Hidden Health Science

Posts Tagged ‘Health’

from NCCAM

It turns out that when we eat may be as important as what we eat. Scientists at the Salk Institute for Biological Studies have found that regular eating times and extending the daily fasting period may override the adverse health effects of a high-fat diet and prevent obesity, diabetes and liver disease in mice.

In a paper published May 17 in Cell Metabolism, scientists from Salk’s Regulatory Biology Laboratoryreported that mice limited to eating during an 8-hour period are healthier than mice that eat freely throughout the day, regardless of the quality and content of their diet. The study sought to determine whether obesity and metabolic diseases result from a high-fat diet or from disruption of metabolic cycles.

“It’s a dogma that a high-fat diet leads to obesity and that we should eat frequently when we are awake,” says Satchidananda Panda, an associate professor in the Regulatory Biology Laboratory and senior author of the paper. “Our findings, however, suggest that regular eating times and fasting for a significant number of hours a day might be beneficial to our health.”

These images of liver tissue show the difference in fat accumulation between two groups of mice fed a high-fat diet.

Images: Courtesy of the Salk Institute for Biological StudiesA mouse allowed to eat 24 hours a day (left) had much higher levels of liver fat (white) than one restricted to an 8-hour daily feeding window (right).Panda’s team fed two sets of mice, which shared the same genes, gender and age, a diet comprising 60 percent of its calories from fat (like eating potato chips and ice-cream for all your meals). One group of mice could eat whenever they wanted, consuming half their food at night (mice are primarily nocturnal) and nibbling throughout the rest of the day. The other group was restricted to eating for only eight hours every night; in essence, fasting for about 16 hours a day. Two control groups ate a standard diet comprising about 13 percent of calories from fat under similar conditions.

After 100 days, the mice who ate fatty food frequently throughout the day gained weight and developed high cholesterol, high blood glucose, liver damage and diminished motor control, while the mice in the time-restricted feeding group weighed 28 percent less and showed no adverse health effects despite consuming the same amount of calories from the same fatty food. Further, the time-restricted mice outperformed the ad lib eaters and those on a normal diet when given an exercise test.

“This was a surprising result,” says Megumi Hatori, a postdoctoral researcher in Panda’s laboratory and a first author of the study. “For the last 50 years, we have been told to reduce our calories from fat and to eat smaller meals and snacks throughout the day. We found, however, that fasting time is important. By eating in a time-restricted fashion, you can still resist the damaging effects of a high-fat diet, and we did not find any adverse effects of time-restricted eating when eating healthy food.”

Hatori cautioned that people should not jump to the conclusion that eating lots of unhealthy food is alright as long as we fast. “What we showed is under daily fasting the body can fight unhealthy food to a significant extent,” she says. “But there are bound to be limits.”

Obesity is a major health challenge in many developed countries, reaching global pandemic proportions. According to the Centers for Disease Control and Prevention, more than one-third of American adults and 17 percent of youth are obese. Obesity increases the risk of a number of health conditions including: high blood pressure, high cholesterol and type 2 diabetes. Lifestyle modifications, including eating a healthy diet and daily exercise, are first-line interventions in the fight against obesity. The Salk study suggests another option for preventing obesity by preserving natural feeding rhythms without altering dietary intake.

Scientists have long assumed that the cause of diet-induced obesity in mice is nutritional; however, the Salk findings suggest that the spreading of caloric intake through the day may contribute, as well, by perturbing metabolic pathways governed by the circadian clock and nutrient sensors.

The Salk study found the body stores fat while eating and starts to burn fat and breakdown cholesterol into beneficial bile acids only after a few hours of fasting. When eating frequently, the body continues to make and store fat, ballooning fat cells and liver cells, which can result in liver damage. Under such conditions the liver also continues to make glucose, which raises blood sugar levels. Time-restricted feeding, on the other hand, reduces production of free fat, glucose and cholesterol and makes better use of them. It cuts down fat storage and turns on fat burning mechanisms when the animals undergo daily fasting, thereby keeping the liver cells healthy and reducing overall body fat.

The daily feeding-fasting cycle activates liver enzymes that breakdown cholesterol into bile acids, spurring the metabolism of brown fat – a type of “good fat” in our body that converts extra calories to heat. Thus the body literally burns fat during fasting. The liver also shuts down glucose production for several hours, which helps lower blood glucose. The extra glucose that would have ended up in the blood – high blood sugar is a hallmark of diabetes – is instead used to build molecules that repair damaged cells and make new DNA. This helps prevent chronic inflammation, which has been implicated in the development of a number of diseases, including heart disease, cancer, stroke and Alzheimer’s. Under the time-restricted feeding schedule studied by Panda’s lab, such low-grade inflammation was also reduced.

