Journal of Complementary and Alternative Medical Research

Changes in Inflammatory and Haematological Markers Following Castor Oil Pack Therapy in a Woman with Rheumatoid Arthritis: A Case Report

2026-11-02T09:32:15+00:00

Aims: To describe the clinical and laboratory course of a woman with rheumatoid arthritis treated with castor oil packs for four weeks.

Presentation of Case: A 36-year-old woman with a one-year history of polyarthritis, positive for rheumatoid factor and meeting the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria, declined conventional pharmacological treatment and chose naturopathic care. She applied castor oil packs at home to the abdomen with hot fomentation and to the affected joints with a hot, moist cloth, for 1 hour per session, 5 days a week for 4 weeks, alongside a balanced diet and pranayama. Between baseline and week 4, the erythrocyte sedimentation rate decreased from 65 to 24 mm/h, C-reactive protein from 1.2 to 0.3 mg/dL and total leucocyte count from 11,290 to 5,200 cells/mm³, and haemoglobin rose from 10.4 to 12.5 g/dL. Joint swelling resolved, and tenderness remained only in the elbows. Pain on the visual analogue scale decreased from 7 to 2. She reported less morning stiffness, and no adverse events were reported. She was then referred for rheumatological reassessment.

Discussion: The changes observed suggest that inflammation subsided, but no composite disease-activity score was calculated. Experimental data on topical ricinoleic acid, and the lack of effect of heat alone on these markers in controlled trials, make a contribution from the oil plausible; natural fluctuation, diet and pranayama could also explain the changes.

Conclusion: These observations do not establish efficacy or disease control. They justify controlled evaluation of castor oil packs as a complementary measure alongside, not instead of, standard rheumatological care.

Multimodal Naturopathic Management of Class III Obesity in a Woman: A Case Report

2026-11-06T09:53:44+00:00

Background: Obesity is a chronic, multifactorial condition that can coexist with musculoskeletal symptoms, menstrual and metabolic disturbances and reduced physical activity. This case report describes a multimodal naturopathic management approach in a woman with class III obesity and associated back and knee pain.

Case Presentation: A 34-year-old woman presented to Alva’s Anandamaya Arogyadhama, Moodubidire, on 22 July 2026 with obesity of approximately 10 years’ duration, back pain for 6 months and knee pain for 8 months. She also had a documented history of polycystic ovary syndrome (PCOS) for approximately 1 year and a previous history of allergic asthma. Her baseline height was 159 cm and her weight were 115 kg, corresponding to a BMI of approximately 45.5 kg/m². Waist circumference was 129 cm and hip circumference 144 cm (waist-to-hip ratio approximately 0.90).

Intervention: The patient underwent an individualised naturopathic programme incorporating a therapeutic diet, supervised fasting and water-fasting periods, hydrotherapy and naturopathic applications, massage and reflexology, yoga practices and breathing exercises, along with physiotherapy for back and knee symptoms and selected complementary pressure-based procedures documented in the treatment records.

Outcomes: During the five documented assessments from 22 July to 18 August 2026 (28 calendar days inclusive), body weight decreased from 115 to 99 kg (16 kg; 13.91%), and calculated body mass index decreased from approximately 45.5 to 39.2 kg/m². Waist circumference decreased from 129 to 119 cm and hip circumference from 144 to 122 cm, although the calculated waist-to-hip ratio increased from 0.90 to 0.98. Random blood glucose measurements decreased from 156 to 122 mg/dL, while the recorded knee-pain visual analogue score decreased from 7/10 to 2/10. The endpoint hip circumference warrants source-record verification, and random glucose readings during fasting cannot establish sustained changes in glycaemic control.

Conclusion: This case documents the application of a multimodal naturopathic approach for an individual with class III obesity and associated musculoskeletal complaints. Because this is a single case without a control group and with incomplete standardised post-intervention laboratory measurements, the observed changes should be interpreted cautiously and cannot establish causality.

