Some Frequently Asked Questions, first published in SAGA Magazine (8)
Professor George Lewith
I recently bought a herbal remedy for insomnia and was recommended to buy a flower essence as well to enhance the effect of the herbs. The label says it contains the energetic essences of various flowers – what does this mean, if anything?
There is some evidence that a variety of different herbal remedies may help insomnia. In particular Valerian looks promising, but you will need to use it for 3 or 4 weeks before it begins to have a well-defined and consistent effect. There is no evidence that Valerian is either addictive or gives rise to withdrawal symptoms when you stop taking it. My advice would be firstly to try and use one remedy at a time; the evidence for the herbal is probably more powerful than for the flower essence. Flower essences were initially developed by the Victorian homeopathy Edward Bach. He believed that the “energetic signatures” of various flowers carried particular healing properties, and literally extracted these “energies” through a formalised, but very simple, process by floating the flowers on liquid and then using distillates of the liquid to create a remedy. These remedies are often used to treat problems that have an emotional origin, and insomnia is often related to some degree of anxiety and worry. Unfortunately, the clinical trial evidence for flower remedies having specific effects is very limited, largely because there are almost no clinical trials in this area. On this basis recommending a combination of herbs and flower essences makes sense, but the recommendation is not founded on substantive evidence. Flower essences share with homeopathy the idea that the remedy itself has some sort of “vital force or energy” that can somehow act to promote healing. While this concept is central to the teaching of homeopathy and flower essences, it is purely a theoretical concept and has very little meaning in the context of conventional physics. Energy healing and energetic essences are a language that is often quite difficult to explain, but they are frequently used, and sometimes indeed misused, within complementary and alternative medicine.
My friend has seen an iridologist who has recommended changing her diet because she suffers from bronchitis a lot in the winter. I am wondering whether to try this too as I have a similar problem, but I don’t understand how iridology works.
In theory iridology is simply a diagnostic system. Different parts of the iris are said to represent different organs or organ systems, and so an iridologist looks very carefully at the iris to see which parts of it are “normal” and which parts of it are “abnormal”. They then use this information to make a diagnosis that frequently uses the “organ connections” that were first discovered in traditional Chinese medicine. For instance in complementary medicine in general, the lung and large intestine are often “linked”. This means that therapeutically altering your diet can affect the wellbeing of your lung. This link has some substance within conventional medicine; we know now, for instance, that taking probiotics (good gut bacteria) during the winter can affect the number of respiratory infections suffered by children, so keeping a “healthy gut” seems to also keep your respiratory tract in a healthy condition. It then becomes then not too big a jump to suggest that altering your diet may also have an effect on your digestive system, which in turn may have an effect on keeping your lungs and respiratory tract in a good state. Whether, of course, you can make this diagnosis through iridology is another matter. Recent studies looking at the diagnostic value of iridology have failed to confirm its value as a diagnostic system. To my knowledge, there have been no studies using iridology as a therapeutic system, but the iridologist is probably seeing considerable abnormalities in the lung reflected in the areas of the iris that are supposed to represent your digestion. As a consequence, I suspect that some fairly simple dietary recommendations, such as “milk avoidance” have been made to your friend. I would suggest that it might be both reasonable and safe for your friend to follow this advice; the rationale for the diagnosis might be questionable, but the treatment itself might work and is safe. The only caution would be to make sure that you don’t lose too much weight, and that you seek advice to make sure that your diet is nutritionally complete. Stick with the diet for a couple of months to see if it makes a difference and then reassess how you feel.
Is it true that biofeedback training can lower blood pressure and, if so, can I get it on the NHS?
