Complementary treatments

Article index

> Points to consider
> Acupuncture
> Homoeopathy
> Herbal remedies
> Dietary methods
> Other methods
> The Lightning Process

Though there is an increasing body of evidence to show the benefits of complementary medicine many of the reports of complementary treatments are anecdotal – that doesn't mean that they don't work for particular individuals, it means that no formal medical evidence has been independently collected and approved by the medical community in general. It is an area of great controversy.

As a result, complementary treatments are not widely supported by mainstream medical professionals (although there is a discernible change in attitude toward particular methods for particular ailments: acupuncture for pain control, for example, or homoeopathy); however, as mainstream medicine is currently limited in what it has to offer people with ME/CFS, some people feel that complementary methods are at least worth a look.

A number of people find that they have been helped by one or more such methods, and some are outlined below. As with mainstream methods, benefit is not universal: while some people feel improvement, some experience no effect; some people may feel worse and even relapse. If you would like to know more, try contacting your local Support Group or, even better, try to get along to their meetings to meet people face to face. There will usually someone there who has experiences they can share.

Ideally, for any treatment you choose to undergo there should be available validated and relevant scientific evidence to which you can make reference. If this is not available, then you are urged to be very cautious before you embark on any course of complementary treatment or therapy.

Complementary therapists tend to the ‘whole person', as opposed to particular symptoms or a particular condition. As a result, your first consultation could be quite lengthy and you could be asked many questions about yourself, not just about your perception of your illness, so check with the practitioner when you make your first appointment so that you can have your thoughts in order.

If you are thinking of using complementary medicine, please consider the following:

1. Registration

It is possible for some people to call themselves complementary therapists in certain fields of complementary medicine: they often need have no qualification, or have attended only the briefest of training sessions, so be careful. There are also areas of complementary medicine that are restricted by law. Do make as many enquiries as possible and consider:-

• To whom could you complain if you felt you were being unfairly treated?
• Does the therapist have a professional indemnity insurance?
• A reputable practitioner will have registered with a bona fide organisation which will insist on certain standards.

2. Cost

Many complementary practitioners are available only on a private basis: i.e., you can expect to have to pay! Treatment of a long-term chronic illness will almost invariably mean repeated visits, sometimes weekly or monthly for a number of years. With ME/CFS in particular, be aware that few people, if any, can predict the course of your illness, even when you have been under their care for a length of time, so many treatment regimes can be open-ended and can become expensive. Some treatments such as homeopathy, acupuncture, massage, osteopathy and other treatments may be available on the NHS, so ask your GP.

Some treatments come with a money-back guarantee. It sounds as if you can't lose, but make sure you understand the terms and conditions, and get them in writing. A 90-day money-back guarantee on a food supplement for instance might depend on you taking the supplement for the full 90 days; but within only a few days, some people with ME/CFS find that some substances don't agree with them and can make their condition worse.

3. Effects

• Healing crises – It is not unusual for people to start to feel worse before they feel better with some of these treatment methods; alternatively, it is an unfortunate feature of ME/CFS that you could react adversely to a treatment which is apparently ‘harmless'. If you have any doubts, you should discuss them with your practitioner.
• Placebo effect – Many people who are sceptical of complementary methods attribute any benefits perceived to the placebo effect (ie that a patient will improve simply because they believe they are receiving effective treatment). This is indeed a possibility, but if improvement is due to this, it may be only temporary. It is to be remembered that conventional medicine can also engender the placebo effect.

4. Choice

There are many complementary options available, so it can be difficult to know where to start. Unfortunately with ME/CFS, there do not appear to be particular methods which give consistently helpful results so if you are keen to try complementary methods, you may need to be prepared to try a variety of approaches, or even a combination of approaches.

Acupuncture has come to the fore in the West only in the last thirty years or so, however it can be traced back over three thousand years in China. Several approaches have been developed over that time, but all are aimed at the treatment of the full range of physical, mental and spiritual problems.

