Alternative or integrative medicine is a holistic approach to healthcare. Many of these techniques have been used for centuries in many different cultures. Today, there is a growing body of research to suggest that integrative therapies have much to offer patients in treatment and rehabilitation, and to promote wellness overall. This is particularly the case for health conscious people who lead a “wellness-oriented” lifestyle and are concerned with nutrition, fitness, stress, and their environment, as well as those with chronic conditions.
Although there is a growing acceptance of the value of holistic approaches, it has been long overlooked due to dogma in Western medicine. Naturally, the origins of medicine are deeply rooted in a culture’s religious and philosophical beliefs. The same goes for Western allopathic practices; in the 1600s, enlightenment philosophy marked the mind as distinct from the body. This set the stage for a reductive view of medicine, where the body is reduced to its constituent parts to gain an understanding of the whole.
It’s only until the past few decades that healthcare practitioners have attempted to conceptually ‘reunite’ the body and mind, and better understand it as a whole system. That is, medical and integrative therapies are working in tandem to understand how mental health, nutrition, lifestyle choices, immunity and physical health intersect. The basic principles of integrative medicine comprise a partnership between practitioner and patient, applying the appropriate use of conventional and alternative methods to improve the body’s innate healing response. Here, we study the case for integrative medicine, as it pertains to patient well-being and public health.
Which Therapies Does Integrative Medicine Include?
According to the definition provided by the NCCIH (National Center for Complementary and Integrative Health), “most integrative therapies fall into one of two subgroups—natural products or mind and body practices”. These could include interventions in nutrition, natural supplements, homeopathy, mind-body medicine, lifestyle changes, physiotherapy, or counselling. There are also a variety of whole-systems practices that originate from other cultures, as touched on here in the introduction.
Examples include Ayurvedic medicine and traditional Chinese medicine.
Holistic approaches incorporate many integrative therapies. For example, mind–body therapies include meditation, mindfulness, guided imagery, music therapy, creative arts therapy, hypnosis, yoga, tai chi, and qigong, among other physical and spiritual practices. Other examples include physical manipulative therapies, massage and chiropractic medicine, or energy-based practices like reiki. Examples of dietary supplements or natural products include antioxidants, vitamin megadoses, specialised diets, medicinal mushrooms and herbs.
There is increasing evidence that both categories of integrative medicine have benefits for patients with chronic conditions. For example, a collaborative study performed by the Beijing University of Chinese Medicine, the Chinese Institute of Sports Medicine and the University of Sydney found that qigong can improve cardiopulmonary aerobic capacity, physical fitness, and bone mineral density in patients with stable cardiovascular disease (CVD) [1]. Although there tends to be a strong focus on diet and nutrition in CVD treatment, there have also been several studies conducted about mind-body integrative therapies.
Equally, compelling research is emerging about the benefits of natural products. A particularly interesting field is mycotherapy. For instance, researchers from the Beijing Normal University and the Hong Kong Baptist University recently conducted a large scale study of the effects of certain edible mushrooms on gut microbiota for patients suffering from chronic bowel complaints. The results were remarkable: even common edible varieties like the white button mushroom were shown to increase microbial diversity and stimulate a local inflammatory response. Meanwhile, traditionally medicinal varieties like the Chaga mushroom were found to positively alter bacterial flora and prevent viral infection [2].
Many species of mushroom have also been found to be a valuable source of natural bioactive compounds such as beta-glucans, terpenoids, vitamins, minerals, proteins and prebiotics. These compounds have shown a positive impact on both patient’s mental and physical health. In a study conducted at the Department of Clinical Psychology, Kyoto Bunkyo University, 30 women were randomly assigned cookies either containing H. erinaceus mushroom powder or a placebo for four weeks.
They were then asked to rate their moods using the Indefinite Complaints Index (ICI) and the Center for Epidemiologic Studies Depression Scale (CES-D). In the group taking the mushroom extract, each of the CES-D and the ICI score after intake was significantly lower than the previous one, indicating a positive impact on the patients’ emotional well-being [3].
Who can Benefit from Integrative Therapies?
A healthcare professional offering integrative therapies will focus on the whole body as opposed to seemingly separate, organ-specific complaints. By considering all the variables that could impact a patient’s well-being, such as their environment, activity, emotional well-being and lifestyle, the practitioner can gain a comprehensive view of their health. Thus, this offers a more in-depth perspective on the patient’s ongoing condition and their physical health overall.
Unlike allopathic medicine, integrative medicine focuses on prevention; this makes it suitable for a variety of patients, or indeed, those that are interested in maintaining optimal health. Integrative medicine is, therefore, particularly useful for those living with chronic conditions such as diabetes, multiple sclerosis, arthritis, asthma, and some viral conditions such as hepatitis C and HIV. This is because such therapies reinforce the body’s innate ability to heal, utilising lifestyle alterations, mind-body medicine, and patient education to manage the condition.
Particularly interesting case studies about integrative medicine come from oncology [4]. Oncology patients and survivors have unique needs due to the physical and emotional pressures of cancer and its treatment; for instance, chemotherapy affects every patient differently and the side effects can be chronic. Therefore, integrative therapies are frequently used to complement allopathic treatment. These will often help alleviate secondarisms, such as pain, depression, nausea, fatigue, hepatotoxicity, skin alterations or leukopenia (deficiency of white blood cells).
