Aticles so far include Reiki, Biofeedback, Homeopathy, Ayurvedic Medicine

An Introduction to Reiki

Reiki (pronounced "ray-kee") is an energy medicine practice that originated in Japan. In Reiki, the practitioner places his hands on or near the person receiving treatment, with the intent to transmit ki, believed to be a life-force energy. Practitioners also believe that they can treat themselves with Reiki and send ki across short or long distances. In the United States, Reiki is part of complementary and alternative medicine (CAM). This Backgrounder provides a general overview of Reiki and suggests some resources you can use to learn more about this practice.

Key Points

People give and receive Reiki for various health purposes.
It is not fully known whether Reiki influences health and how it might do so. The existence of ki has not been proven scientifically.
The National Center for Complementary and Alternative Medicine (NCCAM) is sponsoring studies to find out more about Reiki's effects, how it works, and diseases and conditions for which it may be most helpful.
If you are considering or using Reiki or any other CAM therapy, talk to your health care provider about it. This is for your safety and a complete treatment plan.Reiki as an Energy Medicine Therapy

The word Reiki is made up of two Japanese words: Rei, or universal spirit (sometimes thought of as a supreme being), and ki. Thus, the word Reiki means "universal life energy."

In CAM, Reiki belongs to a domain (area of knowledge) called energy medicine. In this domain, therapies are based on the belief that disturbances in energy cause illness. Energy medicine practitioners seek to improve the flow and balance of energy in a beneficial way.

About Energy Medicine

Energy medicine seeks to use, for potential health purposes, forces of two types:

Forces that scientific instruments can measure (for example, forces associated with electromagnetic fields).
Forces (called biofields or putative energy fields) that some people believe surround and penetrate the human body, but whose existence is not yet scientifically proven. Ki, the life-force energy described in Reiki, is in this second category.Researchers have been interested in detecting and describing the physical properties of biofields. Some, using certain sophisticated tools, have claimed to detect or photograph differences in study participants before and after energy treatments. However, it is not clear what is being detected or photographed. Others have claimed to detect energy interactions between healers and people they treat. However, these findings have not been validated, and the exact nature of the energies is not clear.

A Description of Reiki

Reiki is a therapy that the practitioner delivers through the hands, with intent to raise the amount of ki in and around the client, heal pathways for ki, and reduce negative energies. Reiki can be practiced in several ways: on its own, along with other CAM therapies, and along with conventional medical treatments.

When a practitioner performs Reiki, usually the client sits or lies comfortably, fully clothed. The practitioner places her hands on or slightly above the client's body, using 12 to 15 different hand positions, with the intent to transmit ki. The hands are positioned with the palms down, fingers and thumbs extended. Each hand position is held until the practitioner feels that the flow of energy has slowed or stopped, typically about 2 to 5 minutes. Some Reiki practitioners believe they are helped by "spirit guides" for proper flow of the energy.
Practitioners perform Reiki most often in offices, hospitals, clinics, and private homes. The practitioner and client determine the number of sessions together. Typically, the practitioner delivers at least four sessions of 30 to 90 minutes each.
Depending on their level of training, people can perform Reiki on themselves as well as on people who are either close by or at some distance away (even at a long distance). In the latter case, Reiki is a type of "distant healing."

More About Ki

People who believe in the existence of ki hold that ki:

Is spiritual in origin.
Makes up and moves through all living things.
Is available in infinite quantities, positive in nature, and important to all aspects of health.
Is present both inside the body and on its surface.
Flows throughout the body in specific channels.
Has its flow disturbed by negative thoughts or feelings.They also believe that if ki's flow is disrupted, the body's functioning becomes disrupted, and health problems can occur. The concept that sickness and disease arise from imbalances in a vital energy field is the foundation not only of Reiki but of some other CAM therapies, such as traditional Chinese medicine (in which the energy is called qi or chi) and homeopathy (vital force).

Use for Health Purposes

People have sought Reiki treatment for a wide variety of health-related purposes. Some examples include:

Effects of stress.
Chronic pain.
Recovery from surgery and anesthesia.
Side effects of chemotherapy and radiation therapy for cancer.
Lowering heart rate.
Improving immunity.
Mental clarity.
Sense of well-being and/or spirituality.
Enhancing the sense of peace in people who are dying.A recent national survey on Americans' use of CAM found that 1.1 percent of the 31,000 participants had used Reiki in the year before the survey.

Effects of Reiki

Clients may report a deep feeling of relaxation after a Reiki session. Relaxation in and of itself may have beneficial health-related effects, such as reducing pain, nausea, and fatigue. A client might also experience warmth, tingling, sleepiness, refreshment, and/or the easing of one or more other symptoms after treatment.

Reiki appears to be generally safe, and serious side effects have not been reported. Some practitioners advise caution about using Reiki in people with psychiatric problems.

Sometimes a Reiki client experiences what practitioners call a "cleansing crisis." The person may have symptoms such as a feeling of weakness or tiredness, a headache, or a stomach ache. Reiki practitioners believe that these are effects of the body releasing toxins. They advise the client on how to deal with such symptoms if they occur, such as by getting more rest, drinking plenty of water, or eating a lighter diet.

