Intro to Complementary and Alternative Medicine Syllabus Fall 2014

Instructor Information

Instructor Email Office Location & Hours

Myra C. Parran mparran@college.edu 123 College Rd.

Health Admin Bldg. Rm 222

Mon.-Thurs. 2:00-4:05

Fri. by appointment ONLY

General Information

Description

Welcome to an exciting and rigorous 3 day informative course on Complementary and

Alternative Medicine. During our time together we will cover: the history of Complementary and

Alternative Medicine, the definition of both, ethical practices, legal standards and we will be

reviewing statistical data on both. In addition, we will be discussing various relaxation

techniques as well as meditation techniques and stress management.

Expectations and Goals

It is my expectation that all participants leave this course very knowledgeable about

Complementary and Alternative Medicine. I expect everyone to arrive on-time to ensure they

don’t miss any valuable information, because I will be starting on time. My goal is to provide

each participant with the knowledge and skills needed to fully understand Complementary and

Alternative Medicine as a whole leaving no questions unanswered.

Course Materials

Required Materials

[1] Notebook (for taking notes)

[1] Highlighter

Pen/pencil

Course Schedule

Day Topic

Aug. 9 0900 – 10:30 History/Statistics/Practices

and Standards

Aug. 16 0900 – 10:30 Relaxation Techniques

Aug. 23 0900 – 10:30 Meditation Techniques

and Stress Management

NOTE: If you are going to be absent from a session, please be sure to email me so that we

can make arrangements for you to get the information that you need. THIS IS VERY

IMPORTANT to ensure that we all meet our goal.

Additional Information and Resources

Lesson 1 – Handout

Scholarly Article - State of Complementary and Alternative Medicine in Cardiovascular, Lung,

and Blood Research

Lesson 2 – Handout

Resources Listing

LESSON PLAN-1

Instructor: Myra Parran

Subject: Intro to Complementary and Alternative Medicine

Brief Description: Participants will be introduced to a number of alternative practices that are

available in the place of various medication regiments. They will receive background

information on different practices, types of treatments, benefits of choosing Complementary and

Alternative Medicine as opposed to traditional practices, and information on helpful physical and

online resources to turn to for assistance.

Objectives: Participants will review a brief history and origin of complementary and alternative

medicine to include examples of each.

Participants will understand the difference between complementary and alternative medicine.

Participants will understand the importance of both ethical practices and legal standards.

Participants will review statistical data.

When: Saturday August 9, 2014

Time: 0900 – 10:30 a.m.

Materials: Note pad, handouts, pen, and highlighter

Lecture Notes:

I. Introduction-define both Complementary and Alternative Medicine: Complementary

Medicine-non main stream approach along with conventional medicine. Alternative

Medicine-non mainstream approach without the use of conventional medicine.

A. Discuss misconceptions

1. Few Americans use these methods

2. No scientific evidence for natural therapies

3. Doctors do not discuss natural therapies

B. History and Origin – Research/Office of Eternal Medicine

C. Statistical Data

1. Research for allocated funding; ≈$70 million a year

2. >40% of the population using CAM in some way at an annual expenditure of

≈$30 billion

D. Ethical and Legal practices

1. Issues of establishing an appropriate standard of care in cases of medical

negligence

2. Regulation and integration

II. Question & Answer Session

LESSON PLAN-2

Instructor: Ms. Parran

Subject: Relaxation Practices

Brief Description: Participants will be introduced to a number of relaxation practices that are

available in the place of various medication regiments. They will receive background

information on different practices, types of treatments, benefits of choosing Complementary and

Alternative Medicine as opposed to traditional practices, and information on helpful physical and

online resources to turn to for assistance.

Objectives: To familiarize community with mind and body practices that are available as an

alternative to traditional medicines. When: August 16, 2014

Time: 0900 – 10:30 a.m.

