As for colloidal silver, you can't say you weren't warned

With cold and flu season arriving a bit earlier than usual this year, consumers may be tempted to try colloidal silver. They even may be tempted to try it in large doses. Here's some advice: Don't.

The substance is currently pitched as a flu fighter, among other things. Harumph. Not only is there no proof colloidal silver works in such a fashion, it's not the harmless tonic some would have you think.

We've said this before, of course, but Paul Karason drives the point home better than we ever could. The man turned blue (seriously) after taking large quantities of the substance, simply water laden with silver particles.

Here's the Today/MSNBC story (with photos -- worth seeing).

As for the "I told you so's":

In May: Scam 'cures' for swine flu face crackdown The FDA and FTC target peddlers of colloidal silver and other potentially harmful products. Tamiflu and Relenza are the only approved treatments.

In February: Does colloidal silver boost immunity or overall health? The metal is popular in alternative medicine circles, but claims are unproven and large doses can be harmful.

As that story notes: "Contrary to claims made by some websites, silver in large enough doses can cause side effects. In rare cases, it can collect under the skin and react with sunlight to create a permanent bluish tint, a condition known as argyria. Although unsightly, argyria is not dangerous."

And heck, in 2003: Be leery of the silver bullet

Here's more on colloidal silver products from the National Center for Complementary and Alternative Medicine. It notes that silver has been used medically for centuries, but that, you know, modern medicine has some advantages over it.

-- Tami Dennis

Credit: Los Angeles Times

It's soluble fiber, not wheat bran, for irritable bowel, study says

To treat irritable bowel syndrome, most physicians recommend that patients consume dietary fiber to help keep the bowels active. But a new controlled trial suggests that the type of fiber consumed is important. Soluble fiber, such as psyllium, reduces symptoms and pain of the disorder, but insoluble fiber such as wheat bran can increase problems, Dutch researchers reported online today in BMJ, formerly known as the British Medical Journal.

Irritable bowel syndrome, which is characterized by irregular bowel movements, cramps, bloating and other problems, affects as much as 10% of the population and can be severely disabling. Few good treatments are available, in part because physicians seem unsure about its root causes.

In the first study of its kind, Dr. Rene Bijkerk of the University Medical Center Utrecht in the Netherlands and colleagues studied 275 patients, ages 18 to 65, with irritable bowel syndrome, commonly known as IBS. A third were given 10 grams of psyllium fiber every day for 12 weeks, a third were given 10 grams of wheat bran, and a third were given 10 grams of rice flour as a placebo.

Patients taking the psyllium fiber received significantly more relief than those taking placebo, and some reported that they had pain-free periods as long as two weeks while taking the fiber. Those taking wheat bran, however, showed no significant improvement, and many of them dropped out of the trial because their symptoms worsened.

-- Thomas H. Maugh II

Image credit: Visuals Unlimited/Corbis

Acupuncture boosts effects of painkillers, natural or prescription

High-tech images of the brains of chronic pain sufferers have found that the ancient practice of acupuncture fights pain by making key brain cells more sensitive to the pain-dampening effects of opioid chemicals. The study, published online in the August issue of the journal NeuroImage, comes less than a year after the publication of a controversial study that concluded acupuncture was no more effective than sham treatment at reducing pain.

Researchers at the University of Michigan's Chronic Pain and Fatigue Research Center used a positron emission tomography (PET) scanner to view the brains of 20 women diagnosed with fibromyalgia who reported suffering nerve and muscle pain at least 50% of the time. The PET scans were conducted during each woman's first acupuncture session and, a month later, her eighth.

In the regions of the brain that process and dampen pain signals -- the amygdala, caudate, cingula, thalamus and insula -- the PET scans showed an increase in the receptivity -- and possibly the number -- of brain cells to which opioid substances bind. Study author Richard E. Harris said that suggests that acupuncture appears to make the body more responsive to opioid painkillers.

But the mainstay of traditional Chinese medicine also appears to enhance the body's ability to regulate pain naturally, Harris said. Many of the analgesic chemicals the body produces, including endorphins (the source of what endurance athletes call "the runner's high") and enkephalins (which act to tamp down the sensation of pain), also bind to the opioid receptors. So if acupuncture treatments enhance those chemicals' ability to find a receptor to bind to, these natural painkillers work better as well.

Harris, a molecular and cell biologist at the University of Michigan and a licensed acupuncturist, said the group's findings are consistent with research that has found patients treated with acupuncture before surgery often need less post-operative medication to manage their pain. The acupuncture in these cases may have the effect of sensitizing the brain's opioid receptors to medication, making it work better.

The study may even support the controversial earlier finding that sham acupuncture works as well as real acupuncture to reduce pain, but that the two work in to reduce pain in different ways. In that experiment, patients seemed to gain considerable pain relief merely by a procedure that inserted needles into the body randomly, as oppose to following the paths of energy meridians that guide needle placement in acupuncture.

