Rheumatic Fever

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Thuja (Eastern White Cedar, Thuja Occidentalis) [1, 26, 27, 28]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present. Little is known about the full effects of Thuja, so it is not recommended for medicinal use. Thuja can be poisonous if ingested in large amounts.

Recommendation: no recommendation (There is insufficient evidence to support claims that Thuja helps to treat rheumatism)

Grade of Evidence: very low quality of evidence

Peppermint Oil [1, 20, 21, 22, 23, 24, 25]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (There is insufficient evidence to support claims that peppermint helps to treat rheumatism)

Grade of Evidence: very low quality of evidence

Mugwort (Artemisa Vulgaris) [1, 17, 18, 19]:

Please note, this management does NOT treat the condition itself. It has been proposed only as a weak supportive symptomatic support, and even then, has been discounted due life-threatening side effects

Recommendation: No recommendation (There is insufficient evidence to support claims that mugwart helps to treat symptoms of rheumatism. More research is needed.)

Grade of Evidence: very low quality of evidence

Mistletoe (Iscador, Viscum Album) [1, 12, 13, 14, 15, 16]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present. WARNING: The mistletoe plant should NOT be eaten because it is poisonous. May cause seizures, coma and death. It should only be taken as a purified mistletoe extract, and only in recommended doses.

Recommendation: No recommendation (There is insufficient evidence to support claims that mistletoe has any affect on the treatment of rheumatism)

Grade of Evidence: low quality of evidence

Kava (Piper Methysticum) [1, 8, 9, 10, 11]:

WARNING: In rare cases, kava may lead to liver failure and other life threatening problems. The FDA warns that those who have had liver problems, or are on medicacations which may affect the liver, patients should check with their doctors before taking Kava. Other side effects include headache, upset stomach, drowsiness, weight loss, bloody urine, and muscle weakness.

Recommendation: No recommendation (There is insufficient evidence to support claims that Kava helps to treat Rheumatism. More research is needed)

Grade of Evidence: Very low quality of evidence

Gotu Kola (Centella Asiatica, Hydrocotyle Asiatica)[1, 2, 3, 4, 5, 6, 7]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (There is insufficient evidence to support claims that Gotu Kola helps in the treatment of rheumatism in any way. More research is needed.)

Grade of Evidence: low quality of evidence

* www.gradeworkinggroup.org

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. Winston, D., Maimes, S., Adaptogens: Herbs For Strength, Stamina, and Stress Relief, 2007, pp. 226-7

3. "A Double-Blind, Placebo-Controlled Study on the Effects of Gotu Kola (Centella asiatica) on Acoustic Startle Response in Healthy Subjects". Journal of Clinical Psychopharmacology. 20(6):680-684, December 2000. Bradwejn, Jacques MD, FRCPC *; Zhou, Yueping MD, PhD ++; Koszycki, Diana PhD *; Shlik, Jakov MD, PhD

4.  B. M. Hausen (1993) "Centella asiatica (Indian pennywort), an effective therapeutic but a weak sensitizer." Contact Dermatitis 29 (4), 175–179 doi:10.1111/j.1600-0536.1993.tb03532.x

5. Cataldo, A., Gasbarro, V., et al., "Effectiveness of the Combination of Alpha Tocopherol, Rutin, Melilotus, and Centella asiatica in The Treatment of Patients With Chronic Venous Insufficiency", Minerva Cardioangiology, 2001, Apr; 49(2):159-63

6. http://en.wikipedia.org/wiki/Gotu_kola#Medicinal_effects

7. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/gotu-kola

8. http://www.publish.csiro.au/?act=view_file&file_id=SP05005.pdf

9. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/kava

10. http://www.kavazen.com/pages/library.htm#KavaZen and Kava Safety

11. http://nccam.nih.gov/health/kava/index.htm

12. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/mistletoe

13. http://nccam.nih.gov/health/mistletoe/ataglance.htm

14. http://www.nlm.nih.gov/medlineplus/ency/article/002883.htm

15. http://www.botanical.com/botanical/mgmh/m/mistle40.html

16. http://www.bmj.com/content/333/7582/1293.full?ijkey=56e55886cc53e0c478801e74001edc3bea1c322e&keytype2=tf_ipsecsha

17. Anliker MD, Borelli S, Wüthrich B. Occupational protein contact dermatitis from spices in a butcher: a new presentation of the mugwort-spice syndrome. Contact Dermatitis. 2002;46:72-74.

18. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/mugwort

19. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. Philadelphia, PA: Lippincott Williams & Wilkins; 2004.

20. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/peppermint

21. http://www.ncbi.nlm.nih.gov/pubmed/17420159

22. http://www.ncbi.nlm.nih.gov/pubmed/19507027

23. http://www.medicine.ox.ac.uk/bandolier/booth/alternat/AT022.html

24. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-peppermint.html

25. http://nccam.nih.gov/health/peppermintoil/index.htm

26. http://www.nlm.nih.gov/medlineplus/ency/article/002769.htm

27. http://plants.usda.gov/plantguide/pdf/cs_thoc2.pdf

28. http://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3Aproject=medlineplus&query=thuja&x=0&y=0

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