This fact sheet provides basic information about the herb European mistletoe—common names, uses, potential side effects, and resources for more information. European mistletoe is a semiparasitic plant that grows on several types of trees in temperate regions worldwide. Where the term "mistletoe" is used in this fact sheet, it refers to European mistletoe. (European mistletoe is different from American mistletoe, which is used as a holiday decoration.)

What Mistletoe Is Used For

• Mistletoe has been used for centuries in traditional medicine to treat seizures, headaches, and other conditions.
• Mistletoe is used mainly in Europe as a treatment for cancer.

This fact sheet provides basic information about European elder—common names, uses, potential side effects, and resources for more information. European elder is a tree native to Europe and parts of Asia and Africa, and it also grows in the United States. There are several different types of elder, such as American elder, but European elder is the type most often used as a supplement.

What Elderberry Is Used For

• Parts of the elder tree—such as the berries and flowers—have long been used for pain, swelling, infections, coughs, and skin conditions.
• Today, elderberry and elder flower are used for flu, colds, fevers, constipation, and sinus infections.

This fact sheet provides basic information about the herb ephedra—common names, uses, potential side effects, and resources for more information. Ephedra is an evergreen shrub-like plant native to Central Asia and Mongolia. The principal active ingredient, ephedrine, is a compound that can powerfully stimulate the nervous system and heart.

What Ephedra Is Used For

• Ephedra has been used for more than 5,000 years in China and India to treat conditions such as colds, fever, flu, headaches, asthma, wheezing, and nasal congestion.
• It has also been an ingredient in many dietary supplements used for weight loss, increased energy, and enhanced athletic performance.

This fact sheet provides basic information about the herb echinacea—common names, uses, potential side effects, and resources for more information. There are nine known species of echinacea, all of which are native to the United States and southern Canada. The most commonly used, Echinacea purpurea, is believed to be the most potent.

What Echinacea Is Used For

• Echinacea has traditionally been used to treat or prevent colds, flu, and other infections.
• Echinacea is believed to stimulate the immune system to help fight infections.
• Less commonly, echinacea has been used for wounds and skin problems, such as acne or boils.

This fact sheet provides basic information about dandelion—common names, uses, potential side effects, and resources for more information. Dandelion greens are edible and are a rich source of vitamin A. Dandelion has been used in many traditional medical systems, including Native American and traditional Arabic medicine.

What Dandelion Is Used For

• Historically, dandelion was most commonly used to treat liver diseases, kidney diseases, and spleen problems. Less commonly, dandelion was used to treat digestive problems and skin conditions.
• Today, dandelion is used by some as a liver or kidney "tonic," as a diuretic, and for minor digestive problems.

This fact sheet provides basic information about cranberry—common names, uses, potential side effects, and resources for more information. Cranberries are the fruit of a native plant of North America. These red berries are used in foods and in herbal products.

What Cranberry Is Used For

• Historically, cranberry fruits and leaves were used for a variety of problems, such as wounds, urinary disorders, diarrhea, diabetes, stomach ailments, and liver problems.
• Recently, cranberry products have been used in the hope of preventing or treating urinary tract infections or Helicobacter pylori (H. Pylori) infections that can lead to stomach ulcers, or to prevent dental plaque. Cranberry has also been reported to have antioxidant and anticancer activity.

The undeclared ingredient may pose a threat to the consumer because the interaction of the analogue with some prescription drugs (such as nitroglycerin) may lower blood pressure to dangerous levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take other prescription drugs.

This fact sheet provides basic information about the herb chasteberry—common names, uses, potential side effects, and resources for more information. Chasteberry is the fruit of the chaste tree, a small shrub-like tree native to Central Asia and the Mediterranean region. The name is thought to come from a belief that the plant promoted chastity—it is reported that monks in the Middle Ages used chasteberry to decrease sexual desire.

What Chasteberry Is Used For

• Chasteberry has been used for thousands of years, mostly by women to ease menstrual problems and to stimulate the production of breast milk.
• Chasteberry is still used for menstrual problems, such as premenstrual syndrome, as well as for symptoms of menopause, some types of infertility, and acne.

This product poses a threat to consumers because Sibutramine is known to substantially increase blood pressure and/or pulse rate in some patients and may present a significant risk for patients with a history of coronary artery disease, congestive heart failure, arrhythmias or stroke.

This fact sheet provides basic information about the herb chamomile—common names, uses, potential side effects, and resources for more information. Two types of chamomile are used for health conditions: German chamomile and Roman chamomile. While the two kinds are thought to have similar effects on the body, the German variety is more commonly used in the United States and is the focus of this fact sheet.

What Chamomile Is Used For

• Chamomile has been widely used in children and adults for thousands of years for a variety of health conditions.
• The herb is often used for sleeplessness; anxiety; and gastrointestinal conditions such as upset stomach, gas, and diarrhea.
• It is used topically for skin conditions and for mouth ulcers resulting from cancer treatment.

This fact sheet provides basic information about the herb cats claw—common names, uses, potential side effects, and resources for more information. Cats claw grows wild in many countries of Central and South America, especially in the Amazon rainforest. The use of this woody vine dates back to the Inca civilization.

What Cat's Claw Is Used For

• Cat's claw has been used for centuries in South America to prevent and treat disease.
• It has been used for a variety of health conditions, including viral infections (such as herpes and HIV), Alzheimer's disease, cancer, and arthritis.
• Cat's claw has been used to support the immune system and promote kidney health, as well as to prevent and abort pregnancy.

This fact sheet provides basic information about the herb black cohosh—common names, uses, potential side effects, and resources for more information. Black cohosh, a member of the buttercup family, is a plant native to North America. It was used in Native American medicine and was a home remedy in 19th-century America.

What Black Cohosh Is Used For

• Black cohosh has a history of use for rheumatism (arthritis and muscle pain) but has been used more recently to treat hot flashes, night sweats, vaginal dryness, and other symptoms that can occur during menopause.
• Black cohosh has also been used for menstrual irregularities and premenstrual syndrome, and to induce labor.

