Natural and Alternative Treatments -
Are they Effective?

Hello, everyone! My name is Placeholder and I am a 3^rd year student studying Health Sciences at McMaster University. My passion lies in studying emerging medical technologies and the ways they can be used to improve human life.

My aim in The Biology Blog is to bring the world of medical and biological research to a more accessible place and help everyone learn about the ways it can be applied to their daily lives.

Today, I decided to write about alternative and complementary practices in medicine, which continue to be a topic of debate among many. Being from a Chinese background, alternative practices such as Traditional Chinese Medicine are common in my culture — but different practices are also common in the West and everywhere else in the world. These practices are seen by some to offer benefits outside of conventional treatment, but others doubt their effectiveness because of their differences from scientifically proven methods. As scientific research advances, will these alternative practices be considered outdated or will they still have a place in modern health?

Many individuals choose to use treatments outside of conventional medicine. As the names suggest, alternative treatments refer to those used in place of conventional medicine and complementary treatments refer to those used alongside it. These treatments may include traditional or herbal medicine developed from a variety of cultures such as traditional European or Chinese medicine.

The effectiveness of these treatments is often debated upon, with some supporters referencing positive outcomes after treatment while critics point out the lack of scientific evidence behind such practices. Some believe traditional and natural remedies to be safer and less invasive alternatives to conventional modern medicine, some choose to use complementary treatments alongside conventional medical treatment, and others look to alternative practices when conventional medicine is unable to help their conditions.

In today's blog post, we'll look into various practices used outside of conventional medical treatment from a scientific perspective and deciding — are these treatments effective and safe alternatives to conventional medicine? In particular, we will be looking into the practices of naturopathy, homeopathy, manipulative therapies, and herbalism, which are commonly used forms of alternative and complementary medicine in the west.

Naturopathy originates from traditional European medical practices that were popular during the 19^th century. It focuses on the use of natural remedies to leverage the body's natural healing process. Licensed naturopathic doctors are not medical doctors but do undergo 4 years of professional training in naturopathy and have experience in health-related sciences, nutrition, and psychology.

Naturopathy may incorporate and encourage a wide range of practices, including:

• Usage of herbal medications and dietary supplements
• Councelling on dietary and lifestyle changes
• Homeopathy — a form of alternative medicine based on the principle "like cures like"
• Manipulative therapies — where the physician applies massage and pressure
• Acupuncture — based on the traditional Chinese practice
• Detoxification — ridding the body of toxins through diet choices and use of herbs
• Psychotherapy

The main principle of naturopathy is to aid in the body's natural healing process while avoiding treatments with adverse side effects. Naturopathy focuses on identifying and resolving underlying causes of diseases rather than simply relieving their symptoms. Compared to conventional medical doctors, naturopaths take a more holistic and personal approach to health, emphasizing the health of the entire individual rather than that of a particular organ or system and educating patients on lifestyle choices to boost overall health and prevent future illness.

Many naturopathic treatments involve diet changes, most of which are healthy. However, recommendations may sometimes be unnecessary such as recommending a gluten free diet when it is not needed. In some cases, dietary restrictions may result in nutritional deficiencies. Naturopathy is generally safe, but since it is not heavily regulated like conventional healthcare, its safety is not guaranteed.

If one chooses to use naturopathy, it is recommended to use it alongside conventional medicine and should not be considered an alternative. Although not well studied scientifically, it may promote long-term health and can help patients who are not obtaining relief from conventional medicine.

Homeopathy was developed in the 18^th century by German physician Samuel Hahnemann, becoming popular among European countries and eventually spreading to North America. It is a form of traditional medicine that follows the principle of "like cures like". Herbs that create similar symptoms in healthy people are said to stimulate natural healing and are administered in diluted quantities.

Homeopathy believes that the more diluted the medication, the greater its potency. However, this belief runs against scientific patterns, which predict that higher dosages should result in more pronounced effects. Active ingredients are often diluted in water or alcohol in fixed proportions and run through the same dilution process several times. In fact, some homeopathic treatments are diluted enough to only contain several molecules of the original substance or even no active ingredient at all! Homeopathic potency levels are often written as nX or nC, representing a concentration level of 1/10ⁿ and 1/100ⁿ, respectively. For example, a potency level of 4C means a solution of 1 part of active ingredient per 100⁴ = 100,000,000 parts of the solution.

Homeopathy may be used in attempting to treat minor issues such as nausea or colds. However, there is little scientific evidence of its actual effectiveness, especially with the extremely low concentration of active ingredient in its remedies. For example, a solution that is diluted enough to contain only water should not have any effect at all. Positive effects of homeopathy can often be attributed to the placebo effect — in which the patient who uses the medication feels better due to the psychological effect coming from the belief that the treatment will work. The safety of homeopathic treatments can range, with some homeopathic medications containing harmless substances such as commonly consumed foods and others containing potentially harmful substances such as toxic heavy metals.