Some Other Points to Consider About Reiki as CAM

If you are considering or using Reiki as CAM:

Do not use Reiki as a replacement for conventional care or to delay the time it takes you to see a doctor about a medical problem.
It is important to discuss any CAM therapies you are considering or using with your health care provider, for a complete treatment plan and your safety.
Ask the Reiki practitioner about his training and experience. Ask about any costs as well, for these can vary from fees to donations to no charge.
Reiki has not been well studied scientifically, but you can find and read research studies published on its use for various health conditions.History of Reiki

There are different beliefs about the origin of Reiki--one is that it is based on Tibetan sutras (texts of Buddhism) written by monks. Sources agree that in the mid-19th century, Dr. Mikao Usui, a Japanese physician and monk, developed this healing approach and spiritual path, named it Reiki, trained others in it, and developed an organization.

One of Dr. Usui's students further developed these teachings and opened his own clinic in Tokyo, where, in 1936, an American named Hawayo Takata went for treatment. Later, she trained in Reiki, became a Master, and is credited with introducing Reiki to the West in the late 1930s.

Training, Licensing, and Certification

A person does not need a special background or credentials to receive Reiki training. Many who seek the training are health care professionals. Students must learn the practice from an experienced Reiki teacher or Master, as it is not a therapy that can be self-taught.
There are a number of different schools of Reiki. Usually there are three or four levels (or degrees) of expertise, depending upon the school or type. Each level begins with an attunement, or initiation into that level. Receiving an attunement is believed to bring the ability to access Reiki energy and to open what is conceived as a central core of energy in the body.

Training for each level typically takes 1 or 2 days. The techniques taught can vary greatly between Reiki schools and teachers. In time, some students undertake the effort to become a Reiki Master, which enables one to teach Reiki and perform attunements. This process can take years. Some members of the Reiki professional community are interested in developing additional, voluntary standards for their profession.

The laws regulating the practice of Reiki vary from state to state, and sometimes by local areas as well. For example, in Florida, a Reiki practitioner must also be a certified massage therapist. Most other states do not consider Reiki to be massage and thus do not regulate it as a form of massage therapy.

Some Points of Controversy

As in other CAM therapies, there are areas of controversy in Reiki. For example:

Since little is known scientifically about Reiki, accepting its teachings about its healing properties and about ki is a matter of faith.
Some people believe that effects attributed to Reiki occur for psychological reasons (such as the placebo effect or suggestibility), or that there are no true effects.
Some people feel Reiki is incompatible with their religious or spiritual beliefs.
Government licensing and regulation of Reiki practice is a controversial area.NCCAM-Funded Research

Some recent NCCAM-supported studies have been investigating:

How Reiki might work
Whether Reiki is effective and safe for treating the symptoms of fibromyalgia.
Reiki's possible impact on the well-being and quality of life in people with advanced AIDS.
The effects of Reiki on disease progression and/or anxiety in people with prostate cancer.
Whether Reiki can help control blood sugar levels or improve heart function in people who have nerve pain from diabetes.

What is biofeedback?

Biofeedback uses your mind to control your body. Biofeedback is a type of complementary and alternative medicine called mind-body therapy. Using feedback from a variety of monitoring procedures and equipment, a biofeedback specialist will try to teach you to control certain involuntary body responses, such as:

Brain activity
Blood pressure
Muscle tension
Heart rateOnce you learn to recognize and control these responses, you can use biofeedback to help treat a wide range of mental and physical health problems. Even if you don't have a specific disease or condition, biofeedback may help your overall health and sense of well-being.

What conditions benefit from biofeedback?

Biofeedback has been shown to be helpful in treating about 150 medical conditions, including:

Asthma
Raynaud's disease
Irritable bowel syndrome
Hot flashes
Nausea and vomiting associated with chemotherapy
Incontinence
Headaches
Irregular heartbeats (cardiac arrhythmias)
High blood pressure
EpilepsyClinical trials are evaluating biofeedback in other conditions as well.

What happens during a biofeedback session?

You can receive biofeedback training in physical therapy clinics, medical centers and hospitals. A typical biofeedback session lasts 30 to 60 minutes.

During a biofeedback session, a therapist will apply electrical sensors to different parts of your body. These sensors will monitor your body's physiological response to stress — for instance, your muscle contraction during a tension headache — and then feed the information back to you via auditory and visual cues. These cues may take the form of a beeping sound or a flashing light. With this feedback, you'll start to associate your body's response — in this case, pain — with certain physical functions, such as your muscles tensing.

Once you begin to recognize that your headache, in this case, is a result of tense muscles, the next step is to learn how to invoke positive physical changes in your body, such as relaxing those specific muscles, when your body is physically or mentally stressed. Your eventual goal will be to produce these responses on your own, outside the therapist's office and without the help of technology.

