From heresy to beneficial: Alternative therapies outlined

Not too long ago, their book would have been considered medical heresy.

But medicine has changed so much that a team of medical providers at Mayo Clinic has now produced a book about alternative therapies.

Patients often use things like herbal remedies, steeped concoctions and body-mind connections to heal their symptoms, aches and infections -- without sharing what they're doing with their health providers.

The authors of the "Mayo Clinic Book of Alternative Medicine," hope patients will instead openly discuss their non-traditional efforts with their doctors.

Alternative therapies -- anything used to treat the body not typically taught in medical school -- include today's widely accepted acupuncture and massage. The melding of traditional and alternative therapies, or "integrated medicine," has gained popularity as the doors to "integrated medicine" open.

"I think that people will have an open-minded perspective and recognize that some of the information in this book relates more to common sense than it does to esoteric new approaches to health," said Dr. Paul Limburg, one of the authors, and associate director for research in the Complementary and Integrative Medicine Program at Mayo.

General internist Dr. Larry Bergstrom said nutrition, spirituality and herbalism all come under the umbrella of integrative therapies that can be combined with traditional Western medicine.

Bergstrom said patients shouldn't keep secrets about what they're doing, because combinations of some medicines and herbal remedies can be dangerous.

Congress in 1994 passed legislation that made dietary supplements such as vitamins, minerals, herbal mixtures and amino acids a class of compounds not considered food or considered drugs.

"That really left a lot of safety implications," said general internist Dr. Mark C. Lee, one of the several authors. If the patient is doing something on his own and not telling his doctor, that sometimes works against traditional therapies, he said.

The book separates therapies into categories of green light for effective for indicated conditions, and safe; yellow for caution, studies show the therapy might be effective but there might also be risks; and red for therapies that should not be used because risks far outweigh benefits.

Beneficial alternative therapies as shown through science:

? Glucosamine and chondroitin "appear to be safe and produces fewer adverse side effects" than medications like NSAIDs against osteoarthritis. Some studies conflict, but side effects are low. People with severe symptoms were the most likely in one study to see a benefit.

? Massage "is a great complementary and alternative treatment," the authors say. "Almost everyone feels better after a massage."

? Spinal manipulation is "an effective treatment for uncomplicated low back pain, especially if the pain has been present less than four weeks."

? Peppermint "has some benefits in treating certain digestive disorders such as irritable bowel syndrome and possibly heartburn. However, its muscle-relaxing qualities could worsen hearburn symptoms associated with gastroesophageal reflux disease, so take it under a doctor's supervision."

What's not beneficial?

Goldenseal, for example, "has demonstrated some antibiotic and anti-inflammatory qualities. But studies about its effectiveness and safety are poor quality. Goldenseal was given a red light because "it can produce serious side effects if used for longer periods, and there's insufficient evidence that it works."