Multisystem Effects of Repeated Co-codamol Exposure in Male Wistar Rats: Haematological, Biochemical, Oxidative, Inflammatory, Histopathological and Molecular-docking Evidence

2026-10-17T10:37:15+00:00

Co-codamol combines paracetamol (acetaminophen) and codeine, but the multisystem effects of repeated exposure to the combined formulation remain insufficiently characterised. This study evaluated the effects of repeated oral co-codamol administration on haematological, hepatic, renal, oxidative, inflammatory and histopathological parameters in adult male Wistar rats and examined predicted interactions of selected constituents with analgesia-associated molecular targets. Twenty rats were randomly allocated to four groups (n = 5). Groups A, B and C received co-codamol at 100, 97 and 90 mg/kg body weight, respectively, while Group D received normal saline. Treatments were administered orally once daily for 28 consecutive days. Repeated co-codamol exposure was associated with alterations in erythrocyte, leucocyte, platelet and red-cell indices. Changes were also observed in serum alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase and alkaline phosphatase activities, together with serum creatinine and urea concentrations. Hepatic and renal malondialdehyde, reduced glutathione, superoxide dismutase and total protein were assessed, with treatment-associated alterations observed in several of these parameters. Hepatic and renal IL-6 and IL-10 concentrations were also altered. Histopathological examination demonstrated treatment-associated changes in liver and kidney tissues. Molecular docking showed favourable predicted interactions between codeine and selected analgesia-associated targets. The measured responses were not uniformly proportional to dose across all endpoints. Overall, repeated co-codamol exposure was associated with multisystem biological alterations under the experimental conditions, while the docking findings provide computational hypotheses that require experimental validation.

Effect of Cool Immersion Bath on Metabolic Changes among Overweight Individuals: A Randomized Controlled Trial

2026-10-24T08:09:54+00:00

Background: The increasing prevalence of overweight is a major health concern because of its links to heart disease and metabolic disorders. There is growing interest in identifying non-pharmacological interventions for weight control.

Aim: This study aimed to explore the impact of cool immersion baths on the metabolic health of overweight adults through metabolic adjustments and increased energy use associated with temperature regulation.

Methods: In a randomised controlled trial, 60 participants aged 18 to 25 years with a BMI between 25.0 and 29.9 were divided into two groups of 30. For eight weeks, the intervention group underwent a 20-minute immersion bath at 18–26°C every other day, while the control group maintained their usual routine. Measurements were taken before and after the eight-week period, including body composition, anthropometric measurements, physiological parameters, and biochemical parameters, such as blood glucose levels.

Results: After eight weeks of intervention, the study group demonstrated significant within-group reductions in systolic and diastolic blood pressure, respiratory rate, fasting and postprandial blood glucose, hip and waist circumference, waist–hip ratio, waist–height ratio, visceral fat, and subcutaneous fat percentage. In the adjusted between-group analysis, significant differences were observed for systolic blood pressure (p<0.001), diastolic blood pressure (p<0.001), respiratory rate (p<0.001), postprandial blood glucose (p<0.001), hip circumference (p=0.004), waist circumference (p<0.001), waist–hip ratio (p=0.001), and waist–height ratio (p=0.001). No statistically significant between-group differences were observed for fasting blood glucose, body weight, BMI, body fat percentage, visceral fat, subcutaneous fat percentage, weight without fat, or muscle mass.

Conclusion: The present study suggests that an alternate-day cool immersion bath intervention may have beneficial effects on selected cardiovascular, respiratory, glycaemic, and anthropometric parameters in overweight individuals. However, further research with larger populations and assessment of additional markers is required to validate these clinical benefits.

Effect of Foot Reflexology with Aromatic Oil to Assess Sleep Quality among Healthy Young Adults: A Randomized Controlled Trial

2026-10-26T12:57:28+00:00

Background: Sleep disturbances can affect daily functioning and quality of life. Evidence concerning the combined use of foot reflexology and aromatic oil among healthy young adults remains limited.

Aim: To study the effect of foot reflexology with aromatic oil on sleep quality among healthy young adults.

Study Design: Randomised, open-label, controlled trial.

Place and Duration of Study: The study was conducted at Alva’s College of Naturopathy and Yogic Sciences, Mijar, Moodubidri, for 30 days in April 2026.

Methodology: This randomised controlled study included 60 healthy young adults (18–25 years) who were identified as having sleep disturbances. Participants were randomly allocated to two groups: the study group (n = 30) and the control group (n = 30). Study Group 1 (n = 30) received foot reflexology with lavender aromatic oil (Lavandula angustifolia) for 20 min daily, including 10 min per foot, six days per week for 30 days. Control Group 2 (n = 30) continued its usual routine without any intervention. Sleep quality and quality of life were assessed before and after the study using a numerical rating scale and standardised questionnaires. Ethical approval was obtained from the Institutional Ethics Committee, and written informed consent was obtained from all participants.

