A – For the last couple of years the prevailing strain of flu has brought with a deep, sometimes distressing cough that lingers long after most symptoms have cleared up.

Many common essential oils can help if you have a cough. They can be used as inhalations, or diluted into a base oil and used for massage or as a chest rub, or added to a warm bath, or a bowl of hot water to make an effective steam inhalation. When you are on the go, you can add a few drops to a tissue or hankie, keep this in a plastic bag to use whenever you feel congested to help open your airways.

While it’s worth consulting a healthcare practitioner if coughs linger far too long, essential oils are a simple and affordable treatment and have several properties that can soothe the throat, break up mucous and reduce inflammation.

We have heard of several cases where people have succumbed to this year’s flu more than once and so making use of the anti-bacterial benefits of essential oils, for instance by using them in diffusers to clean and disinfect the air, is also a good way to get the most out of them.

Here is our choice of effective essential oils to help treat coughs:

Eucalyptus

The eucalyptus or blue gum tree is indigenous to Australia and was used medicinally by the Aborigines. It is now cultivated in North Africa, Spain, California and India, as well as Australia. Its main active ingredient is cineole, which has an antimicrobial effect that can help fight off bacteria that cause illnesses. It also has an anti-inflammatory action that helps to break up mucus, relieve pain, and ease the muscle tension that often accompanies a cold or flu.

While it has a slightly medicinal aroma, eucalyptus is widely recognized for its ability to treat coughs and associated respiratory ailments like pharyngitis, bronchitis, and sinusitis.

Cinnamon

The cinnamon tree is a native of east India and Indonesia. The inner bark of the young twigs, sold as cinnamon sticks, has been used in cooking and as a medicine for thousands of years.

Cinnamon, has a reassuring, spicy aroma and has also been shown be a powerful anti-bacterial. A recent review concluded that cinnamon has multiple medicinal properties including the ability, when inhaled, to stop the bacteria that cause respiratory illness from reproducing. To get the most from inhalations try using in a diffuser or as a steam inhalation.

Rosemary

A native of the Mediterranean countries, rosemary is now grown all around the world. It is a classic culinary herb and has also been used as a medicinal and a sacred herb for thousands of years. Its main active component is rosmarinic acid which, in addition to being, anti-inflammatory – thus helping to relax the muscles in your trachea – is also antiviral and antibacterial. Used on the skin, for instance in a chest rub or massage, it has a warming and head-clearing effect.

One small 2011 study found that a spray containing eucalyptus, peppermint, oregano and rosemary essential oils was able to improve symptoms of upper respiratory ailments in those who used it.

Chamomile

The cheerful flowers of the chamomile plant are familiar to most people.

Both Roman chamomile (Anthemis nobilis) and German chamomile (Matricaria recutita) are known for their calming, soothing properties.  While they have similar actions and are often used interchangeably, studies tend to concentrate on one or the other with German chamomile the more widely used and studied.

Both types of chamomile essential oil contain the powerful anti-inflammatories: bisabolol and apigenin. Both substances work to reduce inflammation, fever and pain in a similar way to NSAIDS like paracetamol. German chamomile has been shown to have anti-inflammatory properties. Roman chamomile has been shown to help soothe part of the lungs called the bronchus to relax as well as relieve coughing.

Chamomile is anti-inflammatory and anti-viral and there is evidence that steam inhalations with chamomile extract can be helpful in relieving upper and middle respiratory tract congestion. The chamomile acted quickly (within 15 minutes) and the benefits lasted 2-3 hours.

Bergamot

Named after the Italian city of Bergamo, these oranges have a very sour fruit with a deeply scented rind the distinctive aroma of which is used as an ingredient in Earl Grey tea and eau de cologne. When inhaled it has a cooling, refreshing effect. It can also help relieve fever and headaches and has an antidepressant effect that can help balance moods and ease anxiety when you are ill.

The essential oil contains the active substance camphene, which is also found in nutmeg and cypress oils and which, studies show, acts as an expectorant. Bergamot oil is anti-microbial and has been shown to inhibit the growth of bacteria, viruses, and fungi.

Peppermint

This popular herb is a hybrid of other types of mint cultivated throughout the world. It has been used as a medicinal herb for thousands of years, particularly to aid breathing and digestion. Peppermint contains a substance called menthol which is often used in commercial chest rubs and can help relieve stuffy or blocked noses, and make breathing easier.

In an essential oil burner or as a steam inhalation or chest rub it has expectorant, antispasmodic and decongestant properties to aid coughs, asthma, bronchitis and sinusitis, flu and head colds.

One study in healthy found that in those who consumed peppermint in a drink, it helped to relax the bronchial muscles which may explain why the oil appears to ease breathing in people with coughs. So consider adding peppermint tea to you healing regimen.

Geranium

Many are surprised to learn that geranium oil is produced from the leaves, not the flower, of this familiar plant. Geranium essential oil has an overall cooling, balancing effect and is useful for lifting low moods. Studies show it is also useful for easing infections in the upper respiratory tract, including bronchitis.

In one review, which looked at the benefits of several herbs for coughs, geranium was found to be superior to placebo in alleviating the frequency and severity of patients’ cough symptoms; it also helped improve patients’ moods. Geranium also has antibacterial properties that make is a useful room disinfectant a bout of cold or flu.

Lavender

An aromatic shrub native to the Mediterranean region, lavender has a long history of use as a medicine and its sweet, calming aroma is recognised the world over. It has sedative properties that aid restful sleep and mild analgesic properties make it good for easing headaches and migraine. It is also an effective antispasmodic that can help ease any kind of spasmodic cough.

Lavender is also an anti-inflammatory that can help soothe inflamed bronchi. This alongside its natural sedative and anti-inflammatory characteristics may benefit those with respiratory symptoms, including asthma. For example, one study found that lavender oil inhalation inhibited airway resistance caused by bronchial asthma. Try using it as a chest rub or steam inhalation or sprinkled on your pillow to aid healing sleep.

Tea Tree

A plant, which like eucalyptus, has a long history of use among the Aborigines of Australia, who crushed the leaves and used them to treat coughs, wounds and skin problems. Although it has a slightly medicinal aroma, it is a useful antiseptic and works particularly well in a steam inhalation.

Its powerful antimicrobial properties, giving it the ability to kill the bacteria that can cause respiratory conditions. It also has anti-inflammatory and immune stimulating properties that strengthen the body and help it fight off infection. During convalescence, adding tea tree to a body massage can aid recovery.

Oregano

Prized for centuries for its healing qualities, oregano has a broad spectrum antibiotic action and warming, drying properties that may help heal respiratory and other infections. It is traditionally used to treat complaints as diverse as indigestion and diarrhea, rheumatism and stubborn coughs. For coughs it is often recommended as a treatment for clearing sinuses and loosening and thinning phlegm, thus making breathing easier.

