Complementary Therapies

Submitted on Jan 16, 2024
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Acupuncturist inserts an acupuncture needle into a woman's back.

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Decisions about your healthcare are important — including decisions about the types of therapy to use. Most healthcare providers will agree that using complementary (also called alternative or integrative) therapies together with standard medicines can help people living with HIV live longer, healthier lives. Most often, people living with HIV use complementary therapies to ease the side effects of HIV drugs, to boost their immune systems, and/or to improve their overall health.

Talk to your healthcare provider before you begin using complementary or alternative treatments.

Complementary therapies refer to a series of healthcare treatments that are not usually part of conventional (Western) medicine. These types of treatments can include acupuncture, aromatherapy, biofeedback, homeopathy, hypnosis, massage therapy, Ayurveda, relaxation techniques, nutritional supplements, energy work, and traditional healing.

An important note: While it is important for everyone to tell their healthcare providers about any and all complementary or integrative practices they use, it is especially important for people living with HIV. HIV and HIV drugs affect the immune system, which may influence how your body reacts to some complementary or integrative therapies. Some HIV drugs also interact with certain supplements or herbs. Talk to your healthcare provider before you begin using complementary or alternative treatments. This gives your provider a full picture of what you do to manage your health and makes sure that the treatments you choose are safe and helpful for you.

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What Are Some Common Complementary Therapies?

Acupuncture

Acupuncture was developed in China several thousand years ago. It involves inserting small thin metal needles in the skin at particular points on the body. By activating these specific points, acupuncturists try to remove blockages in the flow of one's life force or vital energy, called qi (pronounced "chee"). In Traditional Chinese Medicine (TCM), energy or qi is believed to circulate through the body. Proper circulation or flow of qi promotes health and well-being. Acupressure uses finger pressure rather than needles to stimulate healing points on the body and achieve proper flow of qi.

Be sure your acupuncturist uses only disposable, sterile needles.

Many studies now demonstrate the potential benefits of acupuncture. Acupuncture can be helpful for conditions such as pain, headache, nausea, diarrhea, menstrual cramps, and menopausal symptoms, among others. In the US, many states require acupuncturists to be licensed (their title is L.Ac.), and an increasing number of insurance plans cover acupuncture. You can find a licensed acupuncturist through the organization that grants the licenses, the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). Be sure your acupuncturist uses only disposable, sterile needles.

Aromatherapy

Aromatherapy involves the use of essential oils to improve emotional or physical health. These oils are inhaled or rubbed into the skin, and are generally used to reduce pain, improve mood, and promote relaxation. There is no strong evidence that aromatherapy boosts the immune system. However, tea tree oil has been shown to kill microbes (germs) on the skin. It is important that you discuss any use of essential oils with your healthcare provider.

Biofeedback

Biofeedback is a technique that trains people to control some of the body's operations that usually occur naturally (involuntary actions), such as breathing rate (how fast we breathe), heart rate (how fast our heart beats), or blood pressure. By being connected to devices that measure these actions and watching these measurements (e.g., heart rate) on a monitor, people can affect the inner workings of their bodies and get some control over the body's involuntary actions. Biofeedback is most often used to help people with headaches and pain.

Cannabis

Cannabis is the name of a family of plants. Consuming cannabis (marijuana, herb, weed, pot) can have numerous medicinal purposes (and is also known for its use for recreational reasons). There are various ways to take cannabis. These include inhalation (smoking or vaping), applying to skin, and orally through a tincture, drink, or food.

Cannabis can ease anxiety, reduce inflammation, improve appetite, and relieve pain – including neuropathic pain, according to one study. There are not yet clinical studies showing cannabis improves menstrual (period) pain; however, there is significant anecdotal evidence (stories about individual experiences) that people have experienced relief using cannabis in this way.

However, cannabis can also cause or worsen mental health disorders, including anxiety and paranoia (thinking one is threatened even if there is no evidence for this), memory and attention issues, and psychosis (loss of contact with reality).