Theory

Traditional Chinese Medicine recognises a ‘vital energy flow' (qi, ki, or chi) through the body. Areas of high concentration are referred to as ‘meridians' or ‘channels' but this energy is considered to permeate all areas of the body. For full health, this energy flow should be perfectly balanced with no areas of excess or deficiency. The energy flow can be manipulated by the insertion of fine needles into ‘acupuncture points' on the body.

Diagnosis

A holistic approach! Practitioners will ask questions, look, listen, use their sense of smell and sense of touch, feeling for tender points and a number of different pulses. To give you an idea of the detail, when checking pulse they feel for six different ones and consider rate, width, strength, quality and rhythm in each case.

Treatment

For a condition such as ME/CFS, particularly if it is long-standing, you can expect to attend many sessions. Generally a session will last around half an hour, the basic form of treatment involving the insertion of (once-only, disposable) needles into the skin, and sometimes moxabustion (the burning of a herb on or close to the skin). During treatment a patient may feel no more than a dull ache or a tingling, although sometimes there are feelings such as light headaches, nausea or vomiting; very rarely a patient may faint during treatment. It is important to tell the practitioner if you are (or think you may be) pregnant, as some acupuncture points should be avoided during pregnancy.

Acupuncture methods

• Traditional Chinese MedicineTCM is the form taught and practised in China today. The needles are inserted quite deeply and may be left in place for 20 minutes or so, occasionally the therapist twirling, lifting and thrusting them as required.
• 5 Element AcupunctureDiagnosis is aided by palpation of the lower abdomen, and needles are inserted at a superficial level (the acupuncture points are different from those of TCM). The ‘5 Elements' refer to fire, water, metal, wood and earth which in Chinese Medicine characterise movement of energy.
• Stems and BranchesIncludes consideration of energy flow together with Chinese astrology
• Trigger Point / MyofascialPalpation of myofascial layers of tissue in certain energetic zones of the face and body, and then insertion of needles.
• AuricularNeedles are inserted in the ear since it is thought this mirrors the whole human body. Auricular acupuncture is sometimes used alongside TCM acupuncture.
• ElectroacupunctureThe needles are stimulated electrically, a dc current being passed between pairs of needles in an effort to move blocked qi to relieve pain.

Effectiveness

We are aware of very little in the way of double-blind placebo-controlled trials involving people with ME/CFS, however anecdotally it appears acupuncture can help some people in varying degrees – from mild to significant improvement (although, as always, there are some who react adversely). A recent review of acupuncture trials and their effectiveness for people with ME/CFS showed only short term benefit in some trials and no benefit in others.

Practitioners

In the UK the British Acupuncture Council sets professional, ethical and training standards of a high level. is a nationwide group of family doctors and hospital specialists who practise acupuncture alongside more conventional techniques. The BMAS believes that acupuncture has an important role to play in health care today, and that it is vital to put forward a balanced case in order that informed opinion can encourage its use.

Homoeopathy is the practice of treating like with like; that is to say treating an illness with a substance that produces the same symptoms as those displayed by the person who is ill. Homoeopaths' reasoning is that these symptoms do not come from the illness itself but are the body's reaction to it, so rather than trying to suppress them, homoeopathy seeks to stimulate them.

Homoeopaths recognise that people vary in their response to an illness and so a homoeopath's remedies are determined not only by the patient's symptoms, but also by their temperament and responses.

Although homoeopaths generally practise privately, many doctors, some of them GPs, practise homoeopathy within the NHS; besides providing prescriptions for homoeopathic remedies, they can refer their patients to one of the UK hospitals which have a homeopathic unit or department. These hospitals will accept referrals from other doctors too, so if you think it's worth further investigation and are prepared to travel, you could speak to your GP. Most doctors who practise homoeopathy are Members or Fellows of the Faculty of Homoeopathy; to find a practitioner, write to:

The Royal London Homoeopathic Hospital
Great Ormond Street
London
WC1N 3HR

For a free leaflet, “How to get homoeopathic treatment on the NHS” send a stamped and addressed envelope to:
The British Homeopathic Association and Faculty of Homeopathy
Hahnemann House
29 Park Street West
Luton
LU1 3BE

Be aware: Anyone is allowed to set up as a homoeopath, even if they are not medically qualified!