“Implicit in our findings,” says Panda, “is that the control of energy metabolism is a finely-tuned process that involves an intricate network of signaling and genetic pathways, including nutrient sensing mechanisms and the circadian system. Time-restricted feeding acts on these interwoven networks and moves their state toward that of a normal feeding rhythm.”

Amir Zarrinpar, a co-first author on the paper from the University of California San Diego, said it was encouraging that a simple increase in daily fasting time prevented weight gain and the onset of disease. “Otherwise, this could have been only partly achieved with a number of different pills and with adverse side effects,” he says.

The multimillion-dollar question is what these findings mean for humans. Public health surveys on nutrition have focused on both the quality and quantity of diet, but they have inherent flaws such as sampling bias, response bias and recall errors that make the results questionable. Thus, says Panda, with the current data it is difficult to connect when we eat, what we eat with how much weight we gain.

“The take-home message,” says Panda, “is that eating at regular times during the day and overnight fasting may prove to be beneficial, but, we will have to wait for human studies to prove this.”

The good news, he adds, is that most successful human lifestyle interventions were first tested in mice, so he and his team are hopeful their findings will follow suit. If following a time-restricted eating schedule can prevent weight gain by 10 to 20 percent, it will be a simple and effective lifestyle intervention to contain the obesity epidemic.

Other researchers on the study were Christopher Vollmers, Amir Zarrinpar, Luciano DiTacchio, Shubhroz Gill, Mathias Leblanc, Amandine Chaix, Matthew Joens and James A.J. Fitzpatrick, from the Salk Institute; and Eric A. Bushong and Mark H. Ellisman, of the University of California, San Diego.

This work was partially supported by the Pew Scholars Program in Biomedical Sciences, NIH grant R01DK091618 to M.M., Sanofi Discovery Innovation Grant, and Anderson Foundation support to S.P.; JSPS fellowship to M.H.; Blasker Science and Technology Grant Award to C.V.; NIH grant T32DK007202 to A.Z.; and NIGMS grant 8P41GM103412 to M.H.E.

Contacts and sources:
Salk Institute for Biological Studies

The Salk Institute for Biological Studies is one of the world’s preeminent basic research institutions, where internationally renowned faculty probe fundamental life science questions in a unique, collaborative, and creative environment. Focused both on discovery and on mentoring future generations of researchers, Salk scientists make groundbreaking contributions to our understanding of cancer, aging, Alzheimer’s, diabetes and infectious diseases by studying neuroscience, genetics, cell and plant biology, and related disciplines.Faculty achievements have been recognized with numerous honors, including Nobel Prizes and memberships in the National Academy of Sciences. Founded in 1960 by polio vaccine pioneer Jonas Salk, M.D., the Institute is an independent nonprofit organization and architectural landmark.

Read more at Nano Patents and Innovations

from ANH-USA

Not only are doctors being advised to reject chelation therapy—they’re being asked to report on their colleagues who practice it.

The American College of Medical Toxicology held a conference at the US Centers for Disease Control and Prevention (CDC) this past February about the “use and misuse” of chelation therapy—a misleading title suggesting some semblance of scientific objectivity, which was nowhere in evidence. The conference was more like a Salem witch hunt in which chelators played the role of the accused witches and warlocks.

Why is chelation so threatening to mainstream medicine? There is no disputing that heavy metals are extremely toxic. The human body is engineered to remove small amounts daily, but not the large amounts we often pick up from modern sources. One of those sources has of course been vaccines, which have used mercury as a preservative (it is still used in the US flu shot). Another source has been dental “silver” amalgam, which also contains mercury. This may be part of the reason for the hostility to chelation.

How does the therapy work? One method involves injecting into the patient’s bloodstream organic chemicals, which can bind and remove the heavy metals in the bloodstream (metals which are toxic to humans and interfere with various physiological functions). There are also oral or suppository supplements for chelation, and some foods are natural chelators (e.g., cilantro and chlorella).

Read the rest here.

A new study into cannabis and its relation to weight gain or loss has found that, interestingly, it is associated with weight loss and should be further studied as a possible obesity-fighter.

