Alternative & Integrative Health Archive

Almost everyone suffers from trouble sleeping at one time or another. Insomnia — defined as trouble falling asleep or staying asleep — isn't a single disorder itself, but rather a general symptom, like fever or pain.

Because insomnia is so common, you can walk into any drugstore and find a bewildering variety of over-the-counter sleep products. And people are buying them. One small survey of people ages 60 and over found that more than a quarter had taken nonprescription sleeping aids in the preceding year — and that one in 12 did so daily.

Q. Some of my friends take saw palmetto supplements to reduce urinary problems caused by an overgrown prostate, which I was recently diagnosed with. My friends swear by it, but is there any good evidence this stuff helps? Is saw palmetto safe?

A. The short answer is that we don't have great scientific evidence that taking saw palmetto truly reduces male urinary problems. On the other hand, it doesn't appear to cause major side effects either.

Q. Are there any benefits to taking vitamin E supplements? Or any risks?

Tap into your brain's circuitry to boost treatment for your health condition.

Wear sunscreen, and avoid direct exposure to the sun.

Physical therapy and weight loss can relieve knee pain and protect your mobility.

A large study reinforces the current thinking on hormone therapy after menopause: it doesn't shield women from heart disease and may slightly increase their risk of a stroke.

For decades, doctors believed that hormone therapy could prevent heart disease. But in 2002, findings from the landmark Women's Health Initiative revealed that long-term hormone use boosted heart attack, stroke, and breast cancer risk.

By Anne Fabiny, M.D., Editor in Chief

President Barack Obama recently announced the Precision Medicine Initiative, a new program to speed up discoveries based on information and technology stemming from the Human Genome Project. "Precision medicine" and "personalized medicine" are terms that describe health care tailored to an individual patient's genetic makeup, using information about a patient's genome to diagnose illness and design therapies to treat and cure disease. This approach has been described as "the medicine of the future."

However, it may be reassuring to know that although your doctor doesn't have your genome at hand, he or she is likely to be giving you personalized care as we understand it today.

For many people with rheumatoid arthritis, medication can help relieve symptoms and even limit joint damage. But nondrug approaches, such as physical and occupational therapy, are also essential to help reduce pain, improve range of motion, increase strength, and protect joints.

Specially trained clinicians can provide these nondrug treatments. Your primary care doctor or rheumatologist may refer you to a physiatrist, physical therapist, or occupational therapist, for example.

Q. I have developed bunions, making it impossible to wear most of my shoes without pain. Is there anything I can do to help the problem without undergoing surgery?

A. There are several things that can be done for bunions, which develop when the first metatarsal bone of the foot turns outward and the big toe points inward (toward the other toes), causing the joint to bulge outward. A podiatrist would be able to suggest ways to relieve your pain and prevent your bunions from getting worse. He or she will likely recommend different types of shoes, especially if you've been wearing shoes with pointed toes, high heels, or both. Podiatrists often prescribe custom-fitted padded inserts, known as orthotics, that are worn inside your shoes to help relieve pressure on your bunions. Surgery is usually a last resort, but your podiatrist will also be able to discuss the risks and benefits of different types of bunion surgery.