Results: After 30 days, participants receiving foot reflexology with aromatic oil showed a significant reduction in numerical rating scale scores (3.500(1.00) to 1.00(1.00); P < 0.001) and PSQI scores (8.00(1.75) to 3.00(1.00); P < 0.001). Their SF-36 quality-of-life scores increased (43.00(5.00) to 57.00(5.00); P < 0.001) compared with the control group. No adverse effects or dropouts occurred during the study.

Conclusion: The findings suggest that foot reflexology combined with aromatic oil may be a complementary approach to improving sleep quality among healthy young adults. Regular use of this intervention may help reduce sleep-related difficulties. Furthermore, no adverse effects were reported during the intervention period, suggesting that the approach was well tolerated by participants. These findings indicate the potential role of foot reflexology with aromatic oil as a simple, non-invasive, and well-tolerated complementary intervention for improving sleep quality.

Knowledge, Attitudes, and Preferences Regarding Acupuncture for Chronic Pain among Sri Lankan Adults: A Cross-Sectional Online Survey

2026-11-09T13:36:01+00:00

Background: Acupuncture has gained attention as a complementary approach to chronic pain management, with clinical evidence demonstrating benefits across various chronic pain conditions. However, its acceptance and utilisation may be influenced by patients' knowledge, perceptions and expectations regarding the intervention.

Objective: To assess the knowledge, attitudes, and preferences of Sri Lankan adults regarding the utilisation of acupuncture for chronic pain management and to examine their associations with sociodemographic characteristics.

Methods: A cross-sectional study was conducted among participants aged 18 years or older. Data were collected using a self-administered questionnaire divided into four sections: demographics, knowledge, attitudes, and preferences. Knowledge was categorised using Bloom’s cut-off criteria. Group comparisons were conducted using t-tests, ANOVA with Tukey HSD post hoc tests, and Monte Carlo permutation tests for categorical associations.

Results: Among 468 complete responses, the mean age was 34.5 years (SD 12.9) and 282 respondents (60.3%) were women. Good, moderate and poor knowledge categories included 144 (30.8%), 246 (52.6%) and 78 (16.7%) respondents, respectively. Acupuncture was correctly identified as a potential chronic-pain treatment by 360 respondents (76.9%), whereas 306 (65.4%) incorrectly believed that it applied to every medical condition. A total of 366 respondents (78.2%) considered acupuncture generally safe and 360 (76.9%) supported its availability in mainstream hospitals. A strong overall preference was recorded for 192 respondents (41.0%), and 258 (55.1%) selected the highest preference level for hospital integration. Knowledge scores differed significantly by gender, age, ethnicity, education and income (all p < .001). Preference scores differed by age, education, income and civil status, but not by gender or ethnicity. Knowledge and preference were weakly positively related (R² = 0.138).

Conclusions: The study revealed that favourable perceptions coexisted with important uncertainties regarding therapeutic scope, and that knowledge was only modestly associated with preference. The findings should not be generalised to all Sri Lankan adults.

Cupping Therapy in Athletes: Current Evidence on Effectiveness, Safety, Physiological Mechanisms, and Clinical Applications: A Narrative Review

2026-10-18T09:22:58+00:00

Background: Cupping therapy is used in athletic settings, although its reported popularity is more readily documented than evidence of its comparative efficacy. Suction-based procedures differ in their invasiveness, and evidence from patients with chronic pain cannot be assumed to apply directly to sports recovery. Objective: To critically examine athlete-specific research on symptom relief, physiological recovery, performance, harms and regulatory considerations, with mechanistic and non-athlete evidence interpreted separately. Methods: A targeted narrative search of peer-reviewed primary studies, systematic reviews and authoritative anti-doping guidance was complemented by citation tracking and verification of bibliographic records; evidence was appraised qualitatively without meta-analysis or a formal certainty-rating exercise. Results: A review of 11 historical athlete trials (498 participants) reported some favourable symptom and biomarker findings, mostly relative to untreated controls, but identified high or unclear risk of bias and no safety reporting. More recent trials showed mixed findings, including a randomised comparison involving 81 recreational runners that found no statistically significant benefit for muscle pain, fatigue, perceived recovery or vertical-jump height compared with sham manual intervention. A sham-controlled study of 40 baseball players found no advantage in objective exercise performance, whereas comparisons in taekwondo, table tennis and runners detected selected short-term subjective, autonomic or sleep outcomes. A 32-runner wet-versus-dry trial found no between-group advantage for measured endurance performance. A separate non-sham within-participant comparison in active men reported sprint-power differences, which cannot establish efficacy against sham treatment. Conclusions: Short-term symptom relief is possible, but evidence for accelerated tissue repair, durable recovery, injury prevention or performance enhancement is insufficient. Adverse-event rates cannot be estimated reliably, and blood-withdrawing wet cupping raises specific safety and 2026 anti-doping concerns.

