Chanting Mantras- harmonizing the electrical activity of
the brain
 Progressive Relaxation
 Yoga and Tai chi

Relaxation and Meditation
 Generally benefits:
 High Blood Pressure
 Skin disorders
 Insomnia
 Anxiety
 Headaches
 Depression
 Fatigue
 Chronic anger
 Arrhythmia
 Hostility
 Digestive Problems
 Allergies

Vitamin and Mineral Therapy
 Environmental: Soils are depleted so foods are
depleted
 Stress: Drains the body of nutrients
 Each nutrient is the key to a biochemical door
 In small doses – essential reactions are maintained
 In larger doses – act as natural medications optimizing
the body’s ability to heal.

Vitamin and Mineral Therapy
 As an example Vitamin E has been known to address:
 Angina
 Diabetes
 Menopause
 Premenstrual syndrome
 Prostate problems
 Shingles
 Varicose Veins

Aromatherapy
 Use of aromas for physical, mental and emotional
healing
 Sources are essential oils distilled from herbs and
flowers
 Applied to skin entering the blood stream
 Inhaled and linked to the limbic system and
hypothalamus in the brain

Uses for Aromatherapy
 Digestive complaints
 Skin problems – including burns
 Infections
 Stress and emotional upset
 Hormone Imbalance
 Respiratory complaints
 Air freshener
 Cleansers

Aromatherapy: Materials used
Some of the materials employed include:
 Absolutes: fragrant oils extracted primarily from flowers or delicate plant tissues through
solvent or supercritical fluid extraction (e.g., rose absolute). The term is also used to describe
oils extracted from fragrant butters, concretes, and enfleurage pommades using ethanol.
 Aroma lamps or diffusers: an electric or candle-fueled device which volatilizes essential oils,
usually mixed with water.
 Carrier oils: typically oily plant base triacylglycerides that dilute essential oils for use on the skin
(e.g., sweet almond oil).
 Essential oils: fragrant oils extracted from plants chiefly through steam distillation (e.g.,
eucalyptus oil) or expression (grapefruit oil). However, the term is also occasionally used to
describe fragrant oils extracted from plant material by any solvent extraction. This material
includes incense reed diffusers.
 Herbal distillates or hydrosols: the aqueous by-products of the distillation process (e.g.,
rosewater). Common herbal distillates are chamomile, rose, and lemon balm.
 Infusions: aqueous extracts of various plant material (e.g., infusion of chamomile).
 Phytoncides: various volatile organic compounds from plants that kill microbes Many terpene-
based fragrant oils and sulfuric compounds from plants in the genus "Allium" are phytoncides,
though the latter are likely less commonly used in aromatherapy due to their disagreeable
odors.
 Vaporizers: typically higher oil content plant based materials dried, crushed, and heated to
extract and inhale the aromatic oil vapors in a direct inhalation modality.

Aromatherapy: Modes of Application
The modes of application of aromatherapy include:
 Aerial diffusion: for environmental fragrance or aerial disinfection
 Direct inhalation: for respiratory disinfection, decongestant,
expectoration as well as psychological effects
 Topical applications: for general massage, baths, compresses,
therapeutic skin care

Word of Warning:
 Essential oils are extremely potent and most cannot be
applied directly to the skin undiluted.
 Dilute with massage oil
 Women should not use essential oils during the first
three months of pregnancy. (thujone)

Imagery
 “Using the power of the mind to influence the body”
 Images can be sounds, tastes, smells or a combination of
sensations. It is the biological connection between the
mind and body.
 The average person has 10,000 thoughts and images in their
minds everyday.
 At least half of these are negative – like worry
 This alters your physiology and makes you susceptible to
dis-ease.
 Learn to direct and control your mind images to be positive
and it will have a tremendous impact on your heath.

Imagery
 It is a healing tool in virtually all the world’s cultures.
 It began with the Ancient Egyptians and Greeks.
 Only Western Medicine has discarded it as a healing
tool.