Types of biofeedback

Your therapist may use several different techniques to gather information about your body's responses. Determining the one that's right for you will depend on your particular health problems and objectives. Machines and techniques include:

Electromyogram (EMG). An EMG uses electrodes or other types of sensors to measure muscle tension. By the EMG alerting you to muscle tension, you can learn to recognize the feeling early on and try to control the tension right away. EMG is mainly used to promote the relaxation of those muscles involved in backaches, headaches, neck pain and grinding your teeth (bruxism). An EMG may be used to treat some illnesses in which the symptoms tend to worsen under stress, such as asthma and ulcers.
Temperature biofeedback. Sensors attached to your fingers or feet measure your skin temperature. Because your temperature often drops when you're under stress, a low reading can prompt you to begin relaxation techniques. Temperature biofeedback can help treat certain circulatory disorders, such as Raynaud's disease, or reduce the frequency of migraines.
Galvanic skin response training. Sensors measure the activity of your sweat glands and the amount of perspiration on your skin, alerting you to anxiety. This information can be useful in treating emotional disorders such as phobias, anxiety and stuttering.
Electroencephalogram (EEG). An EEG monitors the activity of brain waves linked to different mental states, such as wakefulness, relaxation, calmness, light sleep and deep sleep.Finding a biofeedback therapist: Ask questions

Once you decide to try biofeedback, you'll need to find a qualified biofeedback therapist. Contact the Biofeedback Certification Institute of America (BCIA) and ask for the names of people certified in your area. BCIA therapists must be licensed in another area of health care — for instance, as a physical therapist — or be working under the guidance of a health care professional. They should be accustomed to working with patients, and you can expect them to have a good bedside manner.

If you can't find a BCIA-certified therapist in your area, ask your doctor or another medical expert with knowledge of complementary and alternative medicine to recommend someone who has experience in treating the specific symptoms that are bothering you. As with any health care practitioner, you may have to meet with several individuals to find the one with whom you feel most comfortable.

Be sure to ask each therapist to provide references. Find out the therapist's other areas of professional expertise, and whether he or she has experience treating the specific problem for which you're seeking help. Check to see whether your health insurer will cover the cost of treatment.

Pros and cons of biofeedback

Biofeedback may appeal to you for several reasons:

It can reduce, or even eliminate, your need for medication. It has the potential to help conditions that have not responded to medication.
It helps puts you in charge of your own healing by providing measurable feedback, allowing you to monitor your progress and learning.
It can decrease your medical costs.On the other hand, you may be hesitant to try biofeedback because experts aren't entirely sure how the therapy works. Many people who have tried biofeedback can't explain how they're able to control their bodies to relieve their symptoms.
To truly assess whether biofeedback is effective in treating your particular symptoms, keep a daily diary to monitor your use of the treatment as well as how you feel before, during and after the therapy.

Although biofeedback is considered safe, talk to a doctor knowledgeable about this form of complementary and alternative medicine if you have depression, severe psychosis, diabetes or other endocrine disorders. Biofeedback can interfere with the use of some medications, such as insulin.
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Homeopathy, also known as homeopathic medicine, is a form of health care that developed in Germany and has been practiced in the United States since the early 19th century. Homeopathic practitioners are commonly called homeopaths. This fact sheet answers some frequently asked questions on homeopathy and reviews scientific research on its use and effectiveness.

Key Points

In homeopathy, a key premise is that every person has energy called a vital force or self-healing response. When this energy is disrupted or imbalanced, health problems develop. Homeopathy aims to stimulate the body's own healing responses.
Homeopathic treatment involves giving extremely small doses of substances that produce characteristic symptoms of illness in healthy people when given in larger doses. This approach is called "like cures like."
Various explanations have been proposed as to how homeopathy might work. However, none of these explanations has been scientifically verified.
Research studies on homeopathy have been contradictory in their findings. Some analyses have concluded that there is no strong evidence supporting homeopathy as effective for any clinical condition. However, others have found positive effects from homeopathy. The positive effects are not readily explained in scientific terms.
It is important to inform all of your health care providers about any therapy that you are currently using or considering, including homeopathic treatment. This is to help ensure a safe and coordinated course of care.1. What is homeopathy?

The term homeopathy comes from the Greek words homeo, meaning similar, and pathos, meaning suffering or disease. Homeopathy is an alternative medical system. Alternative medical systems are built upon complete systems of theory and practice, and often have evolved apart from and earlier than the conventional medical approach used in the United States.a (http://nccam.nih.gov/health/homeopathy/index.htm#a) Homeopathy takes a different approach from conventional medicine in diagnosing, classifying, and treating medical problems.

Key concepts of homeopathy include:

Homeopathy seeks to stimulate the body's defense mechanisms and processes so as to prevent or treat illness.

Treatment involves giving very small doses of substances called remedies that, according to homeopathy, would produce the same or similar symptoms of illness in healthy people if they were given in larger doses.
Treatment in homeopathy is individualized (tailored to each person). Homeopathic practitioners select remedies according to a total picture of the patient, including not only symptoms but lifestyle, emotional and mental states, and other factors.2. What is the history of the discovery and use of homeopathy?

In the late 1700s, Samuel Hahnemann, a physician, chemist, and linguist in Germany, proposed a new approach to treating illness. This was at a time when the most common medical treatments were harsh, such as bloodletting,c (http://nccam.nih.gov/health/homeopathy/index.htm#c) purging, blistering, and the use of sulfur and mercury. At the time, there were few effective medications for treating patients, and knowledge about their effects was limited.

Hahnemann was interested in developing a less-threatening approach to medicine. The first major step reportedly was when he was translating an herbal text and read about a treatment (cinchona bark) used to cure malaria. He took some cinchona bark and observed that, as a healthy person, he developed symptoms that were very similar to malaria symptoms. This led Hahnemann to consider that a substance may create symptoms that it can also relieve. This concept is called the "similia principle" or "like cures like." The similia principle had a prior history in medicine, from Hippocrates in Ancient Greece--who noted, for example, that recurrent vomiting could be treated with an emetic (such as ipecacuanha) that would be expected to make it worse--to folk medicine. Another way to view "like cures like" is that symptoms are part of the body's attempt to heal itself--for example, a fever can develop as a result of an immune response to an infection, and a cough may help to eliminate mucus--and medication may be given to support this self-healing response.