Computational Genomics: The Convergence of AI and CRISPR in Precision Medicine

2026-10-24T09:23:51+00:00

Artificial intelligence (AI) and CRISPR-based genome editing offer complementary approaches to investigating genetic variation and developing targeted interventions in precision medicine. This narrative review examines the principles underlying AI-assisted genomic analysis and programmable genome editing, with particular attention to their potential integration in disease research and therapeutic development. Machine learning and deep learning models can analyse genomic and other molecular datasets, assist in identifying disease-associated variants, and support the prioritisation of candidate therapeutic targets. In CRISPR research, computational methods can inform guide RNA selection, estimate editing efficiency and potential off-target activity, and assist in interpreting functional screening results. Combining these approaches may improve the selection of experimental targets and strengthen investigation of biological mechanisms relevant to inherited disorders, cancer and other complex conditions. The review also discusses AI-assisted clinical decision support, pharmacogenomics, and applications of genome editing in molecular research. However, the reliability of integrated approaches remains dependent on representative training data, transparent computational methods, appropriate experimental validation and safe delivery of editing components. Unintended genomic alterations, variable editing outcomes, model bias, data privacy concerns, ethical issues and regulatory requirements continue to constrain clinical translation. Further progress will require reproducible research, long-term safety assessment and interdisciplinary collaboration. Overall, AI-guided CRISPR research may contribute to the development of more individualised therapeutic strategies, but its clinical value must be established through rigorous validation and responsible implementation.

Ficus auriculata Lour. (Moraceae) as a Medicinal and Nutritional Resource with Phytochemical Diversity and Pharmacological Potential

2026-10-29T11:45:36+00:00

Ficus auriculata Lour. (Moraceae) is a wild edible fig traditionally used as food, fodder and in local medicinal practices across parts of Asia. This review synthesises literature published up to 2026 on its botanical characteristics, ethnomedicinal uses, nutritional composition, phytochemical constituents and reported pharmacological activities. Information was identified through a literature survey using PubMed, Google Scholar and ScienceDirect, with relevant English-language studies and ethnomedicinal reports considered. Fruits, leaves, bark, stems and roots have been investigated for nutrients and secondary metabolites, including phenolics, flavonoids, tannins, glycosides and selected terpenoid compounds. The fruit provides dietary fibre, carbohydrates, vitamins and minerals, while the species also contributes to traditional fodder systems. Experimental investigations report antioxidant, antimicrobial, anti-inflammatory, glucose-lowering, hepatoprotective, gastroprotective and anticoagulant activities in particular extracts or assay systems. Antiproliferative and cytotoxic findings vary among extracts and cellular models, and evidence of anticancer effects remains preliminary. Available acute-toxicity observations offer limited reassurance for the specific preparations and doses evaluated but cannot establish long-term or clinical safety. Variation in extraction methods, plant parts and experimental designs limits direct comparisons across studies. Overall, F. auriculata is a potentially useful nutritional resource and a subject for further phytochemical and pharmacological research; however, extract standardisation, mechanistic investigation, comprehensive toxicological assessment and properly designed clinical studies are needed before therapeutic applications can be substantiated.

Neuroautonomic and Hypothalamic–pituitary–adrenal-axis Mechanisms of Yoga in Disorders of Gut–brain Interaction: A Narrative Review

2026-10-29T11:55:52+00:00

Background: Disorders of gut–brain interaction (DGBI), including irritable bowel syndrome (IBS), functional dyspepsia and functional abdominal pain, are highly prevalent and are associated with dysregulated autonomic and hypothalamic–pituitary–adrenal (HPA) axis signalling between the brain and the gut. Yoga combines postures, regulated breathing and meditation, each of which may act on these pathways. We review the human evidence for these mechanisms.