The anti-inflammatory properties of cannabis can help address the ongoing low-level inflammation in the body that is caused by HIV. One study found that using cannabis for this purpose also reduces cognitive impairment (problems with thinking) in people living with HIV. Cannabis can interact with some HIV drugs and other medications. It is important that your provider knows about your cannabis use to watch for potential problems.

It is also important to note that cannabis, even for medicinal use, is illegal in many places in the world. Smoking itself – whether weed or tobacco – has negative health consequences. Consider your overall health and the potential effects of cannabis before consuming cannabis products. For more information about the health effects and legal aspects of cannabis use, please see our fact sheets Cannabis, HIV, and Your Health and Cannabis, Health, and the Law in the US.

Chiropractic Care

A chiropractor can help relieve headaches and pain in the back, neck or shoulders by manipulating your spine or joints. They may also recommend exercises, such as stretching, or changes to your daily activities to help alleviate the pain. The spine is a crucial part of your body, so make sure that any chiropractor you consult is certified. Each US state has its own Board of Chiropractic Examiners (List of State Licensing Boards) for licensing chiropractors. The American Board of Chiropractic Specialties certifies chiropractors in particular specialties, such as occupational health.

Herbs and Dietary Supplements

[T]he FDA recommends that people who are taking any kind of HIV drugs not take St. John's Wort.

These therapies may involve the use of herbs such as echinacea, garlic, goldenseal, chamomile, and Chinese herbs (e.g., astragalus). Health professionals may also prescribe foods and vitamins as part of a biological-based therapy. Multivitamins often contain antioxidants, such as vitamins A, C, and E, which combine with particles called free radicals to make these free radicals inactive and not harmful. Free radicals are natural by-products of the body's functions that can cause damage to cells and lead to disease.

Because echinacea, astragalus, and other supplements affect the immune system, they may interact with your HIV drugs. St. John's Wort, which is an herbal treatment for depression, has been shown to affect how two classes of HIV drugs, protease inhibitors and non-nucleoside reverse transcriptase inhibitors, act. As a result, the FDA recommends that people who are taking any kind of HIV drugs not take St. John's Wort. Discuss any herbs or supplements with your healthcare provider before taking them. For more details about supplements, please see our fact sheet on Vitamins and Supplements.

Homeopathy

Homeopathy aims to activate the body's own healing abilities by giving small doses of very diluted (thinned out) substances. It is based on the idea that "like cures like," or the Law of Similars. This idea suggests that diseases can be cured by small amounts of substances that cause similar symptoms in healthy people. Homeopathic remedies are made from small amounts of a variety of plants, minerals, and animal products that are crushed and dissolved in liquid. By adding more and more liquid to the original mixture, the remedy – a homeopathic 'tincture' – is diluted (made less strong).

Scientific studies of homeopathy have had mixed results. Some studies show homeopathy's benefits, while others do not show any difference between a homeopathic treatment and a placebo (no actual treatment). People most often use homeopathy to treat allergies, asthma, ear infections, digestive disorders, headaches, and menopausal symptoms. Because homeopathic remedies sometimes include substances that can affect your immune system or cause drug interactions, remember to talk to your healthcare provider before using them.

In the US, the Food and Drug Administration (FDA) regulates homeopathic remedies but does not evaluate them for safety or effectiveness. There is no license for homeopathic doctors in the US. Only three states have boards licensing MDs (medical doctors) or DOs (doctors of osteopathic medicine) to practice homeopathy: Arizona, Connecticut, and Nevada. However, a number of states license naturopathic physicians, who use homeopathy and other natural therapies. Laws and regulations for the practice of homeopathy vary from state to state.

Hypnosis

During hypnosis, or hypnotherapy, a trained therapist uses techniques to help you become deeply relaxed and enter a different state of consciousness called a trance. In a trance, your body relaxes while your mind becomes more focused. The hypnotherapist does not control your mind or your actions. Rather, you become very open to suggestions, such as the suggestion to quit smoking. The therapist makes suggestions for changing behaviors or relieving symptoms that are specific to your situation.

