Deep Breathing Exercise for Nausea

Deep Breathing Exercise for Nausea.jpeg

One of the most common fears patients express when facing surgery is postoperative nausea, which can range from minor queasiness to protracted periods of vomiting. Feeling sick to one's stomach and throwing up after surgery is a common problem, affecting between a quarter and a half of those placed under general anesthesia, and more than half of those at high risk (women who don't smoke and have a history of motion sickness).

I've explored the science behind treating nausea with ginger (see Natural Nausea Remedy Recipe), but if you're too nauseous to eat, what do you do? Well, people are often sent home with anti-nausea rectal suppositories. Surveys, however, show that cultural and sexual attitudes may make a number of people sensitive to anything involving the rectum. Though the wording of the question researchers asked was, "are you happy to have a drug put in your back passage?" I can imagine many of the respondents thinking "well, maybe I wouldn't so much mind, but wouldn't exactly be happy about it," especially when you're feeling sick and throwing up.

For women who've had a C-section, they might not want to take drugs at all if they're breastfeeding, so researchers decided to put aromatherapy to the test. Research has shown that essential oils of both spearmint and peppermint are effective in reducing nausea and vomiting after chemotherapy, but this was after swallowing them.

Would just the smell of peppermint help with nausea? I explore this in my video Peppermint Aromatherapy for Nausea. Researchers had women take deep whiffs of peppermint extract (like you'd buy at a store) and it seemed to work. Eighty percent of the mint-sniffers felt better within just a few minutes, compared to no improvement in the placebo group who sniffed water with green food coloring, or the control group who didn't sniff anything.

The study was criticized for being small and for not using pure peppermint oil. Peppermint extract is peppermint oil plus alcohol. Maybe it was the smell of alcohol that made people better? And that's actually not too much of a stretch. In 1997, researchers reported a simple, innocuous, and inexpensive treatment for postoperative nausea and vomiting--the smell of isopropyl alcohol, which is what is found in those alcohol wipes, the little prep pads that nurses swab you with before shots. They found that they could just effectively tear one open and wave it under someone's nose and relieve nausea and vomiting in more than 80% of folks after surgery. It has been since shown to work as well as a leading anti-nausea drug, and may even work faster, cutting nausea in half within 10 to 15 minutes, rather than 20 or 25.

So was it the alcohol, the peppermint, or both? Researchers decided to put it to the test. They instructed patients to take three slow, deep breaths, smelling alcohol, peppermint, or nothing. The smell of peppermint cut nausea in half within five minutes, and so did the alcohol. But so did smelling nothing! So maybe it had nothing to do with the scent; maybe it was just the instruction to take slow, deep breaths. That would make it a really cost-effective intervention. Maybe it shouldn't be so surprising, given the proximity of the vomiting and breathing centers within the brain.

And indeed, controlled breathing was found effective with or without any scent. So next time you feel nauseous, inhale deeply through your nose to the count of three, hold your breath to the count of three, and exhale out the mouth to the count of three. Do that three times.

Ironically, the researchers continued to advocate using those nasty smelling alcohol pads even though they themselves showed they weren't any more effective than breathing alone. Why? Since isopropyl alcohol has a readily detectable odor, patients are more likely to think that their post-operation nausea and vomiting is being actively treated when they inhale alcohol vapors rather than just engaging in breathing exercises.


What do you think of still using the alcohol pads even though they were shown to offer no additional benefit? I have a whole video on such questions: The Lie That Heals: Should Doctors Give Placebos?

For those who can swallow, I offer more about powdered ginger in my video Dangerous Advice From Health Food Store Employees.

There's more on aromatherapy here:

What about actually eating the peppermint?

Of course, the best way to avoid postsurgical nausea is to try to avoid surgery in the first place. Those that eat healthy may be less likely to go under the knife. See Say No to Drugs by Saying Yes to More Plants.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank / Flickr. This image has been modified.

