Wednesday, May 18, 2011

Does Alternative Medicine Cost More Money Or Less For Fibromyalgia?

There are two schools of thought on this issue.  One says that adding insurance coverage for alternative medicine will cost more money because people will use both.  The other says that using alternative medicine saves money because people get less sick and take care of themselves more.  Can we have the drumroll please?  The cost less people win!  Washington state did an analysis of people who had coverage and the people who use alternative medicine cost the insurance companies about $400 dollars less.  Most interesting is that the really sick people cost insurers almost $1500 less per year.  Some of these people had  back pain, fibromyalgia or menopausal symptoms. 

In terms of Fibromyalgia, I went looking for the alternatives for Fibromyalgia on WebMD.  The person writing about Fibromyalgia is an M.D. who happens to have Fibromyalgia.  He's written thirteen books on Fibromyalgia.  He also happens to be "a physician speaker for pharmaceutical companies that make medications used to treat fibromyalgia."  I sense a vague conflict of interest when discussing alternative treatments as primary. Not surprisingly, he doesn't mention dietary change, GABA, DHEA, probiotics, or a range of other likely treatments.  Instead he focuses on a number of antidepressant herbs that are basically milder versions of the antidepressant pharmaceuticals being used.   

In focusing on the antidepressant aspect of treatment, our expert is playing to the "all in your head" phenomenon I see more and more often in chronic diseases.  But the reality is that a range of other factors affect Fibromyalgia patients, including a blunted adrenal response.  A number of different studies support this connection (one is below).  So rather than saying it's all in your head, we should be looking at the rest of the body.  Maybe this is why alternative medicine saves people money.  We look toward the big picture rather than just managing the symptoms. 

J Rehabil Med. 2010 Sep;42(8):765-72.

Evidence of reduced sympatho-adrenal and hypothalamic-pituitary activity during static muscular work in patients with fibromyalgia.

Kadetoff D, Kosek E.

SourceOsher Center For Integrative Medicine, Stockholm Brain Institute, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.

OBJECTIVE: To assess activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenocortical axis during static exercise in patients with fibromyalgia.
PATIENTS AND METHODS: Sixteen patients with fibromyalgia and 16 healthy controls performed a static knee extension until exhaustion. Plasma catecholamines, adrenocorticotropic hormone and cortisol, as well as blood pressure and heart rate, were assessed before, during and following contraction. Plasma C reactive protein was analysed at baseline.
RESULTS: Blood pressure and heart rate increased during contraction (p < 0.001) and decreased following contraction (p < 0.001) in both groups alike. Compared with baseline, plasma catecholamines increased during contraction in both groups (p < 0.001), but patients with fibromyalgia had lower levels of plasma adrenaline (p < 0.04) and noradrenaline (p < 0.08) at all times. Adrenocorticotropic hormone increased at exhaustion in controls (p < 0.001), but not in patients with fibromyalgia, who also had lower adrenocorticotropic hormone at exhaustion (p < 0.02) compared with controls. There were no group differences, or changes over time in plasma cortisol. High sensitivity C reactive protein was higher in patients with fibromyalgia compared with controls (p < 0.02).

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