A review of scientific literature suggests that there is strong evidence of beneficial health effects of tai chi and qi gong, including for bone health, cardiopulmonary fitness, balance, and quality of life. Both tai chi and qi gong (also known as qigong) have origins in China and involve physical movement, mental focus, and deep breathing. Because of the apparent similarities between tai chi and qi gong, the researchers reviewed the literature on both practices together. The review was published in the American Journal of Health Promotion.

This fact sheet provides basic information about bitter orange—common names, uses, potential side effects, and resources for more information. The bitter orange tree is native to eastern Africa and tropical Asia. Today, it is grown throughout the Mediterranean region and elsewhere, including California and Florida. Bitter orange oil is used in foods, cosmetics, and aromatherapy products. Bitter orange oil from the trees leaves is called petitgrain, and oil from the flowers is called neroli.

What Bitter Orange Is Used For

• Bitter orange has been used in traditional Chinese medicine and by indigenous people of the Amazon rainforest for nausea, indigestion, and constipation.
• Current uses of bitter orange are for heartburn, loss of appetite, nasal congestion, and weight loss. It is also applied to the skin for fungal infections such as ringworm and athlete's foot.

A laboratory study suggests that silymarin—an extract from the milk thistle plant—has multiple effects against the lifecycle of the hepatitis C virus. Hepatitis C is a chronic (long lasting) disease that primarily affects the liver and is often difficult to cure. The laboratory study examined the antiviral properties and mechanisms of silymarin on cultured (grown in a lab) human liver cells infected with the virus. The study, funded in part by NCCAM, was published in the journal Hepatology.

This fact sheet provides basic information about bilberry—common names, uses, potential side effects, and resources for more information. Bilberry is a relative of the blueberry, and its fruit is commonly used to make pies and jams. It has been used for nearly 1,000 years in traditional European medicine. Bilberry grows in North America, Europe, and northern Asia.

What Bilberry Is Used For

• Historically, bilberry fruit was used to treat diarrhea, scurvy, and other conditions.
• Today, the fruit is used to treat diarrhea, menstrual cramps, eye problems, varicose veins, venous insufficiency (a condition in which the veins do not efficiently return blood from the legs to the heart), and other circulatory problems.
• Bilberry leaf is used for entirely different conditions, including diabetes.

Fish oil, when combined with epigallocatechin‑3‑gallate (EGCG—a polyphenol and antioxidant found in green tea), may affect chemical processes in the brain associated with Alzheimers disease, according to a study published in Neuroscience Letters. This study, which used an animal (mouse) model of Alzheimers disease, builds on previous research linking the disease to peptides (amino acid chains) called beta‑amyloids and laboratory studies suggesting that EGCG decreases memory problems and beta‑amyloid deposits in mice.

This fact sheet provides basic information about the herb astragalus—common names, uses, potential side effects, and resources for more information. Native to China, astragalus has been used for centuries in traditional Chinese medicine. In the United States, the herb gained popularity in the 1980s. There are actually over 2,000 species of astragalus; however, the two related species Astragalus membranaceus and Astragalus mongholicus are the ones primarily used for health purposes.

What Astragalus Is Used For

• Historically, astragalus has been used in traditional Chinese medicine, usually in combination with other herbs, to support and enhance the immune system. It is still widely used in China for chronic hepatitis and as an adjunctive therapy in cancer.
• It is also used to prevent and treat common colds and upper respiratory infections.
• Astragalus has also been used for heart disease.

This fact sheet provides basic information about the herb Asian ginseng—common names, uses, potential side effects, and resources for more information. Asian ginseng is native to China and Korea and has been used in various systems of medicine for many centuries. Asian ginseng is one of several types of true ginseng (another is American ginseng, Panax quinquefolius). An herb called Siberian ginseng or eleuthero (Eleutherococcus senticosus) is not a true ginseng.

Common Names—Asian ginseng, ginseng, Chinese ginseng, Korean ginseng, Asiatic ginseng

Latin Name—Panax ginseng

This fact sheet provides basic information about aloe vera—common names, uses, potential side effects, and resources for more information. Aloe veras use can be traced back 6,000 years to early Egypt, where the plant was depicted on stone carvings. Known as the "plant of immortality," aloe was presented as a burial gift to deceased pharaohs.

Common Names—aloe vera, aloe, burn plant, lily of the desert, elephants gall

Latin Names—Aloe vera, Aloe barbadensis

Nadie desea que llegue la temporada de los resfriados y la gripe. En los Estados Unidos se registran alrededor de mil millones de resfriados al año. De hecho, el resfriado común se encuentra entre las causas principales de consultas médicas y ausencias de escuela o de trabajo. Pero la gripe y sus posibles complicaciones causan aún más preocupación. Se calcula que anualmente entre el 5 y 20 por ciento de la población de los Estados Unidos es afectada por la gripe. Aunque la mayoría de la gente se recupera sin problemas, las complicaciones relacionadas con la gripe resultan en más de 200.000 hospitalizaciones y 36.000 muertes cada año.

A fin de prevenir o tratar estas enfermedades tan comunes, hay quienes buscan soluciones en la medicina complementaria y alternativa. Esta hoja informativa ofrece información básica sobre los resfriados y la gripe, al igual que la perspectiva científica acerca de algunos de estos enfoques de medicina complementaria y alternativa. Si está considerando emplear terapias de medicina complementaria y alternativa para estos malestares, esta información le ayudará a hablar con su médico sobre el tema.

On June 22, I was invited to participate on National Public Radio's The Diane Rehm Show along with Dr. Richard Davidson, NCCAM grantee at the University of Wisconsin-Madison, and Mr. Jonathon Foust, founder of the Mindfulness Training Institute in Washington, D.C. The topic was "The Power of Meditation."

The U.S. Food and Drug Administration is warning consumers that Magic Power Coffee, an instant coffee product marketed as a dietary supplement for sexual enhancement, contains an active drug ingredient that can dangerously lower blood pressure.