Chiropractic therapy is a form of manipulative therapy in which a chiropractor induces spinal manipulations on a patient to treat joint-related pain conditions. Manipulations on the spine and other joints aim to maintain proper joint alignment, which impacts the surrounding muscular and nervous systems that attach to it. Chiropractors are licensed and undergo 4 years of professional training, but are not medical doctors and cannot prescribe medications. Similarly to many non-conventional treatments, chiropractic therapy takes a holistic approach that focuses on the health of the body as a whole.

Chiropractic therapy offers an alternative to medical treatment for pain, particularly that associated with the spine and neck. A study published in 2018 showed spinal manipulations to be effective for neck pain by increasing the level of pain-relieving hormones such as oxytocin, neurotensin, and orexin-A.

Because it is not practiced by conventional doctors, chiropractic therapy is considered by some to be a pseudoscience. However, unlike many other alternative practices such as homeopathy, it is widely accepted by the majority of medical physicians and is often recommended for use alongside conventional medicine as a complementary treatment.

Many patients are often also concerned about the safety of chiropractic treatment. It is for the most part considered safe, but like all treatments, there are risks. Treatment may entail several side effects, including temporary muscle soreness, stiffness, and increased pain. More serious complications are also possible but rare, including:

• Cervical artery dissections — tearing in neck arteries, which can lead to stroke
• Cauda equina syndrome — deterioration of lower spinal cord function
• Spinal disk problems and fractures

Chiropractors can also offer services such as soft tissue therapy, exercise and nutrition counseling, postural testing and analysis, ultrasound, electronic stimulation, and low-level laser therapy.

Osteopathy is a type of medical care that focuses on the physical manipulation of the tissues, muscles, and bones to treat illnesses. At a glance, osteopathy appears to be described similarly to chiropractic therapy. They both focus on the use of manipulative therapy to treat pain-related conditions and are holistic approaches to the health of the whole body. They are both commonly used complementary treatments that focus on natural healing over the use of surgery and medications. However, osteopathy has several key differences compared to chiropractic therapy.

In terms of qualifications, osteopaths are considered medical doctors and are qualified to prescribe medications or recommend surgeries. They undergo 4 years of medical school and additional residency to become Doctors of Osteopathic Medicine, with a greater focus on the musculoskeletal system compared to other doctors.

Compared to chiropractors, osteopaths focus more on soft tissues and muscles. They may also look at more generic issues such as colds or digestion issues, whereas chiropractors would focus on spinal alignment and joint pain.

Naturopathy often encourages the use of herbs as treatment for illnesses and as dietary supplements. The following are examples of herbs used in naturopathy, their uses, and the scientific research around their effects:

Stinging nettle originates from the plant Urtica dioica and is consumed as extracts in herbal medicine. The raw version of the plant can cause skin irritation and is often used as a counterirritant to counteract pain. For most other uses, it is cooked to remove its irritative effects. It is also said to be effective for treating infections, inflammation, allergic rhinitis, asthma, arthritis, high blood pressure, and diabetes. However, there are insufficient large-scale clinical trials to provide decisive evidence of these effects.

Stinging nettle has been theorized to have the following therapeutic effects, although more research is required to confirm their efficacy:

• Reducing the effects of enlarged prostate in men by blocking the synthesis of hormones such as dihydrotestosterone
• Reducing inflammation by blocking histamine receptors, which is also effective against allergic rhinitis
• Reducing the effects of high blood pressure
• Produce vasodilators, which relax blood vessels
• Produce calcium channel blockers, which reduce the force of heart contractions
• Reducing blood sugar levels with compounds that mimic insulin

Stinging nettle may interact with other medications. For example, it can strengthen the effects of diuretics (medications that promote urination), which could result in dehydration. It can also react with blood thinners, blood pressure medication, and diabetes medication. In addition, stinging nettle should be avoided by pregnant women because it could result in contractions of the uterus that cause miscarriage.

St. John's Wort has traditionally been used to treat a variety of conditions such as depression, insomnia, kidney and lung problems, and wounds. Currently, it is primarily used for psychological disorders such as depression, ADHD, anxiety, and OCD. Clinically, it has shown a positive impact on depression compared to placebo treatments, but its effectiveness against other disorders is unknown. The active substance that achieves its antidepressive effect is debated upon, but possible candidates include hypericin, pseudohypericin, and hyperforin.