Oregano essential oil contains a high level of a substance called carvacrol which has been shown to be an effective antimicrobial agent against many types of germs.

Try adding 5-8 drops of oregano oil to 1-2 tsp of coconut oil to use as a chest rub when you have a cough.

A – Red, itchy insect bites are a common experience and while most will eventually clear up on their own, for some people, especially those with who have sensitive or dry skin, they can cause a local allergic-like reaction that persists for a fairly long time.

In fact, we have heard many reports from people saying they think bug bites are getting worse or that they are more sensitive to them these days. Whether that is true or not is hard to say, but we do know that essential oils have properties that can help calm the inflammation and itching that can drive you to distraction.

By removing the itch you also remove the temptation to scratch, which can break the surface of the skin allowing infection to take hold. But if a mild infection does take hold, there are antimicrobial essential oils that can help heal it.

Obviously, if you have a severe reaction or infection you should seek medical help as soon as possible.

Try these first

Essential oils are highly concentrated oils extracted from plants, such as herbs, flowers, or trees. While many need to be diluted, some can be used neat and it’s worth keeping a range in your natural first aid kit to deal quickly and easily with bites and stings.

Lavender (Lavandula angustifolia)

Lavender is extremely useful for wounds, ulcers and sores of all kinds. It is soothing and has a local anti-inflammatory and analgesic action to relieve the swelling and pain associated with bug bites. Lavender also has antiseptic properties to prevent and treat infections. As a first-aid remedy it can be used neat on the skin to treat not just insect bites and stings, but cuts and abrasions as well.

Tea tree (Melaleuca alternifolia)

Best known for its antiseptic properties, tea tree is a good all-rounder to keep in your first aid kit for healing all kinds of wounds and sores. It has a broad spectrum of antimicrobial activity may help prevent bug bites from getting infected.

There is also research that shows that tea tree oil is a natural antihistamine. Histamine is released by the body when it comes into contact with an allergen. Although it is part of your body’s natural defences, too high levels can cause inflammation. Try washing bites in a 10% solution (1 part tea tree to 10 parts water) to reduce swelling and itchiness.

Chamomile (Matricaria recutita)

Chamomile’s anti-inflammatory properties makes it useful for soothing problem, allergic or sensitive skin. It is another oil that can be applied neat for immediate relief of itchy and inflamed rashes and bites. It has also been shown to promote faster healing and tissue regeneration than corticosteroids.

Peppermint (Mentha piperita)

Peppermint oil has cooling and toning effects on the skin and can be particularly soothing for skin that is irritated for instance by bites, stings, hives and other allergic skin reactions. Peppermint is also antiseptic and antimicrobial to help reduce the risk of infection. Peppermint can be applied directly to skin, but those with sensitive skin should dilute it. A 2% dilution would be 12 drops of peppermint oil to 30ml (2 tbl) of a carrier oil such as almond, grapeseed or coconut.

Lemongrass oil (Cymbopogon citratus)

Commonly used as an insect repellent, lemongrass is also an antibacterial, pain relieving and strongly antiseptic oil. Research has shown that is has anti-inflammatory properties which can help reduce pain and itching following insect bites and stings. Use in a 2% dilution as with peppermint (above).

Camphor oil (Cinnamomum camphora)

Camphor oil has a warming action due to its ability to increase local circulation. This may provide some relief to itchy bites. For bites that burn, however, choose a more soothing oil such as chamomile or lavender (above). Camphor should be well diluted and one way to get its benefits without worrying about dilutions is to keep some white Tiger Balm, which contains camphor and menthol (an active ingredient in peppermint oil), on hand.

What else can you do?

Sometimes you will need to use more than one strategy to treat bug bites. Other natural remedies may be useful to support the healing process including:

Witch hazel is distilled from the leaves and stems of the Hamamelis virginiana plant. It has a cooling, soothing, toning effect on skin and is mildly antiseptic. You can make an infusion from the leaves and bark or simply buy a good quality distilled witch hazel and use it to clean the area around the bite or sting, or dab on or use in a compress as needed to cool the area.

Aloe vera is another good remedy to keep on hand. Store the gel in the refrigerator and dab onto bites as soon as possible to relieve red, itchy inflamed skin.

Pyrethrum spray is a traditional homeopathic remedy for bites and stings. Keep a small bottle of pyrethrum handy and use immediately to help reduce inflammation and itching. If you are travelling to places where the risk of bites is high, this is a good remedy to pack.

Baking soda or Epsom salts can be added to the bath to address large areas of bites that are itchy and inflamed. Both can help reduce the swelling, which will eases the itching sensation. Add a cupful of either one to a tepid bath and soak the affected area(s).

Make an oatmeal bath bag. Oatmeal produces a soothing liquid that calms skin inflammation and itching. Cut the foot off an old pair of tights. Put a handful of dry oatmeal into it and tie it off. Soak it well and squeeze; use the soothing cream this produces to cleanse instead of soap. Alternatively simply use a larger length of tights (large enough to take 1-2 cupfuls of oats) like a giant ‘teabag ’to infuse the water with soothing oat extract.

Finally, old standbys like calamine lotion can be really useful to ease itching and help dry up weepy sores while a clay pack or poultice can help draw out stings.

To make a clay pack, mix powdered clay (bentonite clay, has the strongest drawing action) with just enough water to make a paste which has the consistency of toothpaste. You can also if you like add up a few drops of essential oil of your choice. Apply directly to the affected area, cover with a clean waterproof dressing that generously covers the area around the sting. You may need to leave it on for several hours or overnight or until the clay is dry. Rinse off with tepid water.

A – Gingivitis is the earliest stage of gum disease, which if left untreated, can lead to tooth loss. It’s a common dental problem and its symptoms include red, swollen, inflamed gums that may feel tender or bleed when a person brushes their teeth.

It’s important to treat gingivitis as soon as it appears and the good news is that there are a number of natural remedies which you can use at home to keep gums healthy. Here’s some options that will help.

Salt water

Salt water is one of the oldest healing remedies and modern research has shown that rinsing the mouth with a saltwater solution can relieve inflamed gums caused by gingivitis. Salt water is antiseptic and anti-inflammatory and it is something that anybody can make and use at home.

Add 1 tsp of sea salt to a short tumblerful of boiled water that has been allowed to cool until it is lukewarm. Stir until the salt is dissolved and use switch through and rinse out the mouth before sitting the solution out. When symptoms are acute do this 3 times a day.

