Feature Stories

• New Campaign Encourages Open Communication About CAM
  A new campaign from NCCAM, which offers free educational materials, is encouraging dialogue between patients and their health care providers about CAM use.



• A Walk in the Botanical Research Centers "Garden"
  Visit the NIH Botanical Research Centers "garden" to find out how Russian tarragon, prunella (self-heal), borage oil, and other botanical and dietary supplement ingredients are being examined to prevent and treat diseases and conditions.



• CAM and Fibromyalgia: At a Glance
  Fibromyalgia is a condition involving pain, "tender points" on the body, and fatigue. About nine out of 10 people with this condition use CAM. What is known from science about CAM's effectiveness for fibromyalgia?

People with chronic health conditions such as fibromyalgia often turn to some form of complementary and alternative medicine (CAM)—a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. This fact sheet provides basic information on fibromyalgia and "what the science says" about the effectiveness of CAM practices that many people with fibromyalgia use. If you are considering a CAM therapy for fibromyalgia, this information can help you talk to your health care provider about it.

Diabetes is a chronic condition affecting millions of Americans. Conventional medical treatments are available to control diabetes and its complications. However, some people also try complementary and alternative medicine (CAM) therapies, including dietary supplements. This fact sheet provides basic information on diabetes (with a focus on type 2), summarizes scientific research on the effectiveness and safety of selected supplements that people with diabetes sometimes use, and suggests sources for additional information.

Key Points

• In general, there is not enough scientific evidence to prove that dietary supplements have substantial benefits for type 2 diabetes or its complications.
• It is very important not to replace conventional medical therapy for diabetes with an unproven CAM therapy.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

According to the National Institute on Aging (NIA), Alzheimer's disease affects nearly 4.5 million Americans and is the most common form of dementia in the elderly. Alzheimer's disease is an incurable disease with a slow progression beginning with mild memory loss and ending with severe brain damage and death. While no treatment is proven to stop Alzheimer's disease, some conventional drugs may limit symptoms for a short period of time in the early stages of the disease. Emerging research shows a correlation between red wine consumption and reduced risk of Alzheimer's disease-type cognitive decline. Authors of a new NCCAM-funded study in mice found that grape seed-derived polyphenolics—similar to that in red wine—significantly reduced Alzheimer's disease-type cognitive deterioration.

According to the National Institute of Mental Health at NIH, Attention Deficit Hyperactivity Disorder (ADHD) affects 3 to 5 percent of children in the United States and it is one of the most common mental disorders that develop in children. NIMH states that children with ADHD have impaired functioning in multiple settings, including home, school, and in relationships with peers. Children with chronic conditions like ADHD are reported to have higher rates of complementary and alternative medicine use and may turn to dietary and herbal supplements such as St. John's wort. However, according to authors of a new NCCAM-funded study, St. John's wort does not appear to have an impact on the symptoms of ADHD in children and adolescents.

The National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health (NIH), has launched Time to Talk, an educational campaign to encourage patients—particularly those age 50 or older—and their health care providers to openly discuss the use of complementary and alternative medicine (CAM). CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine, such as herbal supplements, meditation, naturopathy, and acupuncture.

According to a national consumer survey conducted by NCCAM and AARP, almost two-thirds of people age 50 or older are using some form of CAM, yet less than one-third of these CAM users talk about it with their providers. The NCCAM/AARP survey revealed some reasons why this doctor-patient dialogue about CAM does not occur.

I am now 4 months into this exciting and challenging new job as Director of NCCAM. In this short period, I have been given an excellent orientation to all areas of responsibility of the Center, guided by our terrific staff. I have also had the opportunity to speak with many CAM investigators, practitioners, and thought leaders, and some of our critics as well. I am learning a great deal from these various communities and perspectives. Clinicians have given me a sense of the promise that they see in the CAM approaches to health and wellness. Scientists have discussed the many challenges and knowledge gaps in conducting CAM research as well as the opportunities that are emerging from new research methods. NCCAM staff members have shared with me their expertise and experience in the complexities of oversight of our highly varied research portfolio. And CAM advocates who closely follow our progress have shared their perspective and hopes for NCCAM as well.

International Pharmaceuticals, Ltd. is conducting this recall after being informed by representatives of the Food and Drug Administration (FDA) that lab analysis by FDA of a sample from one lot of the product revealed that it contained a potentially harmful undeclared ingredient, hydroxyhomosildenafil. FDA asserts that this ingredient is an analog of sildenafil. Sildenafil is the active chemical ingredient of an FDA-approved drug used for Erectile Dysfunction in men to enhance sexual performance. The use of undeclared chemicals pose a threat to consumers because they may harmfully interact with nitrates found in some prescription drugs (such as nitroglycerin) and may lower blood pressure to dangerous levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take such nitrates.