Methods: PubMed/MEDLINE was searched to August 2026 for human clinical, physiological and mechanistic studies, systematic reviews and meta-analyses. Animal and in vitro studies were excluded.

Results: Some patients with disorders of gut–brain interaction (DGBI) show reduced vagal activity, lower baroreflex sensitivity and prolonged cortisol responses to psychological stress. Stress-related hormones, particularly corticotropin-releasing hormone, may also influence colonic motility and visceral sensitivity. In patients with irritable bowel syndrome (IBS), yoga has been associated with improved parasympathetic activity. Similarly, a six-week slow-breathing programme increased vagally mediated heart rate variability, raised rectal sensory thresholds and reduced symptom severity in patients with constipation-predominant IBS. Studies in girls with functional abdominal pain have also found that yoga can temporarily reduce evening cortisol levels. However, evidence for the involvement of GABAergic signalling, insular brain activity and inflammatory pathways comes mainly from human studies outside the disorders of gut–brain interaction population. Although clinical trials have reported improvements in symptoms, quality of life and functional disability, recent meta-analyses have found no statistically significant overall effects. The certainty of this evidence remains very low because of small sample sizes, differences between studies and a high risk of bias.

Conclusions: Yoga, particularly slow breathing, plausibly improves disorders of gut–brain interaction through vagal, baroreflex and hypothalamic–pituitary–adrenal-axis regulation, but mechanistic and clinical evidence remains preliminary.

Sleep Positional Therapy across Clinical Disorders: Mechanisms, Evidence and a Position-Prescription Framework

2026-10-29T12:08:39+00:00

Background: Sleep position is seldom considered in clinical care, although body position changes upper-airway geometry, lung volume, cardiac loading, gastro-oesophageal anatomy and uteroplacental blood flow. It is a low-cost and modifiable factor.

Aims: To summarise the clinical evidence and physiological mechanisms for sleep positional therapy across disorders, to grade the certainty of this evidence and to propose a condition-specific position-prescription framework.

Methods: This narrative review followed the Scale for the Assessment of Narrative Review Articles (SANRA). PubMed, Google Scholar and Scopus were searched for English-language studies published from January 2000 to August 2026 using combinations of sleep, position and condition terms, including Medical Subject Headings. Each study was assigned a design-based level of evidence (I–V), and the overall certainty for each recommendation was rated as high, moderate, low or very low using principles adapted from GRADE.

Results: Moderate-certainty evidence from randomised trials and meta-analyses shows that positional devices reduce supine sleep and the apnoea-hypopnoea index in mild-to-moderate positional obstructive sleep apnoea, although to a lesser extent than continuous positive airway pressure, and that avoiding the right side reduces nocturnal reflux. Low-certainty observational evidence links the supine going-to-sleep position in late pregnancy with stillbirth, and the prone position with sudden unexpected death in epilepsy. Evidence for heart failure and central sleep apnoea is low, and evidence for neurodegeneration and glaucoma is very low, coming mainly from small physiological, cross-sectional and animal studies. Infants are recommended to sleep supine.

Conclusion: Sleep position can be used as a condition-specific, adjunctive measure. Positional advice is best supported in positional obstructive sleep apnoea and nocturnal reflux; in other conditions, it should be regarded as precautionary or hypothesis-generating until larger trials with clinical outcomes are available.

Localized Head and Facial Cooling under Thermoneutral Conditions: Trigeminal Sensory Pathways, Autonomic Responses, and Cognitive Performance-A Narrative Review

2026-10-31T13:11:29+00:00

Background: In naturopathy, cold treatments applied to the head and face, such as cold compresses, head packs, and ice massages, are commonly practised. These treatments have a distinct physiological basis compared to whole-body cold exposure, which can impair cognitive performance. Cooling the face specifically triggers trigeminal nerve pathways, resulting in an autonomic response through the vagus nerve. Increased vagal activity has been associated with attention and working memory, although a direct cognitive benefit from facial cooling has not been established. However, the impact of localized cooling on cognitive performance in thermoneutral settings has not been thoroughly examined.

Objective: To identify clinical implications and address safety concerns, this review synthesises evidence concerning the trigeminal sensory pathways, autonomic responses, and cognitive effects associated with localized head and facial cooling in thermoneutral environments.

Methods: A literature search was conducted in PubMed, Scopus, Google Scholar, and ScienceDirect for English-language studies published up to August 2026. Animal studies were excluded.