Materials: Note pad, handouts, pen, and highlighter

Lecture Notes

I. Background information

A. Used in the U. S. as part of a comprehensive plan to treat, prevent, or reduce

symptoms for conditions such as, stress, high blood pressure, chronic pain

B. Since 2007, about 12% of Americans uses these techniques

II. Relaxation techniques include can include practices such as guided imagery,

biofeedback, self-hypnosis, and deep breathing exercises. These techniques all

concentrate on consciously producing the body’s natural relaxation response by

slower breathing, lower blood pressure, and a feeling of calmness and well-being.

a. Biofeedback – a relaxation technique that uses electronic devices to teach how to

consciously produce the relaxation response

b. Deep breathing – this technique focuses on have the individual consciously slow

their breathing to focus on taking regular and deep breathes.

c. Guided imagery – focusing on pleasant images to replace the negative one in

order to achieve a relaxing feeling. This practice can be guides by a practitioner or

self-guided.

d. Progressive Relaxation – this technique focuses on tightening and relaxing each

muscle group. It is sometimes used in conjunction with guided imagery and

breathing exercises.

III. Risk & side effects

IV. Training and certification

V. Helpful online resources and physical locations for assistance.

LESSON PLAN-3

Instructor: Ms. Parran

Subject: Meditation Techniques and Stress Management

Brief Description: Participants will be introduced to a number of meditation practices that are

helpful in promoting stress reduction and better health. They participate in two 15 minute

mediation exercises to get a personal experience in how beneficial mediation can be in helping

them to relax.

Objectives: To familiarize community with mind and body practices that are available as an

alternative to traditional medicines. When: August 23, 2014

Time: 0900 – 10:30 a.m.

Materials: Note pad, handouts, pen, and highlighter

Lecture Notes

I. Stress can be defined as any undue pressure placed on the body. It can come from a

busy schedule, a demanding challenge, a hardship situation and many other

unforeseen situations. How some people deal with stress - smoking, drinking, sleep,

loss of appetite/over eat, lashing out

II. Participants will share stories of things that stress them out and how they currently

deal with stress. (10 minutes)

III. Effects of stress on the human body

A. Nervous System – fight/flight response, glands release adrenalin and cortisol

B. Heart – decrease effective blood flow, raise blood pressure, risk for heart disease

C. Respiratory system – fast breathing, hyperventilation can lead to panic attacks

D. Sex Drive – decreases sexual desire, feelings of depression, mood swings, anxiety

IV. Participants will engage in meditation exercises (two 15 minute sessions)

V. We will discussion effects of exercises. Review

Lesson 1 Handout

Circulation. 2001; 103: 2038-2041 doi: 10.1161/01.CIR.103.16.2038

Special Report

State of Complementary and Alternative

Medicine in Cardiovascular, Lung, and Blood

Research

Executive Summary of a Workshop

1. Michael C. Lin, PhD;

2. Richard Nahin, PhD;

3. M. Eric Gershwin, MD;

4. John C. Longhurst, MD, PhD;

5. Kenneth K. Wu, MD, PhD

+ Author Affiliations

1. From the National Heart, Lung, and Blood Institute (M.C.L.) and the National Center for

Complementary and Alternative Medicine (R.N.), National Institutes of Health, Bethesda,

Md; the Departments of Medicine, University of California, Davis (M.E.G.) and Irvine

(J.C.L.); and the Department of Internal Medicine and Hematology, University of Texas,

Houston (K.K.W.).

1. Correspondence to Michael C. Lin, National Heart, Lung and Blood Institute, NIH, 6701

Rockledge Drive, Suite 10193, MSC 7956, Bethesda, MD 20892-7956.

Next Section

Abstract

Abstract—The National Heart, Lung, and Blood Institute and the National Center for

Complementary and Alternative Medicine recently cosponsored a workshop on the use of

complementary and alternative medicine (CAM) in cardiovascular, lung, and blood research. In

view of the increasing use of CAM by the general public, it is imperative to promote credible

research by the established biomedical community. The goal of this workshop was to enhance

the exchange of information and ideas between alternative medicine practitioners and scientists

in cardiovascular, lung, and blood research and to foster collaborative research among these

researchers. The workshop focused on 5 areas of research, including a historical and cultural

perspective of CAM, methodological issues in clinical trials, herbal medicine, chelation therapy,

mind/body (meditation) therapy, and acupuncture. CAM has become widely used without

rigorously proven efficacy and safety. To protect the public, it was recommended that the

fundamental mechanistic research for these CAM approaches be vigorously pursued and that any

large-scale clinical trial be carefully executed to avoid any waste of resources and any

unnecessary risk. It was felt that standardization of botanical products and procedure-based

CAM intervention, such as acupuncture and meditation, is essential for meaningful basic and

clinical research. Although botanical products properly consumed are perceived as generally

safe, potential herb-drug interactions are a major safety concern. Clearly, many challenges need

to be addressed by the scientific community before the public can be assured of the proper use of

CAM.