VIP Tabs are sold in retail outlets nationwide and are packaged into 2-capsule blister packs and 8-capsule bottles.

Many people take herbal supplements to boost their immune systems, treat allergy symptoms, prevent a cold—all in an effort to be well and stay healthy. There are hundreds of herbal supplements available in the grocery store or pharmacy or for sale on the Internet. And, there are many claims about their health benefits. How can a consumer decide what's safe or effective?

This booklet will give you a basic understanding of some of the most common herbs in popular dietary supplements—their historical uses, what they're used for now, the scientific evidence on their effectiveness, and side effects or cautions for you to consider.

To manage your health, you need to be an informed consumer. Learn about herbal supplements and talk with your health care provider about everything you are doing to stay well.

Low-back pain is a common condition that can be difficult to treat. Spinal manipulationThe application of controlled force to a joint, moving it beyond the normal range of motion in an effort to aid in restoring health. Manipulation may be performed as a part of other therapies or whole medical systems, including chiropractic medicine, massage, and naturopathy. is among the treatment options used by people with low-back pain in attempts to relieve pain and improve functioning. It is performed by chiropractors and other health care professionals such as physical therapists, osteopaths, and some conventional medical doctors. This fact sheet summarizes the current scientific knowledge about the effects of spinal manipulation on low-back pain.

Martin H. Goldrosen, Ph.D., was recently appointed director of the Division of Extramural Activities at the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health.

In announcing Dr. Goldrosen's appointment, Josephine P. Briggs, M.D., NCCAM Director, said "The Division of Extramural Activities is crucial to NCCAM's ability to review and fund high-quality research, as well as coordinate grant management and advisory committee activities. Dr. Goldrosen's experience and his extensive research background make him well-suited for this important work for NCCAM."

Yoga is a mind–body practice in complementary and alternative medicine (CAM) with origins in ancient Indian philosophy. The various styles of yoga that people use for health purposes typically combine physical postures, breathing techniques, and meditation or relaxation. This Backgrounder provides a general overview of yoga and suggests sources for more information.

Yoga in its full form combines physical postures, breathing exercises, meditation, and a distinct philosophy. Yoga is intended to increase relaxation and balance the mind, body, and the spirit.

Early written descriptions of yoga are in Sanskrit, the classical language of India. The word "yoga" comes from the Sanskrit word yuj, which means "yoke or union." It is believed that this describes the union between the mind and the body. The first known text, The Yoga Sutras, was written more than 2,000 years ago, although yoga may have been practiced as early as 5,000 years ago. Yoga was originally developed as a method of discipline and attitudes to help people reach spiritual enlightenment. The Sutras outline eight limbs or foundations of yoga practice that serve as spiritual guidelines.

This 5-day series of events will highlight the science and practice of yoga. Participants will not only learn about yoga but also experience it first-hand through stretching and practice. NIH grantees as well as other local and international speakers will explore yoga practice for health. For a schedule of events and additional information visit: does.ors.od.nih.gov/fitness/yogaWeek.htm.

NCCAM provides resources and information on some health issues that affect women, such as menopause, osteoarthritis, and urinary tract infections. We also highlight some of the clinical trials related to women's health issues.

Decisions about medical care and treatment should be made in consultation with a health care provider and based on the condition and needs of each person. Discuss information on complementary and alternative medicine (CAM) with your health care provider before making any decisions about treatment or care. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

I am pleased to present the President's Fiscal Year (FY) budget request for the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health. The FY 2009 budget includes $121,695,000, which is $118,000 more than the comparable FY 2008 appropriation of $121,577,000.

The public's concept of health is broader than preventing and treating disease. Increasingly, Americans are using strategies that they can employ themselves to improve their health, maintain wellness, and improve quality of life. As part of this participatory approach to health, millions of people are using complementary and alternative medicine (CAM). Many of the leading U.S. medical institutions now offer integrative medicine services. These programs include personalized CAM interventions such as yoga, meditation, massage, and acupuncture. However, we know relatively little about the true potential of CAM to improve health and well being or to preempt disease, or about how best to use most CAM modalities. We also need to understand how CAM practices interact with other therapies and whether they are safe.

Given this consumer-driven call for better approaches to improved health and wellness, the medical research community has begun to explore promising CAM approaches and develop the scientific evidence base for CAM modalities that can be integrated as part of comprehensive health care. Using proven scientific methods and rigorous standards, NCCAM is building the research enterprise and the evidence base to better unders