The use of plants for treating symptoms and the underlying causes of illness can be traced back many thousands of years. Plants are the precursors of modern pharmacology. The Chinese and Indian cultures continue to rely heavily on herbs.

The treatments

Since they are less concentrated, herbal medicines can be slower to take effect than some conventional drugs. The herbs tend to be highly specific in their actions, and herbal formulae contain a range of herbs that not only possess different properties and qualities, but also aim to target different aspects of the patient's disharmony. A herbal practitioner has to weigh up many factors when preparing a formula. As a result, any one individual's preparations may vary throughout their course of treatment.

Herbal Remedies and ME/CFS

There is no doubt that many plants do possess powerful pharmacological properties. There is some evidence that herbal remedies are efficacious but caution must be exercised in assessing the claims made by some herbalists. Herbal remedies should not be confused with food supplements, such as evening primrose oil, which as been subjected to clinical trials, which you can purchase directly from The ME Association.

Safety

You should be aware that just because a herb is natural, that doesn't make it safe or free from side effects. While many are quite safe if taken within the specified dosage range, the dose must be more specific with others and monitored closely. Some are particularly toxic and have been known to lead to organ failure; people with liver complaints should be particularly cautious. Safety of herbs depends on a number of things, in particular what (if any) sort of medication you may already be taking, and your past health. We would especially caution the use of the Internet to purchase herbal remedies as there is no knowing whether the product has been adulterated or made up from a different plant than that used by medical herbalists. If you experience adverse reactions to herbal medicines, please notify

• your GP or pharmacist, who can then fill in a ‘Yellow Card'. The Department of Health's yellow card scheme, which is designed to identify suspected adverse reactions to both orthodox and alternative treatments, receives about 17,000 yellow card reports each year. The cards provide early warning of drug toxicity and the results can then be used to identify people with conditions who might be at increased risk of suffering such a reaction.

and/or

• Traditional Remedies Surveillance Unit
  Medical Toxicology
  Guy's and St Thomas's Hospital Trust
  London
  SE14 5ER

Finding A Herbalist

Always consult a qualified herbalist. There are two recognised professional organisations, The College of Practioners of Phytotherapy and The National Institute of Medical Herbalists. Both organisations have Websites from which more information is available.

Practitioners will have undergone a four-year course in Herbal Medicine. Some will have the letters MNIMH or FNIMH and others PhD. or MD.after their names. Members are required to operate in accordance with a Code of Practice and there are ethics, complaints and disciplinary procedures. It is planned that from 2011, Medical Herbalists will be part of the National Health Service.

Generally a well-balanced whole-food diet is thing to aim for, but some people with ME/CFS report food (and chemical) intolerances. These are not ‘allergies' in the medical sense (although these do occur). Whereas the commonly-reported culprits are dairy products, cereals etc., these are not by any means the only ones perceived to cause problems; it can be almost anything – and in combination. It is extremely important to be very careful about this approach, as a fully-nutritious diet is paramount to the best recovery prospects, and it can be psychologically unhelpful to restrict the diet unnecessarily.

There are many ‘allergy clinics' which use a variety of methods to identify food intolerances and, as with complementary methods in general, there are advocates and sceptics for all. An elimination diet is possibly the most straight forward if long-winded way, but you should discuss this with your GP.

Arguably the most controversial dietary method of all is ‘Candida Control'. Those in favour suggest that a yeast which occurs naturally in the human gut can get out of control and cause problems. An ‘anti-candida regime' is advocated: in essence this is a very-low-sugar or sugar-free diet, but some practitioners also suggest the taking of anti-fungal drugs and particular food supplements. Anecdotal reports suggest that in some cases it can be helpful.