Herbal Remedies
 Forms:
 Teas
 Tincture – concentrated
liquid
 Tablets and capsules
 Fresh
 Uses
 Food
 Poultices
 Compresses
 Creams
 Salves
Use of Medicinal Plants for health and healing

Herbal Remedies
 Typical imbalances addressed with herbs:
 Cardiovascular disease
 Diabetes
 Memory Problems
 Arthritis
 Acute illnesses
 Skin issues
 Use with the guidance of a qualified Natural Medicine
specialist (e.g. herbalist)

NCCIH.gov: Herbs at a Glance
Acai Cranberry Ginkgo Passionflower Valerian
Aloe Vera Dandelion Goldenseal Peppermint Oil Yohimbe
Asian Ginseng Echinacea Grape Seed Extract Pomegranate
Astralagus Ephedra Green Tea Red Clover
Bilberry European Elder Hawthorn Rhodiola
Bitter Orange European
Mistletoe
Hoodia Sage
Black Cohosh Evening Primrose
Oil
Horse Chestnut Saw Palmetto
Bromelain Fenugreek Kava Soy
Butterbur Flaxseed &
Flaxseed Oil
Lavender St. John’s Wort
Cat’s Claw Garcinia
Cambogia
Licorice Root Tea Tree Oil
Chamomile Garlic Milk Thistle Thunder God Vine
Cinnamon Ginger Noni Turmeric

Some herbs are more medicinal than
others……Dandelion is beneficial to the
liver.

Many Americans take both dietary supplements and prescription or over-the-counter drugs.
Sometimes, these drugs and supplements may interact in harmful ways.
It’s important to tell all your health care providers about all dietary supplements and drugs you take.
That way, they can help you avoid harmful interactions.

Some Supplements May Increase the Effects—and Side Effects—of Drugs
Sometimes, taking a drug and a supplement together may increase the drug’s effects. The
drug’s effects may become too strong, and unwanted side effects may increase.
Drug + Supplement = the drug's effect may be too strong, and side effects may increase
For example, the herb schisandra may slow down the processes in your body that change drugs
into inactive substances. So if you take this herb while you’re also taking a drug, the amount of
the drug in your body may increase. As a result, the drug’s effects may be too strong.
Another example
Like schisandra, goldenseal may slow down the processes in your body that change drugs into
inactive substances, leading to increases in drug levels in your body.

Some Supplements May Decrease the Effects of Drugs
Sometimes, taking a drug and a supplement together may decrease the drug’s effects. This
means that you aren’t getting the full benefit from the drug that your health care provider
wants you to have.
Drug + Supplement = The drug is less effective than it should be
One popular herbal supplement is especially well known for decreasing the effects of drugs. It
does this by speeding up the processes in your body that change drugs into inactive substances.
This herb may decrease the effectiveness of more than 70 percent of all drugs.
Which of these herbs is the one that decreases the effects of many drugs?
Black cohosh
Echinacea
Saw palmetto
St. John’s wort
Answer:
St. John’s wort can decrease the effects of many drugs.

More About St. John’s Wort
St. John’s wort interacts with many types of drugs. In most instances, it speeds up the processes that change
the drug into inactive substances, leading to a decrease in drug levels in your body.
However, St. John’s wort interacts with some drugs in other ways. For example, taking St. John’s wort with
certain types of antidepressants can cause harmful side effects.
Some Drugs That Interact With St. John’s Wort
Anesthetics
Anti-anxiety drugs
Anticoagulants (blood thinners)
Antidepressants
Cancer drugs
Cholesterol-lowering drugs (statins)
Diabetes drugs
Digoxin (digitalis), a drug used to treat heart problems
Drugs that suppress the immune system (used to prevent rejection of transplanted organs)
Drugs used to prevent seizures
Drugs used to treat HIV infection
Fexofenadine (an antihistamine)
Finasteride (a drug used for prostate problems)
Ivabradine (a drug used to treat angina)
Methadone
Nifedipine and verapamil (used to treat high blood pressure or heart problems)
Omeprazole (an acid reducer used to treat digestive tract problems)
Oral contraceptives (birth control pills)
Talinolol (a beta-blocker used for high blood pressure and heart problems)
Theophylline (an asthma drug)
Voriconazole (a drug used to treat fungal infections)

When Drug-Supplement Interactions Are
Especially Important
Next you’ll learn about two situations when drug-supplement interactions can be especially important:
When you’re taking a drug that has what health care providers call a “narrow therapeutic range”
When you’re going to have surgery.
In these situations, it’s particularly important to talk with all of your health care providers about the dietary
supplements you’re taking now and any you may be considering taking in the future.