Results: The face is one of the most cold-sensitive regions of the body. Cooling the forehead or face consistently lowers heart rate and increases indices of cardiac vagal activity. Facial cooling also leads to sympathetic co-activation with a modest rise in blood pressure, reduces cortisol responses to acute psychosocial stress, and slightly increases or maintains cerebral blood flow velocity. Naturopathic ice massage of the head and spine shifts heart rate variability towards vagal dominance. Whole-body and painful cold impair attention and executive working memory.

Conclusion: Through neurovisceral integration, localised head and facial cooling elicits trigeminal–vagal responses and may reduce stress reactivity, providing a plausible pathway through which attention and working memory could be influenced. However, direct evidence of cognitive improvement following localised cooling under thermoneutral conditions is lacking. Standardised cooling conditions, validated cognitive tests, and adequately powered, sham-controlled studies are necessary.

Naturopathic and Food-Based Interventions for Anaemia in Adolescent Girls and Young Women: A Critical Narrative Review of Effectiveness, Mechanisms and Safety

2026-11-06T10:01:45+00:00

Anaemia among adolescent girls and young women is a heterogeneous clinical and public-health problem in which dietary inadequacy, menstrual blood loss, infection, inflammation and inherited disorders may coexist. Food-first strategies and interventions described as naturopathic are attractive because of their perceived accessibility, cultural familiarity and potential for sustained prevention, but their effects are often inferred from nutrient composition or short-term haemoglobin changes rather than demonstrated recovery of iron stores. This critical narrative review examines food-based dietary modification, absorption-enhancing practices, botanical products, iron-containing cookware, nutrition education and related lifestyle approaches in menstruating adolescents and young adults. Peer-reviewed clinical, nutritional and public-health literature published through 27 August 2026 was synthesised alongside authoritative diagnostic guidance, with attention to causal inference, biochemical outcomes, safety and population relevance. The most defensible evidence supports improving the quantity and bioavailability of dietary iron as an adjunct to diagnosis-directed care, particularly where inadequate food access or suboptimal dietary patterns contribute to deficiency. Controlled feeding and absorption studies clarify the influence of haem iron, ascorbic acid, tea and phytate, but mechanistic gains cannot automatically be translated into correction of established anaemia. Small studies of iron-rich foods and Moringa oleifera suggest potential benefits, although limited randomisation, contamination by co-interventions and inadequate ferritin measurement constrain causal interpretation. Evidence for iron cookware is inconsistent; nutrition education reliably improves knowledge more often than validated haematological endpoints. Traditional formulations raise additional concerns about heterogeneous composition and contaminant testing, whereas robust evidence for yoga, hydrotherapy or other non-dietary modalities as independent anaemia treatments remains insufficient. Naturopathic strategies should therefore be appraised as potentially useful supportive measures rather than replacements for investigation of anaemia aetiology, appropriate iron therapy or management of abnormal bleeding. Future trials require confirmed diagnoses, adequately powered and independently allocated comparison groups, validated iron biomarkers and longer follow-up.

Impact of Yoga on Muscle Recovery Following Exercise-Induced Muscle Damage: Mechanisms, Evidence, and Future Directions- A Critical Narrative Review

2026-11-06T12:37:29+00:00

Exercise-induced muscle damage (EIMD), particularly after unfamiliar eccentric loading, can impair strength and provoke delayed-onset muscle soreness. Yoga is increasingly considered within post-exercise recovery routines, yet the term spans low-load movement, stretching, breathing, attention and demanding muscular work. This critical narrative review evaluates whether yoga improves functional recovery after EIMD, distinguishes symptom relief from tissue restoration, and examines plausible biological and behavioural mechanisms. Peer-reviewed literature from 2000 to 30 August 2026 was identified through scholarly searches and citation examination, with earlier foundational work retained where essential. Directly relevant yoga studies were interpreted alongside research on muscle-damage biology, stretching, autonomic regulation, immune signalling, pain and sleep. The directly relevant evidence is sparse. An observational comparison of previously yoga-trained and untrained women and a repeated-week post-exercise study report potentially favourable soreness outcomes, but training-history confounding, treatment-order effects and differences in exercise loading limit causal interpretation. A small randomised crossover study found changes in selected autonomic and immune indices after yoga following prolonged running; it did not establish recovery of damaged muscle. Evidence from trials and reviews of post-exercise stretching does not show a reliable improvement in soreness, strength or performance. Yoga may plausibly influence perceived discomfort, arousal and sleep-related behaviour, while inflammatory and autonomic mechanisms remain insufficiently linked to objective restoration of force production. Vigorous yoga can also add mechanical loading during an intended recovery period. Future trials should randomise participants after a standardised damaging challenge, use credible comparator conditions, record intervention dose and harms, and prioritise multiday strength or performance recovery. At present, gentle yoga may be an acceptable comfort-oriented activity, but claims that it accelerates repair of exercise-damaged skeletal muscle are not established.