From the abstract:

The aim of this study was to investigate the effect of an organic cannabis extract on ?-cell secretory function in an in vivo diet-induced obese rat model and determine the associated molecular changes within pancreatic tissue. Diet-induced obese Wistar rats and rats fed on standard pellets were subcutaneously injected with an organic cannabis extract or the vehicle over a 28-day period. The effect of diet and treatment was evaluated using the intraperitoneal glucose tolerance tests (IPGTTs) and qPCR analysis on rat pancreata harvested upon termination of the experiment.

The cafeteria diet induced an average weight difference of 32 g and an overall increase in body weight in the experimental groups occurred at a significantly slower rate than the control groups, irrespective of diet. Area under the curve for glucose (AUC_g) in the obese group was significantly lower compared to the lean group (p < 0.001), with cannabis treatment significantly reducing the AUC_g in the lean group (p < 0.05), and remained unchanged in the obese group, relative to the obese control group. qPCR analysis showed that the cafeteria diet induced down-regulation of the following genes in the obese control group, relative to lean controls: UCP2, c-MYC and FLIP. Cannabis treatment in the obese group resulted in up-regulation of CB1, GLUT2, UCP2 and PKB, relative to the obese control group, while c-MYC levels were down-regulated, relative to the lean control group. Treatment did not significantly change gene expression in the lean group. These results suggest that the cannabis extract protects pancreatic islets against the negative effects of obesity.

The study was conducted by R-A Levendal, D. Schumann, M. Donath, and CL Frost of the Nelson Mandela Metropolitan University in South Africa and at the University Hospital Basel in Switzerland.  Find out more about it here.

by Dr. Mercola

Did you know there are two types of vitamin D, and they are NOT interchangeable?

In fact, taking the wrong one could do you more harm than good…

Drisdol is a synthetic form of vitamin D2—made by irradiating fungus and plant matter—and is the form of vitamin D typically prescribed by doctors.

This is not the type produced by your body in response to sun or safe tanning bed exposure, which is vitaminD3.

A recent meta-analysis by the Cochrane Databaseⁱlooked at mortality rates for people who supplemented their diets with D2 versus those who did so with D3, the form naturally produced by your body, highlighting the significant differences between the two.

The analysis of 50 randomized controlled trials, which included a total of 94,000 participants, showed:

• A six percent relative risk reduction among those who used vitamin D3, but
• A two percent relative risk increase among those who used D2

According to the Vitamin D Councilⁱⁱ:

“You would think a paper that took a look at tens of thousands of subjects and analyzed the efficacy of prescription vitamin D (D2) and over-the-counter vitamin D (D3) would warrant a news story or two.

To my knowledge, these papers are the first to paint such a clear picture about the efficacy between D3 and D2.

While there may be explanations for D3′s superiority other than improved efficacy, for the time being, these papers send doctors a message: use D3, not D2.”

The Difference Between Supplemental Vitamin D2 and D3

The notion that vitamin D2 and D3 were equivalent was based on decades-old studies of rickets prevention in infants. Today, we know a lot more about vitamin D, and the featured study offers compelling support for the recommendation to take vitamin D3 if you need to take an oral supplement—which is the same type of D vitamin created in your body when you expose your skin to sunlight.

Supplemental vitamin D comes in two forms:

1. Ergocalciferol (vitamin D2)
2. Cholecalciferol (vitamin D3)

I personally recommend getting your vitamin D from safe sun exposure (or a safe tanning bed), as there’s compelling reason to believe the vitamin D created in your skin in response to sun exposure has some slight but important differences that make it even more beneficial than supplemental vitamin D3. I will address this more in just a moment, but first, let’s review the differences between the two types of supplemental vitamin D. Aside from the featured findings that supplemental vitamin D3 reduced the relative mortality risk by six percent, while D2 actually INCREASED mortality risk by two percent, the two types differ in the following ways:

• According to the latest research, D3 is approximately 87 percent more potentⁱⁱⁱ in raising and maintaining vitamin D concentrations and produces 2- to 3-fold greater storage of vitamin D than does D2.
• Regardless of which form you use, your body must convert it into a more active form, and vitamin D3 is converted 500 percent faster than vitamin D2.
• Vitamin D2 also has a shorter shelf life, and its metabolites bind poorly with proteins, further hampering its effectiveness.

