Illnesses associated with lifestyle cost the NHS £11bn

Herbs and Helpers

Health problems related to poor diet, drinking and smoking are costing the NHS in England more than £11bn each year, officials say.

Public Health England (PHE) says that unless they are tackled more effectively the NHS will become unaffordable.

It warns conditions such as diabetes and smoking-related bronchitis are a new and untreatable epidemic.

But the town of Fleetwood, Lancashire, plans to tackle these problems head on.

Around four out of 10 middle-aged people already have a long-term condition for which there is currently no cure.

Dr Rebecca Wagstaff of PHE says these conditions pose a real threat to the future sustainability of the health service.

“When you look back to Victorian times, we worried about things like diphtheria and polio, and we’ve actually managed to conquer those now.

“The new threats are things like diabetes and chronic bronchitis. They could overwhelm us.”

“They are illnesses for which there is no cure, and they cost the NHS more than £11bn each year. That’s a phenomenal amount of money and more than that, it is taking years off people’s lives.”

Creating a healthy town

The picture is particularly stark in areas of high unemployment and poverty.

Fleetwood in Lancashire, a once prosperous fishing town, is one such community.

Figures from PHE show that on average people die here younger compared to the rest of England.

Life expectancy for a man living in the Pharos ward of Fleetwood is nearly seven years lower compared to more prosperous ward of Tithebarn, just six miles away.

Illnesses such as type 2 diabetes, cancer, lung and heart disease – mostly related to lifestyle choices such as diet, exercise, alcohol and smoking – are claiming lives at an alarming rate.

Local GP Dr Mark Spencer is leading an effort to change that picture.

He has forged a coalition of local people and health workers to break a damaging cycle of sickness.

Dr Spencer says a new approach is needed in towns like Fleetwood, with high levels of unemployment and poverty, because the standard public health messages don’t work.

“When I say to folk, ‘How about losing a little bit of weight? How about giving up the fags?’, they say to me, ‘Why should I bother? My life’s rubbish.’

“How can we turn the conversation from what’s making me ill, to what makes me well?

“And if we focus on what makes me well, actually then what are the benefits of that across the town?”

Healthier Fleetwood

The BBC has been offered the chance to follow this ambitious project over the next year, which will attempt to help people change the behaviour that is damaging their health.

It involves a broad range of different approaches, from educating children in primary schools about food and diet, working with local sports clubs to encourage people to get active, and creating more open green spaces in the town.

Chris Murray values his time at the Willow Garden Project
The Willow Garden Project is the type of scheme that it is hoped could help.

A patch of waste ground has been transformed into a beautiful allotment and garden, full of fruit and vegetables.

It is looked after by people with learning difficulties and brain injuries, including Chris Murray, who suffered a brain injury after a fall.

He says at the Willow Garden Project he finds friendship and support

“I meet some of my friends here and it’s really beneficial to me.

“It makes me feel good and I’d be lost without tending to this place on a Tuesday.

“I don’t know what I’d do with myself to be honest.”

Fleetwood is not alone – many towns and communities across the UK face similar problems.

Over the coming months and years, the challenge will be transforming the health of the people of Fleetwood.

But health experts say it is a challenge the entire country must face up to.

Source: BBC

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Acupuncture And Herbs Gain International Recognition

Herbs and Helpers

State, federal, and international organizations recognize and regulate acupuncture and herbs after thousands of years of widespread utilization.

Traditional Chinese Medicine (TCM) is an ancient form of medicine including acupuncture, herbal medicine, tuina therapeutic massage, dietetics, movement arts including qi gong and taiji (tai chi), and more. Its roots date back to over 5,300 years ago; Otzi the mummy, discovered in the Northern Italian Alps, had numerous acupuncture point locations tattooed on his body (Dorfer et al.).

Modern scientific evidence confirms the therapeutic value of acupuncture and MRI studies confirm that specific acupuncture points induce hemodynamic changes in specific brain networks relating to the healing of specific medical disorders (He et al.). There are approximately 20,000 licensed acupuncturists in the USA and there are numerous state acupuncture medical boards and national organizations providing oversight of the profession. Nonetheless, the wheels of the federal government often turn slowly and the profession, technically, did not exist in the USA until recently.

The US Bureau of Labor and Statistics (BLS) now recognizes acupuncturists. The profession has been assigned a Standard of Occupational Classification Code (SOC). The new code (SOC – 29-1291) has far reaching implications for licensed acupuncturists. This opens the door to federal recognition across the board. Federal inclusion within various departments and agencies is facilitated by the numerical designation. This includes new possibilities for inclusion in Medicare, Medicaid, Veteran Affairs facilities, and more.