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Deep Breathing Exercise for Nausea

Deep Breathing Exercise for Nausea.jpeg

One of the most common fears patients express when facing surgery is postoperative nausea, which can range from minor queasiness to protracted periods of vomiting. Feeling sick to one's stomach and throwing up after surgery is a common problem, affecting between a quarter and a half of those placed under general anesthesia, and more than half of those at high risk (women who don't smoke and have a history of motion sickness).

I've explored the science behind treating nausea with ginger (see Natural Nausea Remedy Recipe), but if you're too nauseous to eat, what do you do? Well, people are often sent home with anti-nausea rectal suppositories. Surveys, however, show that cultural and sexual attitudes may make a number of people sensitive to anything involving the rectum. Though the wording of the question researchers asked was, "are you happy to have a drug put in your back passage?" I can imagine many of the respondents thinking "well, maybe I wouldn't so much mind, but wouldn't exactly be happy about it," especially when you're feeling sick and throwing up.

For women who've had a C-section, they might not want to take drugs at all if they're breastfeeding, so researchers decided to put aromatherapy to the test. Research has shown that essential oils of both spearmint and peppermint are effective in reducing nausea and vomiting after chemotherapy, but this was after swallowing them.

Would just the smell of peppermint help with nausea? I explore this in my video Peppermint Aromatherapy for Nausea. Researchers had women take deep whiffs of peppermint extract (like you'd buy at a store) and it seemed to work. Eighty percent of the mint-sniffers felt better within just a few minutes, compared to no improvement in the placebo group who sniffed water with green food coloring, or the control group who didn't sniff anything.

The study was criticized for being small and for not using pure peppermint oil. Peppermint extract is peppermint oil plus alcohol. Maybe it was the smell of alcohol that made people better? And that's actually not too much of a stretch. In 1997, researchers reported a simple, innocuous, and inexpensive treatment for postoperative nausea and vomiting--the smell of isopropyl alcohol, which is what is found in those alcohol wipes, the little prep pads that nurses swab you with before shots. They found that they could just effectively tear one open and wave it under someone's nose and relieve nausea and vomiting in more than 80% of folks after surgery. It has been since shown to work as well as a leading anti-nausea drug, and may even work faster, cutting nausea in half within 10 to 15 minutes, rather than 20 or 25.

So was it the alcohol, the peppermint, or both? Researchers decided to put it to the test. They instructed patients to take three slow, deep breaths, smelling alcohol, peppermint, or nothing. The smell of peppermint cut nausea in half within five minutes, and so did the alcohol. But so did smelling nothing! So maybe it had nothing to do with the scent; maybe it was just the instruction to take slow, deep breaths. That would make it a really cost-effective intervention. Maybe it shouldn't be so surprising, given the proximity of the vomiting and breathing centers within the brain.

And indeed, controlled breathing was found effective with or without any scent. So next time you feel nauseous, inhale deeply through your nose to the count of three, hold your breath to the count of three, and exhale out the mouth to the count of three. Do that three times.

Ironically, the researchers continued to advocate using those nasty smelling alcohol pads even though they themselves showed they weren't any more effective than breathing alone. Why? Since isopropyl alcohol has a readily detectable odor, patients are more likely to think that their post-operation nausea and vomiting is being actively treated when they inhale alcohol vapors rather than just engaging in breathing exercises.


What do you think of still using the alcohol pads even though they were shown to offer no additional benefit? I have a whole video on such questions: The Lie That Heals: Should Doctors Give Placebos?

For those who can swallow, I offer more about powdered ginger in my video Dangerous Advice From Health Food Store Employees.

There's more on aromatherapy here:

What about actually eating the peppermint?

Of course, the best way to avoid postsurgical nausea is to try to avoid surgery in the first place. Those that eat healthy may be less likely to go under the knife. See Say No to Drugs by Saying Yes to More Plants.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank / Flickr. This image has been modified.

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Can Peppermint Improve Athletic Performance?