What about Dietary Sources? Animal-Based versus Plant-Based Vitamin D

Aside from taking an oral vitamin D supplement, you can also obtain small amounts of vitamin D from your diet. Here too, it’s important to realize that not all food sources provide the same kind of vitamin D. Plant sources provide you with D2. The more beneficial D3 can only be had through animal-based sources such as:

• Fish, such as salmon, mackerel, tuna and sardines
• Egg yolk
• Raw milk

Dairy processors producing pasteurized milk have also been fortifying milk with vitamin D since 1933. Today, about 98 percent of the milk supply in the U.S. is fortified with approximately 400 International Units (IU) of vitamin D per quart. While dairies used to fortify their milk with vitamin D2, most have now switched over to D3. But, if you still drink pasteurized milk (which I don’t recommend), check the label to see which form of vitamin D has been added. (If you drink raw milk, then you’re getting the naturally-occurring vitamin D in the milk fat.) Keep in mind that although milk is fortified, other dairy products such as cheese and ice cream does typically not contain added vitamin D.

Vitamin D Can Make or Break Your Health, So Get the Right Kind!

There’s overwhelming evidence that vitamin D is a key player in your overall health. This is understandable when you consider that it is not “just” a vitamin; it’s actually a neuroregulatory steroidal hormone that influences nearly 3,000 different genes in your body. Receptors that respond to the vitamin have been found in almost every type of human cell, from your brain to your bones.

Just one example of an important gene that vitamin D up-regulates is your ability to fight infections, as well as chronic inflammation. It produces over 200 antimicrobial peptides, the most important of which is cathelicidin, a naturally occurring broad-spectrum antibiotic. This is one of the explanations for why it can be so effective against colds and influenza.

Optimizing your vitamin D levels should be at the top of the list for virtually everyone, regardless of your age, sex, color, or health status, as vitamin D deficiency has been linked to an astonishingly diverse array of common chronic diseases, such as:

The IDEAL Way to Optimize Your Vitamin D Levels

While this article is focused on the two types of oral vitamin D supplementation, it’s important to realize that the IDEAL way to optimize your vitamin D levels is through appropriate sun or safe tanning bed exposure. While your skin does create vitamin D3 in response to sun light, which is theoretically the same as the D3 you get from an oral supplement, there’s cause to believe that the vitamin D created from sun exposure may have additional health benefits, and here’s why:

• When you expose your skin to the sun, your skin also synthesizes high amounts of cholesterol sulfate, which is very important for heart and cardiovascular health. In fact, according to research by Dr. Stephanie Seneff, high LDL and subsequent heart disease may in fact be a symptom of cholesterol sulfate deficiency. Sulfur deficiency also promotes obesity and related health problems like diabetes
• When exposed to sunshine, your skin also synthesizes vitamin D3 sulfate. This form of vitamin D is water soluble, unlike oral vitamin D3 supplements, which is unsulfated. The water-soluble form can travel freely in your bloodstream, whereas the unsulfated form needs LDL (the so-called “bad” cholesterol) as a vehicle of transport. According to Dr. Stephanie Seneff, there’s reason to believe that many of the profound benefits of vitamin D are actually due to the vitamin D sulfate. As a result, she suspects that the oral non-sulfated form of vitamin D might not provide all of the same benefits, because it cannot be converted to vitamin D sulfate
• You cannot overdose when getting your vitamin D from sun exposure, as your body has the ability to self-regulate and only make what it needs

So essentially, getting regular sun exposure has much greater health ramifications than “just” raising your vitamin D levels and preventing infections. Sun exposure also appears to play a role in heart and cardiovascular health, and much more!

If you cannot get your vitamin D requirements from sun exposure, I recommend using a safe tanning bed (one with electronic ballasts rather than magnetic ballasts, to avoid unnecessary exposure to EMF fields). Safe tanning beds also have less of the dangerous UVA than sunlight, while unsafe ones have more UVA than sunlight. If neither of these are feasible options, then you should take an oral vitamin D3 supplement. It will certainly be better than no vitamin D at all.

How Much Vitamin D Should You Take?

Some 40 leading vitamin D experts from around the world currently agree that there’s no specific dosage level at which “magic” happens; rather the most important factor when it comes to vitamin D is your serum level (the level of vitamin D in your blood). So you really should be taking whatever dosage required to obtain a therapeutic level of vitamin D in your blood.