Hahnemann tested single, pure substances on himself and, in more dilute forms, on healthy volunteers. He kept meticulous records of his experiments and participants' responses, and he combined these observations with information from clinical practice, the known uses of herbs and other medicinal substances, and toxicology,d (http://nccam.nih.gov/health/homeopathy/index.htm#d) eventually treating the sick and developing homeopathic clinical practice.
Hahnemann added two additional elements to homeopathy:

A concept that became "potentization," which holds that systematically diluting a substance, with vigorous shaking at each step of dilution, makes the remedy more, not less, effective by extracting the vital essence of the substance. If dilution continues to a point where the substance's molecules are gone, homeopathy holds that the "memory" of them--that is, the effects they exerted on the surrounding water molecules--may still be therapeutic.
A concept that treatment should be selected based upon a total picture of an individual and his symptoms, not solely upon symptoms of a disease. Homeopaths evaluate not only a person's physical symptoms but her emotions, mental states, lifestyle, nutrition, and other aspects. In homeopathy, different people with the same symptoms may receive different homeopathic remedies.Hans Burch Gram, a Boston-born doctor, studied homeopathy in Europe and introduced it into the United States in 1825. European immigrants trained in homeopathy also made the treatment increasingly available in America. In 1835, the first homeopathic medical college was established in Allentown, Pennsylvania. By the turn of the 20th century, 8 percent of all American medical practitioners were homeopaths, and there were 20 homeopathic medical colleges and more than 100 homeopathic hospitals in the United States.

In the late 19th and early 20th centuries, numerous medical advances were made, such as the recognition of the mechanisms of disease; Pasteur's germ theory; the development of antiseptic techniques; and the discovery of ether anesthesia. In addition, a report (the so-called "Flexner Report") was released that triggered major changes in American medical education. Homeopathy was among the disciplines negatively affected by these developments. Most homeopathic medical schools closed down, and by the 1930s others had converted to conventional medical schools.

In the 1960s, homeopathy's popularity began to revive in the United States. According to a 1999 survey of Americans and their health, over 6 million Americans had used homeopathy in the preceding 12 months.16 (http://nccam.nih.gov/health/homeopathy/index.htm#16) The World Health Organization noted in 1994 that homeopathy had been integrated into the national health care systems of numerous countries, including Germany, the United Kingdom, India, Pakistan, Sri Lanka, and Mexico.7 (http://nccam.nih.gov/health/homeopathy/index.htm#7) Several schools of practice exist within homeopathy.17 (http://nccam.nih.gov/health/homeopathy/index.htm#17)
Persons using homeopathy do so to address a range of health concerns, from wellness and prevention to treatment of injuries, diseases, and conditions. Studies have found that many people who seek homeopathic care seek it for help with a chronic medical condition.18 (http://nccam.nih.gov/health/homeopathy/index.htm#18),19 (http://nccam.nih.gov/health/homeopathy/index.htm#19),20 (http://nccam.nih.gov/health/homeopathy/index.htm#20) Many users of homeopathy treat themselves with homeopathic products and do not consult a professional.13 (http://nccam.nih.gov/health/homeopathy/index.htm#13)

3. What kind of training do homeopathic practitioners receive?

In European countries, training in homeopathy is usually pursued either as a primary professional degree completed over 3 to 6 years or as postgraduate training for doctors.

In the United States, training in homeopathy is offered through diploma programs, certificate programs, short courses, and correspondence courses. Also, homeopathic training is part of medical education in naturopathy.e (http://nccam.nih.gov/health/homeopathy/index.htm#e) Most homeopathy in the United States is practiced along with another health care practice for which the practitioner is licensed, such as conventional medicine, naturopathy, chiropractic, dentistry, acupuncture, or veterinary medicine (homeopathy is used to treat animals).

Laws about what is required to practice homeopathy vary among states. Three states (Connecticut, Arizona, and Nevada) license medical doctors specifically for homeopathy.

Naturopathy, also known as naturopathic medicine, is an alternative medical system that emphasizes natural healing approaches (such as herbs, nutrition, and movement or manipulation of the body). Some elements of naturopathy are similar to homeopathy, such as an intent to support the body's own self-healing response.

4. What do homeopathic practitioners do in treating patients?

Typically, in homeopathy, patients have a lengthy first visit, during which the provider takes an in-depth assessment of the patient. This is used to guide the selection of one or more homeopathic remedies. During followup visits, patients report how they are responding to the remedy or remedies, which helps the practitioner make decisions about further treatment.

5. What are homeopathic remedies?

Most homeopathic remedies are derived from natural substances that come from plants, minerals, or animals. A remedy is prepared by diluting the substance in a series of steps. Homeopathy asserts that this process can maintain a substance's healing properties regardless of how many times it has been diluted. Many homeopathic remedies are so highly diluted that not one molecule of the original natural substance remains.Remedies are sold in liquid, pellet, and tablet forms.

6. How does the U.S. Food and Drug Administration (FDA) regulate homeopathic remedies?

Because of their long use in the United States, the U.S. Congress passed a law in 1938 declaring that homeopathic remedies are to be regulated by the FDA in the same manner as nonprescription, over-the-counter (OTC) drugs, which means that they can be purchased without a physician's prescription. Today, although conventional prescription drugs and new OTC drugs must undergo thorough testing and review by the FDA for safety and effectiveness before they can be sold, this requirement does not apply to homeopathic remedies.

