Some Frequently Asked Questions, first published in SAGA Magazine (2)
Professor George Lewith
I have suffered from insomnia for years and tried all the usual things, including taking sleeping pills for a while. However, I disliked the side effects and would prefer a natural alternative. What can you recommend?
Insomnia is a huge problem affecting between 5% and 10% of people in England over the age of 25, and 35% over the age of 65. Many people taking conventional medicines experience unpleasant side effects, so you are definitely not alone. There are a number of quite safe alternatives to conventional medicine, but unfortunately they haven’t been well evaluated. The first thing to do is to look at proper sleep hygiene. Make sure your bedroom is uncluttered, calm and quiet, away from your workspace. Make sure you give yourself time to wind down after work and before you go to bed, and try to have regular hours for sleep.
There are various complementary medical treatments that are said to work for insomnia, and indeed may have some sound basis. Acupuncture causes the release of calming, opiate-like, natural chemicals in the brain, endorphins. Many people who have acupuncture for other reasons find it makes them sleepy, so it is not unreasonable to suggest that acupuncture can be used for insomnia. You will often need weekly treatments over perhaps six or eight weeks, but it might just help establish a normal sleep pattern. People often get insomnia after a particularly stressful event, and if you can calm and normalise the system this can help. There are a variety of homeopathic remedies that are said to be useful for insomnia, and often they will be prescribed based on your general constitution, so there isn’t a particular remedy for insomnia. The remedy that will be prescribed will depend on your exact presentation and whether it is partly triggered by anxiety, depression, or just a bad habit. A number of herbal remedies can also be used, in particular Valerian. You often need to use this for four to six weeks continuously; it won’t work on a “one off” basis and you will need to get a reputable manufacturer and make sure you are taking a reasonable dose. However, the preliminary evidence suggests that there are few side effects, although if you are taking a herbal remedy you should make sure your doctor is aware of that, particularly if you are taking other prescribed medication. Aromatherapy oils may also be useful in this condition. There is some good preliminary evidence to suggest that a few drops of lavender on your pillow, or bedclothes, at night may have a very positive effect in inducing sleep. Again, you will need to persist. Most people find the smell of lavender pleasant, it is safe, and the major adverse reaction that you can get is that sometimes people develop a skin allergy or irritation, as a consequence of essential oils.
There are a variety of safe alternatives for insomnia within complementary medicine, and I would encourage you to try and think about a combination of sleep hygiene and some form of simple complementary medical treatment to help you.
My GP thinks I might benefit from treatment at a homeopathic hospital for my arthritis and is willing to refer me. Is this likely to be worthwhile?
The Royal London Homeopathic Hospital does have a unit specialising in arthritis, but whether homeopathy actually helps arthritis is unclear. There are, in general, two types of arthritis, osteoarthritis, which is thought of as “wear and tear” and tends to affect the big joints of the body, such as hips and knees, and rheumatoid arthritis, which is an inflammatory arthritis affecting the small joints, such as fingers and toes. The evidence in rheumatoid arthritis is that homeopathy quite possibly does work, although the trials are too few and too small to be certain. Our research group is just conducting another trial in this area and it will be interesting to see the outcome. Conventional treatments for rheumatoid arthritis often involve very powerful medication, and if the amount or extent of suppressive medication you take can be helped by some homeopathy, then that can only be valuable. As far as osteoarthritis is concerned, the evidence is less good that homeopathy might help. There are some valuable alternatives, which include both acupuncture and various herbal medicines that may really be of benefit. For instance Devil’s Claw, which looks very promising in the treatment of osteoarthritis of the knee. The Royal London Homeopathic Hospital specialises in the treatment of arthritis conditions, so it would certainly be wise for you to be referred there. The unit is run by conventional doctors who will be able to use a combination of homeopathic and conventional medicine in a thoughtful manner. I think it would be worthwhile for your GP to refer you.
I’ve read that some herbs can improve memory – or at least stop it getting worse. Is there any truth in this?
Poor memory can be caused by a whole variety of things. There is some evidence that if you are depressed your memory becomes quite bad. Depression in older people can often be mistaken for some forms of dementia. There is good evidence that the herbs St John’s Wort, or Hypericum, can help with depression, some trials suggesting that even in very severe depression it is just as good as conventional medicine. So if your memory difficulties are a result of depression it is certainly worthwhile considering a herbal remedy in conjunction with your general practitioner. Don’t use any herbs without discussing possible interactions between herbs and conventional medicine. There is also quite strong evidence that Ginkgo Biloba will improve circulation in the brain, and this too may help with memory. Some types of memory loss seem to be caused by the fact that there simply isn’t enough blood circulating in your brain as you get older, and Ginkgo seems to help this
My mother has had several aromatherapy treatments in our local hospital’s stroke unit. She enjoyed them, but is it worth my arranging to have more sessions from a private therapist when she goes home?
There is no doubt that aromatherapy helps you in general. Most people who have aromatherapy find it a pleasant and enjoyable experience, partly because of the invigorating effect of the oils and partly because of the gentle massage. This can certainly help people overall and encourage them in their rehabilitation, particularly if they have had a stroke. I would imagine a combination of massage and oils would have a powerful soothing effect and would be really helpful, particularly if some of the limbs are painful or in spasm after the stroke. However, there is no definite evidence that aromatherapy helps strokes. It really depends on your mother’s perception of the treatment; if she is enjoying it and feels it is beneficial then I would definitely continue.
I know there is no conventional treatment to cure IBS but are there any complementary approaches that work?
IBS is a very common condition; approximately 20% of the population in the United Kingdom have IBS at some point, and it accounts for between 20 – 50% of the attendance at hospital gastroenterology clinics. There are a variety of complementary medical treatments that are said to work for IBS. There is strong evidence that food exclusions may help, although you won’t get a reaction every time you eat wheat or milk, as you may be having it in various different foods half a dozen times a day. You are going to need to avoid the offending food for 4 to 6 weeks to see if you are likely to benefit from it. One of the things that often happens in conventional medicine is that people recommend you eat a high fibre diet if you have irritable bowel. For some people that actually makes them worse and they may have an undiagnosed coeliac disease (a reaction to gluten in wheat, oats and rye), which may present with irritable bowel often in later life. Most conventional doctors recognise that we under-diagnose coeliac disease. There is some suggestion that acupuncture may help; acupuncture affects the nervous system and may quite specifically act on the gut spasms and pain experienced by those who suffer from irritable bowel. There is good evidence that relaxation in the form of hypnosis can help, so calming the mind can be very important in irritable bowel. Sometimes calming herbal medicines, such as Turmeric or nutritional supplements such as probiotics (good gut bacteria) can be of benefit. Overall there is a considerable amount of evidence that a variety of different complementary medical interventions can be really helpful in this condition. The best way to go about this is firstly to be absolutely certain that you do have irritable bowel, which means a proper medical diagnosis, then decide which treatment you think might be the most appropriate, and either go through your GP or contact the relevant professional organisation, so that you can identify a competent practitioner who may be able to help you.
Contacts / Links:
British Society for Allergy, Environmental and Nutritional Medicine
British Medical Acupuncture Society
British Society of Medical and Dental Hypnosis
www.saga.co.uk/magazine