Make a mouthwash

This minty mouth wash is both healing and antiseptic when used regularly. To make about 10mls you will need:

• 1 tbl dried peppermint leaves
• 100ml (3 ½ al oz) mineral water
• 1stp table salt
• 1tbl aloe vera juice
• 1tbsp glycerine
• 10 drops peppermint essential oil
• 2 drops tea tree essential oil
• 1 drop myrrh essential oil

Method

1. Make an infusion with the dried peppermint and boiled water

2. Filter the dried herb into a mixing bowl

3. Dissolve the salt in the hot infusion, add aloe vera juice and glycerine

4. Add the essential oils

5. Pour into sterilised bottle and leave to cool before applying lid

Shake well before each use and use twice a day to rinse after brushing teeth.

Oil pulling

Try using coconut oil as an oral rinse to help reducing bacteria, control plaque, fighting tooth decay and gum infection.  A traditional method is called ‘oil pulling’ has been shown to reduce plaque and signs of gingivitis when used regularly. Studies have also shown that oil pulling is as effective as chlorohexidine for bad breath.

To do this, take a couple of tablespoons of coconut oil, melt in your mouth (this will happen quickly) and then swish the oil through your teeth and around your mouth for 20 minutes before spitting out. No need to rinse afterwards.

Probiotics

Probiotics are living microorganisms, principally bacteria that are safe for human consumption and have beneficial effects on human health. Using them to improve dental health is a relatively new area of exploration, though it is increasingly being considered as an answer to the emergence of antibiotic-resistant bacteria.

One 2009 review found the weight of the evidence showed the following benefits:

• Probiotics incorporated into dairy products were able to neutralise acidic conditions in the mouth and interfere with cariogenic (cavity-causing) bacteria.
• Patients with periodontal disease who used chewing gum or lozenges containing probiotics saw their periodontal status improve.
• Probiotics in gargling solutions or gum inhibit the production of volatile sulphur compounds that contribute to bad breath.

Previous research has suggested that the probiotic L. reuteri Prodentis can inhibit plaque and have anti-inflammatory and antimicrobial effects that could make it useful in maintain health teeth and gums, though not all studies have found a positive effect.

In 2014 scientists found that a probiotic lozenge containing cultures of  Lactobacillus rhamnosusGG (LGG) and Bifidobacterium animalis subsp. lactis BB-12 (BB-12) reduced the number of streptococci (bacteria associated with gum disease) in the mouth.

Aloe vera

Aloe vera is the oldest medicinal plant that has maintained its popularity over the course of time. It is widely known for its medicinal uses in wound healing, as an analgesic, and for its anti-inflammatory properties.

In one 2013 study people who rinsed twice a day with 10ml of aloe vera mouthwash had less inflammation in their gums than those who did not use the aloe. In another 2016 study aloe mouthwash was as effective as 0.2% chlorhexidine in preventing dental plaques. In this study the participants rinsed with 10mls of 100% aloe juice. You can also make a good everyday mouthwash by using 2 parts aloe to 1 part water. Mix as required and use 1-2 times daily.

Myrrh

Myrrh’s antiseptic properties make it an excellent mouthwash ingredient to treat infection or inflammation including mouth ulcers, sore throat, bleeding inflamed gums, bad breath and thrush. As a result some natural toothpastes and mouthwashes now incorporate myrrh into their ingredients.

A review conducted by Egyptian researchers, concluded that myrrh “is one of the most effective herbal medicines in the world for sore throats, canker sores and gingivitis.”

You can get the benefits of myrrh by simply adding a 2 drops of the essential oil to 60ml of warm water and use this to swish through your mouth. Do not swallow.

Preventing gingivitis

In addition to remedies to help soothe gingivitis it is important to practice good dental hygiene to keep it from occurring in the first place. Make sure you:

• brush your teeth for 2 minutes, twice daily
• floss daily to remove food particles that lead to bacteria and plaque build-up
• quit or avoid smoking as this can raise the risk of gingivitis – and other health issues
• use a medium to soft-bristled toothbrush and replace it regularly
• use an electric toothbrush if possible
• visit your dentist regularly for a good clean and check-up

Finally… check the ingredients in your toothpaste.

Many commercial toothpastes contain harsh detergents which can cause inflamed gums. Ingredients like silica, a common abrasive powder found in toothpaste, s can build up under the surface of the gums causing granulomas – small nodules of inflamed tissue – that can mimic gingivitis. This inflammation can leave the gums more vulnerable to infection.

Antibacterials like triclosan are not only irritants they can encourage bacterial resistance, making gingivitis even harder to treat.

There are many excellent natural toothpastes on the market some of which include helpful ingredients such as aloe vera and myrrh. Try swapping your old toothpaste for one of these.

• For more on this topic see our article Beyond brushing – healthy teeth and gums protect the body in multiple ways

A –  Our editor Pat Thomas has written about the placebo effect in her book What Works, What Doesn’t. Here’s some of what she says:

A placebo is a substance with no (known) medicinal properties which causes a patient to improve because of his or her belief that it will work. When used in drug or other research a placebo is administered to a ‘control group’ – a group of individuals who are receiving non-medical treatment who can be compared to another group, which is receiving genuine, usually experimental, treatment.

The goal of such research is to prove that the experimental treatment is better than taking or doing nothing. However, this is often not the case. When those in the control group experience the same or even better outcomes than those in the experimental group, this is known as the ‘placebo effect’. When applied as a procedure (as in trials with ultrasound, surgical procedures, acupuncture or biofeedback) a placebo is known as a sham treatment.

The placebo effect is particularly significant for those interested in wellness because it reminds us of the power of suggestion and belief – an innate power that can change the way the body functions, and one that is normally only attributed to man-made drugs. Placebos also provide a broad platform from which to construct broader questions about relationships – between the body and the mind, but also between the practitioner and the patient – and how influential these are to health and illness.

The benefits of belief

Conventional medicines, having been tested in medical trials, are supposed to be free from any association with the placebo effect. Yet many scientific trials completely ignore the complexities of the placebo and the possible placebo effect that the simple act of prescribing a remedy or treatment can have on a patient.

For instance, when a doctor can see no clear pattern to an illness he may throw something in the general direction of the patient’s symptoms, if only to reassure the patient that he is doing his best. Even if it is the wrong remedy, the fact of doing something to help may inspire the patient to recover.

Across the country, in fact throughout the world, the overuse of the wrong drugs and procedures in this haphazard way may be concealing a widespread placebo effect – the very thing which serious scientists aim to eliminate when conducting medical trials. The overuse of antibiotics is a good example.