Key Words:

acupuncture

medicine, herbal

cardiovascular diseases

alternative medicine

meditation

A workshop entitled “Complementary and Alternative Medicine in Cardiovascular, Lung and

Blood Research,” which was sponsored by the National Heart, Lung, and Blood Institute and the

National Center for Complementary and Alternative Medicine (NCCAM), was convened June 12

through 13, 2000 in Bethesda, Maryland. This workshop was co-chaired by Kenneth Wu, John

Longhurst, and Eric Gershwin. In addition to the 20 speakers, the workshop was attended by

nearly 100 participants.

The objective of this workshop was to promote the exchange of information and ideas, to

identify opportunities, and to foster collaboration among scientists who are interested in using

complementary and alternative medicine (CAM) in cardiovascular, lung, and blood research. The

workshop focused on 5 areas of research, including a historical and cultural perspective of CAM,

methodological issues in clinical trials, herbal medicine, chelation therapy, mind/body

(meditation) therapy, and acupuncture.

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Background and History

Wayne Jonas provided a historical and cultural overview of CAM. CAM approaches in health

maintenance have recently become highly popular in the United States, with >40% of the

population using it in some way at an annual expenditure of ≈$30 billion. This trend is partly

prompted by increasing appreciation of the importance of the “whole person” in health and the

skepticism of the general public about orthodox medicine.

Several CAM therapies have been shown to be effective for specific ailments (see the National

Institutes of Health [NIH] Consensus Conference on Acupuncture and NIH Technology

Assessment Conference on Integration of Behavioral and Relaxation Approaches Into the

Treatment of Chronic Pain and Insomnia), and many more remain untested and unproven.

Therefore, care in using alternative approaches is imperative. Complete evaluation of

complementary medicine must include both scientifically rigorous and clinically pragmatic

perspectives when assessing its value or danger.

A recent survey on the use of alternative care providers was reported by Barbara Altman. It has

become clear that most people who use CAM do so without informing their primary care

physicians and that few physicians are knowledgeable about CAM. CAM therapies encompass a

diverse and growing assortment of healthcare approaches. These approaches, which are often

used in conjunction with conventional medicine, include acupuncture, biofeedback, chiropractic,

herbal medicine, massage, and meditation.

William Harlan stressed the need to use the randomized, controlled trial as the “gold standard” to

determine the efficacy and effects of CAM. However, recognizing the broad use of CAM,

observational studies by CAM practitioners should not be disregarded. For many CAM therapies,

no reliable information exists concerning the numbers and types of patients who use them,

delivery and dosage, patient condition before and after treatment, and relevant side effects. These

issues can be investigated adequately in observational studies. Such studies form the basis of

further studies, provide information on the consistency of the delivery of a therapy, and give an

estimate of the effect size. Although recent reviews suggest that observational studies may

provide the same answer as a randomized, controlled trial, it is premature to equate the 2 types of

studies as sources of confident and specific information about the value of a therapy. The

uniqueness of many CAM therapies, such as the special need for standardization and

characterization of botanicals and the need to insure their purity and absence of potentially

harmful contaminants in these botanicals also presents special challenges in designing any

rigorous clinical trials, ensuring the safety of patients in the trial, and determining the potential

reproducibility of the trial.

Stephen Straus described the role of the NIH in the support of research in CAM. In 1991,

Congress mandated the establishment of the Office of Alternative Medicine at the NIH. This

office was elevated to the status of Center in 1998, with a current funding of ≈$70 million a year.

The goals of the NCCAM are to invest in research, both through investigator-initiated projects

and solicitations, to expand the cadre of researchers by training and recruiting established

scientists, to compile data on CAM approaches, and to disseminate pertinent information about

CAM more effectively to the community. The philosophical difference between the practitioners

of ancient approaches and mainstream researchers is a major challenge. The extensive use of

untested CAM practices by the US public has dictated that NCCAM make clinical research its

highest priority and the centerpiece of its research portfolio. Currently, NCCAM has supported

clinical trials on such topics as St John’s wort in depression, gingko biloba and dementia, gingko

biloba and vascular function in peripheral artery disease, shark cartilage and cancer, acupuncture

in osteoarthritis and cardiovascular disorders, and glucosamine/chondroitin and arthritis.