NF-Oct20 Enhancing Athletic Performance With Peppermint.jpeg

Ever since smoking was prohibited in night clubs, customers have increasingly noticed other unpleasant smells present in the club--like body odors. So, researchers in Europe thought they'd try to cover them up. The researchers measured the effects of peppermint, for example, on dancing activity and asked people to rate their energy level. They found that with peppermint scent, people felt more cheerful and danced more, and so, concluded the researchers, "environmental fragrancing may be expected to have a positive effects on club revenue." Innovative nightclubs are already inviting "aroma jockeys" to smell the places up.

The business community caught whiff of this and thought maybe peppermint smell would get their secretaries to type faster. And it worked! There was improved performance on clerical tasks associated with the administration of peppermint odor.

In an age where athletic competitions are frequently won or lost by mere hundredths of a second, athletes are continually looking for new ways to excel in their sport. Researchers threw some collegiate athletes onto a treadmill and piped different smell into their nostrils, and those on peppermint reported feeling less fatigued, more vigorous, less frustrated, and felt they performed better. But did they actually perform better? See my video, Enhancing Athletic Performance with Peppermint.

A different study published in the Journal of Sport and Exercise Psychology measured actual performance, and participants were actually able to squeeze out one extra pushup before collapsing and cut almost two seconds off a quarter mile dash with an odorized adhesive strip stuck to their upper lip. Interestingly there was no significant difference in basketball free throws. The researchers think the reason is that free throws actually require some skill, and all the peppermint can do is really improve athlete's motivation.

Unfortunately follow-up studies were not able to replicate these results, showing no beneficial effect of smelling peppermint on athletic performance, so how about eating peppermint? Researchers measured the effects of peppermint on exercise performance before and after ten days of having subjects drink bottles of water with a single drop of peppermint essential oil in them. And all the subjects' performance parameters shot up, churning out 50 percent more work, 20 percent more power, and a 25 percent greater time to exhaustion. Improvements were found across the board in all those physiological parameters, indicating increased respiratory efficiency. They attribute these remarkable results to the peppermint opening up their airways, increasing ventilation and oxygen delivery.

Now, you can overdose on the stuff, but a few drops shouldn't be toxic. Why not get the best of both worls by blending fresh mint leaves in water rather than use the oil?

Sometimes aromatherapy alone may actually help, though:

Beet juice can also enhance athletic performance. See the dozen or so videos in the series starting with Doping With Beet Juice. Other ways healthy food can synergize with exercise:

I use peppermint in my Pink Juice with Green Foam recipe and talk about using the dried in Antioxidants in a Pinch. It can also help reduce IBS symptoms, as seen in Peppermint Oil for Irritable Bowel Syndrome.

Some other tea caveats, though:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

Image Credit: Cory Denton / Flickr

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Orange Aromatherapy for Anxiety

NF-Mar31 Does Orange Aromatherapy Reduce Anxiety?.jpg

Aromatherapy -- the use of concentrated essential oils extracted from plants to treat disease -- is commonly used to treat anxiety symptoms. Anxiety disorders are the most prevalent class of psychiatric disorders in the general population. However, their treatment is challenging, because the drugs used for the relief of anxiety symptoms can have serious side effects.

Thankfully, credible studies that examine the effect of essential oils on anxiety symptoms are gradually starting to appear in the medical literature. However, in most of these studies, exposure to the essential oil odor was accompanied by massage. This makes it difficult to draw firm conclusions about the effect of the aroma itself.

A typical example includes this study where patients in the intensive care unit the day after open-heart surgery got foot massages with orange-scented oil. Why not back massages? Because they just had their chests cracked open so they have huge sternotomy wounds. Patients showed a significant psychological benefit from the aromatherapy massage.

But how do we know the essential oil had anything to do with it? Maybe it was just the massage. If that's the case, then great--let's give people massages! I'm all for more ICU foot rubs. "There is considerable evidence from randomized trials that massage alone reduces anxiety, so if massage is effective, then aromatherapy plus massage is also effective." One study where cancer patients got massaged during chemo and radiation even found that the massage without the fragrance may be better. The researchers thought it might be a negative Pavlovian response: the patient smells the citrus and their body thinks, "Oh no, not another cancer treatment!"