Many doctors continue to prescribe antibiotics for cold and flu, even though these conditions are caused by viruses and cannot be cured with antibiotics (which only work against bacteria). Nevertheless, many people report feeling better after having taken these drugs, and often request them the next time they fall ill with the same complaint.

Not a dirty word

With this in mind it can be difficult to say categorically how much of any drug’s efficacy is down to a genuine pharmacological effect and how much is down to the mutual belief (by doctor and patient) that it might do some good.

The prescribing physician also has a role to play in the placebo effect. When a doctor enthusiastically supports a treatment, the placebo response could be greater than 80%. Similarly studies have shown that the effectiveness of the placebo is increased when both practitioner and patient believe that the treatment will work and in nearly 40% of the time under these circumstances, it will.

The debate on what it is, how it works, when it works, whether it’s ethical and whether there is a difference between “true” and “perceived” placebo effects, ignores the facts – placebo and sham treatments can improve and even cure  30-70% of those to whom they are administered.

Studies have shown that placebos can relive pain, reduce drug use, heal ulcers and more – so placebo certainly shouldn’t be considered a dirty word!

In fact, as one review published in Medical Anthropology Quarterly in 2000, and focusing on the cultural variations in the placebo effect in treating ulcers, anxiety and blood pressure, concluded, “placebo healing is the ultimate and inescapable ‘complementary medicine’”.

How does it work?

Many scientists believe placebos work by exerting a systemic effect, such as releasing natural morphine-like substances that circulate throughout the body. While this may be true, placebos can also have extremely specific effects. In one famous anecdote 13 people extremely sensitive to poison ivy were rubbed on one arm with a harmless leaf, and told it was poison ivy. The other arm was rubbed with poison ivy, and they were told it was harmless. All 13 developed a rash where they were rubbed by the harmless leaf, while only two reacted to the poison ivy leaf.

Another theory is that placebos somehow stimulate the secretion of small brain peptide messengers like endorphins that have strong effects on mood and sensitivity to pain.

Although there are no measurements to confirm this, support comes from the observation that placebo pain relief can be diminished by the administration of naloxone, a drug that blocks opiate effects and also reduces the analgesic response to acupuncture.

Stimulation of endorphin secretion alone, however, would not explain all the wide-ranging benefits of placebos. The common denominator appears to be the belief, faith and/or expectation of a favourable outcome.

In addition, stress can contribute to or aggravate the course of almost any illness. Placebos can provide a sense of control for many, which can reduce stress and create a more positive outlook. What is more, the resultant expectation of a positive outcome may translate into genuine benefits.

A caring effect

Finally, there is what is called the “caring effect” – though some argue this is not a true placebo effect. Some doctors believe there is no difference between placebo and no treatment. Others believe that placebo barely differs from what one paper published in the Lancet called “caring effects” – a form of active treatment, the effect of which can be measured.

For instance caring about, as well as for people with chronic arthritis can reduce pain and substantially improve mobility – reducing the individual’s need for pain relieving drugs and also the cost of treatment (both in financial terms, and in terms of potential adverse effects).

After an observational study suggested that twice-weekly telephone contact helped people with osteoarthritis, a controlled trial was done to assess the effectiveness of monthly telephone contact for one year. People with symptomatic osteoarthritis fared better than those who had no support, showing significant improvements in pain, physical disability and psychological disability. Other studies show that a regular telephone call may be as beneficial as clinic visits, particularly for the elderly.

Randomised trials of emotional support given to women in labour have been shown to reduce caesarean rates, and labouring women who have good emotional support are also less likely to need pain-relieving drugs. Likewise, extra time spent with an anaesthetist before an operation discussing pain and pain relief can lessen post-surgical pain and shorten hospital stays; and a patient whose doctor has taken the time to talk about headache pain, its nature and its relief is likely to respond better to whatever treatment is offered.

Such discussions are becoming increasingly rare in the cause and effect cattle market of today’s clinics and hospitals. But as the authors suggested: “To account for clinical improvement solely by placebo effects (as simplistic interpretation of controlled trials might easily do) is an insult to the importance of caring. It diverts attention from the fundamental need always to provide optimum caring as a necessary basis for technical intervention. These are caring effects, and so they should be called.”

A – You might have heard of the terms ‘prebiotics’ and ‘probiotics’ being mentioned in association with digestive health. While both are important to health, they function in slightly different ways.

The human intestines (gut) are home to anywhere from 500 to 1000 different species of bacteria, some good, and some bad.

The bad ones – such as E. coli, Salmonella and Clostridium – are commonly responsible for stomach upsets like diarrhoea. However, these are kept in check by the good bacteria, the principal ones being Lactobacillus acidophilus and bifidobacteria, which are naturally derived from the body’s own lactic acid, and which we obtain from our mother during pregnancy and with breastfeeding.

For the most part ‘good’ or ‘friendly’ bacteria outnumber the ‘bad’ or ‘unfriendly’ bacteria and play an important role in digestive health. But friendly bacteria also perform various important functions as well; they ferment organic acid into glucose, lower blood cholesterol, synthesise vitamins, break down the enzymes, proteins and fibres in food, and generally boost the immune system. The gut is also home to a sophisticated nervous system known as our ‘second brain’, which is why gut disorders also tend to come with a side of mind and mood disorders as well.

Several things – diet, stress, alcohol and smoking – can change the balance of bacteria in the gut and an imbalance in gut bacteria has been linked to immune system problems such as allergies and arthritis, but also to neurological disorders such as Parkinson’s disease and ADHD.

You can feed and encourage thriving communities of good bacteria in your gut in two ways – through prebiotics (available in foods and supplements) and through probiotics (usually taken as supplements – though also present in some foods).

Prebiotics

The best way to look after our gut bacteria is by feeding it well and the best foods for it are known as ‘prebiotics’.

Prebiotics are essentially dietary fibre – the indigestible components of food. They are naturally resistant to heat, oxygen, the body’s enzymes and stomach acids, and are therefore not destroyed, digested or absorbed as they travel through your digestive system.

Because of this they reach the colon intact, where they promote the growth and function of beneficial lactobacilli and bifidobacteria in your gut.

Because of the Western diet many of us consume, we don’t get enough fibre to help maintain a healthy gut. In general we should be consuming around 30g of fibre daily, however the current average intake of fibre in the UK, for example, is around 18g/day.

Prebiotics are also available in the form of food supplements such as ‘fructooligosacharides’ (FOS) and inulin which, research shows, are the most beneficial types of prebiotics for feeding our gut bacteria.

They belong to the same family of fructo-polysaccharides, and the primary difference between them is that inulin is a longer chain fructo-polysaccharide than FOS.