Recently, NCCAM initiated the Frontier Medicine Research Program, which covers areas in

which there have been few, if any, rigorous attempts at research. These include Reiki for

rehabilitation after cardiac surgery and distance healing (prayer) for AIDS.

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Botanicals

Varro Tyler gave the opening talk on herbal medicine. As much as a third of the US population

has used herbal medicine, spending nearly $4 billion in 1998. The most popular remedies are

echinacea, St John’s wort, garlic, and ginkgo biloba. The use of herbal medicine continues to

increase rapidly. Because current law allows herbs to be sold as dietary supplements, herbal

products are not subject to any regulation, and their purity, safety, and efficacy are not

controlled. Unfortunately, the quality of herbal products is extremely variable. In fact, many

products available on the market do not even contain any of their purportedly active

ingredient(s). Therefore, in the interest of public health, it would be reasonable for the Food and

Drug Administration (FDA) to allow drug approval only with associated mandatory quality and

safety standards based on “reasonable” efficacy.

Norman Gillis discussed the protective effect of ginseng against lung injury caused by free

radicals. Using cultured cells and an intact lung model, it was shown that ginseng or its active

ingredient, ginsenosides, promotes vasodilation and prevents injury by enhancing the

biosynthesis of nitric oxide in the endothelial lining of the lung. Eric Gershwin examined the

possible relationship between dietary changes and the increased prevalence of asthma in the

United States. The use of food coloring, excessive dietary salt in processed food, and reduced

zinc intake due to lower red meat consumption can potentially contribute to the severity of

asthma. In addition, the replacement of animal fats with vegetable oils in the American diet may

have changed the lipid composition in the body, causing a different distribution of fatty acid

metabolites, many of which modulate ion transport, mucus secretion, and smooth muscle

contraction. Although some of these dietary changes have been beneficial in the prevention of

cardiovascular disease, their potential impact on asthma is complex and remains to be examined.

Consumption of microorganisms in yogurt is thought to help reduce susceptibility to a variety of

diseases. Dietary magnesium is also a contributing factor to bronchodilation. Some herbs, such

as ginseng and ephedra, have been shown to be effective in relieving the severity of asthma.

Therefore, CAM approaches incorporating the use of dietary supplements may be beneficial in

the management of asthma.

Garlic is one of the most studied herbs in the United States. The ability of garlic supplements to

lower elevated serum cholesterol levels and reduce atherosclerotic plaque formation is equivocal,

with early trials demonstrating an effect but more recent trials failing to confirm these

observations. One possible cause for these discrepancies is differences in the garlic preparations

tested. Considerable evidence indicates that allicin is essential to garlic’s hypolipidemic and

antithrombotic effects. Efficient release of allicin requires high alliinase enzymatic activity.

Larry Lawson found that several preparations used in the recent negative studies released very

low concentrations of allicin. He suggested that these low levels are a result of low alliinase

activity in the tested products or alliinase instability in the acidic conditions found during

digestion in the stomach. Therefore, the release of allicin from a product needs to be

standardized under U.S. Pharmacopeia–defined gastrointestinal conditions and verified before

beginning a clinical trial. A meta-analysis of all existing randomized trials investigating the

effects of garlic on cardiovascular factors was performed by Ron Ackerman and Cindy Mulrow.

They confirmed the short-term benefits of garlic on lipid lowering and antiplatelet effects.

However, no significant effect on blood pressure or glucose level was found.

A highly standardized extract of ginkgo biloba, EGB761, is widely used in Europe for treating

disorders due to vascular insufficiency, including diminished cognitive function associated with

aging. Many products containing ginkgo biloba extracts, some of uncertain purity or

standardization, are also being widely used in the United States. John Farquhar presented

evidence indicating that ginkgo biloba may have either an anti-platelet aggregation or an

antioxidant effect, which could be responsible for some of its beneficial effect on the vascular

system. Three major active ingredients have been identified in ginkgo biloba, and at least one of

these has been shown to enhance endothelial cell-derived NO levels in an in vitro study. The

question has been raised whether the NO effect is due entirely to decreased NO breakdown (due

to ginkgo’s known in vitro antioxidant action) or by a direct stimulation of NO synthase. A

mechanistic study of ginkgo’s vascular effects is currently in progress in patients with peripheral

vascular disease.