Drugs With a Narrow Therapeutic Range
Having the right amount of certain drugs in your body is crucial. If the amount of the drug is even a little too
low or too high, it can cause big problems.
Drugs like these are said to have a “narrow therapeutic range” or “narrow therapeutic index.”
Interactions are of special concern for drugs with a narrow therapeutic range.
Examples of Drugs With a Narrow Therapeutic Range
Carbamazepine (used to prevent seizures)
Cyclosporine (used to prevent organ transplant rejection)
Digoxin (used to treat heart problems)
Levothyroxine (used to treat thyroid problems)
Phenytoin (used to prevent seizures)
Warfarin (an anticoagulant—also called a blood thinner)
If you’re taking a dietary supplement, and your health care
provider prescribes a drug with a narrow therapeutic range,
what should you do?
Tell your health care provider that you’re taking the supplement and ask the provider what you should do.

If You’re Going To Have Surgery
If you’re going to have surgery, talk to your health care providers as far in advance of the operation as
possible and tell them about all dietary supplements that you’re taking.
Some dietary supplements may cause problems during surgery because:
◾They may affect your response to anesthetics or to other medicines that you may be given
before, during, or after the operation
◾They may increase your risk of bleeding.
Some health care providers will ask patients to discontinue all herbal supplements several weeks before
having elective surgery (surgery that can be scheduled in advance).
If you’re having an emergency operation, you won’t have a chance to stop taking supplements ahead of
time. But it’s still important for you or a family member to tell your surgeon and anesthesia provider
about all dietary supplements that you’re taking so that they can be prepared for any problems that
might occur.

Here’s a Hint for Your Next Visit to a Health Care Provider
When you visit a health care provider, it’s a good idea to bring a written list of
◾All the drugs and supplements you take
◾How often you take them
◾The doses you take.
But there’s something else you may also want to do, especially if you take any products that have
multiple ingredients.
Bring the bottles of the products to the health care provider’s office.
If you have the labeled bottles, any questions about what’s in your dietary supplements can be
answered right away.

To Find Out More
To find more information about supplement-drug interactions and other aspects of the safety of dietary
supplements, try these resources:
Your health care providers and your pharmacist
The National Center for Complementary and Integrative Health’s online resources on dietary
supplements and herbs
The Office of Dietary Supplements at the National Institutes of Health
The U.S. Food and Drug Administration
MedlinePlus, a resource provided by the National Library of Medicine.

Dark Field Microscopy
 Using the microscope with a dark field light source
 Assesses the immune system
 If there is illness there typically will be a unique cycle
of substances in the blood

Dark Field Microscope
 Dark-field microscopy is a very simple yet effective technique and well suited for uses
involving live and unstained biological samples, such as a smear from a tissue culture or
individual, water-borne, single-celled organisms. Considering the simplicity of the setup,
the quality of images obtained from this technique is impressive.
 The main limitation of dark-field microscopy is the low light levels seen in the final
image. This means that the sample must be very strongly illuminated, which can cause
damage to the sample. Dark-field microscopy techniques are almost entirely free of
artifacts, due to the nature of the process. However, the interpretation of dark-field
images must be done with great care, as common dark features of bright-field
microscopy images may be invisible, and vice versa.
 While the dark-field image may first appear to be a negative of the bright-field image,
different effects are visible in each. In bright-field microscopy, features are visible where
either a shadow is cast on the surface by the incident light or a part of the surface is less
reflective, possibly by the presence of pits or scratches. Raised features that are too
smooth to cast shadows will not appear in bright-field images, but the light that reflects
off the sides of the feature will be visible in the dark-field images.