That said, based on the most recent research by GrassrootsHealth—an organization that has greatly contributed to the current knowledge on vitamin D through their D* Action Study—it appears as though most adults need about 8,000 IU’s of vitamin D a day in order to raise their serum levels above 40 ng/ml.⁴ For children, many experts agree they need about 35 IU’s of vitamin D per pound of body weight.

At the time GrassrootsHealth performed the studies that resulted in this dosage recommendation, the optimal serum level was believed to be between 40 to 60 ng/ml. Since then, the optimal vitamin D level has been raised to 50-70 ng/ml, and when treating cancer or heart disease, as high as 70-100 ng/ml, as illustrated in the chart above.

What this means is that even if you do not regularly monitor your vitamin D levels (which you should), your risk of overdosing is going to be fairly slim even if you take as much as 8,000 IU’s a day. However, the only way to determine your optimal dose is to get your blood tested regularly, and adjust your dosage to maintain that goldilocks’ zone.

For more information, including an in-depth explanation of everything you need to know before you get tested, please see Test Values and Treatment for Vitamin D Deficiency.

by Dana Ullman, Huffington Post

The Swiss government has a long and widely-respected history of neutrality, and therefore, reports from this government on controversial subjects need to be taken more seriously than other reports from countries that are more strongly influenced by present economic and political constituencies. When one considers that two of the top five largest drug companies in the world have their headquarters in Switzerland, one might assume that this country would have a heavy interest in and bias toward conventional medicine, but such assumptions would be wrong.

In late 2011, the Swiss government’s report on homeopathic medicine represents the most comprehensive evaluation of homeopathic medicine ever written by a government and was just published in book form in English (Bornhoft and Matthiessen, 2011). This breakthrough report affirmed that homeopathic treatment is both effective and cost-effective and that homeopathic treatment should be reimbursed by Switzerland’s national health insurance program.

The Swiss government’s inquiry into homeopathy and complementary and alternative (CAM) treatments resulted from the high demand and widespread use of alternatives to conventional medicine in Switzerland, not only from consumers but from physicians as well. Approximately half of the Swiss population have used CAM treatments and value them. Further, about half of Swiss physicians consider CAM treatments to be effective. Perhaps most significantly, 85 percent of the Swiss population wants CAM therapies to be a part of their country’s health insurance program.

It is therefore not surprising that more than 50 percent of the Swiss population surveyed prefer a hospital that provides CAM treatments rather to one that is limited to conventional medical care.

Beginning in 1998, the government of Switzerland decided to broaden its national health insurance to include certain complementary and alternative medicines, including homeopathic medicine, traditional Chinese medicine, herbal medicine, anthroposophic medicine, and neural therapy. This reimbursement was provisional while the Swiss government commissioned an extensive study on these treatments to determine if they were effective and cost-effective. The provisional reimbursement for these alternative treatments ended in 2005, but as a result of this new study, the Swiss government’s health insurance program once again began to reimburse for homeopathy and select alternative treatments. In fact, as a result of a national referendum in which more than two-thirds of voters supported the inclusion of homeopathic and select alternative medicines in Switzerland’s national health care insurance program, the field of complementary and alternative medicine has become a part of this government’s constitution (Dacey, 2009; Rist, Schwabl, 2009).

Read the rest at this link.

from BreastCancer.co

Breast cancer survival rates are higher now than they’ve ever been in the past, but health challenges including high rates of depression are still a problem. Researchers at the University of Missouri have been testing how meditation techniques can help with this.

The researchers in the Sinclair School of Nursing have found that breast cancer survivors’ health improves after they learn Mindfulness-Based Stress Reduction (MBSR), a type of mindfulness training that incorporates meditation, yoga, and physical awareness.

“MBSR is another tool to enhance the lives of breast cancer survivors,” SSN doctoral student Jane Armer says. “Patients often are given a variety of options to reduce stress, but they should choose what works for them according to their lifestyles and belief systems.”

The MBSR program includes eight to ten weeks of group sessions where the participants learn the MBSR skills. The study found that survivors who utilized MBSR had improved moods, more mindfulness, and less depression overall. It can be used for anyone in post-diagnosis, during or after surgery or treatment.

Image by jainaj via Flickr

Americans are using more alternative and preventive medicine as costs for traditional healthcare swells. 38 percent of American adults use alternative and complementary medicine, according to the National Institutes of Health. An increasing reliance on alternative and preventative medicine is not surprising when healthcare costs rise 8 percent each year, nearly three times the rate of inflation.