Hypnosis can help you relax, reduce stress, relieve anxiety, and ease pain. It is often used before surgical or dental procedures when someone is especially nervous. Hypnotherapy is also used to treat eating disorders, addictions, phobias, insomnia, and digestive problems.

Massage Therapy

Massage involves a trained therapist using their hands to physically handle the body's soft tissues and muscles. There are a variety of massage styles ranging from soft stroking to deep muscle kneading. Massage has been practiced as a healing therapy for centuries around the world. Massage therapy affects the whole body, and can relieve muscle tightness, improve circulation, clear waste products, boost the immune system, reduce stress, and help you relax.

Massage therapists in the US become certified after completing training and passing an exam. Many states recognize the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). You can also find massage therapists in your area by going to the website for the American Massage Therapy Association (AMTA).

Since massage involves direct contact between the therapist's hands and your skin, you will be asked to undress (with the possible exception of underwear) when the therapist leaves the room. Professional therapists should provide plenty of sheets and blankets with which to cover yourself on the massage table. If you feel uncomfortable for any reason, do not hesitate to talk to the therapist or find a different therapist.

It is important for people who are pregnant to be cautious about getting massages. If you are pregnant and want a massage, make sure you find a therapist who is specially trained to massage pregnant people.

Mind-Body Techniques

These activities enhance the mind's ability to affect bodily functions and symptoms. Mind-body techniques often include patient support groups, prayer, and therapies that use creative methods such as art, music, or dance. Practices such as biofeedback, hypnosis, journaling, and meditation are considered mind-body techniques.

Achieving a deep state of relaxation is one way to help ease stress and renew the body. Techniques for deep relaxation include meditation, mindfulness, guided visualization, progressive muscle relaxation, certain types of yoga, or Chinese exercises such as Qigong (Chi Kung), and Tai Chi. You can also use audiotapes or attend classes/workshops to guide you in accessing deep states of relaxation.

Mindfulness meditation may help people living with HIV who are under stress. Transcendental meditation may also improve the quality of life of those living with HIV. A much larger study over a longer time is planned to examine the specific psychological and physical effects of transcendental meditation.

What Kind of Complementary Treatment Will My Healthcare Provider Suggest?

When recommending complementary therapies, healthcare providers base their decisions on their patients’ physical and mental conditions, as well as their strengths, lifestyle, medical history, support systems, and other factors. This enables the provider to knit together a care plan tailored to each patient and may involve the following:

  • Diet change: Replacing refined/simple carbohydrates with whole grains, fresh vegetables, and fruits for overall health. Your healthcare provider may also suggest choosing low-to-moderate fat sources of protein such as turkey, chicken, and fish and limiting dairy and red meats.
  • Vitamin and mineral supplements: Your healthcare provider may prescribe multivitamin/mineral supplements that include vitamins A, D, E, and C (these are antioxidants), B-vitamins, calcium, magnesium, copper, zinc, manganese, potassium, chromium, and selenium (for more information, see our fact sheet on Vitamins and Supplements)
  • Digestive health treatments: Herbs such as barberry, ginger, goldenseal, peppermint, and parsley support digestive functions. Acidophilus and other 'healthy bacteria' help you maintain a strong digestive system that absorbs nutrients as efficiently as possible.
  • Physical activity and exercise: Cardiovascular fitness can strengthen the heart and circulatory system. This is done by increasing one's heart rate (how fast the heart is beating) about 20 percent more than the resting heart rate, and keeping it up for at least 30 minutes, at least five times per week.
  • Stress reduction: Deep relaxation practice two times per day for 15-20 minutes can reduce many health risks and maintain one's focus on practicing good health and wellness.

Remember to talk to your healthcare provider before you use any complementary treatments.

More and more, the medical community recommends complementary therapies for many types of conditions. Since complementary treatments have become more common, the US National Institutes of Health (NIH) has created a department called The National Center for Complementary and Integrative Health (NCCIH) that is dedicated to the study of these treatments.

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