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Chelation Therapy

Chelation therapy for metal poisoning has been used for many years. One agent, ethylenediamine

tetra-acidic acid (EDTA), was found by clinical observation to benefit patients with vascular and

degenerative diseases. However, no clinical trials have confirmed its potential benefit. Ted

Rozema, who has used this therapy to treat cardiovascular diseases for nearly 2 decades,

suggested that calcium chelation may be responsible for this effect of EDTA. He recommends a

major research effort, including clinical trials, to resolve the controversy. This recommendation

was supported by a number of other speakers.

Iron is required for cell growth and, in particular, DNA replication. Iron chelators, such as

deferoxamine, have been shown to have an antiproliferative effect. Lawrence Horwitz

discovered a novel chelator, exochelin, which was isolated from Mycobacterium tuberculosis

bacteria. Because of its solubility in lipids, exochelin is 10 times more effective than

deferoxamine in arresting the growth of vascular smooth muscle cells. The proliferation of

vascular smooth muscle cells is characteristic of restenosis after angioplasty. Furthermore,

excessive iron stores are associated with myocardial infarction. Exochelin, with its reversible

growth inhibition and lack of cytotoxicity, may be used as a therapeutic agent for several

cardiovascular complications.

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Mind-Body Medicine

Stress is a major contributor to high rates of cardiovascular disease morbidity and mortality. The

transcendental meditation (TM) program is the most widely researched standardized meditation

technique for stress reduction. Robert Schneider and colleagues conducted a randomized,

controlled trial of stress reduction with TM for hypertensive black Americans. This trial was the

first to show that TM can be effective in reducing blood pressure, with high cultural acceptability

and compliance in a high-risk minority population. Follow-up randomized trials and other

controlled studies have reported reductions in other cardiovascular disease risk factors, such as

smoking, alcohol abuse, psychosocial stress, and oxidized lipids. Furthermore, recent studies

have demonstrated reductions in myocardial ischemia and regression of carotid atherosclerosis in

subjects randomized to the TM program compared with controls. Clinical outcome studies have

reported reduced rates of cardiovascular disease morbidity and mortality in TM practitioners

compared with controls. The cost-effectiveness of the TM program in the prevention and

treatment of cardiovascular disease is also emphasized. Vernon Barnes further showed that a

decrease in vasoconstrictive tone during TM may be the hemodynamic mechanism responsible

for reducing blood pressure. Changes of the levels of stress-related neuromodulators, such as

cortisol, catecholamines, and serotonin, have also been found to occur during or after TM

practice.

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Acupuncture

Lixing Lao reviewed the history and the safety of acupuncture. At a NIH Consensus

Development Conference on acupuncture in 1997, conference panel members recognized

promising aspects of acupuncture research, affirmed acupuncture’s efficacy in certain conditions,

such as pain relief and treatment for nausea, and noted encouraging research on acupuncture

treatments for asthma, bronchitis, myocardial infarction, and rehabilitation from stroke.

Appropriate use of acupuncture by trained practitioners seems to be very safe. During the last 35

years, only 80 cases of complications and adverse effects of acupuncture have been reported in

the United States, and there were an estimated 5.4 million patient visits in 1997 alone. Zang-Hee

Cho reported his use of positron emission tomography and functional MRI in the mechanistic

study of the neural basis of acupuncture. These techniques detect changes in blood flow and

oxygenation relating to neural activity in the brain. Specific activation of certain brain regions,

including some of the pain perception centers such as the limbic area and hypothalamus, can be

demonstrated during the application of acupuncture. It was suggested that a neural imaging

center dedicated to CAM research is highly desirable.

Recent evidence suggests that hypertension and certain cardiovascular diseases can be improved

by treatment with acupuncture. Peng Li defined the neuronal pathways responsible for the long-

lasting effect of electroacupuncture on blood pressure in a rodent model and demonstrated that

low-frequency electroacupuncture activates opioid receptors and provides a therapeutic effect on

hypertension. Conversely, high-current electroacupuncture activates the cholinergic system and

leads to increased blood pressure, which alleviates shock and bradycardia. Using a feline model,

John Longhurst demonstrated that stimulating a well-recognized acupoint over the median nerve

on the ankle reduces the extent of myocardial ischemia. Acupuncture seems to act through the

direct stimulation of sensory nerves to release endorphins and opiates. Although acupuncture has

been used as a treatment for hypertension in China and Russia, it has yet to gain acceptance in

the United States. Using a randomized, doubled-blind, crossover design, Norman Kaplan hopes

to show that acupuncture at certain acupoints produces long-lasting blood pressure reductions in

hypertensive patients but not in normotensive subjects. To be of clinical value, acupuncture must

provide an antihypertensive effect that persists far beyond the actual procedure.