More recently the ambient odor of orange was tested in a dental office to see if it reduces anxiety and improves mood. Ambient odor of orange was diffused in the waiting room and appeared to have a relaxant effect--less anxiety, better mood, and more calmness--compared to a control group where there was no odor in the air. No odor, that is, except for the nasty dentist office smell. Maybe the orange scent was just masking the unpleasant odors. Maybe it had nothing to do with any orange-specific molecules. More research was necessary.

So in another study, highlighted in my video, Orange Aromatherapy for Anxiety, researchers exposed some graduate students to an anxiety-producing situation and tested the scent of orange, versus a non-orange aroma, versus no scent at all. The orange did appear to have an anxiety-reducing effect. Interestingly, the observed anxiety-reducing effects were not followed by physical or mental sedation. On the contrary, at the highest dose, the orange oil made the volunteers feel more energetic. So orange aromatherapy may potentially reduce anxiety without the downer effect of Valium-type drugs. Does that mean we can get the benefits without the side effects? I've talked about the concerns of using scented consumer products before, even ones based on natural fragrances (Throw Household Products Off the Scent), and there have been reports of adverse effects of aromatherapy.

Alternative medicine isn't necessary risk-free. For example, there are dozens of reported cases of people having their hearts ruptured by acupuncture. Ouch.

But the adverse effects of aromatherapy were mostly from skin irritation from essential oils being applied topically, or even worse swallowed. Certain citrus oils can also make your skin sensitive to sunlight.

Lavender may also help for both anxiety (Lavender for Generalized Anxiety Disorder) and migraines (Lavender for Migraine Headaches).

The only other aromatherapy-related video is Wake Up and Smell the Saffron, though I have others on natural ways do reduce anxiety, including:

Natural, though, doesn't always mean safe. See, for example:

Of course eating citrus is good too! I have videos on Reducing Muscle Fatigue With Citrus and Keeping Your Hands Warm With Citrus, but Tell Your Doctor If You Eat Grapefruit.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Tim Sackton / Flickr

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Treating Migraines With Lavender

 

 

 

 

 

 

 

 

Treating Migraines With Lavender

Lavender has been studied recently for several purposes, including treatment of mood and anxiety disorders (see, for example, the video I profiled in my last post, Lavender for Generalized Anxiety Disorder). Though it’s better known for its analgesic (pain-killing) properties, there hasn’t been a single documented clinical trial on lavender for the treatment of migraine headaches, which affect tens of millions of Americans every year. That is, until now: “Lavender Essential Oil in the Treatment of Migraine Headache: A Placebo-Controlled Clinical Trial.”

Migraine sufferers were asked—at the early signs of headache—to rub two to three drops of lavender essential oil onto their upper lip and inhale its vapor for a 15-min period, then score the severity of their headache for the next two hours. In the control group they did the same thing, but with drops of unscented liquid wax instead. Neither group was allowed to use any painkillers. In the lavender group 74 percent of patients had an improvement in their symptoms—significantly better than placebo.

Although lavender wasn’t directly compared to more conventional treatments and outcome measures differed, as you can see in the associated video Lavender for Migraine Headaches, lavender appears to stack up pretty well against typical migraine drugs. Lavender helped about three quarters of the time; high dose Tylenol may only work about half the time; and Ibuprofen 57% of the time. The top prescription drug, generic Imitrex, is effective 59% of the time, and the hardcore treatment they use in emergency rooms where they inject you under the skin works 70% of the time. Fortunately all of these work better than the original migraine therapy, known as trepanning, where doctors drilled holes in our head to let the evil spirits escape!

The lavender researchers concluded that the results of the study suggest that inhalation of lavender essential oil may be an effective and safe treatment modality in acute management of migraine headaches.

Migraine sufferers may also want to experiment with avoiding potential triggers such as aspartame (see my video Diet Soda and Preterm Birth). Saffron may also help with headaches (Saffron for the Treatment of PMS) as well may the avoidance of certain parasites (Pork Tapeworms on the Brain and Avoiding Epilepsy Through Diet). A note of caution, though: Pregnant migraine sufferers seeking natural remedies should be wary of advice they may get (Dangerous Advice From Health Food Store Employees).