Remedies are required to meet certain legal standards for strength, quality, purity, and packaging. In 1988, the FDA required that all homeopathic remedies list the indications for their use (i.e., the medical problems to be treated) on the label. The FDA also requires the label to list ingredients, dilutions, and instructions for safe use.

7. Have any side effects or complications been reported from the use of homeopathy?

The FDA has learned of a few reports of illness associated with the use of homeopathic remedies. However, the FDA reviewed these reports and decided that the remedies were not likely to be the cause, because of the high dilutions.

Here is some general information that has been reported about risks and side effects in homeopathy:

Homeopathic medicines in high dilutions, taken under the supervision of trained professionals, are considered safe and unlikely to cause severe adverse reactions.
Some patients report feeling worse for a brief period of time after starting homeopathic remedies. Homeopaths interpret this as the body temporarily stimulating symptoms while it makes an effort to restore health.
Liquid homeopathic remedies can contain alcohol and are permitted to have higher levels of alcohol than conventional drugs for adults. This may be of concern to some consumers. However, no adverse effects from the alcohol levels have been reported either to the FDA or in the scientific literature.
Homeopathic remedies are not known to interfere with conventional drugs; however, if you are considering using homeopathic remedies, you should discuss this with your health care provider. If you have more than one provider, discuss it with each one.
Contact his health care provider if his symptoms continue unimproved for more than 5 days.
Keep the remedy out of the reach of children.
Consult a health care provider before using the product if the user is a woman who is pregnant or nursing a baby.8. What has scientific research found out about whether homeopathy works?

The results of individual, controlled clinical trials of homeopathy have been contradictory. In some trials, homeopathy appeared to be no more helpful than a placebo; in other studies, some benefits were seen that the researchers believed were greater than one would expect from a placebo.

9. Are there scientific controversies associated with homeopathy?

Yes. Homeopathy is an area of complementary and alternative medicine (CAM) that has seen high levels of controversy and debate, largely because a number of its key concepts do not follow the laws of science (particularly chemistry and physics).

It is debated how something that causes illness might also cure it.
It has been questioned whether a remedy with a very tiny amount (perhaps not even one molecule) of active ingredient could have a biological effect, beneficial or otherwise.

There have been some research studies published on the use of ultra-high dilutions (UHDs) of substances, diluted to levels compatible with those in homeopathy and shaken hard at each step of dilution. The results are claimed to involve phenomena at the molecular level and beyond, such as the structure of water, and waves and fields. Both laboratory research and clinical trials have been published. There have been mixed results in attempts to replicate them. Reviews have not found UHD results to be definitive or compelling.

There have been some studies that found effects of UHDs on isolated organs, plants, and animals.There have been controversy and debate about these findings as well.
Effects in homeopathy might be due to the placebo or other non-specific effect.
There are key questions about homeopathy that are yet to be subjected to studies that are well-designed--such as whether it actually works for some of the diseases or medical conditions for which it is used, and if so, how it might work.
There is a point of view that homeopathy does work, but that modern scientific methods have not yet explained why. The failure of science to provide full explanations for all treatments is not unique to homeopathy.
Some people feel that if homeopathy appears to be helpful and safe, then scientifically valid explanations or proofs of this alternative system of medicine are not necessary.10. Is NCCAM funding research on homeopathy?

Yes, NCCAM supports a number of studies in this area. For example:

Homeopathy for physical, mental, and emotional symptoms of fibromyalgia (a chronic disorder involving widespread musculoskeletal pain, multiple tender points on the body, and fatigue).
Homeopathy for brain deterioration and damage in animal models for stroke and dementia.
The homeopathic remedy cadmium, to find out whether it can prevent damage to the cells of the prostate when those cells are exposed to toxins.

Ayurvedic medicine (also called Ayurveda) is one of the world's oldest medical systems. It originated in India and has evolved there over thousands of years. In the United States, Ayurveda is considered complementary and alternative medicine (CAM)--more specifically, a CAM whole medical system. Many therapies used in Ayurveda are also used on their own as CAM--for example, herbs, massage, and yoga. This Backgrounder will introduce you to Ayurveda's major ideas and practices and provide sources for more information on these or other CAM therapies.

CAM is a group of diverse medical and health care systems, practices, and products that are not currently considered part of conventional medicine. Complementary medicine is used together with conventional medicine. Alternative medicine is practiced in place of conventional medicine. Conventional medicine is medicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals. Some conventional medical practitioners also practice CAM. Whole medical systems are healing systems and beliefs that have evolved over time in different cultures and parts of the world.

Key Points

The aim of Ayurveda is to integrate and balance the body, mind, and spirit. This is believed to help prevent illness and promote wellness.
In Ayurvedic philosophy, people, their health, and the universe are all thought to be related. It is believed that health problems can result when these relationships are out of balance.
In Ayurveda, herbs, metals, massage, and other products and techniques are used with the intent of cleansing the body and restoring balance. Some of these products may be harmful when used on their own or when used with conventional medicines.
Before you seek care from an Ayurvedic practitioner, ask about the practitioner's training and experience.
Tell your health care provider(s) about any CAM therapies you are using, including Ayurveda. This is for your safety and a comprehensive treatment plan.1. What is Ayurvedic medicine?

