THE BEST ALTERNATIVE MEDICINE Dr. Kenneth R. Pelletier Introduction by Dr. Andrew Weil FIRESIDE Rockefeller Center 1230 Avenue of the Americas New York, NY 10020 www.SimonandSchuster.com Copyright © 2000 by Dr. Kenneth R. Pelletier, Inc. All rights reserved, including the right of reproduction in whole or in part in any form. First Fireside Edition 2002 FIRESIDE and colophon are registered trademarks of Simon & Schuster, Inc. For information about special discounts for bulk purchases, please contact Simon & Schuster Special Sales: 1-800-456-6798 or [email protected] Designed by Pagesetters Incorporated Manufactured in the United States of America 10 9 8 7 6 5 4 3 2 The Library of Congress has cataloged the Simon & Schuster edition as follows: Pelletier, Kenneth R. The best alternative medicine : What works? What does not?/ Kenneth R. Pelletier ; introduction by Andrew Weil. p. cm. Includes bibliographical references and index. 1. Alternative medicine. I. Title. R733.P45 2000 615′.5—dc21 99-26629 CIP ISBN 0-684-84207-6 0-7432-0027-6 (Pbk) eISBN 9-781-4391-2895-4 NOTE TO READERS This publication contains the opinions and ideas of its author. It is intended to provide helpful and informative material on the subjects addressed in the publication. It is sold with the understanding that the author and publisher are not engaged in rendering medical, health, or any other kind of personal professional services in the book. The reader should consult his or her medical, health or other competent professional before adopting any of the suggestions in this book or drawing inferences from it. The author and publisher specifically disclaim all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this book. “Alternative medicine needs an ‘evidence-based’ middle ground for the public and for practitioners. The research and wise counsel from Dr. Kenneth Pelletier, in The Best Alternative Medicine, provides us all with an inspired framework for integrating conventional and alternative medicine.” —John W. Farquhar, M.D., Professor of Medicine and Director, Stanford Wellness Center, Stanford University School of Medicine “In The Best Alternative Medicine Dr. Pelletier gives us the most up-to-date and authoritative information on which therapies work and which don’t. Concise, readable, invaluable.” —James S. Gordon, M.D., Director, Center for Mind-Body Medicine, Washington, D.C.; author, Manifesto for a New Medicine “It’s so-o-o wonderful that we’ve finally moved beyond the old knee-jerk head- butting between pro—and anti—alternative medicine forces and can now engage in rational discussions of what works, what does not, and who decides. Dr. Pelletier is an important change-agent in this process. His book is necessary reading for all concerned.” —Tom Ferguson, M.D., Adjunct Associate Professor of Consumer Health Informatics, University of Texas Health Science Center “The real future of medicine is the integration of the best of evidence-based conventional and alternative therapies. Dr. Pelletier’s book is a landmark contribution to the medicine we want and the medicine we need.” —Michael Lerner, President, Commonweal; author, Choices in Healing “Dr. Kenneth Pelletier’s The Best Alternative Medicine brings the global field of healing into focus by offering empirical wisdom in a wilderness of wishful thinking. With an open-minded, appreciative analysis of complementary approaches to wellness, Pelletier ultimately reveals that there is no alternative to medicine—only methods that work and those that do not. An essential reference, it may well become a classic.” —Dan Millman, Author of Everyday Enlightenment, and Body/Mind Mastery “Dr. Pelletier tells us not only ‘what works’ and ‘what does not’ but all the ‘maybes’ as well, the gray areas where most of the important questions about alternative medicine reside right now. This book gives readers the essential information to make decisions about the ‘maybes’ that affect their health.” —Walter M. Bortz, II, M.D., Palo Alto Medical Foundation “All good medicine is the result of a marriage between an open mind and a generous heart grounded in the principles of rigorous science. The Best Alternative Medicine is good medicine and it delivers exactly what it promises.” —Christiane