A physician's credentials—the licenses, certificates, and diplomas on the office walls—tell us about that person's professional qualifications to advise and treat us. We seek similar assurances when we choose a complementary and alternative medicine (CAM) practitioner, such as an acupuncturist, a chiropractor, or a massage therapist. This fact sheet provides a general overview of the status of CAM credentialing, summarizes licensure for selected types of CAM practitioners, and suggests sources for additional information.

Antioxidants found in green tea may help repair DNA damage caused by sun exposure, according to a recent study in mice. Exposure to ultraviolet (UV) radiation can damage DNA and, in turn, trigger suppression of the immune system—a risk factor for developing skin cancer. The study, funded in part by NCCAM and published in the journal Cancer Prevention Research, examined the effects of polyphenols from the leaves of the green tea plant, which are thought to fight free radicals (highly unstable molecules that can damage cells) and have anticarcinogenic activity.

An extract derived from shark cartilage—AE‑941—did not improve overall survival in patients with non-small cell lung cancer, according to a study jointly funded by NCCAM and the National Cancer Institute. Shark cartilage has been reported to have antiangiogenic properties (preventing the growth of new blood vessels around tumors), and preliminary research in animals suggested that AE‑491 has antitumor activity. Findings from this study were published in the Journal of the National Cancer Institute.

Circadian rhythms are the physical, mental, and behavioral changes that occur over the course of a day, responding primarily to light and darkness in the environment. Special non-image forming cells in the eye's retina that contain melanopsin (a pigment involved in the regulation of nonvisual responses) and are sensitive to blue light are known to affect these daily rhythms. These nonvisual responses also have been noted with higher intensity light levels. Now, new research reveals that green light and the cones and rods in the retina used for vision are also involved. The research, published in Science Translational Medicine, examined how melatonin (a major hormone associated with human sleeping patterns) responds to different wavelengths of light and suggests that light therapy for sleep disorders may be optimized by stimulating both visual and nonvisual systems.

The Food and Drug Administration (FDA) is warning of the potential risk of overdosing infants with liquid vitamin D.

Some liquid vitamin D supplement products on the market come with droppers that could allow parents and caregivers to accidentally give harmful amounts of the vitamin to an infant. These droppers can hold a greater amount of liquid vitamin D than an infant should receive.

Many adolescents with inflammatory bowel disease are currently using or would consider using complementary and alternative medicine (CAM)—specifically mind-body therapies such as relaxation and guided imagery—to help manage their symptoms, according to a study published in the journal Inflammatory Bowel Disease. This disease is actually a group of disorders (including Crohn's disease and ulcerative colitis) that cause inflammation of the intestines. The physical and emotional problems associated with irritable bowel disease in adolescents often affect quality of life.

Some previous studies have reported associations between low magnesium consumption and the development of asthma. Now, recent research supported by NCCAM and published in the Journal of Asthma provides additional evidence that adults with mild-to-moderate asthma may benefit from taking magnesium supplements.

Recent research, funded in part by NCCAM and published in the journal Gastroenterology, has shown that an extract of the milk thistle plant may help treat hepatitis C virus infection. Hepatitis C, a liver disease caused by a virus, is usually chronic (long-lasting), with symptoms ranging from mild (or even none) to severe.

In a recent laboratory study, a fatty acid from seaweed reduced the ability of HIV‑1 viruses to enter immune system cells. The study was reported in the journal AIDS Research and Human Retroviruses. Drug-resistant strains of HIV‑1 have been on the rise, prompting the need for new therapeutic agents. Previous studies have demonstrated that products derived from natural sources have the potential to inhibit HIV‑1 infection. In this laboratory study, researchers evaluated palmitic acid (from Sargassum fusiforme, a type of seaweed that grows off the coasts of Japan and China) to see if palmitic acid reduced the ability of HIV‑1 viruses to enter CD4+ T‑cells (white blood cells that are HIV‑1's main target).

Citing study results in mice, researchers at the Northwestern University Feinberg School of Medicine reported for the first time that the form of vitamin E found primarily in food (gamma‑tocopherol) increased lung inflammation in induced asthma, while the form of vitamin E found primarily in dietary supplements (alpha‑tocopherol) reduced inflammation. The study, supported in part by NCCAM and published in the Journal of Immunology, has implications for understanding why asthma rates have increased during the last 40 years.

Transcutaneous electric acupoint stimulation (TEAS), a form of acupuncture that uses skin electrodes to apply electrical stimulation at different points on the body, may help people addicted to opioid drugs, according to researchers at Harvard Medical School and McLean Hospital near Boston. The study, supported in part by NCCAM and published in the Journal of Substance Abuse Treatment, also suggests that combining this technique with prescribed drugs that ease withdrawal symptoms may improve other outcomes for people addicted to opioids.

An investigation on how aromatherapy affects health failed to show any improvement in immune status, wound healing, or pain control among people exposed to two scents. But results of the randomized controlled trial, published in the journal Psychoneuroendocrinology, did show that lemon (considered to be a stimulant) appeared to enhance mood, while lavender (thought to be a relaxant) had no effect on mood.

A popular dietary supplement and a curry spice may affect Alzheimer's disease–related chemical processes in the brain, according to a study reported in The Journal of Neuroscience. Alzheimer's disease is the most common form of dementia in older people. This study, which used an animal (mouse) model of Alzheimer's disease, builds on previous research linking the disease to peptides (amino acid chains) called β‑amyloids and to defective insulin-processing by the brain. A particular β‑amyloid, Aβ‑42, is associated with Alzheimer's disease. There is also epidemiological evidence—type II diabetes appears to increase the risk of Alzheimer's disease—to suggest a connection between insulin resistance and the disease.

Results of laboratory research are the first to indicate that extracts of the herb black cohosh (Actaea racemosa) may stimulate bone formation, according to a study published in the journal Bone. Although results from the study suggest that black cohosh may have potential implications for the prevention or treatment of postmenopausal bone loss, there is no evidence yet that this laboratory research can be extended to treatments in people.