Although they both have very similar effects in terms of promoting the size, diversity and physiological functions of our gut bacteria. Both of these can be naturally derived from chicory, they are naturally sweet and can be used as a healthy alternative to sugar when the powder is sprinkled over food such as porridge for example.

Other foods that act as prebiotics include: raw oats, unrefined wheat and barley, Jerusalem artichokes, chicory, leeks, garlic, onions, asparagus, bananas and dandelion greens.

Pulses contain other complex carbohydrates like resistant and slowly digestible starch as well as other forms of oligosaccharides which also act as prebiotics feeding and encouraging the growth of healthy flora in the gut.

Probiotics

Probiotics are ‘perishable’ live bacteria; as they travel through the digestive tract they are easily killed by enzymes and acids in our mouth and stomach. Those that reach the lower part of the gut must compete with other types of bacteria present to get established. A high intake of the supplemental probiotic bacteria is therefore necessary to see any benefits.

When choosing a probiotics supplement we recommend ones that:

• Contain a few billion active bacteria. Opinions vary but between 1 and 10 billion is reasonable
• A clear label. It’s helpful if the label tells you how many viable organisms there are in the product at its expiration date, since this will be less than when they are manufactured. This figure guarantees the minimum dose you will receive.
• Are resistant to stomach acid, or can be dissolved in water so that they pass through the stomach environment fairly quickly
• Contain the best researched strains: Lactobacillus and Bifidobacteria

Probiotic supplement can be particularly helpful in conjunction with antibiotic therapy. While antibiotics tend to kill off beneficial gut bacteria, causing symptoms such as diarrhoea, probiotic supplements help to recolonise the intestines and prevent most of the gut side-effects of antibiotics. For similar reasons, they are equally good to have on hand to combat the food-poisoning bugs that cause “traveller’s diarrhoea”.

But supplements with live probiotics have a short shelf life and require refrigeration, and freeze dried supplements – which also have an expiration date – must be kept dry and at room temperature.

In order for probiotics to provide any health benefits, they also need to survive the harsh digestive process, an environment designed to kill bugs that may cause illness, which is why most now come in capsules and enteric coated pills designed to resist stomach acids and reach the colon intact. Probiotics supplements also have the advantage being manufactured to deliver a minimum effective dose of live bacteria.

Probiotcs in your diet

You can also get beneficial live bacteria form your diet. Yogurt is the most well-known of these. A product of fermented milk, yogurt naturally contains probiotics from the species Lactobacillus bulgaricus and Streptococcus thermophilus. Additional live bacteria including the strains acidophilus and bifidus are commonly added to enhance yogurt’s probiotic content.

Some, however, contend that kefir is the better choice. Kefir is best made at home by made by adding kefir grains to milk, which causes a unique fermenting process to occur.

Avoid commercial kefir drinks unless they specifically say they contain live bacteria. Often these are sugary drinks with little real health benefits to offer. The flavour of real kefir is more tart than milk – similar to an unsweetened yogurt drink or buttermilk. Blending kefir with fruit to make a smoothie or pouring it over cereal, rather than drinking it plain, may make the taste more acceptable to some.

Foods that use lactic acid bacteria for the fermentation process also contain live probiotic cultures. That includes pickled vegetables such as the Korean specialty kimchi. Kimchi is spicy a condiment made from fermented vegetables including cabbage and carrot, mixed with seasonings such as hot pepper flakes, ginger, and salt.

Sauerkraut and lacto-fermented pickles are also sources of live bacteria. So are fermented soybean foods such as tempeh, miso, and natto.

A healthy, wholefood varied diet is arguably the best way to help maintain a healthy gut. But the bottom line is that although feeding our bacteria with prebiotics is important, it just as important to have the right balance of beneficial bacteria to be fed in the first place, which is why both probiotics and prebiotics are just as important as each other.

It’s commonly thought that food that has been burnt could cause cancer. This is in part down to one particular molecule that forms when food is cooked at high temperatures, known as acrylamide. But while the chemical is a known potential toxin and carcinogen in its industrial form, the link between consuming it in food and developing cancer is much less clear.

The reason we even know about acrylamide’s potential dangers are down to a railway tunnel. Nearly 20 years ago, workers were building a tunnel through the Hallandsås ridge on the Bjäre peninsula in southern Sweden. Cows nearby started to show strange symptoms, staggering around and in some cases collapsing and dying. This prompted an investigation that showed that they had been drinking contaminated stream water and that the contamination was from a toxic molecule, acrylamide.

A common toxin

The construction workers had been using its polymer, polyacrylamide, as a crack sealant. This was, in itself, quite safe. But the polymer-forming reaction was incomplete, so some unreacted acrylamide was still present. The workers were tested to see if they also had unsafe levels of acrylamide in their blood, with a second “control” group of people who had no known exposure to industrial acrylamide used as a benchmark. However, it turned out that the control group also had surprisingly high amounts of acrylamide in their blood.

At first it was thought that burgers might be the source. Then high levels of acrylamide were found in potato products such as fried potatoes, as well as in coffee.

It then became clear that acrylamide formation was associated with carbohydrate-rich foods, rather than protein-rich ones, and with foods that had been heated above 120°C (250°F), that is food that has been fried, roasted or baked. This was a new discovery, but acrylamide must always have been formed in this style of cooking, ever since cooking was invented.

Chemical reactions

Acrylamide is formed in reactions between the natural amino-acid asparagine and some (naturally-occurring) carbohydrates. You don’t find acrylamide in uncooked or boiled food. Dairy, meat or fish products are much less likely to contain acrylamide. It doesn’t matter whether the food is “organic” or not, it’s the type of food that counts. Acrylamide is also formed when smoking tobacco.

A “golden rule” has been suggested: cook food until it goes yellow, not brown or black. This restricts acrylamide formation, though if you cook at too low a temperature you are less likely to kill off bacteria, so there is more risk of food poisoning.

While scientists have identified the source of acrylamide, they haven’t established that it is definitely a carcinogen in humans when consumed at the levels typically found in cooked food.

A 2015 review of available data concluded that “dietary acrylamide is not related to the risk of most common cancers”. Although, it added that a modest association for kidney cancer, and for endometrial and ovarian cancers in people who had never smoked, couldn’t be ruled out.

Meaty concerns

Going back to the barbecue, there are other chemicals in meat that could be a concern. These generally fall into two classes: polycyclic aromatic hydrocarbons (PAHs – compounds with several hexagonal “benzene rings” fused together) such as naphthalene and benzopyrene; and heterocyclic amines (HCAs). The PAHs are formed from meat fat and juices dripping onto flames in cooking, and HCAs are generated, again in cooking, from reactions between molecules including amino-acids and sugars.