Northrup, M.D., author, Women’s Bodies, Women’s Wisdom “When traveling to a new land, it helps to have an authoritative guidebook written by an experienced and professional traveler. The Best Alternative Medicine is just such a guide for those venturing into the land of complementary and alternative medicine. It points out the highlights, great sites to visit, and, importantly, how to avoid pitfalls (and rip-offs). Don’t leave home without it!” —David Sobel, M.D., M.P.H., Director of Patient Education, Kaiser Permanente Northern California; author, Mind & Body Health Handbook ACKNOWLEDGMENTS From the cover of Time magazine to the innovative research funded by the National Institutes of Health, there is a virtual explosion of recent interest in complementary, alternative, and integrative medicine. Rather like any “overnight” phenomenon, this area of research and clinical practice has been in gestation for decades in the United States and hundreds of years in indigenous healing traditions in every nation on earth. Conducting my research and writing this book would not have been possible without the genius, dedication, research and clinical funding, encouragement, and enduring friendship of so many colleagues over these last twenty-five years. Each person named here has made a major, significant contribution in sorting through the complexities of complementary and alternative medicine and integrating demonstrably effective interventions into conventional health care. Acknowledging these individuals has given me the opportunity to reflect upon each person and their unique contributions and abiding perseverance. Although this enumeration is incomplete, it is surely heartfelt. First of all I would like to thank my longtime friend and colleague Dr. Andrew T. Weil for his forward to this book; I am truly honored by his reflections. From the onset I thank my colleagues at the Stanford University School of Medicine, including Dr. John W. Farquhar, Dr. William L. Haskell, Dr. Stephen P. Fortmann, Dr. John A. Astin, Dr. James F. Fries, Dr. David Spiegel, Dr. Christopher Gardner, Dr. Marcia Stefanick, Dr. Wes Alles, Dr. Abby King, Dr. C. Barr Taylor, Dr. Walter Bortz, Dr. Gene Spiller, Professor Alain Enthoven, Dr. Jeffrey Croke, Dr. Halsted Holman, Chris Scott, and Peter Van Etten, president and CEO of the UCSF/Stanford Health System. Paralleling the work of my Stanford colleagues are the individuals who made the writing and preparation of this book possible: Ms. Cindy Wood, Ms. Lauri Young, Ms. Adeline Hwang, Ms. Sandra Stahl, and Ms. Ellen DiNucci. For their consummate editing and writing skills, I am indeed indebted to both Ms. Kathy Goss and Cameron Stauth in the sculpting of the final manuscript. Most important, I wish to thank Frederic W. Hills of Simon & Schuster for more encouragement, patience, and mentoring than I could have imagined. Also, a thanks to his able assistant, Ms. Priscilla Holmes for her work on the manuscript. At ICM, I want to thank my representatives, Ms. Lisa R. Bankoff and Ms. Suzanne Gluck, for securing such a renowned editor and publishing house. Research requires funding, and that difficult task attains Herculean proportions in new areas such as complementary and integrative alternative medicine. For their vision and courage of commitment, I would like to acknowledge the National Institutes of Health, National Center for Complementary and Alternative Medicine (NCCAM), with particular respect for Dr. Wayne B. Jonas, Dr. Richard L. Nahin, Dr. Geoffrey Cheung, Dr. Carole Hudgings, and Dr. William Harlan. In the funding of the NCCAM, there are the pioneering efforts of Senator Tom Harkin, Senator Orrin Hatch, and Dr. Joe Jacobs. Funding from the NIH-NCCATA has allowed the creation of the Complementary and Alternative Medicine Program at Stanford (CAMPS). Additional funding and support has permitted CAMPS to undertake further innovative research and establish a clinic, thanks to the generosity of the Fetzer Institute with Dr. Jeremy Waletzky and Robert F. Lehman, the Nathan Cummings Foundation with Charles Harpen and Ms. Andrea Kydd, Michael S. Currier, the Fresno Foundation with Ed Rontell, Colby and Lani Jones, Larry Biehl, and E. Lewis Reid. Additionally, Michael