A better understanding of the brain mechanisms behind the placebo effect may help clinicians maximize people's health beyond the power of positive thinking, according to an article published in the journal Brain. The placebo effect is a beneficial health outcome resulting from a person's anticipation that an intervention—pill, procedure, or injection, for example—will help them. A clinician's style in interacting with patients also may bring about a positive response that is independent of any specific treatment.

Add a widget/button to your Web site or to your local social network profile. Four out of 10 adults in the U.S. use some form of complementary and alternative medicine (CAM). Help spread the news that it's important for patients and health care providers to discuss the use of CAM.

According to a recent analysis of the 2002 National Health Interview Survey, approximately 6 percent of U.S. adults used complementary and alternative medicine (CAM) to treat their back pain during the previous year. The data from this analysis, published in the Journal of the American Board of Family Medicine, also revealed that a majority (60 percent) of survey respondents who used the most common CAM therapies for back pain perceived "a great deal" of benefit.

The National Center for Complementary and Alternative Medicine (NCCAM) brings you a new issue of the newsletter Complementary and Alternative Medicine: Focus on Research and Care, at http://nccam.nih.gov/news/newsletter/2010_may/. Among the stories we are featuring:

• Natural products are the among the most popular CAM approaches used by Americans. What does the science say so far about three—fish oil, cranberry, and probiotics?
• An NCCAM staff member who specializes in medicinal uses of plants shares his perspective.
• Do antixodants help counter "free radicals" and "oxidative stress? Find out what the science says about these substances found in foods and supplements.
• One of NCCAM's first large clinical trials sheds light on health issues in older adults and on conducting research on supplements.
• Dr. Briggs discusses NCCAM's strategy for researching natural products.

In addition to this newsletter, you can subscribe to the "NCCAM Update" eBulletin, now published twice per month. To learn more about subscriptions NCCAM offers, visit http://nccam.nih.gov/news/subscribe.htm.

We appreciate your continuing interest in NCCAM.

American ginseng (Panax quinquefolius) extract caused laboratory cultures of colorectal cancer cells to die, indicating that the herb may have an anti-cancer effect, according to a study published in the journal Cancer Letters. Although results from the study suggest that combining ginseng with antioxidants such as vitamin C may potentially enhance this effect, there is no evidence yet that this laboratory research can be extended to treatments in people.

People with heart failure may benefit from practicing tai chi, according to research supported in part by NCCAM and published in the journal Sleep Medicine. Because patients with chronic heart failure often experience insomnia and impaired breathing during sleep—which could further impair heart function and lead to potentially dangerous heart rhythm disturbances—improving sleep and sleep breathing is an important goal.

A form of vitamin E (gamma-tocopherol) commonly found in foods may be a useful additional treatment for asthma, according to preliminary research. Because of its antioxidant properties, vitamin E has been thought to have potential therapeutic benefits for people with asthma. However, there have been discrepancies in benefits reported for dietary vs. supplemental vitamin E, possibly because the gamma-tocopherol form of the vitamin is often found in food, whereas most supplements contain another form (alpha-tocopherol).

A physicians response to a patient with low-back pain (LBP) should take into account psychological and social factors as well as physical symptoms, according to an article published in The Journal of Family Practice. The article looks at two case studies in light of evidence-based clinical guidelines developed by Roger Chou et al. for the American Pain Society and the American College of Physicians. The articles authors, whose work was funded in part by NCCAM, recommend a measured approach to the use of imaging (x-rays and MRI/CT scans) and medication.

Repeating a mantram (also known as a mantra—the practice of silently focusing on a spiritual word or phrase frequently throughout the day)—may help HIV-positive individuals develop coping skills and reduce anger, according to a study published in the International Journal of Behavioral Medicine. NCCAM-funded researchers from the Veterans Affairs San Diego Healthcare System and University of California, San Francisco, analyzed the effects of a group-based mantram training program, based on data from a study involving 93 HIV-positive individuals.

Recent studies have shown that use of herbal dietary supplements—chamomile, echinacea, garlic, ginkgo biloba, and ginseng—by the elderly within the United States has increased substantially. Sellers, such as retail stores, Web sites, and distributors, often claim these supplements help improve memory, circulation, and other bodily functions. GAO was asked to determine (1) whether sellers of herbal dietary supplements are using deceptive or questionable marketing practices and (2) whether selected herbal dietary supplements are contaminated with harmful substances. To conduct this investigation, GAO investigated a nonrepresentative selection of 22 storefront and mail-order retailers of herbal dietary supplements. Posing as elderly consumers, GAO investigators asked sales staff (by phone and in person) at each retailer a series of questions regarding herbal dietary supplements. GAO also reviewed written marketing language used on approximately 30 retail Web sites. Claims were evaluated against recognized scientific research published by the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). GAO also had an accredited lab test 40 unique popular single-ingredient herbal dietary supplements for the presence of lead, arsenic, mercury, cadmium, organichlorine pesticides, and organophosphorous pesticides.

Researchers at the University of Maryland, Baltimore, used a roundworm that has some genetic and biochemical similarities to humans to examine complex herbal preparations thought to combat adverse effects of aging. The worms, called Caenorhabditis elegans, or C. elegans, have a brief life span (about 20 days). In an NCCAM-funded study, researchers assessed two traditional Chinese multiherbal formulas—Huo Luo Xiao Ling Dan (HLXL), taken for chronic inflammatory pain (e.g., joint pain from arthritis); and Shi Quan Da Bu Tang (SQDB), taken to reduce fatigue and improve general wellness. They found that cinnamon bark, a component of both formulas, increased the worms' life span.

New findings from the Ginkgo Evaluation of Memory (GEM) study show that the herbal supplement Ginkgo biloba did not prevent heart attack, stroke, or death in a group of older adults. However, the herb may reduce the risk of developing peripheral arterial disease (also known as peripheral vascular disease), a painful and potentially life-threatening condition affecting blood circulation in the legs, arms, stomach, and kidneys.