Animal testing has shown exposure to high levels of chemicals such as these is linked with cancer, but these are levels of exposure much higher than humans would get from eating meat. Some studies do appear to have shown that meat that has been burned, fried or barbecued is associated with higher possibilities of certain cancers, but these links are hard to prove for certain.

If you are really concerned, you could reduce exposure risks by cooking in a microwave rather than over naked flames, and turning meat regularly. You could also eat less meat or replace the meat with vegetables when grilling.

Of course, your food may not be as tasty, since grilling, baking or toasting produce a lot of molecules that enhance flavour. But if you have a healthy diet with lots of fruit, vegetables and whole grain food, none of which contain acrylamide, things are easier.

It is all a question of proportion.

• Simon Cotton is a  Senior Lecturer in Chemistry, University of Birmingham.
• This article was originally published on and includes a added subheads here for ease of reading.

A — Psoriasis is a long-term autoimmune skin condition and, so far, conventional medicine has no real cure to offer. It can be managed through a variety of methods and symptoms can be helped through several alternative treatments including the use of essential oils.

With this condition there is an over-production of skin cells, usually on areas of the body such as shins, elbows, lower back or scalp. These silvery-coloured, scaly layers of itchy dry skin are known as plaques. Although relatively common, the symptoms and the course of the disease vary greatly from person to person.

In the UK and northern Europe around 1-2% of the population has psoriasis. The condition can wax and wane often disappearing or reappearing for reasons that are hard to fathom. There is a hereditary factor for psoriasis, although it can also be aggravated by stress or trauma. Symptoms can be alleviated by sea/salt water and sunshine (but also some cases can be made worse by exposure to sun).

It may take more than one approach to find relief and we would always recommend some kind of constitutional treatment − diet, investigation of allergies, stress reduction, etc − to help get to the root of the problem.

Essential oils, which are the natural oils from plants obtained by distillation, can be part of a multifaceted approach.

Applied topically (always well diluted in a base oil) they also have antioxidant and antimicrobial properties which may be helpful in skin healing. So while essential oils will not cure psoriasis they can reduce dryness and itching, reduce stress, promote healing and enhance a sense of well-being. When inhaled they can have a profound effect on the mind and emotions.

There is surprisingly little research into the use of essential oils to treat psoriasis so recommendations are often based on a mixture of what research is available and practitioner experience. The most common oils used for psoriasis include:

Lavender A calming oil with anti-inflammatory properties, lavender can help soothe the skin while also promoting new skin growth and healing. Lavender is also an antibacterial and antiseptic that can help alleviate burning and itching.  In addition to relieving inflammation the linalool and linalyl aldehyde in lavender also have an analgesic effect that helps to reduce pain.

Chamomile It’s anti-inflammatory properties makes it useful for soothing problem, allergic or sensitive skin, or problem hair and a sensitive or allergic scalp. For skin problems like eczema it has been found to be as effective as hydrocortisone.

Frankincense With antiseptic, antibacterial, antioxidant and anti-inflammatory properties, frankincense can help provide relief for stubborn psoriasis patches. It can also help repair cells, stimulate the immune system and balance hormones.

Myrrh Like frankincense myrrh is a tree resin with anti-inflammatory and anti-bacterial properties.  It is a good choice for healing the chapped, flaky and cracked skin of psoriasis patches.

Geranium Antibacterial properties help protect the skin from infection and geranium and it is also good for improving circulation. Geranium is also great for softening and protecting skin. It is an uplifting oil that can also help with low moods and stress.

Bergamot has a soothing effect on dry, itchy skin and can help improve the appearance of scars.

Helichrysum, also known as immortelle, is a fantastic, naturally regenerative oil that’s also cooling and soothing for the skin. It’s antiseptic and anti-inflammatory properties help heal scars and skin eruptions. Deeply de-stressing and uplifting, it’s perfect to help relieve stress, nervous exhaustion and depression.

Tea tree is found widely in commercial skin products. Its antiseptic properties are why you will often find it in shampoos for scalp psoriasis. There is some evidence for its effectiveness as an antipsoriatic.

Cedarwood A combination of antiseptic and astringent properties means that it’s good for balancing oily skin and hair, and helping to heal infections and skin eruptions. Has an uplifting aroma that makes it excellent in the treatment of nervous tension, anxiety, and stress.

If you are new to essential oils try using bergamot, cedarwood, helichrysum, lavender sandalwood are all good choices to begin with. For a basic moisturising and medicinal blend try choosing any three of these and then add two drops each to 20ml of a light vegetable oils base such as apricot kernel or coconut oil, and massage into the affected areas twice daily or as needed.

Don’t forget your base oils

You should always use essential oils well diluted and this is especially true if your skin is damaged or you have a skin condition like eczema or psoriasis. The right choice of base oil can add an important healing component to the essential oil blend. Consider the following:

Coconut oil is light and emollient and has anti-inflammatory properties that may help ease psoriasis pain. It can help moisturise the skin and scales. Raw, unrefined, unbleached organic coconut oil is best and adds a pleasant coconut aroma to aromatherapy blends.

Calendula macerated oil made by infusing marigold flowers into another oil like sunflower. The result is a rich golden herbal oil with recognised healing properties. Calendula is a popular choice, especially for sensitive and dry skin due to its ability to quickly soothe irritated skin and repair skin tissue. It is a good choice as a base to help control the symptoms of psoriasis and other related skin diseases. Studies have demonstrated its anti-inflammatory benefits.

Argan oil High levels of antioxidant vitamin E and essential fatty acids make argan a soothing oil for all skin types, as well as for hair and nails. It’s of benefit in psoriasis because it’s both anti-inflammatory and antiseptic.

Apricot seed oil is a light cold-pressed oil, rich in rich in gamma linoleic acid, or GLA, which helps skin to maintain its moisture balance. Light enough to leave no greasy residue. There is laboratory evidence that it can help control the growth of skin cells in psoriasis.

Black seed oil is anti-microbial, warming and can help to soothe any inflammation while also speeding up the skin’s healing process. It is a useful moisturiser and is reputed to help reduce scale thickness.

Neem oil contains anti-inflammatory compounds to ease eczema and psoriasis, while its skin softening properties can improve the appearance of scaly, dry skin. One research report suggested that nimbidin, one of the components found in neem oil, has anti-inflammatory properties comparable to standard drugs like phenylbutazone (a non-steroidal treatment) or prednisolone (a steroid treatment).

Castor oil is a heavier oil that provides a barrier for skin. It is a natural emollient and also works to soften skin. Look for cold pressed castor oil and use daily.

A — A recent news story noted that women taking an emergency contraceptive pill containing levonorgestrel are being advised to check the ingredients of other medicines they are taking because they could stop the pill working.