Murphy, George Leonard, and Steve Donovan and the board of directors of the Esalen Institute generously donated to CAMPS the Esalen Archive of over twelve thousand hard-copy articles from an Esalen program funded by Laurance S. Rockefeller. Research funding has also been provided by Dr. Albert R. Martin and Ms. Bobbi Kimball of Blue Shield of California; Jay M. Gellert, Dr. Arthur M. Southam, and Dr. Antonio P. Legoretta of Health Net/FHS; Bain J. Farris of Anthem Blue Cross/Blue Shield; Dr. Des Cummings, Jr., of the Florida Hospital/Disney/Celebration collaboration; and the participating companies of the Stanford Corporate Health Program, including AT&T, American Airlines, ARCO, Anthem Blue Cross/Blue Shield, Bank of America, Health Net (FHS), Disney, IBM, Kaiser Permanente, Levi Strauss, Merck, Mercer, Motorola, San Mateo county, Rite Aid/PCS, Shaklee/Yamanouchi, United Behavioral Health, Medstat, and Xerox. For each chapter of this book and for research projects in various domains, a number of professional experts provided literature searches and reviews, critiques of draft materials, and a wealth of knowledge, wisdom, and critical assessment of these complex areas of clinical and research knowledge. Within the areas of mind/body medicine, a particular acknowledgment goes to Dr. John A. Astin, Dr. Frederic Luskin, Ms. Katie Newell, and Dr. John Kabat-Zinn; in chiropractic, Dr. William Meeker; for acupuncture, Dr. Joseph M. Helms, Dr. Brian Berman, and Dr. Yuan-Chi Lin; nutrition and dietary supplements, Dr. Pamela M. Peeke, Dr. Christopher Gardner, and the late Dr. James H. Whittam; European herbals, Mark Blumenthal and Dr. Ted Kaptchuk; traditional Chinese medicine, Dr. Miki Shima and Dr. Subhuti Dharmananda; Ayurvedic, Dr. Shri K. Mishra; homeopathy, Dr. Jennifer Jacobs, Dr. Roger Morrison, and Dana Ullman; naturopathy, Dr. Carlo Calabrese; within the area of spirituality, Dr. Dick Tibbits and Dr. Larry Dossey; and for the insurance coverage of CAM, John Weeks and Ms. Ariane Marie. Individually and collectively, these scholars and clinicians contributed their best insights and critical orientation to those complex areas and I am hopeful that the results are a modest reflection of their dedication. Whatever insights reside in these chapters is due to their knowledge. Whatever deficiencies remain are solely due to my limitations. With the funding of ten collaborative research centers, the NIH National Center in complementary and Alternative Medicine (NCCAM) has enabled a core group of researchers to meet, work together, and engage in the critique and mutual development of an array of increasingly sophisticated research. Details of these centers are included throughout the book and many of these colleagues have already been acknowledged, or will be in the final section of this introduction. For now, I wish to thank the following Center colleagues for many exciting and productive meetings: Dr. Leanna J. Standish, Dr. Brian M. Berman, Dr. Fredi Kronenberg, Dr. Thomas J. Kiresuk, Dr. William L. Meeker, Dr. Samuel C. Shiflett, Dr. Judith Stern, Dr. M. Eric Gershwin, Dr. Guy S. Parcel, Dr. Mary Ann Richardson, Dr. Steven F. Bolling, Dr. Sarah Warber, Dr. Nancy Schoenberger, Dr. Betsy B. Singh, Dr. Ann Gill Taylor, Ms. Christine Wade, Dr. Fayez K. Gishan, and Dr. Andrew Weil. As I was writing this book, my wife, Elizabeth, was thrown from one of her horses and sustained severe injuries. While conventional medicine provided excellent diagnostics, it offered virtually nothing in terms of treatment. Fortunately, a skilled group of alternative medicine practitioners combined and coordinated their skills in a model of true health care that resulted in a full and complete recovery. For their insight, dedication, extraordinary professional skills, and loving care, we want to extend a heartfelt personal acknowledgement to Ms. Pat Scott, Ms. Diana Herold, Ms. Rhonda Hackett, Dr. Roger Morrison, Dr. Miki Shima, and Dr. Harry D. Friedman, who are among the true healers of our time. Finally, let me conclude with an anecdote that Jane Goodall recounted to open a lecture at the State of the World Forum in the fall of 1996. Standing before a plenary of world leaders, she acknowledged her colleagues by noting a Texas