Naturopathic Medicine
Emphasis is disease prevention and wellness
 Techniques include:
 Nutritional therapy
 Herbal Medicine
 Homeopathy
 Traditional Chinese Medicine
 Other physical therapies
Theory:
 Body is self-regulating with the natural ability to maintain
balance.
 A body in balance resists disease
 Naturopaths believe that Western Medical drugs or surgery
can suppress symptoms in the short run, but over time they
actually weaken the body

Naturopathic Medicine
 Western Medicine is helpful for acute and emergency
situations
 Naturopathy is beneficial for long-term protection and
wellness
 Use a Naturopath who has been trained at one of the
three main naturopathic medical schools: Bastyr
(Seattle), Southwest (Phoenix), National (Portland)

Energy Healing
 Directing and intensifying life energy (qi -chi) to make
the body stronger.
 Practitioners use their hands to set up a high-
vibrational energy field. The person receiving the
therapy begins to resonate and respond to the energy.
 The body is provided with additional life-energy and
naturally heals itself.

Energy Healing
Historically addresses:
 Pain relief –back and neck
 Internal problems – glands and organs
 Psychological and spiritual problems

Reflexology
 Touch technique to stimulate the “reflex points” on the
feet, hands and ears.
 Each point corresponds to a specific part of the body
 How does it work?
 Stimulates pathways of sensory nerves
 Sends message to the brain
 Brain send message to the specific body part
 Improves blood flow
 Reduces stress within (organs) and without (neck)
 Be prepared for some pain and drink plenty of water

Neurohumoral Physiology and Psychoneuroimmunology (PNI)
 Autonomic Nervous System (ANS) maintains homeostasis by a series of humoral and nervous system
interactions that continually occur at a subconscious, involuntary level
 Preganglionic, Ganglion, Post-ganglionic and Extra-autonomic sites
 These biofeedback loops are integrated into the Central Nervous System (CNS) and neural directives
are passed to the organs of respiration, circulation, digestion, excretion and reproduction via the ANS
 Mens sanum in corpore sano (a sound mind in a sound body)
 ‘Mind gives body a life force’ – Anaximander / Greek philosopher
 Current research: Higher cognitive and limbic emotional centers are capable of regulating virtually all
aspects of the immune system
 Molecules of emotion:
 Endorphins, Enkephalins, Growth Hormone, Thyroid Stimulating Hormone, Sex-Hormone Releasing
Hormones, Vasopressin, Prolactin, etc., etc.
 Thus the rapid increase in mind-body CAM to maximize PNI-mediated recovery

Movement Education
 There are many techniques:
 Alexander Technique
 Aston-Patterning
 Feldendrais Method
 Hellerwork
 Educational Kinesiology

Educational Kinesiology - 01
 Works with brain patterns addressing multiple issues
 Learning disabilities
 Emotional issues
 Addictions
There are 24 movements that help the nerve connections in the brain be more
effective. 4 examples are:
 Brain Buttons
 Cross Crawl
 Cook’s hookup
 Water www.braingym.com

 In the late 1960s, a Southern California public school reading specialist began to
realize the interconnection of sensorimotor abilities, language acquisition, and
academic achievement. In exploring the use of movement to enhance academic skills,
he founded a group of reading centers where, based on his own empirical research
along with study in such fields as psychology, neuroscience, and developmental
optometry, he adapted specific movements to his students’ needs.

 By the early 1980s, Dr. Paul E. Dennison and his wife and collaborator, Gail E.
Dennison, had created Educational Kinesiology (Edu-K)-enhanced learning through
movement. The Dennisons’ visionary insight led them to develop the unique learning-
readiness program known as Brain Gym®, which offers the introductory elements of
the Edu-K work: the 26 core Brain Gym® activities (often called just “the 26”). Today,
people of all ages use these simple, powerful activities to enhance their visual,
auditory, and kinesthetic skills for easier and more pleasurable learning.