By supporting the body’s regenerative capacity, chemotherapy secondarisms are reduced and in some cases, the treatment’s effectiveness is enhanced. For instance, preliminary clinical data on Maitake mushroom’s use as an adjunct to chemotherapy, patients were administered either tablets containing Maitake D-fraction with whole powder, or the Maitake tablets along with chemotherapy.
According to researchers, “the results suggest that breast, lung, and liver cancers were improved by Maitake, but it was less effective against bone and stomach cancers or leukaemia.” The best response rates were from combining Maitake and chemotherapy, where they highlight “it should be noted, however, that most of the patients under the maitake treatment claimed improvement of overall symptoms, even when the tumor regression was not observed. Various side effects from chemotherapy such as lost appetite, vomiting, nausea, hair loss, and leukopenia were ameliorated by 90% of the patients [5].”
Integrative Therapies and ‘The Big Picture’
Certainly, there is a substantial amount of evidence that integrative medicine benefits individual patients. However, there is also a robust argument for its adoption by the mainstream medical establishment as a whole. This is because the rising cost of healthcare is a challenge for the government; in the USA, health accounts for 16% of gross domestic product. This is likely to accelerate due to an ageing population and the proliferation of chronic illness.
Due to the gravity of this issue, policymakers are under mounting pressure to solve it. An option of longstanding interest is preventative care, that is, practices that prevent or delay the occurrence of chronic illness. These preventative protocols are broadly encompassed by integrative medicine, particularly in regard to lifestyle changes and promoting well-being. Equally, by managing the severity of diseases, such as cancer and CVD, healthcare practitioners can reduce pressure on hospital systems.
The health benefits of prevention are clear, as outlined above. But now policy experts are advancing the economic argument that prevention is cost-effective. In 2008, The Trust for America’s Health reported that prevention programs could save the country more than $16 billion annually within five years, a return of $5.60 per dollar invested [6].
The Present and Future of Integrative Medicine
Growing evidence suggests that integrative medicine can alleviate – and to some extent, successfully address – many symptoms of chronic conditions via effective, safe, and health-giving means. Integrative medicine neither rejects conventional medicine nor accepts alternative medicine uncritically. Instead, it recognises that effective medicine should be based in robust scientific research that is open to new paradigms, natural solutions, and less invasive methods where possible. This opens medicine to the broader concepts of wellness and preventative protocols, as well as the treatment of disease.
Equally, these therapies have significant benefits in regard to healthcare funding. Via preventative, cost-effective treatments that foster overall wellness, healthcare professionals can provide treatments that keep patients healthy on a daily basis. Moreover, integrative medicine holds particular promise for reducing the burden of chronic illness for individuals and those close to them.
As a result, integrative therapies are becoming an essential part of mainstream medicine; these complementary therapies are appearing with increasing frequency in health centres, clinics, and university hospitals. By 2013, there were fellowships in integrative medicine in 13 medical schools across the United States. This presence in medical education is increasing, especially as public demand groups.
This signals a move towards a more pluralistic approach to medicine that places the patient’s well-being at the centre of the practice. By offering the broadest possible range of treatments, healthcare professionals can advocate for an holistic approach to medicine that prevents, manages, and alleviates symptoms, while promoting overall wellness. This doesn’t only signal a better quality of life for patients – it also makes healthcare systems more efficient, effective, and resilient.
References
- Zhao, F., Lin, Y., Zhai, L., Gao, C., Zhang, J., Ye, Q., … & Liang, C. (2018). Effects of cardiac rehabilitation qigong exercise in patients with stable coronary artery disease undergoing phase III rehabilitation: A randomized controlled trial (with video). Journal of Traditional Chinese Medical Sciences, 5(4), 420-430.
- Jayachandran, M., Xiao, J., & Xu, B. (2017). A critical review on health promoting benefits of edible mushrooms through gut microbiota. International journal of molecular sciences, 18(9), 1934.
- Nagano M, Shimizu K, Kondo R, Hayashi C, Sato D, Kitagawa K, Ohnuki K (2010) Reduction of depression and anxiety by 4 weeks Hericium erinaceus intake. Biomedical Research 31, 231-237.
- Mao JJ, Palmer CS, Healy KE, Desai K, Amsterdam J (2011) Complementary and alternative medicine use among cancer survivors: a population-based study. J Cancer Surviv: Res Pract 5(1):8–17.
- Nanba H. Maitake D-fraction: healing and preventive potential for cancer. J Orthomol Med 1997;12:43-49.
- Woolf SH, Husten CG, Lewin LS, Marks JS, Fielding JE, Sanchez EJ. The economic argument for disease prevention: distinguishing between value and savings. Washington, DC: Partnership for Prevention; 2009.
- Levi J, Segal LM, Juliano C. Prevention for a Healthier America: Investments in Disease Prevention Yield Significant Savings, Stronger Communities. Washington, DC: Trust for America’s Health, 2008.