Ayurvedic medicine is also called Ayurveda. It is a system of medicine that originated in India several thousand years ago. The term Ayurveda combines two Sanskrit words--ayur, which means life, and veda, which means science or knowledge. Ayurveda means "the science of life."

In the United States, Ayurveda is considered a type of CAM and a whole medical system. As with other such systems, it is based on theories of health and illness and on ways to prevent, manage, or treat health problems. Ayurveda aims to integrate and balance the body, mind, and spirit (thus, some view it as "holistic"). This balance is believed to lead to contentment and health, and to help prevent illness. However, Ayurveda also proposes treatments for specific health problems, whether they are physical or mental. A chief aim of Ayurvedic practices is to cleanse the body of substances that can cause disease, and this is believed to help reestablish harmony and balance.

2. What is the history of Ayurvedic medicine?

Ayurveda is based on ideas from Hinduism, one of the world's oldest and largest religions. Some Ayurvedic ideas also evolved from ancient Persian thoughts about health and healing.

Many Ayurvedic practices were handed down by word of mouth and were used before there were written records. Two ancient books, written in Sanskrit on palm leaves more than 2,000 years ago, are thought to be the first texts on Ayurveda--Caraka Samhita and Susruta Samhita. They cover many topics, including:

Pathology (the causes of illness)
Diagnosis
Treatment
Surgery (this is no longer part of standard Ayurvedic practice)
How to care for children
Lifestyle
Advice for practitioners, including medical ethics
PhilosophyAyurveda has long been the main system of health care in India, although conventional (Western) medicine is becoming more widespread there, especially in urban areas. About 70 percent of India's population lives in rural areas; about two-thirds of rural people still use Ayurveda and medicinal plants to meet their primary health care needs. In addition, most major cities have an Ayurvedic college and hospital. Ayurveda and variations of it have also been practiced for centuries in Pakistan, Nepal, Bangladesh, Sri Lanka, and Tibet. The professional practice of Ayurveda in the United States began to grow and became more visible in the late 20th century.

3. How common is the use of Ayurveda in the United States?

The first national data to answer this question are from a survey released in May 2004 by the National Center for Health Statistics and the National Center for Complementary and Alternative Medicine (NCCAM). More than 31,000 adult Americans were surveyed about their use of CAM, including specific CAM therapies such as Ayurveda. Among the respondents, four-tenths of 1 percent had ever used Ayurveda, and one-tenth of 1 percent had used it in the past 12 months. When these percentages are adjusted to nationally representative numbers, about 751,000 people in the United States had ever used Ayurveda, and 154,000 people had used it within the past 12 months.

4. What major beliefs underlie Ayurveda?

Here is a summary of major beliefs in Ayurveda that pertain to health and disease.

Interconnectedness

Ideas about the relationships among people, their health, and the universe form the basis for how Ayurvedic practitioners think about problems that affect health. Ayurveda holds that:

All things in the universe (both living and nonliving) are joined together.
Every human being contains elements that can be found in the universe.
All people are born in a state of balance within themselves and in relation to the universe.
This state of balance is disrupted by the processes of life. Disruptions can be physical, emotional, spiritual, or a combination. Imbalances weaken the body and make the person susceptible to disease.
Health will be good if one's interaction with the immediate environment is effective and wholesome.
Disease arises when a person is out of harmony with the universe.Constitution and Health

Ayurveda also has some basic beliefs about the body's constitution. "Constitution" refers to a person's general health, how likely he is to become out of balance, and his ability to resist and recover from disease or other health problems. An overview of these beliefs follows.

The constitution is called the prakriti. The prakriti is thought to be a unique combination of physical and psychological characteristics and the way the body functions. It is influenced by such factors as digestion and how the body deals with waste products. The prakriti is believed to be unchanged over a person's lifetime.
Three qualities called doshas form important characteristics of the constitution, and control the activities of the body. Practitioners of Ayurveda call the doshas by their original Sanskrit names: vata, pitta, and kapha. It is also believed that:
Each dosha is made up of one or two of the five basic elements: space, air, fire, water, and earth.
Each dosha has a particular relationship to body functions and can be upset for different reasons.
A person has her own balance of the three doshas, although one dosha usually is prominent. Doshas are constantly being formed and reformed by food, activity, and bodily processes.
Each dosha is associated with a certain body type, a certain personality type, and a greater chance of certain types of health problems.
An imbalance in a dosha will produce symptoms that are related to that dosha and are different from symptoms of an imbalance in another dosha. Imbalances may be caused by an unhealthy lifestyle or diet; too much or too little mental and physical exertion; or not being properly protected from the weather, chemicals, or germs.
In summary, it is believed that a person's chances of developing certain types of diseases are related to the way doshas are balanced, the state of the physical body, and mental or lifestyle factors.