The vast majority of people who have “blood pressure” have no very obvious reason for developing the problem, other than “general stress”. You often seem to find that as you get a little bit heavier, less fit and slightly older, stress seems to take its toll and really presents just another risk factor for raised blood pressure. There are a whole variety of “mind body techniques” that will help mildly raised blood pressure. These include approaches such as biofeedback, meditation, and a whole range of relaxation techniques, including the regular practise of yoga. They all seem to have roughly similar effects, in that they will take 5 or possibly 10 mm of mercury (the usual units in which blood pressure is measured) off both the upper (systolic) and lower (diastolic) blood pressure. This can make a huge difference, particularly if these techniques are used regularly, you can realistically lower blood pressure over the long term. Regular exercise and keeping your weight controlled also helps substantially. Unfortunately, it seems that the NHS does not wish to make substantial investments in these psychological techniques, so I am afraid if you want to use these types of approaches you are probably going to need to either go to a relaxation or yoga class, or perhaps purchase a biofeedback machine from a supplier on the internet. Biofeedback machines are usually very cheap, and if your blood pressure is mildly raised I would strongly recommend that you buy one along with a book of instructions, and use it regularly on a daily basis.
My hands and knees are quite badly affected by arthritis. Is it safe for me to have aromatherapy massage or could it make the problem worse?
In very general terms aromatherapy massage is a really safe procedure. Sometimes if the massage is too violent or aggressive, it may hurt a joint or temporarily cause increased pain, but if you are seeing a competent aromatherapist, and give them a clear history, I am sure that they will be very gentle with you. Aromatherapy is very much more likely to be of help than cause any adverse reactions. The only thing that the oils may occasionally do is cause a skin reaction, but if this happens it is usually a question of changing the oils that the aromatherapist is using. Make sure you tell your aromatherapist about your worries, and I am sure that he or she will be gentle with the first few treatments. I would expect you to find the process both soothing and beneficial.
My grandmother used to make traditional ‘folk’ remedies for us when we had bruises or bumped heads as children. I’d love to find out more about these – do they really work and how to prepare them.
This could mean almost anything, and I am really unsure how to answer it Chris. We could talk about Arnica being a traditional Alpine folk remedy, but that doesn’t really apply to UK. We could talk about hot “drawing poultices” for bruises, but God alone knows what her granny used to make! I am concerned that I am going to give a really incompetent answer to this question, because it is a little bit vague and unfocused. For the first time, can I dip out on this!? I wouldn’t know where to get the information on granny’s poultices and I certainly haven’t used them in the past. It would mean digging through old herbal books and looking for nettle poultices, or something like that, and I would be worried about whether they have been “properly tested” in a conventional context.
Is it worth taking omega-3 supplements to prevent heart disease and, if so, how can I choose which one? There see to be so many different products I’m confused.
There is now really good evidence that omega-3 fatty acids, which are contained in fish, fish oils, and can also be derived form a variety of different plant sources, are important nutrients, particularly in people with existing heart disease. The exact dose of omega-3s is not known yet, but recent research suggests that between ½ and 2 gms per day of fish oils, or between 1½ and 3 gms per day of plant derived omega-3s, will reduce the risk of heart attack and also the chances of dying from a heart attack if you have one. There are some very clear American Heart Association guidelines, and they recommend at least 2 servings of fatty fish a week, along with vegetable oils high in omega-3s. The omega-3s in vegetables are called alpha linolenic acids. Both these sources of omega-3s seem to be very safe and the current evidence suggests that adverse reactions from contaminants in fish currently appear to be very negligible. If you don’t feel like eating this amount of fatty fish, then taking the dose of supplements is also quite safe. Many of the studies have actually been done on people who have got known heart disease, but it is fair to assume that if reasonable doses of omega-3s can help people with known heart disease, then they are very likely to help people who are trying to prevent themselves getting heart disease. We are not quite sure how omega-3s work, although we think they have a direct effect on the clotting mechanisms in the blood, and reduce the inflammation that causes “hardening of the arteries”. They may also have a very mild effect on lowering blood pressure. There is no real evidence about which is the “best product” and it certainly is confusing that so many are available. The most sensible advice is to try to alter your diet and eat enough fatty fish and vegetable oil as part of your regular food intake, but if you really can’t or won’t do that, then any supplement that fulfils the suggested dosage regime seems to be both appropriate and safe.
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