The UK is slowly accepting Traditional Chinese Medicine (TCM) into its system. The very first TCM herbal therapeutic product has been licensed by the MHRA (Medicines & Healthcare Products Regulatory Agency) as an over the counter product. This is in response to The Traditional Herbal Medicinal Products (THMP) Directive set by the European Union. The Official Journal of the European Union (30.4.2004, L 136/85) notes, “authorisation to place a medicinal product on the market have to be accompanied by a dossier containing particulars and documents relating in particular to the results of physicochemical, biological or microbiological tests as well as pharmacological and toxicological tests and clinical trials carried out on the product and thus proving its quality, safety and efficacy.”

Phynova Joint and Muscle Relief Tablets were the very first TCM herbal medicines licensed by the UK’s MHRA. Sigesbeckia (Xi Xian Cao) provides the analgesic properties of the product. The company selling the product recommends it for back, muscle, joint, and other forms of musculoskeletal pain including rheumatism.

The use of Xi Xian Cao, although newly licensed in the UK, has a longstanding history in Traditional Chinese Medicine for use in herbal formulas. It was first documented in the Xin Xiu Ben Cao (Newly Revised Materia Medica) in the year 659. The following are TCM classifications of Xi Xian Cao. This herbal medicine enters the liver and kidney channels and is bitter and cold.

It dispels wind-dampness and opens the channels. For this therapeutic function, Xi Xian Cao is added to herbal formulas for the purposes of treating musculoskeletal pain. Its ability for opening the channels and collaterals extends to benefitting the sinew, reducing joint pain, and relieving muscle cramps, spasms, weakness, and paralysis. Xi Xian Cao is valued for its anti-inflammatory effects. This herb may be processed with alcohol and honey to provide a warming function to offset the cold and bitter nature of the herb.

Xi Xian Cao eliminates heat and toxins, especially for patients with jaundice or malaria. Xi Xian Cao is often used internally or externally for dermatological conditions including sores, rashes, and itching due to wind-damp-heat. Xi Xian Cao has a special function of lowering blood pressure and is used for patients with hypertension due to heat. While the UK recognizes this herb as safe for over the counter use, TCM documentation forbids the use of this herb for pregnant women and children. USA licensed acupuncturists trained and certified in TCM herbal medicine understand these restrictions and recommend herbs based on established precautions and guidelines.

In related acupuncture continuing education news, the California Acupuncture Board will implement a new ethics CEU requirement for licensed acupuncturists. The NCCAOM (National Certification Commission for Acupuncture and Oriental Medicine) has had this requirement for many years. The California Acupuncture Board has not released an enforcement date or guidelines regarding this impending regulation. We will keep you posted on this developing story.

The Georgia Composite Medical Board is developing continuing education requirements for licensed acupuncturists. The board states (Rule 360-6-.11 License Renewal states), “To be eligible for renewal, a licensee must furnish satisfactory evidence of having met 40 hours of Board approved continuing education requirements, including a minimum of one hour concerning infectious disease.” However, full implementation is pending.

A coordinator from the Healthcare Medicine Institute (HealthCMi) spoke with a representative from the Georgia Composite Medical Board who notes that all licensed acupuncturists are encouraged to obtain and document continuing education (CEU) courses in the interim. As a service to licensed acupuncturists, the board posted the following on their website, “As we are in the initial stages of implementing the Acupuncture Act of Georgia, the Board has not yet promulgated rules on continuing education requirements for Acupuncturists. When the Board does promulgate the standards for continuing acupuncture education requirements, the Board conducts a random audit of renewal applicants. You will be notified by mail that your renewal application is being audited for CAE requirements. The renewal applicant will simply forward the appropriate documentation to the Board.”

That’s the HealthCMi bureaucratic roundup for today. Since we mentioned Otzi at the top of the article, let’s take a closer look at the findings. The tattoos were on the following acupoints:

BL21 – 25
LV8
KD7
SP6
GB37
GB38
BL56
BL59
BL60

An X-ray medical analysis of Otzi reveals that he had arthritis. The tattooed acupoints match the arthritis locations in reference to acupuncture point prescriptions according to TCM principles. DNA analysis reveals that Otzi was of southern European descent, particularly Corsican and Sardinian. To learn more about acupuncture and herbal medicine:

References:
Dorfer L, et al. A medical report from the stone age? Lancet Sep 18, 1999;354:1023-5.