5. What is each dosha like?

Here are some important beliefs about the three doshas:

The vata dosha is thought to be a combination of the elements space and air. It is considered the most powerful dosha because it controls very basic body processes such as cell division, the heart, breathing, and the mind. Vata can be thrown out of balance by, for example, staying up late at night, eating dry fruit, or eating before the previous meal is digested. People with vata as their main dosha are thought to be especially susceptible to skin, neurological, and mental diseases.
The pitta dosha represents the elements fire and water. Pitta is said to control hormones and the digestive system. When pitta is out of balance, a person may experience negative emotions (such as hostility and jealousy) and have physical symptoms (such as heartburn within 2 or 3 hours of eating). Pitta is upset by, for example, eating spicy or sour food; being angry, tired, or fearful; or spending too much time in the sun. People with a predominantly pitta constitution are thought to be susceptible to heart disease and arthritis.
The kapha dosha combines the elements water and earth. Kapha is thought to help keep up strength and immunity and to control growth. An imbalance in the kapha dosha may cause nausea immediately after eating. Kapha is aggravated by, for example, sleeping during the daytime, eating too many sweet foods, eating after one is full, and eating and drinking foods and beverages with too much salt and water (especially in the springtime). Those with a predominant kapha dosha are thought to be vulnerable to diabetes, gallbladder problems, stomach ulcers, and respiratory illnesses such as asthma.6. How does an Ayurvedic practitioner decide on a person's dosha balance?

Practitioners seek to determine the primary dosha and the balance of doshas through questions that allow them to become very familiar with the patient. Not all questions have to do with particular symptoms. The practitioner will:

Ask about diet, behavior, lifestyle practices, and the reasons for the most recent illness and symptoms the patient had
Carefully observe such physical characteristics as teeth, skin, eyes, and weight
Take a person's pulse, because each dosha is thought to make a particular kind of pulse7. How else does an Ayurvedic practitioner work with the patient at first?

In addition to questioning, Ayurvedic practitioners use observation, touch, therapies, and advising. During an examination, the practitioner checks the patient's urine, stool, tongue, bodily sounds, eyes, skin, and overall appearance. He will also consider the person's digestion, diet, personal habits, and resilience (ability to recover quickly from illness or setbacks). As part of the effort to find out what is wrong, the practitioner may prescribe some type of treatment. The treatment is generally intended to restore the balance of one particular dosha. If the patient seems to improve as a result, the practitioner will provide additional treatments intended to help balance that dosha.

8. How does an Ayurvedic practitioner treat health problems?

The practitioner will develop a treatment plan and may work with people who know the patient well and can help. This helps the patient feel emotionally supported and comforted, which is considered important.

Practitioners expect patients to be active participants in their treatment, because many Ayurvedic treatments require changes in diet, lifestyle, and habits. In general, treatments use several approaches, often more than one at a time. The goals of treatment are to:

Eliminate impurities. A process called panchakarma is intended to be cleansing; it focuses on the digestive tract and the respiratory system. For the digestive tract, cleansing may be done through enemas, fasting, or special diets. Some patients receive medicated oils through a nasal spray or inhaler. This part of treatment is believed to eliminate worms or other agents thought to cause disease.
Reduce symptoms. The practitioner may suggest various options, including yoga exercises, stretching, breathing exercises, meditation, and lying in the sun. The patient may take herbs (usually several), often with honey, with the intent to improve digestion, reduce fever, and treat diarrhea. Sometimes foods such as lentil beans or special diets are also prescribed. Very small amounts of metal and mineral preparations also may be given, such as gold or iron. Careful control of these materials is intended to protect the patient from harm.
Reduce worry and increase harmony in the patient's life. The patient may be advised to seek nurturing and peacefulness through yoga, meditation, exercise, or other techniques.
Help eliminate both physical and psychological problems. Vital points therapy and/or massage may be used to reduce pain, lessen fatigue, or improve circulation. Ayurveda proposes that there are 107 "vital points" in the body where life energy is stored, and that these points may be massaged to improve health. Other types of Ayurvedic massage use medicinal oils.9. How are plant products used in Ayurvedic treatment?

In Ayurveda, the distinction between food and medicine is not as clear as in Western medicine. Food and diet are important components of Ayurvedic practice, and so there is a heavy reliance on treatments based on herbs and plants, oils (such as sesame oil), common spices (such as turmeric), and other naturally occurring substances.
Currently, some 5,000 products are included in the "pharmacy" of Ayurvedic treatments. In recent years, the Indian government has collected and published safety information on a small number of them. Historically, plant compounds have been grouped into categories according to their effects. For example, some compounds are thought to heal, promote vitality, or relieve pain. The compounds are described in many texts prepared through national medical agencies in India.
Below are a few examples of how some botanicals (plants and their products) have been or are currently used in treatment. In some cases, these may be mixed with metals.

The spice turmeric has been used for various diseases and conditions, including rheumatoid arthritis, Alzheimer's disease, and wound healing.
A mixture (Arogyawardhini) of sulfur, iron, powdered dried fruits, tree root, and other substances has been used to treat problems of the liver.
An extract from the resin from a tropical shrub (Commiphora mukul, or guggul) has been used for a variety of illnesses. In recent years, there has been research interest in its use to possibly lower cholesterol.10. In the United States, how are Ayurvedic practitioners trained and certified?

Practitioners of Ayurveda in the United States have various types of training. Some are trained in the Western medical tradition (such as medical or nursing school) and then study Ayurveda. Others may have training in naturopathic medicine, a whole medical system, either before or after their Ayurvedic training. Many study in India, where there are more than 150 undergraduate and more than 30 postgraduate colleges for Ayurveda. This training can take up to 5 years.