As part of its strategic planning process, NCCAM is seeking broad input from many communities, including researchers, health care providers, CAM providers, educators, and the public.

We are currently seeking comments on two white papers that address two critical areas of NCCAM's research. Comments will be accepted through Friday, May 28, 2010

The National Advisory Council for Complementary and Alternative Medicine (NACCAM) will meet on June 3–4, 2010 in Rockville, MD. The first day of the meeting will examine the potential role of CAM in health behavior research. Current strategies to promote healthy behaviors and behavior change are often inadequate. The literature indicates that CAM approaches are widely used as part of the publics search for health and wellness, yet little is understood about their efficacy and mechanism of action. The association between CAM use and healthy behavior, models and predictors of behavior change, neural mechanisms of behavior change, and behavior change research methodology will be discussed. The discussion at this meeting will inform NCCAM as it considers a research agenda for behavior change and healthy behavior.

The second day of the meeting will include a presentation on stress and health and an update on NCCAMs strategic plan for the next five years.

Participants in a workshop sponsored by the National Institutes of Health have developed guidelines on designing and evaluating clinical research studies investigating soy, representing the first guidelines of their kind in the field of soy research. The guidelines are published in the June 2010 issue of The Journal of Nutrition.

These innovative guidelines are an important tool for increasing the consistency of study design and validity of outcomes in future clinical research on soy. NIH has supported research on soy in its many forms for a variety of outcomes.

Recent research has shown that women who practice hatha yoga (a common type of yoga involving body postures, breath control, and meditation) regularly recover from stress faster than women who are considered yoga "novices." The research, supported in part by NCCAM and published in the journal Psychosomatic Medicine, also showed that yoga may boost the mood of both yoga experts and novices.

An analysis of insurance records in Washington State—which requires private insurers to cover certain complementary and alternative medicine (CAM) practices—showed that more than a quarter of cancer patients visited CAM providers during their cancer treatment. The NCCAM-funded analysis, published in The American Journal of Managed Care, also indicated that related CAM expenditures accounted for 1 percent or less of all treatment costs.

A recent study found that Transcendental Meditation (TM) helped college students decrease psychological distress and increase coping ability. For a group of students at high risk for developing hypertension, these changes also were associated with decreases in blood pressure. This could be good news for the many students experiencing academic, financial, and social pressures that can lead to psychological distress—especially in light of evidence that college-age people with even slightly elevated blood pressure are three times more likely to develop hypertension within 30 years.

As part of its strategic planning process, NCCAM is seeking broad input from many communities, including researchers, health care providers, CAM providers, educators, and the public.

We are currently seeking comments on two white papers that address two critical areas of NCCAM's research. Comments will be accepted through Monday, May 24, 2010

• Principles Guiding CAM Natural Product Research and Development
• Better Strategies for Management of Back Pain

An estimated 46 million adults in the U.S. have been diagnosed with arthritis, according to a national survey. Common symptoms include pain, aching, stiffness, and swelling in or around the joints. Over time, a swollen joint can become severely damaged. Some kinds of arthritis can also cause problems in organs, such as the eyes or skin.

NCCAM supports studies on arthritis. Some people with arthritis may try complementary and alternative medicine (CAM) therapies, including dietary supplements. If you are considering using CAM therapies, talk to your health care providers to ensure safe and coordinated care.

Clinical trial data indicate that supportive interactions with health care providers can benefit patients and may be especially helpful for people who tend to be reclusive (keep to themselves). In a trial funded in part by NCCAM and published in Social Science & Medicine, participants with irritable bowel syndrome (IBS) who received placebo (simulated) acupuncture had some improvement in symptoms, but those who also received support from the acupuncture practitioner experienced even greater improvement.

Witness appearing before the House Subcommittee on Labor-HHS-Education Appropriations (April 28, 2010)

Josephine P. Briggs, M.D., Director
National Center for Complementary and Alternative Medicine

Mr. Chairman and Members of the Committee:

I am pleased to present the President's Fiscal Year (FY) 2011 Budget request for the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health. The FY 2011 budget includes $132,004,000, which is $3,213,000 more than the comparable FY 2010 appropriation of $128,791,000.

As a Lead Administrative Officer, you will serve as a key advisor to the senior staff. You will provide financial and budget management services by coordinating the continuous management of several Labs/Offices/Divisions and Branch budgets. You will coordinate personnel and position management services by managing associated activities, and protecting and ensuring confidentiality. You will participate in a cooperative effort to accomplish the goals of the Labs/Offices/Divisions, and the Center, by maintaining an ongoing and effective relationship with the supervisor and other NCCAM staff for the betterment of administrative systems and process. You will also manage acquisition activities and be responsible for planning, directing, and implementing the work of the Labs/Offices/Division's purchasing. In addition, you will lead an administrative team, and ensure the organization's strategic plan is integrated into the team's strategies, goals, objectives, work plans, work products and services.

As a Program Analyst, you will design and implement systems and conduct analyses for OCRA-related tasks for project oversight and monitoring for the NCCAM clinical studies portfolio. You will develop reviews of research topics that are the focus of new applications considered for funding. You will develop scientific materials to be used as background and preparatory materials for conferences, workshops, and planning group meetings. You will provide assistance for information from other NCCAM and NIH offices and outside organizations and agencies. You will work with the Director, OCRA and Health Scientist Administrators (HSAs) in the oversight of clinical project applications, grants and contracts portfolios.

Recent research, supported in part by NCCAM, suggests that the herbs black cohosh (Cimicifuga racemosa) and red clover (Trifolium pretense) are no better than placebo in treating the hot flashes and night sweats that often accompany menopause. The findings were published in the journal Menopause.

Researchers from the University of Illinois at Chicago College of Medicine and Northwestern University Feinberg School of Medicine tested the herbs in women experiencing at least 35 episodes of hot flashes and night sweats per week. Although conventional menopausal hormone therapy can effectively manage these symptoms, health concerns related to such care have increased interest in alternative treatments.

