UNC testing herbal healing
Alternative therapies get closer look
Jean P. Fisher, Staff Writer

Marjorie Hinsdale could have gone to any Triangle vitamin store and chosen a half dozen herbal supplements to treat her 83-year-old mother's memory and cognitive problems.
She would be just one of millions of consumers who experiment with largely unproven alternative therapies for everything from varicose veins to hot flashes.

Instead, Hinsdale and her mother, Marion Hinsdale, decided to be part of a different kind of experiment -- this one funded by the government. Marion Hinsdale, who lives with her daughter and son-in-law in Chapel Hill, signed up at UNC Hospitals to participate in a national clinical trial that hopes to determine whether an extract of a plant called Chinese club moss is a safe and effective treatment for Alzheimer's disease and other types of dementia.

The remedy, widely used in China as a treatment for cognitive disorders, is already on the shelves of many stores that sell nutritional supplements.

"Both my mother and I are interested in anything that would be considered homeopathic," said Marjorie Hinsdale, who has taken ginseng and ginger supplements for years to alleviate back pain. "The fact that this is a Chinese herb was intriguing to both of us."

The study in which Marion Hinsdale participated is the first controlled U.S. clinical trial to evaluate the extract, an alkaloid called Huperzine A, as a possible Alzheimer's treatment. Even more notable, the National Institute on Aging put up most of the funding, making the trial one of a limited but growing number of federally sponsored research studies exploring natural and alternative therapies.

During the 2007 budget year, the centers of the National Institutes of Health expect to invest $300.5 million in complementary and alternative medicine research. That's just a fraction of the NIH's more-than-$28 billion budget for 2007, but it's nearly three times what the federal government's health research enterprise was spending on alternative medicine studies in 1999.

Published research on alternative and complementary therapies is still relatively limited. Few have been tested in the large, controlled patient trials that produce the data doctors consider essential in understanding a treatment's benefits and risks.

"That kind of data is completely missing today from most nutraceuticals," said Dr. Daniel Kaufer, a UNC-CH neurologist and investigator in the Huperzine A trial. The study's results will help determine the herb's efficacy and safety in patients and could pave the way for a larger, more definitive clinical trial.

Natural therapies that have been proven in such trials gain credibility with consumers and their medical providers.

"It gets their attention and provides evidence that botanical medicine is very powerful," said Christie Yerby, a Chapel Hill specialist in botanical medicine who trained as a naturopathic doctor. North Carolina does not license naturopaths, so Yerby does not prescribe drugs. She works as a health educator, consulting with patients who already use herbs and supplements about toxic ingredients, possible side effects and appropriate dosages.

More doctors now routinely recommend patients with arthritis try a dietary supplement with glucosamine and chondroitin because a large-scale NIH-funded trial showed the supplement reduced pain more than a placebo.

And the results of a 2001 trial funded by the National Eye Institute helped establish high doses of certain antioxidants plus the mineral zinc as an effective means of preventing advanced macular degeneration, a leading cause of vision loss in older adults. A new study, in which UNC Hospitals is also participating, will look at whether supplements of lutein and omega-3 fatty acids can also slow or stop patients from developing the disease.

The results of alternative and complementary medicine trials aren't always favorable. Studies of the popular cold and flu remedy echinacea, for example, have not shown the herb to be more effective than sugar pills at preventing a cold or shortening its duration.

Patients in the Huperzine A trial initially receive either a placebo or a 200- or 400-microgram dose of Huperzine A -- a significantly higher dose than is now available commercially. Neither clinical investigators nor patients know who is receiving what.

After the placebo-controlled phase, all patients receive Huperzine A for eight weeks. And after that, participants are offered the option of taking the supplement for an additional six months. That way, patients or caregivers who think the herb was beneficial can continue taking it, and investigators get longer-term data, which lends further credibility to results.

Kaufer said patients' cognitive functions are assessed throughout the trial using a standard battery of memory and language tests. Changes in personality and ability to bathe, dress and perform other daily activities are also noted.

Chinese patient trials with Huperzine A suggest that the herb may work as well or better than the prescription medications now commonly used to treat mild to moderate Alzheimer's disease, with fewer side effects. Marjorie Hinsdale isn't sure whether Huperzine A helped her mother, who chose to continue taking the herb after completing the required portions of the study. Marjorie Hinsdale thought she might have noticed a slight decline in her mother's cognitive function -- she was perhaps a little more scattered, a bit more forgetful after stopping the Huperzine. If there was a benefit, it was subtle.

Still, both Hinsdales are glad Marion participated in the study.

"We just wanted to contribute in what small way we can," said Marjorie Hinsdale, whose father also has dementia and lives with her in Chapel Hill.

Staff writer Jean P. Fisher can be reached at 829-4753 or jfisher@newsobserver.com.
http://www.newsobserver.com/150/story/500773.html


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COMPLEMENTARY AND ALTERNATIVE MEDICINE LINKSNational Center for Complementary and Alternative Medicine (National Institutes of Health)

For general and consumer information, visit

http://nccam.nih.gov/health/

For information on complementary and alternative medicine clinical trials, visit

http://nccam.nih.gov/clinicaltrials/

NIH Office of Dietary Supplements

http://dietary-supplements.info.nih.gov/