aphorism: “When you see a turtle at the top of a telephone pole, you know it did not get there by itself!” For over twenty-five years, the field of complementary and alternative medicine has been painstakingly built upon the vision, courage, tenacity, and analytic skills of true pioneers. Although this recitation of their names is incomplete, it is with deep honor, respect, and admiration that I am proud to acknowledge these individuals as colleagues, friends, and mentors: Dr. Andrew T. Weil, Dr. David Eisenberg, Dr. Herbert Benson, Dr. Hans Selye, Dr. C. Norman Shealey, Dr. Jonas Salk, Dr. Tom Ferguson, Norman Cousins, John E. Fetzer, Dr. Tracy Gaudette, Ms. Sue Fleischman, Dr. Richard Friedman, Dr. Redford B. Williams, Jach Pursel, Dr. Dean Ornish, Dr. Shirley Brown, Ram Dass, Jerry Green, Dr. Michael Carlston, Dr. Joan Borysenko, Dr. Michael Lerner, Roger S. Greaves, Dr. Rachel Naomi Remen, Dr. Martin L. Rossman, George Vithoulkas, Dr. Paul J. Rosch, Dr. Claude Rossel, Dr. Ray H. Rosenman, Dr. Steven E. Locke, Dr. Chandra Patel, Dr. Deepak Chopra, Dr. David Sobel, Dr. James S. Gordon, Ms. Joan L. Schleicher, Dr. Emmett E. Miller, Dr. Daniel Goleman, Dr. Judith Orloff, Dr. Irving Oyle, John Robbins, Dr. Bernie S. Siegel, Dr. Robert E. Kowalski, Dr. William Regelson, Dr. Bill Goldman, Dr. Anton Jayasuriya, Dr. Sadja Greenwood, Dr. Samuel Benjamin, Dr. W. Ross Adley, Dr. Robert O. Becker, Dr. David E. Bresler, Dr. Jeffrey Bland, Dr. Harry B. Demopoulos, Dr. Ken Dychtwald, Dr. Anthony E. Elite, Dr. Joel Elkes, Dr. Harry D. Friedman, Jack Schwarz, Dr. Jessie C. Gruman, Dr. Malik Hasan, Dr. W. Brugh Joy, Dr. Richard A. Lippin, Dr. Gay Luce, Dr. George Solomon, Dr. Alvin R. Tarlov, Dr. Art Ulene, Dr. Donald M. Vickery, Ms. Faye Wattleton, Dr. David Watts, Arthur M. Young, Ms. Deborah Szekely, and Brendan O’Regan. Each of these individuals has touched and inspired me as well as many, many others, and each of them personifies the vision of keeping your eye on the distant horizon while mapping your course one measured step at a time. For Elizabeth She is my North, my South, my East and West My working week and my Sunday rest My moon, my midnight, my talk, my song I thought that love would last for ever and a day I was not wrong. RESPECTFUL PARAPHRASE OF W. H. AUDEN CONTENTS Acknowledgments Introduction by Andrew Weil, M.D. PART I MAJOR AREAS OF TREATMENT Chapter 1: Think Horses, Not Zebras Chapter 2: Sound Mind, Sound Body: MindBody Medicine Comes of Age Chapter 3: Food for Thought: Dietary Supplements, Phytonutrients, and Hormones Chapter 4: Traditional Chinese Medicine: Three Thousand Years of Evolution Chapter 5: Acupuncture: From Yellow Emperor to Magnetic Resonance Imaging (MRI) Chapter 6: Western Herbal Medicine: Nature’s Green Pharmacy Chapter 7: Naturopathic Medicine: “Do No Harm” Chapter 8: Homeopathy: Like Cures Like Chapter 9: Chiropractic: Thigh Bone Connected to the Knee Bone Chapter 10: Ayurvedic Medicine and Yoga: From Buddha to the Millennium Chapter 11: Spirituality and Healing: As Above … So Below Chapter 12: CAM Insurance: Who Pays How Much to Whom for What Chapter 13: We’re Not in Kansas Anymore: Toward an Integrative Medicine PART II CAM THERAPIES FOR SPECIFIC CONDITIONS • General Precautions • Acne • AIDS • Alcoholism • Allergies • Alzheimer’s Disease • Anxiety • Arthritis • Asthma • Atherosclerosis • Attention Deficit Disorder • Bedwetting (see Enuresis) • Birth Defects • Bronchitis • Bruises • Buzzing in the Ears (see Tinnitus) • Cancer • Cardiovascular (Heart) Disease and Cholesterol • Carpal Tunnel Syndrome • Cervical Spondylitis • Chronic Fatigue • Cirrhosis and Alcoholic Liver Disease • Colds/Flu • Colic • Constipation • Dementia and/or Memory Loss • Dental Craniomandibular Disorder • Depression • Diabetes • Diarrhea • Diverticulitis • Dyslexia • Ear Infection (see Otitis Media) • Eczema • Enuresis • Epilepsy • Eye Disorders • Fibromyalgia • Gastrointestinal (Stomach and Intestinal Disturbances) • Hay Fever • Headaches • Heart Conditions • High Blood Pressure • Impotence • Infertility • Insomnia • Irritable Bowel Syndrome (IBS) • Ischemia • Kidney Stones • Liver Disease • Lupus • Memory Disorders • Ménière’s Disease • Menstrual Symptoms, Menopause, and PMS • Mononucleosis • Nausea • Obesity • Osteoporosis • Otitis Media • Pain • Parkinson’s Disease • Prostate or Prostatic Hypertrophy (Prostate Enlargement) • Psoriasis • Respiratory Problems • Schizophrenia • Sciatica • Scleroderma • Sexual Dysfunction • Sinusitis • Sprains • Substance Abuse • Tendinitis • Thyroid Dysfunction • Tinnitus • Tonsillitis • Tuberculosis • Ulcers • Vaginitis • Varicose Veins • Vertigo • Yeast Infections (see Vaginitis) Bibliography Index INTRODUCTION Alternative medicine is now the fastest-growing sector of American health care. Despite continuing objections from the rearguard of the scientific establishment, many forward-looking doctors have begun to recognize the virtues of complementary medicine. As for the American consumer, millions are voting with their feet and their pocketbooks for treatments other than those conventional physicians are trained to provide. Alternative medicine is clearly moving into the mainstream. Moreover, what is happening in this country is happening around the world. In fact, some countries—notably Germany and China—are far ahead of us in recognizing the validity of alternative therapies and working to integrate them with conventional, Western medicine. In the United States, the National Institutes of Health has created the National Center for Complementary and Alternative Medicine (NCCAM) to study complementary and alternative medicine. Also, a special presidential commission was established in 1999 to study this subject. Clearly, this movement is not a fad but rather a global sociocultural trend with deep historical and intellectual roots. In the United States the change began in the 1960s with loss of blind faith in technology. Up to that time our culture was captivated by a technological dream, the belief that science and technology would do away with all human ills, including poverty, illiteracy, disease, and, possibly, even death. Science and technology revolutionized medicine at the end of the nineteenth century, and throughout the first half of the twentieth century enabled us to make great strides in understanding human biology and intervening in cases of illness. Then in the 1960s came the realization that technology creates as many problems as it solves. In medicine, the created problem is expense—expense that has become unbearable as the new millennium approaches. All over the world health care systems are breaking down as the cost of standard medicine continues to increase. The logical American response to this economic breakdown has been a corporate takeover of health care institutions by people whose only interest is getting what profit they can from a sinking system. This is managed care, and it is making the lives of many people—doctors and patients alike—miserable. Physicians resent their loss of autonomy and inability to practice medicine in the way they imagined it to be when they were idealistic students. Patients are increasingly angry about the impersonality of managed care and the lack of time they get to spend with physicians. This frustration is surely an immediate reason that so many of them are seeking alternatives. But there are other, deeper reasons for the growing popularity of the ideas and practices described in this book. When medicine embraced technology hundreds of years ago, it turned its back on nature and on all of the simple, inexpensive ways of influencing health and disease that previous generations used, many of which are still current in other cultures. It also lost touch with the most basic precepts of its own historical tradition. After all, Hippocrates enjoined physicians first to do no harm and also to revere the healing power of nature. People all over the world are increasingly concerned about the harm inflicted by modern, technological medicine, especially adverse reactions to pharmaceutical drugs that are now so common. In deciding what to put into their bodies, they are more inclined to pay attention to the wisdom of nature and be wary of all that is artificial. They are also fascinated by mind/body interactions, interested in spirituality, and disillusioned with medicine that looks at human beings as physical bodies only. I first met Ken Pelletier at a conference on “holistic” medicine in 1974. The