Recently, I hosted two meetings with groups that represent disparate views of CAM research. These meetings have given me a renewed appreciation for the value of listening to differing voices and perspectives about the work we do.

My NCCAM colleagues and I know there are differing views of the value of doing CAM research. On one side, we have stakeholders who are staunch CAM advocates, and on the other side, we have CAM skeptics.

Each group has its own beliefs and opinions on the direction, importance, and value of the work that NCCAM funds. The advocates would like to see more research dollars supporting various CAM approaches while the skeptics see our research investment as giving undue credibility to unfeasible CAM modalities and want less research funding.

Many people take dietary supplements in an effort to be well and stay healthy. With so many dietary supplements available and so many claims made about their health benefits, how can a consumer decide what's safe and effective? This fact sheet provides a general overview of dietary supplements, discusses safety considerations, and suggests sources for additional information.

Previous research suggests that spinal manipulative therapy (SMT) may be helpful for various types of chronic headaches, including cervicogenic headache (CGH), which is associated with neck pain and dysfunction. In a recent randomized controlled trial, NCCAM-funded researchers from Western States Chiropractic College and other institutions evaluated the dose (number of treatments) and relative efficacy of SMT in a group of 80 patients with chronic CGH.

As a Scientific Program Analyst, you will work closely with NCCAM staff in providing guidance, advice, and assistance for policy, program planning, and evaluation. You will serve as the focal point within the Center for the initiation and conduct of evaluations of NCCAM activities. You will be responsible for updating and revising ongoing processes to identify research accomplishments and trends in support of the program planning, analysis, and evaluation functions of the Center. You will collaborate with NCCAM staff to create analytic databases for ongoing program evaluation of crosscutting issues. You will be responsible for coordinating or conducting in-depth analyses of significant issues or subject matter areas essential to science planning and the establishment of priorities.

Irritable bowel syndrome (IBS) is a problem that affects the large intestine. It can cause abdominal cramping, bloating, and a change in bowel habits. Some people with the disorder have constipation. Some have diarrhea. Some go back and forth between constipation and diarrhea. Although IBS can cause a great deal of discomfort, it does not harm the intestines.

IBS is a common disorder and happens more often in women than men. No one knows the exact cause of IBS. There is no specific test for IBS. However, your doctor may run tests to be sure you don't have other diseases. These tests may include stool sampling tests, blood tests, and x-rays. Your doctor may also do a test called a sigmoidoscopy or colonoscopy. Most people diagnosed with IBS can control their symptoms with diet, stress management, and medicine.

Most pregnant women experience low-back pain, which often is associated with sleep disturbance and can affect daily activities. Because of possible risks associated with many pain medications, pregnant women and their prenatal care providers often consider using complementary and alternative medicine (CAM) therapies, such as massage and spinal manipulation, for back pain. In a recent NCCAM-funded study, researchers at the University of North Texas investigated the effects of osteopathic manipulative treatment on back pain during the third trimester of pregnancy.

In this exploratory trial, 144 women in weeks 28–30 of pregnancy received usual obstetrical care only, usual care plus a systematic osteopathic manipulative treatment protocol provided by an osteopathic specialist, or usual care plus a sham treatment in which the specialist applied pressure with a nonfunctional ultrasound instrument. At each of seven 30-minute weekly sessions, researchers measured back-specific functioning (Roland-Morris Disability Questionnaire) and level of back pain (an 11-point scale). At the end of 7 weeks, back-specific functioning deteriorated significantly less in the osteopathic manipulative treatment group than in the other two groups. Average level of back pain decreased in the osteopathic manipulative treatment group, remained unchanged in the sham ultrasound group, and increased in the usual-care-only group; however, the between-group differences were not statistically significant.

The herbal dietary supplement Ginkgo biloba did not lower blood pressure (BP) or reduce the incidence of hypertension (high BP) in a large group of older men and women, according to research recently reported in the American Journal of Hypertension. Although preliminary studies in animals and humans have indicated that ginkgo might have antihypertensive effects, this research was the first to explore that possibility in a large, long-term, placebo-controlled clinical trial.

The research was part of the NCCAM-funded Ginkgo Evaluation of Memory (GEM) study. The 3,069 GEM participants took either 120 mg of ginkgo or an identical-appearing placebo twice daily. Researchers then monitored a variety of health status measures, focusing on cognitive decline and dementia but also looking at blood pressure and other aspects of aging. Participants' median age was 79 years; median followup was 6.1 years.

Last fall, President Obama visited the National Institutes of Health to discuss the impact of the American Recovery and Reinvestment Act. During his speech, the President made a comment that strongly resonated with me:

"Breakthroughs in medical research take far more than the occasional flash of brilliance, as important as that can be. Progress takes time; it takes hard work; it can be unpredictable; it can require a willingness to take risks and going down some blind alleys occasionally—figuring out what doesn't work is sometimes as important as figuring out what does—all of this needs the support of government." [emphasis mine]

I think this concept is often lost in our eagerness to find answers that will bring help to people suffering from disease.

Chronic, long-term sleep disorders affect millions of Americans each year. These disorders and the sleep deprivation they cause can interfere with work, driving, social activities, and overall quality of life, and can have serious health implications.

In 2002 and 2007, the National Health Interview Survey (NHIS) asked Americans about use of complementary and alternative medicine (CAM). Among respondents with insomnia, 4.5 percent (which translates to a total of 1.6 million U.S. adults) used some form of CAM to treat their condition—primarily biological/herbal therapies or mind-body/relaxation therapies. Most found these therapies helpful.

NCCAM supports studies on sleep disorders. Some people with sleep problems may try CAM therapies, including dietary supplements. If you are considering using CAM therapies, talk to your health care providers to ensure safe and coordinated care.

No one looks forward to the cold and flu season. Americans catch an estimated 1 billion colds each year. In fact, the common cold is among the leading reasons for visiting a doctor and for missing school or work. The flu, with its potential complications, can be an even greater concern. Each year, an estimated 5 to 20 percent of Americans come down with the flu. Although most recover without incident, flu-related complications result in more than 200,000 hospitalizations and 36,000 deaths annually.