Sceptics say that if there is a problem, the problem isn't ‘candida', because it in no way relates to the candida which manifests itself as thrush etc. They argue that there is no medically-approved scientific evidence to support the claims, and some doctors are dismissive of the whole idea.

The ME Association produces a leaflet which you can order direct.

• Osteopathy.Some osteopaths claim that a structural mis-alignment in the body can cause the symptoms attributed to ME/CFS, or can aggravate them. A few trials have been conducted but so far the medical community has not considered them convincing.
• Electromagnetic Stress.There is a body of opinion which suggests that electric, magnetic and electromagnetic fields can affect the body, both harmfully and therapeutically: the ‘electromagnetic soup' resulting from household wiring and appliances (the electric field in particular), radio waves, and atmospheric electrical activity can result in poor health; and some forms of magnetic treatments and electromagnetic frequency generators can aid recovery. Again, the medical community remain sceptical with very little in the way of scientific evidence having been accepted for publication in the mainstream medical journals.
• Geopathic Stress. ‘Geopathic Stress' is said to result from radiation emanating from the Earth. It is a complex and, in the West at least, little researched phenomenon. Advocates say that many illnesses can be attributed to the particular patient having spent a long time (e.g. sleeping every night, or working every day) in a particular spot where these radiations are harmful. They employ dowsers and, in some cases, very sensitive instrumentation to determine where these spots lie.
• Bio-energy treatments. ‘Faith Healing', ‘Spiritual Healing', and ‘Energy-balancing' come under this category. Although no scientifically-accepted explanation for ‘faith' healing has been forthcoming, many doctors do accept that it can have beneficial effects, provided that it is not used as a substitute for sound medical practice. Those who believe they have an explanation talk of the body's aura or electric/electromagnetic field being disturbed and that progress is made by energy transfer between healer and patient. Some bio-energy practitioners specialise in treating people with ME/CFS.
• Buteyko Method. The deals with improvement in breathing techniques, overcoming hyperventilation and consequent better oxygenation of body tissues.

• The Lightning Process The Lightning Process is a training program, typically lasting three days. It combines concepts from Neuro-Linguistic Programming, Hypnotherapy, Life Coaching and Osteopathy. It claims to treat problems such as anxiety, stress, depression, guilt, low self esteem, ME/chronic fatigue syndrome.

• There is an initial event, such as a virus, chemical exposure or stress that caused the illness

• The illness is prolonged and the expected recovery does not happen.

• The patient’s symptoms, combined with a fear of non-recovery, creates more stress so that the body becomes locked into producing the hormones adrenaline, nor-adrenaline and cortisol.

• These hormones, in the long term, bring feelings of exhaustion, affect blood sugar levels, and suppress the immune system.

• The body is therefore “locked” in a loop.

• The Lightning Process claims to be able to unlock that loop and allow the body to recover

Treatment

The patient attends a three-day training Program. The cost varies according to the trainer but starts from around £500. Further appointments may be recommended after the intial training programme is over. The key steps of the process include a series of body movements, postures and core questions which claim to stimulate new neurological pathways. Patients are asked to examine their own thoughts about their illness and how these can create either valuable or destructive thoughts about health or the future. It is in training the patient to address and deal with these destructive thoughts that the illness is treated.

Effectiveness

The ME Association is not aware of any independent clinical trials to assess the efficacy of The Lightning Process. There is anecdotal evidence that some people diagnosed as having ME/chronic fatigue syndrome have improved but others who have attended the training course have reported that either they felt no improvement or relapsed.

Comment

The theory upon which The Lightning Process is based and its claim that the prolonged nature of the illness is caused by “the adrenaline, nor-adrenaline and cortisol loop” is not scientifically proven. We are unaware that patients enrolled in this program have those hormones measured before or after.

As in all such unproven treatments, The ME Association makes no recommendation and advises patients to make their own enquiries and discuss possible treatments with their medical adviser.