Consumers should be cautious when consuming St. John's Wort with other medications because it can alter the metabolism of pharmaceutical drugs by influencing drug transport proteins and enzymes. According to the National Library of Medicine, drug interactions involving this herb include those with birth control pills, transplant rejection agents, antiretroviral agents, heart medications, platelet inhibitors, anticoagulants, and a variety of other medications. Some interactions may reduce or increase the effects of other medications or even result in life-threatening effects. These include:

• Interaction with antidepressants and other serotonin-affecting drugs — can result in dangerous levels of serotonin production. Serotonin is a neurotransmitter and low levels are associated with depression
• May reduce the effectiveness of immunosuppressive medications, chemotherapy medications, cholesterol-lowering statins, etc.
• Interaction with contraceptive drugs — may cause bleeding and irregular birth patterns

Oregano leaves and flowers are sometimes used as a spice. In herbal medicine, oregano oils have traditionally been used to treat respiratory diseases and parasitic infections. Like many herbal medications, the biologically active ingredient is not fully known and is suspected to be carvacrol or thymol. In living and artificial environments outside of the human body, oregano oils have demonstrated several beneficial properties, including:

• Resistance to infections through antimicrobial, antifungal, and antiparasitic effects
• Antioxidant effects
• Antineoplastic effects

However, oregano oils are not an officially recognized treatment in modern medicine. They are generally considered safe, with side effects of higher doses such as abdominal discomfort, heartburn, constipation or diarrhea, nausea and vomiting, dizziness, and headache. Oregano oils should be avoided by pregnant women because they may result in miscarriage.

Many users of natural medicine believe herbal remedies to be safer and fewer in side effects than pharmaceutical drugs. However, this is not always the case. As long as there are active substances, there will be risks, regardless of whether the medications are pharmaceutical or herbal. In addition, herbal medications often interact with prescribed medications, over-the-counter medications, dietary supplements, and even food — herbs such as St. John's wort, as outlined above, have a variety of possible drug interactions.

Pharmaceutical drugs can also interact with other substances. However, whereas the effects and interactions of pharmaceutical medications are rigorously researched, those of herbs are often not as clearly studied and are usually theorized from indirect trials such as in animal or cellular studies. For those using herbal medications, it is important to consult between medical and naturopathic doctors to ensure that they work together to avoid potential drug interactions.

Many of us have often heard of the importance of antioxidants in a healthy diet and their benefits in preventing chronic illnesses such as cancer and heart disease. Naturopathic medicine often encourages the consumption of food containing antioxidants, which are found in a variety of herbs. But you might have been wondering: what are antioxidants and what do they do?

To understand the function of antioxidants, we must first understand the substances that they act against — free radicals. In most stable molecular substances, electrons are shared to fill the orbitals of each of the valance shells. Orbitals can contain up to 2 electrons, each with opposite spin values, which means that electrons are typically paired. However, free radicals are substances that can stably exist with unpaired electrons, many of which involve nitrogen and oxygen species. By lacking electrons, they have oxidative tendencies and are highly reactive, being able to alter lipids, proteins, and nucleic acids. A simple example of a free radical is nitrogen dioxide, as shown below, where nitrogen has a single unpaired electron due to the odd number of total valence electrons in the molecule.

Because they can react with nucleic acids and proteins, free radicals can damage the body's genetic information and cellular machinery and are linked to increasing the risk of diseases such as cancers and heart disease. Free radicals are produced by the body through normal metabolism and can also result from the body's exposure to chemical carcinogens (such as air pollution) and radiation (such as UV radiation).

Antioxidants are substances that reduce the oxidative effects of free radicals by donating electrons, without becoming free radicals themselves. Examples of antioxidants include B-carotene, vitamin C, and vitamin E, which are all substances that cannot be produced by the human body and must be consumed from food.

• Vitamin C is commonly found in most fruits and vegetables such as citrus fruits
• Vitamin E is found in high concentrations in sunflower seeds, almonds, hazelnuts, avocado, etc.
• B-carotene is commonly found in various vegetables such as carrots, lettuce, broccoli

So are treatments used outside of conventional medicine effective and safe? The answer depends on the type of treatment being used.

Some treatments such as chiropractic therapy and osteopathy show positive results in relieving patients of symptoms and pain and can reduce the need for medications with potential side effects. However, that does not make such manipulative therapies risk-free, as outlined earlier in this blog, and it is important for patients to understand them before treatment. These therapies are widely accepted by medical professionals.

On the other hand, practices such as homeopathy contradict modern science and should not be considered reliable treatments, even if they may not incur direct negative effects.

In general, natural and alternative remedies should not be considered substitutes for medical treatment, especially for serious conditions where a lack of effective treatment can be dangerous for the patient. However, with proper consultation with medical professionals, they can be safe complementary treatments to supplement conventional medical care. Mainstream medicine is considerably more well-researched, tested for safety, and proven for effectiveness and patients should not be discouraged from seeking conventional treatment by the more "natural" appeal of alternative practices.