Non-pharmacological Exercise Mimetics and Their Multisystem Health Effects: A Structured Narrative Review

2026-11-06T13:16:46+00:00

Background: Regular exercise produces multisystem adaptations, yet frailty, disability and chronic disease may restrict participation. Several non-pharmacological approaches have been proposed to reproduce selected exercise-responsive pathways.

Aim: To classify these approaches, examine their proposed mechanisms and appraise human evidence on organ-system effects and safety.

Methods: This structured narrative review searched PubMed/MEDLINE using nine predefined concept strings, with restrictions on language (English), publication date (1990–2026) and publication type. Records underwent title, abstract and full PubMed record screening, supplemented by targeted searches.

Results: From 8,082 records, 7,996 were unique; 2,735 titles and 652 abstracts were screened, and 595 records were assessed for eligibility. Seventy-nine database records and 11 targeted records were included, yielding 90 sources. Eight modalities were identified: passive heat, cold exposure, whole-body vibration, neuromuscular electrical stimulation, passive blood-flow restriction, calorie restriction and fasting, dietary bioactive compounds, and intermittent hypoxic conditioning. These modalities engage different subsets of energy-sensing, vascular, thermal, muscular and hypoxia-related pathways. Meta-analyses suggest modest improvements in blood pressure and vascular function with heat therapy, strength and falls outcomes with whole-body vibration, and muscle strength and mass with electrical stimulation. A two-year randomised trial supports improvements in cardiometabolic risk factors with calorie restriction. Evidence for several other modalities remains limited or inconsistent, and some trials reported null findings.

Conclusion: These approaches are partial rather than comprehensive exercise mimetics. They may offer supervised adjunctive options for selected individuals unable to exercise, but cannot replace exercise. Larger trials with clinical outcomes and adequate safety assessment are needed.

Yoga and Neuroimmune Regulation in Autoimmune Disorders: A Mechanistic Review of Stress Signalling, Autonomic Function, and Immune Tolerance

2026-11-09T11:58:38+00:00

Background: Autoimmune disorders arise from interactions among genetic susceptibility, immune dysregulation, neuroendocrine and autonomic signalling, and environmental exposures. Yoga combines physical postures, regulated breathing, meditative attention, and relaxation, and may influence several of these domains. It remains uncertain whether yoga modifies autoimmune disease biology or primarily improves symptoms and function.

Objective: To describe the mechanisms by which yoga could influence stress signalling, autonomic function, inflammatory biology, and immune tolerance in autoimmune disorders, and to appraise the clinical evidence for each mechanistic link.

Methods: This focused narrative review (not a registered systematic review) synthesizes clinical studies of yoga in autoimmune disease, evidence syntheses, and mechanistic literature on the hypothalamic–pituitary–adrenal axis, autonomic–immune communication, and regulatory T cells. Evidence is classified as direct clinical, indirect human, or mechanistic rationale.

Results: The strongest mechanistic signals come from short randomised trials in rheumatoid arthritis (RA), in which yoga added to usual care was associated with changes in disease activity, cytokines, neuroendocrine-associated markers, and T-cell subsets; one trial (n = 64) reported lower T helper 17 (Th17) and higher regulatory T-cell proportions at eight weeks. These findings do not show that yoga acted through those pathways: programmes were multicomponent, comparators were mostly not attention-matched, one formal mediation analysis did not support mediation, and durable tolerance was not tested. Meta-analyses suggest possible benefit for RA function and disease activity, but pooled inflammatory-marker effects are inconsistent and certainty is low. Evidence in multiple sclerosis (MS) concerns fatigue and function, and evidence in systemic lupus erythematosus (SLE) is preliminary. Direct evidence that yoga engages a vagal anti-inflammatory reflex in autoimmune patients is insufficient.