What may surprise some, though, is how effective alternative and preventative medicine can be. Elderberry, used medicinally in Europe for hundreds of years, received some long-overdue respect when researchers in Norway confirmed that it effectively relieves flu symptoms.¹ Even ardent fans of Dr. Oz may have a hard time pronouncing this funny-sounding herb after he featured it on one of his episodes, but Umckaloabo is gaining recognition as an immunity booster since The Journal of Family Practice cited four encouraging studies before saying that Umckaloabo “represents a promising treatment” for viral upper respiratory infections.² And while licorice may go down better than a spoonful of sugar, several studies show that it may be a promising treatment for ulcers as well.

While alternative treatments and herbs have shown promise when used in conjunction with traditional medicine for existing illnesses, the real promise in curtailing healthcare costs lies in prevention. According to the Prevention Institute, even a 5 percent reduction in preventable illnesses and injuries could mean substantial healthcare savings.

While genetics and lifestyle have long been the primary focus of preventative measures, recent science points to the immune system as a powerful predictor of illness. According to the Integrative Medicine Department at Beth Israel Medical Center in New York City, the immune system is the deciding factor between who gets sick and who doesn’t.

An epidemiologic study conducted amongst middle and high school students in Michigan showed that an alarming 1 in 5 of them have abused prescription drugs in the past year.  The study shows that abuse rates amongst adolescents are as high as they are for young adult and adult populations, highlighting concerns that Rx medications are now the drug of choice.

This adolescent age group is a particularly vulnerable one, said Sean Esteban McCabe, PhD, research associate professor at the University of Michigan Substance Abuse Research Center and Institute for Research on Women and Gender in Ann Arbor, and the study’s lead author. “Adolescence represents an important period to monitor controlled medications because individuals often become responsible for their own medication management during older adolescence,” Dr. McCabe said in an email to Pain Medicine News. “In addition, adolescents serve as the leading diversion source for their adolescent peers and many adolescents report using their own leftover medication nonmedically.”

The study was published in the August issue of the journal Archives of Pediatric Medicine (2011; 165:729-735) and it covered four classes of prescription drugs: pain, stimulant, sleeping and anti-anxiety.  It asked specific questions regarding the medicines’ use, including misuse and diversion.  It also included the DAST-10 and CRAFFT mnemonic, both measures of drug or alcohol dependence.

18% of those responding were prescribed the medication in question and 22% of those misused the prescription within the past year.  Close to 10% said they used their prescription meds to intentionally get high or increase the effect of other drugs or alcohol.

Overall, students abused pain drugs more than any other, but these were the least popular (9.8%) for intentionally getting high – that class of drug was actually least used for this purpose.  That dubious honor goes to sleeping pills (17.1%) and anti-anxiety drugs (15.8%).  Not surprisingly, those who abuse prescription drugs are also more likely to abuse other substances like alcohol.

Since the mid-1990s, all four of the drug types in question have been prescribed to younger and younger people.  Given the penchant for older populations to abuse these drugs the more they’re prescribed, seeing children doing it is not surprising. They have both role models (young adults, adults) doing so and easier access.

from NCCAM

Relaxation Training

Scientific Evidence

• One review article noted that relaxation training significantly reduced headache activity compared to other forms of therapy.

Side Effects and Cautions

• Relaxation techniques are generally considered safe for healthy people.
• There have been rare reports that certain relaxation techniques might cause or worsen symptoms in people with epilepsy or certain mental illnesses, or with a history of abuse or trauma. People with heart disease should talk to their doctor before doing progressive muscle relaxation.

Biofeedback

Scientific Evidence

• A review article reported that adding biofeedback to a combination of an antidepressant and high blood pressure medication was more effective in treating tension-type headaches than medication alone.
• Results from one study indicated that biofeedback provided no additional benefit over relaxation therapy in reducing headache frequency and severity.

Side Effects and Cautions

• Biofeedback is generally thought to be safe; however, it may not be appropriate for certain people.

Acupuncture

Scientific Evidence

• In a review of two large trials in people with tension-type headaches, researchers found that adding acupuncture to the use of pain relievers was more effective than using pain relievers alone.
• A review that analyzed results from two large and three small trials comparing true acupuncture with sham acupuncture (in which needles were either inserted at incorrect points or did not penetrate the skin) demonstrated a slightly better effect for true acupuncture in treating tension-type headaches.
• Results of another review article determined that adding acupuncture to acute treatment or routine care may be beneficial in reducing migraine frequency and intensity.