What’s better than treating your pain with natural remedies? Not having pain in the first place! Those eating healthy diets are less likely to be on pain medications in general (Say No to Drugs by Saying Yes to More Plants). See, for example:

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: Avenue G / Flickr

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Using Lavender to Treat Anxiety

 

 

 

 

 

 

 

 

Using Lavender to Treat Anxiety

Lavender oil, which is distilled from lavender flowers, is often used in aromatherapy and massage. Despite its popularity, only recently have scientific investigations been undertaken into its biological activity.

While there have been small-scale studies suggesting benefit from lavender oil massage, we didn’t know if the benefit was coming from the lavender, the massage, or both. In an attempt to separate these two variables, a study was conducted in which patients in intensive care were given massages with either odorless oil or lavender oil. While patients massaged with lavender oil did say they felt less anxious and more positive, there were no objective differences found in terms of blood pressure, breathing, or heart rate. Perhaps the lavender was just been covering up the nasty hospital smells.

Subsequent studies using more sensitive tests did find physiological changes, though. We now know the scent of lavender can actually change brain wave patterns, but we didn’t know what the implications were until recently. Studies have shown the scent of lavender makes people feel better as well as perform math faster and more accurately (whereas the smell of rosemary, for example, seemed only to enable folks to do the math faster, but not necessarily with greater accuracy).

How else might one use natural means to improve cognitive performance? Check out my video Does a Drink Of Water Make Children Smarter? and for more brain hacking tips, Dietary Brain Wave Alteration.

But what if we actually eat lavender flowers? Or in the case of the study I profile in my 3-min video Lavender for Generalized Anxiety Disorder, take capsules of lavender-infused oil so as to perform a double-blind study to compare lavender head-to-head to lorazepam (Ativan).

Generalized and persistent anxiety is a frequent problem and is treated with benzodiazepines (also known as benzos or downers) like Ativan and Valium. Unfortunately, these substances can not only make one feel hungover, but they have a high potential for drug abuse and addiction. So researchers decided to give lavender a try. Ativan certainly reduced anxiety, but so did the lavender. By the end of the study you couldn’t tell which group was which, and among those that responded to either, the lavender actually seemed to work better.

The spice saffron may be aromatherapeutic as well. See Wake Up and Smell the Saffron for its role in treating PMS, above and beyond its other effects on the brain (Saffron vs. Prozac, Saffron for the Treatment of Alzheimer’s, and Saffron Versus Aricept).

Since lavender oil has no potential for drug abuse and no sedating side-effects, it appeared to be an effective and well-tolerated alternative to benzodiazepine drugs for amelioration of generalized anxiety.  

One cautionary note, however: There was a case series published in the New England Journal of Medicine entitled “Prepubertal Gynecomastia Linked to Lavender and Tea Tree Oils.” They reported cases of young boys exposed to lavender-containing lotions, soaps, hair gels, and shampoos starting to develop breasts. These effects disappeared after the products were discontinued, suggesting that lavender oil may possess hormone-disrupting activity. Indeed, when dripped on estrogen receptor positive breast cancer cells, lavender does show estrogenic effects and a decline in male hormone activity. It’s unknown, however, if similar reactions occur inside the body when lavender flowers or lavender oil is ingested.

There are some dietary components known to affect with the hormonal balance of young boys. Check out Dairy & Sexual Precocity.

More on lavender in Lavender for Migraine Headaches.

And more on dietary interventions for anxiety can be found in:

For more flower power see my blog and videos on hibiscus tea (Better Than Green Tea) and chamomile tea (Red Tea, Honeybush, & Chamomile and Chamomile Tea May Not Be Safe During Pregnancy). And hey, broccoli florets are just clusters of flower buds. See The Best DetoxBroccoli Versus Breast Cancer Stem Cells, and dozens of my other broccoli videos.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: tfengreen / Flickr

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