 In 1987 Paul and Gail Dennison founded the Educational Kinesiology Foundation,
d.b.a. Brain Gym® International, a nonprofit public-benefit corporation established to
provide access to learning theory, experiential training, and instructor licensure (see
braingym.org for a listing of courses and instructors).
 The Dennisons teach internationally, and are coauthors of a series of books and
manuals on movement-based learning. Gail is the originator of the Double Doodle
Play and Movement Dynamics courses as well as the Visioncircles program for natural-
vision improvement. In Paul’s autobiographical Brain Gym® and Me: Reclaiming the
Pleasure of Learning, he offers a background and synthesis of Edu-K thinking.

 The 26, along with a wealth of techniques for
movement-based learning, are offered in a variety of
settings that include schools, corporations, elder
facilities, and athletic training programs. The
Dennisons’ contributions to the field of educational
science are far-reaching, and have benefited the lives of
learners in more than 90 countries.

Brain Gym Movements
Brain buttons Cross-crawl

Brain Gym Movements
Cook’s Hookup Drink water

Handwriting: an example of a shift after using brain gym.
Before After

Flower Essences
 Liquid Extracts prepared from wildflowers
 Developed by Dr. Edward Bach in the 1930’s
 How does it work?
 Each essence has a specific energy pattern that affects
the recipient.
 They calm and balance the mind and emotions.
 Bring awareness for creativity, emotional, mental and
physical growth.
 Help create positive emotional states. A person who
feels cynical around holidays might feel more loving
after using a flower essence.

Homeopathy
 Developed in the 1800s by Samuel Hahnemann, a
German doctor.
 Based on the Law of Similars:
 Any substance that can produce symptoms of disease in
a healthy person can help someone who is sick with the
same symptoms.
 The more dilute the remedy the more powerful it is.
 The “energy pattern” of the remedy stimulates the body’s
self-healing energy.

Similia Similibus Curentur: Like Cures Like

1857 painting by Alexander Beydeman, showing historical figures and personifications of
homeopathy observing the brutality of medicine of the 19th century

Homeopathy
 Historically addresses:
 Virtually any condition
 Back pain, colds, digestive problems, minor injuries,
insect bites, burns, sprains, bruises, heart disease,
arthritis, diabetes, allergies, depression, and other
serious diseases.
 Consult a professional homeopath.

Iridology
 First practiced in ancient India, Egypt and China
 Reveals body constitution and inherent weakness
 Reflects conditions and predispositions
 Inflammation
 Toxicity
 Congested lymph
 Acidity

Jensen’s Iridology Chart
www.detox.net.au

Strong constitution: filaments in the eye are close together and fairly straight.
www.drnudelman.ca

Energy Healing: Pseudoscience or not?
Energy medicine, energy therapy, energy healing, or spiritual healing are branches of
alternative medicine based on a pseudo-scientific belief that healers can channel healing energy
into a patient and effect positive results. This idea itself contains several methods: hands-on,
hands-off, and distant (or absent) where the patient and healer are in different locations.
Many schools of energy healing exist using many names, for example, biofield energy healing,
spiritual healing, contact healing, distant healing, Qi Do, therapeutic touch, Reiki or Qigong.
Spiritual healing occurs largely in non-denominational and ecumenical contexts. Practitioners do
not see traditional religious faith as a prerequisite for effecting cures. Faith healing, by contrast,
takes place within a traditional religious context.[9]
While early reviews of the scientific literature on energy healing were equivocal and
recommended further research, more recent reviews have concluded that there is no evidence
supporting clinical efficiency. The theoretical basis of healing has been criticised as implausible,
research and reviews supportive of energy medicine have been faulted for containing
methodological flaws and selection bias, and positive therapeutic results have been dismissed as
resulting from known psychological mechanisms
Edzard Ernst, formerly Professor of Complementary and Alternative Medicine at the University
of Exeter, has warned that "healing continues to be promoted despite the absence of biological
plausibility or convincing clinical evidence ... that these methods work therapeutically and plenty
to demonstrate that they do not". Some claims of those purveying "energy medicine" devices are
known to be fraudulent and their marketing practices have drawn law-enforcement action in the
US

Frequency Healing
 The practice of restoring balance to the body with the
use of frequencies