In an effort to prevent or treat these all-too-common illnesses, some people turn to complementary and alternative medicine (CAM) approaches. This fact sheet provides basic information on colds and flu, as well as "what the science says" about some of these CAM approaches. If you are considering using a CAM therapy for colds or flu, this information can help you talk to your health care provider about it.

The National Center for Complementary and Alternative Medicine (NCCAM) welcomes five new members to the National Advisory Council for Complementary and Alternative Medicine (NACCAM). The council serves as the principal advisory body to NCCAM, the lead Federal agency for complementary and alternative medicine (CAM) research, and a component of the National Institutes of Health.

The council is composed of physicians, scientists, licensed CAM practitioners, and members of the public who contribute their time and expertise over a four-year term. Members meet three times per year, offering advice and recommendations on prioritization, conduct, and support of CAM research, including research training and communication of evidence-based health information.

Update: Due to the impending major snowstorm predicted for the mid-Atlantic region on Friday, the agenda for the February 5, 2010, meeting of the National Advisory Council for Complementary and Alternative Medicine will be shortened.

Those who wish to provide public comments must be present at the meeting. For updates, please visit http://nccam.nih.gov/ or call 301.594.9632.

NCCAM distributes its resources among many programs and mechanisms. The Center is committed to funding the largest number of meritorious projects possible, while allowing the flexibility needed to support selected program priorities and to respond to emerging scientific opportunities.

The Center establishes general guidelines for funding based on the overall NCCAM appropriation, allowing for necessary adjustments throughout the year to reflect directives from Congress, the Department of Health and Human Services, and the National Institutes of Health (NIH), as well as emerging program priorities.

President Obama released his budget for Fiscal Year 2011 on February 1. NCCAMs Congressional Justification for Fiscal Year 2011 was also released that day. The document outlines our plans and priorities, provides details of our budget, and notes our legislative history.

February is National Wise Health Consumer Month. Please take time this month to view our resources on complementary and alternative medicine (CAM) and being an informed consumer. By being aware of issues to consider and questions to ask, you're well on your way to being a wise consumer!

Within the last month, NCCAM has published 4 new Funding Opportunity Announcements related to the American Recovery and Reinvestment Act (ARRA). Also, there are several new NIH Notices announcing availability of funds for competitive revision applications and administrative supplements.

Emmeline Edwards, Ph.D., a specialist in neural mechanisms of complex behaviors, has been appointed director of the Division of Extramural Research at the National Center for Complementary and Alternative Medicine (NCCAM), a component of the National Institutes of Health.

The Division of Extramural Research develops and oversees NCCAM-funded research and research training programs. Division staff provide guidance regarding NCCAM research interests and priorities, and funding mechanisms and opportunities. The Division also coordinates research efforts with other NIH Institutes and Centers.

"We are pleased to have Dr. Edwards join in our mission to research complementary and alternative medicine using the highest possible standards," said Josephine P. Briggs, M.D., NCCAM Director. "Her background and her proven expertise in the oversight of basic and applied research will prove invaluable to NCCAM."

Knee osteoarthritis (OA) is an increasing problem among older adults, causing pain, functional limitations, and reduced quality of life. The traditional Chinese practice of tai chi, with its combination of physical and mental components, seems promising for OA patients; however, scientific evidence to support its use for this purpose has been limited. To strengthen the evidence base on this topic, NCCAM-funded researchers at Tufts Medical Center recently conducted a long-term, randomized, controlled trial comparing tai chi and conventional exercise in a group of 40 adults (mean age 65) with symptomatic knee OA.

As we welcome the New Year and a new decade, I'm mindful that we have just ended NCCAM's 10th anniversary. For us, it has been a decade of growth, progress, and promise.

As we begin this new decade, we are developing our third strategic plan, which will provide guidance for our future scientific direction, priority setting, and advancement of the organization. We have gained invaluable knowledge from our first decade, which is providing the strong base from which we will continue to build. I look forward to the future as we continue our 2010 strategic planning process and beyond as we work to fulfill the scientific mission of NCCAM.

The National Advisory Council for Complementary and Alternative Medicine (NACCAM) is charged with the responsibility of advising, consulting with, and making recommendations to the Director, NCCAM, on matters relating to the research activities and functions of the Center. The role and responsibilities of the council members include secondary review of grant applications in light of NCCAM scientific program priorities and program balance.

The agenda for the upcoming February meeting is posted for your review.

For many older adults, cognitive health and performance remain stable over the course of their lifetime, with only a gradual and slight decline in short-term memory and reaction times. But for others, this normal, age-related decline in cognitive function progresses into a more serious state of cognitive impairment or into various forms of dementia, including Alzheimer's disease. Such loss of cognitive function—the ability to think, learn, remember, and reason—substantially interferes with everyday function. As researchers continue to explore changes in the brain that take place possibly decades before cognitive decline and dementia symptoms appear, they also hope to discover more about the relationship between normal age-related cognitive decline and the development of cognitive impairment or Alzheimer's disease.

The Texas Department of State Health Services is warning consumers, especially pregnant or breastfeeding women, to avoid consuming a traditional product called Nzu because of the potential health risks from high levels of lead and arsenic.

Although the herb Ginkgo biloba is widely marketed and used to improve cognitive health in aging, adequate scientific evidence of its effect on long-term cognitive functioning has been lacking. In a recent study, NCCAM-funded researchers analyzed data from the Ginkgo Evaluation of Memory (GEM) study to determine ginkgo's effect on cognitive health in older adults.

Atlas Operations, Inc. Recalls Many Sexual Enhancement Products (FDA; 12/15/2009)

Atlas Operations, Inc. and FDA notified consumers of a nationwide recall of the company's dietary supplements for sexual enhancement. These products are currently being sold as dietary supplements throughout the United States. FDA lab analyses found that the products tested from certain batches contain Sulfoaildenafil, an analogue of Sildenafil, an FDA-approved drug used as treatment for male Erectile Dysfunction (ED), making these products unapproved drugs. The active drug ingredient is not listed on the product labels.