He, Tian, Wen Zhu, Si-Qi Du, Jing-Wen Yang, Fang Li, Bo-Feng Yang, Guang-Xia Shi, and Cun-Zhi Liu. “Neural mechanisms of acupuncture as revealed by fMRI studies.” Autonomic Neuroscience (2015).

Source: HealthCMI

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DNA Testing: Weeding Out Botanical Adulterants

Herbs and Helpers

Many of the most-adulterated natural products and supplements on the market, as well as the most common adulterants, are not on most people’s radar. When we think about adulteration in the natural products industry, typically we think about adulterants like active pharmaceutical ingredients, fraudulent fillers, and trace allergens. But did you know that a high percentage of botanicals are actually contaminated with other plants—even toxic plants? Most don’t realize this.

For instance, many don’t know that grasses such as oat grass and barley grass, as well as alfalfa, are among the most-adulterated natural products. Surprisingly, one of the top-selling herbs that can be found in kitchens around the world—oregano—is also highly adulterated. In fact, according to an NSF AuthenTechnologies annual review of over 1200 samples from nearly 250 different plant species, over 82% of the oregano samples we tested were contaminated or adulterated in some way by another plant species. (This review was conducted at our next-generation DNA testing lab in California.) Half of the oregano samples contained bindweed (Convolvulus arvensis), a common weed found on roadsides around the world. In some samples, most of the DNA in a bottle of “oregano” actually came from bindweed, not from oregano. It turns out that bindweed is one of the most prevalent adulterants in the natural product supply chain. More than 5% of all botanical samples that we’ve tested over the past year contain this toxic plant.

Bindweed gets into the natural product supply chain as an artifact of poor harvesting practices or as a fraudulent filler. In either case, bindweed can be hazardous to health. Phytochemicals present in bindweed can cause potentially serious health problems. Known adverse effects in animal research include hallucinations, liver damage, ulcers, and even cardiac arrest.

Widespread Botanical Adulteration

In our annual review, NSF AuthenTechnologies found that more than 50% of the plant samples we tested were, in fact, adulterated. This study is not only the most comprehensive review of botanical authentication data to date; it also reveals some pretty alarming and unexpected trends in adulteration.

In addition to bindweed, our study detected nearly 30 other toxic plant adulterants in nearly 150 plant samples, including several “legal high” herbs used as substitutes for recreational drugs.

One such herb is kratom (Mitragyna speciosa). In September, the U.S. Drug Enforcement Agency asked FDA to add kratom, a highly addictive herb whose adverse effects can lead to death, to the agency’s list of Schedule I drugs. On FDA’s import-alert website, FDA says, “there does not appear to be a history of use or other evidence of safety establishing that kratom will reasonably be expected to be safe as a dietary ingredient. In fact, the scientific literature disclosed serious concerns regarding the toxicity of kratom in multiple organ systems. Consumption of kratom can lead to a number of health impacts, including respiratory depression, nervousness, agitation, aggression, sleeplessness, hallucinations, delusions, tremors, loss of libido, constipation, skin hyperpigmentation, nausea, vomiting, and severe withdrawal signs and symptoms.”

In the results from our annual review, we detected kratom in an everyday cinnamon sample. As a mother of two girls, I find these examples of adulteration in common foodstuffs highly alarming.

The Value of Targeted Next-Generation DNA Sequencing

Considering just how insidious botanical adulteration can be, it’s crucial to identify good tools to catch adulteration. DNA testing is a method with a growing profile in recent years.

There is no denying that DNA testing has changed the landscape of numerous fields, such as forensics and medical diagnostics. Like computer microchips that get smaller, faster, and more powerful every year, DNA testing methodologies are becoming cheaper, faster, and more accurate.

Traditional DNA testing techniques have their limitations, however. DNA barcoding, for instance, which uses Sanger Sequencing, falls short in authenticating samples that are processed, including adulterated samples of commercial products. Luckily, there’s a next generation of DNA sequencing that can help identify numerous species in a wide range of processed materials, and in only a few hours and for less, compared to many other traditional methods.

We call this technology Target Specific DNA Sequencing (TSDS). TSDS detects and identifies unwanted and unexpected adulterants, contaminants, and even toxic weeds. Because the test methods are unbiased, TSDS is also a great method for assessing current trends in adulteration throughout the natural product supply chain, from seed to shelf.