Levonorgestrel is synthetic hormone and is used in type of emergency contraception which can be taken within three days of unprotected sex to prevent unwanted pregnancies.

However, certain ingredients in other medicines significantly reduce the effectiveness of the levonorgestrel pill.

The Medicines and Healthcare products Regulatory Agency (MHRA) advisory implicated several conventional medicines including those for:

• epilepsy (e.g. medicines called barbiturates, primidone, phenytoin, or carbamazepine)
• tuberculosis (e.g. rifampicin, rifabutin)
• HIV (e.g. ritonavir, efavirenz)
• fungal infections (e.g. griseofulvin)

Herbal remedies containing St John’s Wort (Hypericum perforatum) were also implicated.

Herbal medicines are powerful bioactive substances. It is important to always tell your doctor what pills you are taking – even if they are herbal ones. The interaction between St John’s wort and contraceptive pills, including the morning after pill, is well-known and any healthcare professional you seek advice from (conventional or complementary) will need this information to help you make the right choices.

In the case of the morning after pill the MHRA advises that women taking St John’s wort should inform their pharmacists because they may need a higher dose of levonorgestrel for it to be effective.

In response to a MHRA advisory the chair of the BHMA, Dr William House, noted:

“We have known for many years that St John’s Wort can prevent hormonal contraceptives and the “morning after pill” from working effectively. Over-the-counter St John’s Wort products in the UK are regulated by the Medicines and Healthcare Products Regulatory Agency (MHRA) and contain an MHRA approved in-pack leaflet which gives details of safe and appropriate use of the product.

“The leaflet gives details of potential drug interactions, side-effects, dosage and how to take the product, as well as advice on when to seek help from a medical practitioner. These regulated products can be identified by a THR logo on the carton and leaflet, and it is important to always read the leaflet before taking in order to ensure that it is safe and appropriate to use.”

The MHRA publishes an online factsheet for helathcare professionals which details St John’s wort interactions with other medications.

A – Tea naturally contains some fluoride which is absorbed into the plant from soil and rainwater. This means the mineral is in the plant rather than on it.

Food is a major source and it’s worth saying that we all need some fluoride – which helps to build strong bones and teeth. Also, the synthetic fluoride used in dental hygiene products and in some types of pesticides, is not the same (and is more highly toxic) as the naturally occurring mineral. Because it is plentiful in food we don’t need to supplement and it is possible to get too much – for instance in areas where the water is naturally very high in fluoride or has had synthetic fluoride added to it.

So how much fluoride is in tea?

A 2013 study in the journal Food Research International analysed fluoride levels in 38 different teas, mainly bought from UK supermarkets. The analysis looked at black blends, green blends, pure blends, oolong, pu’er and economy blends and measured fluoride levels in both dry leaves as well as cups of tea brewed for 2, 10 and 30 minutes.

In dry tea the average fluoride levels were between 103 to 839 milligrams (mg) per kilogram (kg). Economy blends had the highest concentrations; on average around 580mg per kg. Green teas had on average around 397mg per kg and pure blends (comprised of leaves grown in different regions) had the lowest concentrations on average of 132mg per kg.

In brewed teas levels were significantly lower, ranging from 0.43 to 8.85mg per kg.

The longer the tea was brewed the higher the levels were and there were big differences between tea brewed for 2 minutes and tea brewed for 30 minutes.

False economy?

Economy black tea blends, such as Asda Smartprice, Tesco Value, Morrisons Value, Sainsbury’s Basics, contained an average of 6mg of fluoride per litre.

Although, Waitrose Essential also had fluoride in it, levels were significantly lower compared to other economy black tea blends.

To make sense of this figure most experts recommend 4mg of fluoride daily for adults. An adult consuming one litre of economy tea daily (approximately 4 mugfuls), containing 6mg per litre of fluoride, would be getting 75-120% of the recommended fluoride allowance.

Other things to consider

Levels of fluoride in tea vary from year to year, according to where it was grown (acidic soil encourages more uptake in the plant) and when it is harvested (older leaves contain more fluoride than younger ones).

What’s in your cuppa, for instance, may also be higher or lower depending on whether the water you make it with is fluoridated. If you are worried about fluoride in the water supply you can tackle the problem at home with certain types of water filter – such as reverse osmosis. But this isn’t just a problem for home made brews. Ready-made iced tea drinks  – a popular alternative to carbonated sodas – may also be made with fluoridated water.

The natural accumulation of fluoride in tea, however, is only part of the picture of ‘what else’ you are getting when you brew up.

Pesticide residues

Teas are routinely treated with a wide range of pesticides while growing and post-harvest.

A 2014 report  Trouble Brewing produced by Greenpeace India revealed the systematic presence of mixtures of multiple pesticides, many classified as highly or moderately hazardous by the World Health Organization (WHO), in tea grown and sold in India as well as exported abroad by leading international and national brands such as Tetley, Lipton and Twinings.

Pretty much all the samples taken from packaged tea bought in India contained residues of at least one pesticide, and more than half of them contained “cocktails” of more than 10 different pesticides, including one sample, which contained residues of 20 different pesticides.

Around 60% of the samples also contained residues of at least one pesticide above the Maximum Residue Levels (MRL) set by the European Union and nearly 40% exceeded these levels by more than 50%.

In total 34 different pesticides were detected including the highly hazardous oranophosphorous compound monocrotophos and neonicotinoid insecticides such as imidacloprid – associated with reproductive or developmental impacts in animals, as well as the global decline in bee populations and other beneficial insects.

Several of the residues were from pesticides, such as DDT, that were not even registered for use in the cultivation of tea in India.

The findings of this report were similar to a 2012 Greenpeace investigation on pesticides in Chinese tea.

Levels vary

Tea is not washed when it is processed and packaged, so whatever is on the plant when it is plucked stays mostly on the dried leaf. But as with fluoride, the levels of pesticides in a cup of tea can vary enormously.

Not all pesticides, for example, are easily soluble in water and researchers trying to get an accurate picture of pesticide residues in tea have found that different types of liquid (water, water with milk, water with different pH levels) can produce a different result.

As with fluoride, how the tea is processed can be influential on pesticide levels. Roasting at high temperatures has been shown to reduce levels of neonicotinoids in the finished tea. Carbamate pesticides, used widely in tea production, have also been shown to be heat sensitive. In the production of oolong tea, roasting at high temperature for a long period actually caused complete dissipation of two carbamates. Solar withering (drying in the sun) reduced pesticide residues by 25-40%.

Crushing and tearing leaves during processing, has been shown to free up the fatty acid content of a tea leaf and larger older leaves may also have a higher fatty acid content – these things may affect the final level of detectable pesticides in a cup of tea, many of which are more soluble in fats.