Oh, my aching back! I am sure you have all heard this from a family member—or said it yourself.

In previous messages, I've mentioned the high use of complementary and alternative medicine (CAM) for treating back pain. Back pain is a very common and bothersome symptom; it is a symptom that really matters and a major health burden in the United States. It is the leading cause of work-related disability and missed days of work, the fifth-most-common reason for physician visits, and a leading factor in health care costs.

Although progress has been made in the global fight against HIV/AIDS, the epidemic continues to devastate the United States and the international community with 56,300 new HIV infections each year in the U.S. and an estimated 33 million people living with HIV worldwide.

NCCAM supports studies on HIV/AIDS and related complications. Those considering using CAM therapies should talk to their health care providers to ensure safe and coordinated care.

The National Center for Complementary and Alternative Medicine (NCCAM) will celebrate a decade of rigorous research with NCCAM's 10th Anniversary Research Symposium: Exploring the Science of Complementary and Alternative Medicine. Speakers will discuss topics including natural products, mind-body medicine, and the intersection of behavioral science and integrative medicine. People have used some CAM therapies since ancient times and often with little scientific evidence.

Urinary Tract Conditions: Examining the Evidence on Cranberry and Saw Palmetto
Patients with urinary tract infections often ask health care providers about using complementary and alternative medicine to relieve symptoms or prevent recurrences.

Also Featuring: NCCAM's 1st Decade of Discovery and Achievement; An Interview With Wendy Weber, N.D., Ph.D., M.P.H.; North American Research Conference on CAM/Integrative Medicine; New Survey Details Americans' Spending on CAM; and other stories

Take our Reader Survey at http://nccam.nih.gov/news/newsletter/survey.html?nav=rss

GMP Herbal Products and FDA notified consumers and healthcare professionals of a recall of Pai You Guo, a weight loss dietary supplement, due to the presence of undeclared drug ingredients. FDA lab analyses of dietary supplements were found to contain undeclared sibutramine, an FDA-approved drug used as an appetite suppressant for weight loss; and phenolphthalein, a solution used in chemical experiments and a suspected cancer-causing agent that is not approved for marketing in the United States. The FDA has not approved the Pai You Guo products as a drug; therefore the safety and effectiveness of this product is unknown. The product is sold either in a box of 30 capsules or a bag of 10 g powder. The affected products were sold and distributed nationwide via the internet.

IDS Sports announced today that it is conducting a voluntary nationwide recall of five of the companys dietary supplement products sold under the following names: Bromodrol, Dual Action Grow Tabs, Grow Tabs, Mass Tabs, and Ripped Tabs TR.

People with pre-diabetes have higher than normal levels of blood glucose, a form of sugar the body uses for energy. Pre-diabetes, also called impaired fasting glucose or impaired glucose tolerance, can lead to type 2 diabetes, heart disease, and stroke. Preventive measures include weight loss, behavior modification, and glucose-lowering drugs. In China and other Asian countries, Chinese herbal medicines have long been used to prevent or delay the onset of diabetes, and there is anecdotal evidence regarding efficacy for this purpose. A recent review, funded in part by NCCAM, examined related clinical trials to see whether scientific evidence supports recommending Chinese herbal medicine as a treatment option for people with pre-diabetes.

Bodybuilding.com and FDA notified healthcare professionals and patients of a nationwide and international recall of all lots and expiration dates of 65 dietary supplement products that were sold through the Company's website, www.bodybuilding.com.

FDA believes that the recalled products contain the following ingredients that are currently classified, or the FDA believes should be classified, as steroids: "Superdrol," "Madol," "Tren," "Androstenedione," and/or "Turinabol." Acute liver injury is known to be a possible harmful effect of using steroid-containing products. In addition, steroids may cause other serious long-term adverse health consequences in men, women, and children. These include shrinkage of the testes and male infertility, masculinization of women, breast enlargement in males, short stature in children, a higher predilection to misuse other drugs and alcohol, adverse effects on blood lipid levels, and increased risk of heart attack, stroke, and death.

Although acupuncture has long been used to treat pain, the underlying cellular and molecular mechanisms are not fully understood. The process appears to involve the brain's ability to produce opioids (pain-reducing chemicals) that bind to neurons in distinct regions of the brain, and the ability of neurons to produce receptors for these endogenous opioids—specifically, mu-opioid receptors (MORs). Recent clinical trials have indicated that both traditional (actual) and simulated (sham/placebo) acupuncture decrease pain, but other studies have suggested that the neural mechanisms involved may be different.

Alzheimer's disease (AD) is an irreversible, progressive brain disease that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks of daily living. Among older people, AD is the most common cause of dementia (a decline in cognitive function that interferes with daily life and activities). However, AD is not a normal part of aging. Although treatment can slow the progression of AD and help manage its symptoms in some people, currently there is no cure for this devastating disease. Scientists are learning more every day, but right now, they still do not know what causes Alzheimer's disease.

NCCAM supports studies on Alzheimer's and diseases and conditions related to aging. In one recent NCCAM-funded study, it was found that 240 milligrams per day of the dietary supplement Ginkgo biloba was ineffective in reducing the development of dementia and Alzheimer's disease in older people. Those considering using CAM therapies, should talk to their health care providers to ensure safe and coordinated care.

As we are all aware, flu season is upon us. In a typical year, approximately 5 to 20 percent of the population gets the seasonal flu and approximately 36,000 flu-related deaths are reported. This year, we are faced with not only the seasonal flu, but also the novel H1N1 flu virus. This additional virus may cause a more dangerous flu season with more people getting sick, being hospitalized and dying than during a regular flu season. Like seasonal flu, illness in people with H1N1 can vary from mild to severe.

NCCAM is now seeking stakeholder comments on three "big picture" topics:

• Mission
• Priority setting
• Information and communication

Comments will be accepted through November 19, 2009. More »