Previous Section

Recommendations

During the final discussion, it was emphasized that in most cases, CAM has become widely used

without rigorously proven efficacy and safety. To protect the public, there is an increasing

demand to accelerate the initiation of large scale clinical trials with major expenditure. It was

argued that without rigorous research to understand the fundamental mechanisms for these CAM

approaches, the clinical trials are often wasteful in time and resources and even risky. It was

thought that a few alternative therapeutic approaches currently in use by the public are

premature. However, without compelling and overwhelming evidence to prove their

ineffectiveness, it is unlikely that the public will be dissuaded from further use. At the same time,

it would be equally difficult to justify the need to have a large scale and costly trial simply to

prove the ineffectiveness of certain approaches. Clearly, many challenges need to be addressed

by the scientific community before the public can be assured of the proper use of CAM. The

recommendations resulting from the discussion fall under 2 broad categories.

Standardization

Standardized formulations of botanical products have not occurred in either the US market or the

research arena. Before supporting clinical trials on botanical remedies, several issues regarding

the characterization of botanical products must first be addressed, including whether to use

whole extract or a specific fraction, the method of extraction (eg, alcoholic, tea, pressed juice),

and the chemical and genetic standardization of the product. Reliable and well-characterized

products will assure the quality of study outcomes. The recent release of a draft of the FDA

Guidance for Botanical Drug Products (http://www.fda.gov) should help guide the development

of reliable products for research.

Procedure-based CAM (eg, acupuncture, meditation, massage, etc.) has a separate set of

questions. Most types of procedure-based CAM are not clearly defined interventions, as are

synthetic drugs or some types of herbal remedies. Procedure-based CAM interventions are used

in many different ways and are geared toward the individual patient; this creates a situation in

which the prescribed set of treatments used for one patient may not be appropriate for another

patient presenting with the exact same signs and symptoms. This variability greatly increases the

complexity of designing high-quality research. For instance, taking acupuncture as an example,

can we test whether a standardized set of needling points is more appropriate for treating

hypertension then individualized treatment? Assuming a standardized set of points is applicable,

what “dose” of acupuncture should we use to treat hypertension, ie, how long and frequent are

the treatment sessions, and how many sessions do we need? It is essential to answer these basic

questions before proceeding to large clinical trials.

Safety

Many CAM therapies have been used for generations, if not centuries, and they are often the first

line of treatment for individuals without access to conventional Western medicine, suggesting

some level of safety. Although most botanical products are probably safe when used properly by

trained practitioners, some products are toxic at high doses and others may have potentially

adverse effects in some susceptible individuals. In addition, the widespread usage of herbal

remedies, the high probability that herbal remedies and pharmaceutical drugs are being used

together, the general potential for herb-drug interactions, and the recently published reports of

adverse herb-drug interactions support the need for further research in this area. Particularly

needed are more data on the uptake, bioavailability, pharmacodynamics, and mechanisms by

which herbal remedies might exert their effects.

Copyright © 2001 by American Heart Association

Lesson 2 Handout

Helpful Resources

Useful Website:

National Center for Complementary & Alternative Medicine (NCCAM)

http://nccam.nih.gov/

Complementary and Alternative Medicine – Mayo Clinic

http://www.mayoclinic.org/healthy-living/consumer-health/in-depth/alternative-medicine/art-

20045267

Medline Plus

http://www.nlm.nih.gov/medlineplus/complementaryandalternativemedicine.html

Offices that offer Complementary and Alternative Medicine Services

Integrated Therapies

(254) 781-0105 office

2100 E Stan Schlueterloop, J

Killeen, TX 76542

Live Oak Acupuncture & Herbal Medicine

1221 Hewitt Drive, suite C

Waco TX 76712

(254) 741-6030

Acupuncture & Chinese Herbal Medicine

1708 Walnut Avenue

Austin, Texas 78702

(512) 296-1541

The Hills Medical Group

4201 Bee Caves Road,

Suite B112, West Lake Hills, Texas 78746

P: 512-327-4886, F: 512-327-4958