Using the power of Next Generation Sequencing (NGS) technology, TSDS applies specific tests that target unique regions of the genome and that can both authenticate the plant species and identify adulterants. Each specific test relies on a unique combination of polymerase chain reaction (PCR) primers, or probes, which produce millions of copies of each species in the material. Unlike traditional barcoding, which uses only long, universally available PCR primers for all species, the TSDS process also uses unique, short, genus-specific primers. These short primers allow the technology to test a much wider range of products than traditional DNA barcoding can handle, including products that are heated, processed, and extracted.

Once the DNA copies are produced, an NGS machine will elucidate the unique arrangement of bases (A, C, G, T) in the sequence. Each sequence is then compared to a validated reference DNA database for identification.

What Can TSDS Do?

In addition to identifying unexpected botanical adulterants and contaminants, TSDS can indicate the potential presence of an allergen. In a recent study we conducted of ground black and white pepper samples purchased from multiple retailers around the world, we identified fillers and contaminants in approximately 75% of the products tested. In fact, the white pepper samples frequently contained unlabeled wheat or rice flour, posing a potentially serious health risk to those with related allergies. And these fillers weren’t just present in trace levels; in many cases, they comprised a majority of the DNA in the product. Also surprisingly, even products labeled as “non-GMO” and “organic” were not immune to adulteration by these fillers and allergens.

Novel methods such as TSDS are uncovering important trends in botanical adulteration. This is important, because it is critical for suppliers and testing labs to understand which species are commonly adulterated so they can take the necessary precautions to eliminate them from finished products. This information can also be useful to suppliers, manufacturers, and retailers as an early warning system for possible issues that could be detrimental to their businesses and may require further action in areas such as cleaning procedures, cross-contamination in the field or facility, or issues even further down the supply chain.

Source: Nutritional Outlook

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Nine traditional Chinese herbal formulas for the treatment of depression: an ethnopharmacology, phytochemistry, and pharmacology review

Herbs and Helpers

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Authors Feng DD, Tang T, Lin XP, Yang ZY, Yang S, Xia ZA, Wang Y, Zheng P, Wang Y, Zhang CH

Received 8 June 2016

Accepted for publication 23 August 2016

Published 20 September 2016 Volume 2016:12 Pages 2387—2402

DOI https://dx.doi.org/10.2147/NDT.S114560

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Wai Kwong Tang

Article has an altmetric score of 2

Dan-dan Feng, Tao Tang, Xiang-ping Lin, Zhao-yu Yang, Shu Yang, Zi-an Xia, Yun Wang, Piao Zheng, Yang Wang, Chun-hu Zhang

Laboratory of Ethnopharmacology, Institute of Integrated Traditional Chinese and Western Medicine, Xiangya Hospital, Central South University, Changsha, People’s Republic of China

Abstract: Depression is a major mental disorder, and is currently recognized as the second-leading cause of disability worldwide. However, the therapeutic effect of antidepressants remains unsatisfactory. For centuries, Chinese herbal formulas (CHFs) have been widely used in the treatment of depression, achieving better therapeutic effects than placebo and having fewer side effects than conventional antidepressants. Here, we review the ethnopharmacology, phytochemistry, and pharmacology studies of nine common CHFs: “banxia houpo” decoction, “chaihu shugansan”, “ganmaidazao” decoction, “kaixinsan”, “shuganjieyu” capsules, “sinisan”, “wuling” capsules, “xiaoyaosan”, and “yueju”. Eight clinical trials and seven meta-analyses have supported the theory that CHFs are effective treatments for depression, decreasing Hamilton Depression Scale scores and showing few adverse effects. Evidence from 75 preclinical studies has also elucidated the multitarget and multipathway mechanisms underlying the antidepressant effect of the nine CHFs. Decoctions, capsules, and pills all showed antidepressant effects, ranked in descending order of efficacy. According to traditional Chinese medicine theory, these CHFs have flexible compatibility and mainly act by soothing the liver and relieving depression. This review highlights the effective treatment choices and candidate compounds for patients, practitioners, and researchers in the field of traditional Chinese medicine. In summary, the current evidence supports the efficacy of CHFs in the treatment of depression, but additional large-scale randomized controlled clinical trials and sophisticated pharmacology studies should be performed.

Source: Dove Medical Press

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Master Tung Acupuncture and Herbs Alleviate Tinnitus

Herbs and Helpers

Researchers find acupuncture and Chinese herbal medicine effective for the treatment of tinnitus. Results indicate that a combination of herbs and acupuncture is more effective than using only herbal medicine. The research team chose a potent herbal formula combined with a classic acupuncture point prescription with a subtle addition. Two Master Tung acupuncture points were added to the Traditional Chinese Medicine (TCM) acupoint prescription. The combined protocol of acupuncture and herbs achieved significant positive patient outcomes.