Conclusions: Yoga may be a useful adjunct for well-being, fatigue, function, and stress management when adapted to disease limitations and used alongside standard treatment. It should not be represented as a proven disease-modifying therapy or as restoring immune tolerance. Mechanistic claims require larger, preregistered trials with active comparators, standardised exposure, repeated pathway measures, and long-term disease outcomes.

Rosemary Oil Massage and Plum-Blossom Needling in the Management of Hair Loss: A Critical Narrative Review of Clinical Evidence and Safety

2026-11-10T08:38:51+00:00

Background: Botanical scalp preparations and superficial needling are widely discussed as accessible approaches to hair loss, but their clinical evidence is often pooled across different diagnoses, formulations and procedures. Rosemary essential oil, scalp massage and plum-blossom needling are not interchangeable interventions, and their possible combined use raises questions about both effectiveness and percutaneous exposure.

Objective: To critically assess human evidence for rosemary oil massage and plum-blossom needling, distinguish it from adjacent aromatherapy and microneedling research, and identify safety requirements and priorities for confirmatory trials.

Methods: A critical narrative synthesis considered peer-reviewed clinical studies, systematic reviews, relevant mechanistic experiments, dermatological guidance and adverse-event literature published between 1998 and 29 August 2026, with selected foundational material where necessary. The evidence was assessed for diagnostic precision, treatment isolation, comparator credibility, measurement quality, bias and transferability.

Findings: A small comparative trial found improved hair counts within both rosemary oil and 2% minoxidil groups after six months, but lacked a vehicle control or a design establishing therapeutic equivalence. Evidence involving multi-oil aromatherapy or commercial rosemary-containing blends cannot identify the effect of rosemary alone. For alopecia areata, meta-analyses of plum-blossom needling as an adjunct suggest possible improvement in composite regrowth outcomes, yet draw on overlapping small trials with considerable methodological weaknesses. A recent androgenetic alopecia trial of plum-blossom needling plus minoxidil is encouraging but requires independent confirmation. Evidence from motorised or roller microneedling cannot be directly attributed to plum-blossom tapping. Adverse-event reporting is insufficient to establish the safety of either intervention over long periods or in combination, particularly on inflamed or freshly punctured skin.

Conclusions: The interventions remain investigational or adjunctive rather than validated substitutes for diagnosis-specific care. Properly controlled studies must isolate the oil, massage, needle procedure and any combined effect, using standardised outcomes, explicit safety surveillance and adequate follow-up.

Aromatherapy for Stress, Anxiety and Depression: Clinical Evidence, Mechanistic Plausibility and Methodological Challenges

2026-11-10T14:05:28+00:00

Aromatherapy is widely offered to people experiencing psychological distress, yet the term encompasses chemically diverse essential oils, several routes of administration, and interventions that frequently combine odour exposure with massage, rest or supportive interaction. These distinctions complicate claims that aromatherapy specifically modifies stress, anxiety or depression. This critical narrative review evaluates clinical effectiveness, potential mechanisms, measurement quality, contextual moderators and safety, distinguishing inhaled essential oils from topical aromatic massage and orally administered standardised lavender-oil preparations. Peer-reviewed clinical studies, evidence syntheses, experimental investigations and relevant clinical guidance published from 2000 to 4 September 2026 were selected through targeted scholarly searching and citation examination. Findings are most consistent for short-term, self-reported situational anxiety in selected perioperative, dental and other healthcare settings, although small studies, imperfect blinding and heterogeneous comparators substantially restrict certainty. Evidence for reduced perceived stress is promising but inconsistent, and physiological indices of stress do not reliably corroborate questionnaire changes. Depression-related results are more variable and depend on population, severity, outcome measure and intervention type; improvements in mixed symptom samples cannot establish efficacy for major depressive disorder. Experimental olfactory pathways and investigations of individual volatile constituents provide biological plausibility without demonstrating that clinically inhaled concentrations reproduce laboratory pharmacology. Trials of a standardised oral lavender preparation offer a stronger, but route-specific, evidence base and should not be pooled conceptually with fragrance inhalation. Reporting of botanical identity, chemical composition, concentration, exposure, sensory expectations and adverse events remains inadequate. The synthesis proposes an intervention-specific interpretation framework and priorities for scent-matched, adequately powered trials incorporating clinical relevance, objective measures, safety and longer follow-up. Aromatherapy may be considered a preference-sensitive adjunct for short-term symptom comfort, but current evidence does not justify presenting generic aromatherapy as an established treatment for anxiety disorders or depression.