Students who receive all of their Ayurvedic training in India can earn either a bachelor's or doctoral degree. After graduation, they may go to the United States or other countries to practice. Some practitioners are trained in a particular aspect of Ayurvedic practice--for example, massage or meditation--but not in others, such as preparing botanical treatments.

The United States has no national standard for certifying or training Ayurvedic practitioners, although a few states have approved Ayurvedic schools. Some Ayurvedic professional organizations are collaborating to develop licensing requirements.

Consumers interested in Ayurveda should be aware that not every practitioner offering services or treatments called "Ayurvedic" has been trained in an Ayurvedic medical school. Services offered at spas and salons, for example, often fall into this category. If you are seeking Ayurvedic medical treatment, it is important to ask about the practitioner's training and experience.

11. Does Ayurveda work?

Ayurveda includes many types of therapies and is used for many health issues. A summary of the scientific evidence is beyond the scope of this Backgrounder. You can consult the PubMed database on the Internet or contact the NCCAM Clearinghouse for any research results available on a disease or condition. However, very few rigorous, controlled scientific studies have been carried out on Ayurvedic practices. In India, the government began systematic research in 1969, and the work continues.

12. Are there concerns about Ayurvedic medicine?

Health officials in India and other countries have expressed concerns about certain Ayurvedic practices, especially those involving herbs, metals, minerals, or other materials. Here are some of those concerns:

Ayurvedic medications have the potential to be toxic. Many materials used in them have not been thoroughly studied in either Western or Indian research. In the United States, Ayurvedic medications are regulated as dietary supplements (a category of foods; see box below). As such, they are not required to meet the rigorous standards for conventional medicines. An American study published in 2004 found that of 70 Ayurvedic remedies purchased over-the-counter (all had been manufactured in South Asia), 14 (one-fifth) contained lead, mercury, and/or arsenic at levels that could be harmful. Also in 2004, the Centers for Disease Control and Prevention received 12 reports of lead poisoning linked to the use of Ayurvedic medications.
Most Ayurvedic medications consist of combinations of herbs and other medicines, so it can be challenging to know which ones are having an effect and why.
Whenever two or more medications are used, there is the potential for them to interact with each other. As a result, the effectiveness of at least one may increase or decrease in the body. For example, it is known that guggul lipid (an extract of guggul) may increase the activity of aspirin, which could lead to bleeding problems.
Most clinical trials of Ayurvedic approaches have been small, had problems with research designs, lacked appropriate control groups, or had other issues that affected how meaningful the results were.About Dietary Supplements

Dietary supplements were defined in a law passed by Congress in 1994. A dietary supplement must meet all of the following conditions:

It is a product (other than tobacco) intended to supplement the diet, which contains one or more of the following: vitamins; minerals; herbs or other botanicals; amino acids; or any combination of the above ingredients.
It is intended to be taken in tablet, capsule, powder, softgel, gelcap, or liquid form.
It is not represented for use as a conventional food or as a sole item of a meal or the diet.
It is labeled as being a dietary supplement.Other important information about dietary supplements:

They are regulated as foods, not drugs, so there could be quality issues in the manufacturing process.
Supplements can interact with prescribed or over-the-counter medicines, and other supplements.
"Natural" does not necessarily mean "safe" or "effective."
Consult your health care provider before starting a supplement, especially if you are pregnant or nursing, or considering giving a supplement to a child.13. In sum, what should people do if they are considering or using Ayurveda?

Tell your health care provider if you are considering or using Ayurveda or another CAM therapy. This is for your safety and a comprehensive treatment plan. Women who are pregnant or nursing, or people who are thinking of using CAM to treat a child, should be sure to consult their provider.
It is important to make sure that any diagnosis of a disease or condition has been made by a provider who has substantial conventional medical training and experience with managing that disease or condition.
Proven conventional treatments should not be replaced with an unproven CAM treatment.
It is better to use Ayurvedic remedies under the supervision of an Ayurvedic medicine practitioner than to try to treat yourself.
Ask about the practitioner's training and experience.
Tell your provider(s) about any dietary supplements or medications (prescription or over-the-counter) you are using or considering. Prescribed medicines may need to be adjusted if you are also using a CAM therapy. Also, herbal supplements can have safety issues.
Find out whether any rigorous scientific studies have been done on the therapies you are interested in.14. Is NCCAM supporting any studies on Ayurveda?

Yes, NCCAM supports studies in this area. For example:

Researchers at the University of Pennsylvania School of Medicine tested the effects of guggul lipid on high cholesterol. Over the 6-month period of this study, they did not find that adults with high cholesterol showed any improvement in cholesterol levels. In fact, the levels of low-density lipoproteins (the "bad" cholesterol) increased slightly in some people in the group taking guggul. In addition, some in the guggul lipid group developed a skin rash. This team is conducting further studies on herbal therapies used in Ayurveda for cardiovascular conditions, including curcuminoids (substances found in the root of the plant turmeric).
At the NCCAM-supported Center for Phytomedicine Research at the University of Arizona, scientists are investigating three botanicals (ginger, turmeric, and boswellia) used in Ayurvedic medicine to treat inflammatory disorders. They are seeking to better understand these botanicals and determine whether they might be useful in treating arthritis and asthma.
A compound from a plant called Mucuna pruriens, also known as cowhage, is being studied at the Cleveland Clinic Foundation. The research team is investigating the compound's potential to prevent or lessen the severe, often disabling side effects that people with Parkinson's disease experience from prolonged treatment with conventional drugs.