Side Effects and Cautions

• Acupuncture is considered safe when performed by a qualified and competent practitioner using sterile needles.
• Few complications have been reported.
• Serious adverse events related to acupuncture are rare, but include infections and punctured organs.

Tai Chi

Scientific Evidence

• Results from a small clinical trial suggested that a 15-week program of tai chi was effective in reducing the impact of tension-type headaches when compared to a wait-list control group.

Side Effects and Cautions

• Tai chi is a relatively safe practice; however, some health care providers may advise their patients to modify or avoid certain tai chi postures due to acute back pain, knee problems, bone fractures, sprains, and osteoporosis.

Cognitive-Behavioral Therapy

Scientific Evidence

• It has been suggested that cognitive-behavioral therapy may offer additional relief when combined with medication used for preventing migraines.

Massage

Scientific Evidence

• Only a few studies have rigorously examined the role of massage as a headache treatment.
• A 2008 pilot study involving 16 participants suggested that massage may be beneficial in reducing the frequency of tension type headaches as well as the intensity and duration of pain.
• In another small study, researchers observed that a specific type of massage called craniosacral therapy, which involves light touch and manipulation of the skull and spine to release restrictions in tissues, was more effective than no treatment in relieving pain from a tension-type headache but suggested that larger studies are needed to determine the efficacy of massage as a headache treatment.
• Researchers are also investigating whether massage therapy may help prevent migraines. In a 2006 study, researchers randomly assigned 24 people with migraines to receive six 45-minute massages that focused on the muscles of the back, shoulders, head, and neck while 24 people without migraines acted as a control group. Although there was no change in the average intensity of migraines experienced, the researchers observed a significant reduction in migraine frequency among those who received massages.

Side Effects and Cautions

• Massage therapy appears to have few serious risks—if it is performed by a properly trained therapist and if appropriate cautions are followed. The number of serious injuries reported is very small.
• Side effects of massage therapy may include temporary pain or discomfort, bruising, swelling, and a sensitivity or allergy to massage oils.
• Cautions about massage therapy include the following:
  • Vigorous massage should be avoided by people with bleeding disorders or low blood platelet counts, and by people taking blood-thinning medications such as warfarin.
  • Massage should not be done in any area of the body with blood clots, fractures, open or healing wounds, skin infections, or weakened bones (such as from osteoporosis or cancer), or where there has been a recent surgery.
  • Although massage therapy appears to be generally safe for cancer patients, they should consult their oncologist before having a massage that involves deep or intense pressure. Any direct pressure over a tumor usually is discouraged. Cancer patients should discuss any concerns about massage therapy with their oncologist.
  • Pregnant women should consult their health care provider before using massage therapy.

Spinal Manipulation

Scientific Evidence

• Literature reviews suggest that spinal manipulation (a technique often practiced by chiropractors) may offer some benefit for tension-type headaches and that it also may prevent migraines as well as the medication amitriptyline.

Side Effects and Cautions

• Except for high-speed neck manipulation, which is associated with the very rare but serious risk of arterial tearing or stroke, spinal manipulation is not likely to be harmful.
• Side effects from spinal manipulation can include temporary headaches, tiredness, or discomfort in the parts of the body that were treated.

Riboflavin, Coenzyme Q10, and Magnesium

Scientific Evidence

• Some research suggests that the supplements riboflavin and coenzyme Q10 may be helpful headache treatments.
• Studies using magnesium to prevent migraines were inconclusive.

Side Effects and Cautions

• Riboflavin and coenzyme Q10 are generally well tolerated, but magnesium supplements may cause diarrhea.
• Riboflavin supplements are not recommended for pregnant women.

Feverfew and Butterbur

Scientific Evidence

• The herbs feverfew (Tanacetum parthenium) and butterbur (Petasites hybridus) have been used historically for headache relief.
• Study results have indicated that feverfew and butterbur may help reduce migraine frequency.

Side Effects and Cautions

• In clinical trials, use of feverfew was associated with mild side effects such as open sores in the mouth and upset stomach.
• Butterbur is generally well tolerated but may cause mild gastrointestinal upset.
• Some butterbur products contain potentially harmful chemicals called pyrrolizidine alkaloids (PAs). If seeking a butterbur product, look for one labeled or certified as PA-free.
• Feverfew and butterbur are not recommended for pregnant women.