The random sinking of needles through the skin may prompt the body to increase its production of pain-dampening endorphins and enkephalins, Harris surmised. True acupuncture may work differently: Its painkilling effect may come not from boosting the supply of circulating natural analgesics, but by improving the ability of those chemicals to dock at a brain cell and exert their painkilling effects.

While many patients may turn to acupuncture as an alternative to conventional medication, Harris said his group's study suggests that the two means of pain relief can complement each other.

"I don't see them as mutually exclusive, and in some cases, they may work synergistically," Harris said.

-- Melissa Healy

Use of alternative health practitioners falls

A national survey reflecting consumers' use of alternative and complementary medicine (CAM) shows that the use of self-care therapies has increased and that the use of CAM healthcare professionals has decreased. Additionally, certain practices are falling out of favor while more science-based treatments remain popular.

The National Institutes of Health survey is the first in 10 years to assess Americans' interest in herbal and homeopathic treatments, energy healing, acupuncture, tai chi and other healing practices. Researchers surveyed more than 75,000 adults in 2007. About 38% of the adults surveyed said they had used some form of CAM for preventative health purposes or to treat a disease or condition.

The survey found CAM makes up just 1.5% of U.S. healthcare expenditures. However, it accounts for 11.2% of total out-of-pocket expenditures. Of the $33.9 billion spent out of pocket on CAM, most of it was for self-care products, such as classes, products and materials. Compared with the last survey of CAM practices in the U.S., in 1997, visits to CAM practitioners have plunged 50%.

"In that survey, costs were driven primarily by the practitioner costs. In our data the expenditures are driven by the self-care costs," said Dr. Richard Nahin, lead investigator of the study. But, he added, the two surveys were conducted using different methodologies.

Interest in therapies like energy-healing and relaxation have declined, while practices that have more scientific validity and that depend on practitioners who are licensed and regulated, such as acupuncture, are more popular.

The data are available on the website for the National Center for Complementary and Alternative Medicine.

-- Shari Roan

Photo: Lucy Wojskowicz, a holistic health practitioner, gives a Swedish massage with craniosacral therapy to a client. Credit: Liz O. Baylen / Los Angeles Times.
Chart credit: National Institutes of Health

Use of complementary medical therapies plateaus

In 1990, people were stunned when a Harvard researcher published a report showing that more than one-third of Americans use complementary and alternative medicine. But the trend seems to be softening, and even the definition of what constitutes CAM therapy is becoming somewhat problematic.

A federal government survey released today shows only a 2% growth of CAM therapies, such as herbal supplements, meditation, chiropractic and acupuncture from 2002 to 2007. The data, from the 2007 National Health Interview Survey of 23,000 adults and 9,500 children, found that about 38% of adults use CAM and about 12% of children, ages 17 and under. The most common CAM therapies are:

• Natural products that are not vitamins or minerals. The most common of these were fish oil/omega-3/DHA; glucosamine, echinacea, flaxseed oil or pills and ginseng -- 17%.
• Deep breathing -- 12%
• Meditation -- 9%
• Chiropractic -- 8%
• Massage -- 8%
• Others: yoga, 6%; diet-based therapies, 3%; progressive relaxation, 2%; guided imagery, 2%, homeopathic treatment, 1%.

What to make of this? It seems to me Americans are not abandoning conventional Western medicine and are embracing the CAM therapies that research has found to be most useful. For example, fish oil or omega-3 supplements are now widely prescribed in mainstream medicine as evidence shows the substance can cut the risk of cardiovascular disease.

Meditation, massage and yoga are also mainstream practices for dealing with aches, pain and stress. Just this year, the American College of Physicians adopted guidelines for back pain treatment that describe massage, chiropractic and acupuncture as viable treatments. CAM seems to be most popular in areas where mainstream medicine has not had much success, such as in treating chronic pain. In fact, the survey found back pain is the most common reason people turn to CAM therapies."The top four conditions for which adults use CAM are all related to some form of chronic pain," Dr. Richard L. Nahin, a co-author of the report, said this morning in a news conference.

The survey also showed that use of the herb echinacea has fallen in popularity which, one can reasonably speculate, is due to scientific data casting doubt on its effectiveness to prevent or ease respiratory illness. Finally, the survey indicated that some of the same people who use CAM therapies say they delay conventional medical care because they can't afford it. That isn't a ringing endorsement of CAM.

Complementary and alternative therapies are described as  "diverse medical and healthcare systems, practices, and products . . . that are not generally considered to be part of conventional medicine." But whether such therapies as fish oil and massage are really CAM therapies is becoming more vague as researchers weigh in on their usefulness, says Nahin.

CAM therapies fall on a continuum with one end having very little, if any, research support and the other end having substantial support, says Nahin, acting director of the National Center for Complementary and Alternative Medicine's Division of Extramural Research. Fish oil and acupuncture for back pain, for example, may be in a "transition period" between mainstream and CAM, he says.

The report can be accessed at NCCAM.

-- Shari Roan

Photo credit: National Center for Complementary and Alternative Medicine