The study of frequency medicine by
Dr. James Oschman

Electro Interstitial Scan –
an example of a device used

Read the energies of the body
through Muscle Testing

Muscle Testing:
Applied Kinesiology

Learning to Muscle Test
 First: Water, cross-crawls, brain buttons, Cook’s
hookup
 Always be in an “I wonder” attitude
 Rest your hand on the client’s shoulder
 Muscle test with the other hand by gently putting
pressure just above the wrist and asking them to
“resist”
 If the muscle is weak this typically represents
“imbalance”
 If the muscle is strong this typically represents
“balance”

Elements of Muscle Testing
www.drwolfe.com

High Quality Animal Products
 Free Range Organic Eggs
 Organic grass fed animals
 Organic butter
 Oils:
 1/3 saturated
fats
 1/3
monounsaturated
fats
 1/3
polyunsaturated
fats
 Animal fats  Olive  Fish oils
 Coconut oil  Peanut  Flax seed
 Sunflower  Black current

Grains
 Beware of cereals
 Eat a variety of organic grains including:
 Wild Rice
 Brown Rice
 Quinoa
 Couscous
 Bulgur

Broth
 Make a bone broth once a week:
 Whole organic chicken
 Organic Vegetables
 Vinegar
 Water
 Simmer for 2-24 hours and skim off the top

Fruits and Vegetables
 Eat a variety of organic fruits and vegetables
 Best: raw
 Second best: lightly steamed or baked

Salad Dressing
 Make your own with:
 Mustard
 Vinegar
 Olive Oil
 Flax or fish oil
 Option: add parmesan cheese and herbs and blend

Lacto-Fermented Foods
 Organic goat cheeses
 Pickled foods
 Lacto-fermented beverages – kefir from coconuts
 Whey
ALL HELP KEEP THE FLORA IN THE GUT HEALTHY

Alternatives to refined sweeteners
 Eliminate all sucralose, sorbitol, splenda, NutraSweet and aspartame
 Keep sugars to a minimum
 Replace with:
 Dehydrated cane juice
 Maple syrup
 Molasses
 Stevia (sweetener and sugar substitute extracted from the leaves of the plant species Stevia
rebaudiana)
 Raw honey
 Xylitol (sugar alcohol used as a sweetener - safe for diabetics and individuals with
hyperglycemia - Xylitol's lower effect on blood sugar is a function of its glycemic index(GI);
Xylitol's GI is 7, compared 100 for glucose)

Toxic Metals and Additives
 Eliminate:
 Microwave foods
 Aluminum cookware
 MSG
 Artificial Sweeteners
 Chemical additives and food colorings
 Choose:
 Heat food in a toaster oven
 Cook with Stainless Steel or Glass cookware

Stress
 Reduce stress by avoiding /
minimizing:
 Caffeine
 Pesticides
 Amalgams
 Extreme Heat or Cold
 Stale air
 Synthetic fabrics
 Loud Music
 High Heels / Tight Clothing
 Emotional Upset
 Over eating
 Over exercising
 Debt
 Sweating the small stuff

What does the future hold for CAM?
 The current definitions of complementary and alternative medicine (CAM) and
orthodoxy are culturally and politically determined. They obscure the debate about
holism and integrative care and they give therapies and therapists precedence over
patients in the design of health care systems.
 Three current models of delivery of CAM and biomedical care are prevalent in the world.
These models are the:
 Market model
 Regulated model
 Assimilated model
 A fourth model, the patient centered model, which shifts the power from therapists to
patients and regulates products and services irrespective of CAM or biomedical
definitions is the one likely to support the development of truly integrated medicine,
explicitly for the benefit of patients rather than therapists or industries.

Suggestions towards enhanced health and happiness:
 Keep diet simple – whole foods
 Drink plenty of purified water
 Sleep sufficiently
 Exercise regularly
 Practice generosity, forgiveness and tolerance
 Minimize impulsivity, impatience and dogmatism
 Respect history, read it often and don’t commit the mistakes of the ancestors
 Only have good thoughts, utter good words and do good deeds

Cam massumi.mehrdad.michael iaapdc_2017_06_08

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