Nevertheless, it is clear from the Greenpeace study above and other data that significant transfer of pesticide residue from the plant to the cup is possible. And even if levels can be low, it’s worth remembering that a) many pesticides bioaccumulate in the body over time and b) cocktails of pesticides may have much bigger effects even at low levels. If you drink tea multiple times every day over a lifetime it can add up.

Don’t forget tea bags

Just to complete the picture we should say that the chemicals in teabags are also an issue. Paper teabags can be bleached and treated with epichlorohydrin, a compound mainly used in the production of epoxy resins, which keeps the paper bag from falling apart in water. Residues from this process can get into your cup and, studies show, that when epichlorohydrin mixes with water, it produces a substance called 3-MCPD, which has been shown, in animal studies, to suppress immunity, cause cancer in animals, and reduce fertility in male rats.

Mesh tea bags won’t fall apart in water but that doesn’t make them a better choice. Mesh or silk bags – made from materials such as nylon, viscose rayon, and thermoplastic, PVC or polypropylene – are becoming increasingly popular but, in common with most plastics, can leech hormone disrupting chemicals into your cup – a process that is facilitated by exposure to hot water.

What to do?

If tea is your drink of choice then consider these actions to reduce your exposure to harmful chemicals:

Ditch the teabag… or at least go for those that are unbleached. Some manufacturers now guarantee their bags are not epichlorohydrin-treated. Consider also buying loose leaf tea and brew the traditional way.  Or use a personal tea infuser. Bagged tea is also often made from older leaves which accumulate more residues. You might also want to change things up by using powdered matcha green tea.

Try oolong or pu’er teas In the 2013 fluoride study above pu’er and oolong teas had the lowest levels of fluoride, followed by pure blends, black blends and green blends.  Pu’er is a fermented tea and there may be something in the fermentation process that helps to reduce fluoride levels. Oolong is a semi-fermented tea and studies show that the processing it goes through may help remove some fluoride and pesticide residues.

Or try white tea According to the Linus Pauling Institute white tea, which is produce from young buds and shoots is very low in fluoride. It is also likely to be low in pesticides.

Go for the ‘first flush’ Levels of both fluoride and pesticides may be higher in in older leaves so consider buying first flush tea produced from the very first plucking of a tea plant’s harvest season. First flush leaves are the youngest and most tender part of the tea plant and produce a fresh, less astringent tea than subsequent flushes.

You get what you pay for Even if it’s not the first flush, younger tea leaves are more often used to make higher-quality premium teas, while older, leaves are chosen to make the cheaper economy brands.

Buy organic Organic teas are not treated with harmful pesticides, which means you don’t have to worry about toxic resides in you cup. The will still naturally accumulate some fluoride however.

A – Although elite athletes are often the first to pick up on trends for healing – such as copper bracelets or kinesiology tapes – that doesn’t mean that these choices have necessarily been well-researched.

Cupping, a traditional Chinese practice aligned with acupuncture and acupressure, is a good example of this.

The theory behind cupping is that creating strong suction over specific acpupoints helps draw blood to the area and this, in turn, can help relieve pain and speed healing.

There are essentially three methods of cupping: dry, air and wet.

In dry cupping glass cups are warmed using a cotton ball or cotton bud soaked in a flammable substance like white spirit. Burning a substance inside the cup also removes all the oxygen, which creates a vacuum.

The cup is turned upside-down over a specific area and the vacuum created by the lack of oxygen anchors the cup to the skin and pulls it upward on the inside of the glass as the air inside the jar cools. Sucking up the skin is believed to stimulate the flow of blood, balance and realign the flow of essential energy or qi, and draw toxins out of the body.

Air cupping uses a suction pump rather than a flame to create suction and draw the skin up. Some practitioners prefer this because the level of suction can be controlled and it can result in less dramatic bruising.

Wet cupping is a more dramatic form of cupping which involves cutting or puncturing the skin before placing the cup over it. The suction then also draws a small amount of blood, which is believed to speed the removal of toxins from the body.

There’s nothing to show that cupping is essentially unsafe – though the incisions or punctures made to the skin in wet cupping can lead to overuse of antibiotic creams and/or infection.

Proponents – who include swimmer Michael Phelps and gymnast Alex Naddour as well as celebrities such as Victoria Beckham, Jennifer Aniston and Gwyneth Paltrow – say that cupping can help with general aches and pains as well as specific problem s such as back pain. However, modern science has not been able to consistently confirm these benefits.

It seems to work…

There are plenty of negative studies or those that draw skeptical conclusions. But positive studies do exist too.

A small study published earlier this year examined how well cupping therapy worked to treat self-reported neck and shoulder pain. Half the 60 patients received cupping therapy, while the other half got no treatment at all. Patients who underwent cupping did report a significant improvement in pain compared to those who didn’t.

Another study into neck pain suggests that the relief it provides, as assessed by the patients themselves, is meaningful.

One study that looked at cupping as a treatment for 40 patients with knee arthritis also turned up positive results.

There is evidence to indicate that cupping, when combined with acupuncture, may reduce fibromyalgia symptoms more effectively than conventional medications such as amitriptyline.

A handful of reviews have looked at the collective evidence for cupping.

A 2010 review in BMC Complementary and Alternative Medicine concluded that cupping seemed to provide relief from herpes zoster and other painful conditions adding that the quality of studies seemed to be improving in recent years due to increased interest in the therapy.

A 2012 study, which reviewed 135 trials of cupping therapy from 1992 to 2010, concluded much the same but recommended “further rigorously designed trials on its use for other conditions are warranted”.

Yet another review of the evidence in 2014 concluded that there is a potential positive short-term effect of cupping therapy for reducing pain intensity compared with no treatment, heat therapy, usual care or conventional drugs.

None of the studies into cupping suggest any significant adverse effect from the procedure. However, the process isn’t painless and the red welts you see on the athletes’ skin are bruises – and whichever way you look at it bruises are a sign of some kind of damage, however superficial.

…but we don’t know how it works

That it may work is clear. How it works is another matter.

Some believe that the effect is mere placebo and that having gone through the uncomfortable procedure people simply develop the will to believe that it works.

Some practitioners believe that forcing blood to specific areas of the body stimulates a mild immune reaction and that this may be behind its reported benefits.

Others believe that its benefits are down to what is called ‘counter irritation’ – that is, the suction creates a greater or simply different pain which temporarily draws your attention away from the original source of pain or injury. None of these theories has been scientifically proven.

The bottom line is that what works for one person might not work for another. If you are considering trying cupping therapy, talk it over with a qualified practitioner.