Alternative & Integrative Health Archive

There is no evidence that so-called "bioidentical" alternatives to prescription hormones are either safe or effective.

Over the past couple of years, science has validated what many women already know: hot flashes and other symptoms of menopause can persist long after menstrual periods stop. It's also well established that estrogen—alone or combined with a progestin—is the most reliable treatment for menopausal symptoms and that, for most postmenopausal women, it is safe to take these hormones for up to five years at doses that relieve hot flashes.

But in 2002 the Women's Health Initiative reported that Prempro—an FDA-approved preparation combining synthetic estrogens with a progestin—increased the risk of cardiovascular disease and breast cancer. Since then, women have shied away from pharmaceutical companies' hormones. A third of women who use hormones for relief of menopausal symptoms are now choosing custom-mixed preparations from compounding pharmacies, according to research sponsored by the North American Menopause Society (NAMS). Women surveyed by NAMS commonly said they believed "natural" or "bioidentical" hormones from compounding pharmacies to be safer than the available FDA-approved hormones.

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For many conditions, this "alternative" treatment may be just as effective as—and may cause fewer side effects than—pain medication.

If you have chronic pain and are wondering how to avoid the potential side effects associated with long-term use of pain medications, you may want to consider an alternative—acupuncture. Since the technique was introduced in the United States in the 1970s, it has moved from alternative to mainstream medicine. Today, Harvard Medical School and other leading institutions offer courses in acupuncture for physicians, several professional societies certify acupuncturists, and two to three million Americans visit an acupuncturist every year.

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Ask the doctor

Q. I have difficulty falling asleep, and melatonin has not worked. I want to avoid medications and I have read magnesium supplements can help. Should I try them?

A. Magnesium is an important element in many biological functions, including nerve and muscle function, so it is often proposed as a natural treatment. It has gained some acceptance as a preventive treatment for migraine headaches, but there is not strong scientific evidence for its use with insomnia.

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The meditative practice is being used for everything from boosting happiness to treating high blood pressure.

Mindfulness, which trains you to focus your mind on the present moment, is more than a popular meditation technique. It's been shown to help treat depression and anxiety and improve sleep quality. And it's now being studied as a complementary therapy for cancer, stroke, multiple sclerosis, and pain. "We're seeing an exponential increase in doctors embracing mindfulness as a treatment," says Dr. Ronald Siegel, assistant professor of psychology at Harvard Medical School and faculty editor of the Harvard Special Health Report Positive Psychology.

Many people practice meditation in hopes of staving off stress and its related health problems, including heart disease. While some studies of meditation haven't been the most scientifically rigorous, other research strongly suggests that this ancient, mind-calming practice can actually help lower blood pressure — and that it may offer other benefits for the entire cardiovascular system.

"The evidence that chronic stress is pretty toxic for the cardiovascular system is mounting," says Dr. Laura Kubzansky, a professor of social and behavior science at the Harvard T.H. Chan School of Public Health.

In the Journals

A study in The New England Journal of Medicine casts light on a little-known hazard associated with America's multibillion-dollar dietary supplement habit: difficulty swallowing among older people who take vitamin and mineral supplements—particularly calcium supplements.

Using a decade of records from 63 hospitals, researchers with the CDC and FDA estimated that 23,000 Americans end up in the emergency room because of bad reactions to dietary supplements. This includes herbal supplements and those containing vitamins, minerals, and other nutrients (such as amino acids).

Ask the doctor

Q. I find myself getting more and more anxious, but I don't like to take medications. Is there an alternative natural treatment I can try instead?

A. Anxiety is an incredibly common problem. Although there are many FDA-approved medications that have been widely studied and proved effective, studies show that up to 43% of patients with anxiety use alternative medicine to treat it. Among alternative therapies, herbal treatments are widely used both for therapeutic purposes and for comfort.

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Do you worry yourself awake frequently? Cognitive behavioral therapy can help.

If you have trouble getting to sleep and staying asleep, that's insomnia. It happens to everyone from time to time. But it can also become a chronic problem. For some men, fretting about whether they will be able to sleep—and the emotional upset of not being able to when they try—can itself become the root cause of insomnia.

In the journals

Dietary supplements containing the herbal ingredient yohimbe often contain prescription-strength active ingredients that are potentially dangerous, according to a study in Drug Testing and Analysis.

Scientists analyzed 49 popular brands of supplements with yohimbe. They found evidence that 39% of the products tested appeared to contain a pharmaceutical-grade extract of the herb.

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Research we're watching

An analysis published online Sept. 17, 2015, by the British Journal of Sports Medicine suggests that doing tai chi enhances the quality of life for people with common chronic conditions.

Researchers analyzed data from 33 studies involving nearly 1,600 adults. Most were in their 60s or 70s, and all had one or more chronic conditions: osteoarthritis, breast cancer, heart failure, or chronic obstructive pulmonary disease (COPD). All 290 participants in the breast cancer studies were women. There were 452 women (85% of participants) in the arthritis studies, 76 (16%) in the heart failure studies, and 92 (19%) in the COPD studies.