Researchers selected 100 patients with tinnitus for inclusion in a clinical trial. They were randomly distributed them into a control group and an observation group, each consisting of 50 patients. Control group patients were administered a standardized Traditional Chinese Medicine herbal decoction. The observation group was treated with acupuncture and the identical TCM herbal formula. The results were compared after three courses of treatment: the group receiving acupuncture and herbs achieved an 88% total effective rate. The control group, receiving only herbal medicine, achieved a 68% total effective rate. The data indicates that acupuncture combined with herbal medicine, in an integrated protocol, achieves optimal clinical efficacy for patients with tinnitus and associated hearing dysfunction.

The 100 patients in the study had refractory tinnitus; all patients received pharmaceutical drug therapy for tinnitus in the past, with no improvements in their conditions. The goal was to determine the efficacy of acupuncture and herbs for patients unresponsive to medications. The study was conducted at Henan TCM University’s Third Affiliated Hospital from June 2014 to 2015. The patients were not taking medications for tinnitus during the study for purposes of isolating therapeutic variables. The observation group consisted of 28 males and 22 females with an average age of 47 years old. The control group consisted of 29 males and 21 females with an average age of 48 years old.

Patients in the control and observation groups consumed a version of Ma Huang Fu Zi Xi Xin Tang, a TCM decoction. Ingredients included Zhi Fu Zi, Xi Xin, Ma Huang, and Sheng Jiang. This warming decoction was boiled once per day. Patients consumed the therapeutic beverage for three days. If no therapeutic results were achieved, the dosage was doubled. The original dosage was maintained for patients demonstrating clinical improvements. One treatment course equalled one week and three courses of treatment were administered. Patients in the observation group consumed the herbal beverage combined with the following acupoint selection:

TB21 (Ermen)
SI19 (Tinggong)
GB2 (Tinghui)
TB17 (Yifeng)
KD15 (Zhongzhu)
SP6 (Sanyinjiao)
KD3 (Taixi)

Wan Shun Yi (22.08, Master Tung’s Acupuncture)

Wan Shun Er (22.09, Master Tung’s Acupuncture)

The needles were 0.30 mm x 25 mm in size and were perpendicularly inserted. Needle retention time was thirty minutes per acupuncture session. During that time, twenty minutes of mild moxibustion was applied to the following acupoints:

TB21 (Ermen)
SI19 (Tinggong)
GB2 (Tinghui)
SP6 (Sanyinjiao)
KD1 (Yongquan)

Acupuncture was applied for the same total duration as the herbal medicine regimen. Acupuncture treatments were applied for six consecutive days with a one day break during each course of treatment. The herbal medicine only group achieved a 68% total effective rate and the combination protocol of herbs and acupuncture produced an 88% total effective rate.

The use of a very warming herbal formula for the treatment of tinnitus in the treatment protocol was based on the TCM principle that tinnitus is caused by invasion of pathogenic cold combined with stagnation of liver qi. This is one of several differential diagnostic patterns associated with tinnitus in TCM. Given the strength of the herbal formula, the dispensation of the formula is only appropriate under the supervision of a licensed acupuncturist fully trained in Chinese herbal medicine.

Tinnitus affects approximately 20% of the population. Symptoms include a ringing or buzzing sound. There may also be a loud roaring, clicking, or even hissing. The frequency of tones may be either high or low. In TCM, high pitch tones are often associated with excess and low pitch tones with deficiency.

There are many biomedical etiologies associated with tinnitus. The study did not cover the treatment of tinnitus caused by Meniere’s Disease. This is often more appropriately addressed with herbal formulas similar to Ban Xia Bai Zhu Tian Ma Tang.

The study presents an aggressive herbal medicine and acupuncture regimen demonstrating significant positive patient outcomes. At the Healthcare Medicine Institute, we have covered many research papers on this topic. Perhaps one of the most intriguing and successful recent studies was the one conducted at Central Hospital of Otolaryngology and Head and Neck Surgery in Chaoyang City.
View the study by selecting the following link: Tinnitus Study >

Reference:
Du Huiping, Clinical study on effects of combined acupuncture and TCM decoction on sudden Tinnitus and hearing loss, Asia- Pacific Traditional Medicine, 2006, 12 (16).

Source: Health CMI

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