Mental Health
Anxiety and stress exist on a continuum from adaptive, short-term arousal to persistent, impairing conditions such as generalized anxiety disorder (GAD) and panic disorder. Western biomedicine defines specific syndromes using standardized criteria and emphasizes evidence-based psychotherapy and pharmacotherapy. Eastern and traditional systems view anxiety as dysregulated mind–body energy or imbalance across organ systems, prioritizing practices that train attention, calm the autonomic nervous system, and restore resilience—often through meditation, breath, movement, and botanicals. A growing integrative model blends these strengths: pairing the robust symptom relief of cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs)/serotonin–norepinephrine reuptake inhibitors (SNRIs) with mindfulness, yoga, and targeted herbal supports for stress physiology and sleep.
In Western care, diagnosis relies on DSM-5-TR criteria. GAD features excessive, hard-to-control worry for at least six months with symptoms like restlessness, fatigue, muscle tension, irritability, poor concentration, and sleep disturbance. Panic disorder involves recurrent, unexpected panic attacks and persistent concern or behavioral change related to attacks. Clinicians exclude medical causes (e.g., hyperthyroidism, arrhythmias), substance effects, and assess functional impairment and comorbidity (depression, PTSD, substance use). First-line treatments with the strongest evidence are CBT (including exposure-based techniques) and SSRIs/SNRIs. CBT teaches skills to modify catastrophic thinking, increase tolerance of physical sensations, and reduce avoidance—producing large, durable effects across anxiety disorders. SSRIs/SNRIs reduce core symptoms but require weeks to full effect and can cause side effects (e.g., GI upset, sexual dysfunction). Benzodiazepines can relieve acute anxiety but carry dependence, cognitive, and accident risks, so guidelines reserve them for short-term
Well-Studied
Respiratory
Asthma is a chronic inflammatory airway disease marked by variable respiratory symptoms (wheeze, cough, chest tightness, shortness of breath) and expiratory airflow limitation that fluctuates over time. In western medicine, diagnosis is confirmed by characteristic symptoms plus objective evidence of variable airflow obstruction, most commonly on spirometry with bronchodilator reversibility. Management follows a stepwise approach tailored to symptom control and risk of exacerbations, with inhaled corticosteroids (ICS) as the cornerstone. Modern guidelines (e.g., GINA 2024) discourage short-acting beta-agonist (SABA)-only treatment and emphasize as-needed low-dose ICS–formoterol or ICS taken whenever SABA is used, alongside daily controller therapy as needed. Add-ons include long-acting beta-agonists (LABA), long-acting muscarinic antagonists (LAMA), and targeted biologics for severe Type 2 (T2) inflammation. Allergen immunotherapy can help in selected allergic phenotypes, and bronchial thermoplasty may be considered for highly selected refractory cases.
Eastern and traditional systems conceptualize asthma differently. In Traditional Chinese Medicine (TCM), patterns such as Lung Qi deficiency, Kidney not grasping Qi, and Phlegm-Damp obstruction guide individualized herbal formulas and acupuncture. Historically, the TCM herb Ma Huang (Ephedra sinica) was a source of ephedrine—an early bronchodilator that bridged traditional practice and modern pharmacology; however, ephedra-containing supplements are now restricted in many countries due to cardiovascular risks. Acupuncture has mixed evidence, with Cochrane reviews finding insufficient or low-certainty evidence for clinically important lung function improvements, though some patients report symptom relief. Chinese herbal formulas have been studied in small trials with heterogeneous quality.
Ayurveda frames asthma (Tamaka Shvasa) as an imbalance of doshas (often Vata-Kapha) and employs botanicals like Vasaka (Adhatoda/
Well-Studied
Chronic illness
Chronic Fatigue Syndrome, also termed Myalgic Encephalomyelitis (ME/CFS), is a complex, multi-system illness characterized by profound fatigue, marked reduction in pre-illness activity, non-restorative sleep, cognitive difficulties, orthostatic intolerance, and especially post-exertional malaise (PEM)—a delayed exacerbation of symptoms after physical, cognitive, or emotional exertion. PEM is now widely recognized as the cardinal feature of ME/CFS and a key differentiator from primary depression or simple deconditioning. Onset can be sudden (often after an infection) or gradual, and severity ranges from mild functional limitation to complete home- or bed-bound states. The condition affects quality of life at levels comparable to other serious chronic diseases, yet no single biomarker or curative therapy has been validated to date.
Western medicine conceptualizes ME/CFS as a neuroimmune and metabolic disorder evaluated by clinical criteria and exclusion of alternative explanations. Multiple diagnostic frameworks exist, including the Fukuda (1994) criteria, the Canadian Consensus Criteria (2003), and the Institute of Medicine/National Academy of Medicine criteria (2015; Systemic Exertion Intolerance Disease, SEID). All emphasize substantial impairment and persistent fatigue not alleviated by rest, with the IOM/SEID requiring PEM, unrefreshing sleep, and either cognitive impairment or orthostatic intolerance. Research has described autonomic dysregulation, immune activation and heterogeneously altered cytokines, small-fiber neuropathy in some patients, cerebral hypoperfusion, reduced aerobic capacity with abnormal repeat cardiopulmonary exercise testing, and gastrointestinal dysbiosis. Immune-modulating therapies such as rituximab that showed early promise have failed in larger, rigorous trials. Microbiome work reveals compositional and functional differences and links to symptom severity, but interventional evidence remains preliminary.
Management in contemporary, (e
Moderate Evidence
Neurology
Chronic Fatigue Syndrome, also called Myalgic Encephalomyelitis (CFS/ME), is a complex, multi-system condition characterized by profound fatigue that is not improved by rest and is worsened by exertion. A defining, cardinal feature is post-exertional malaise (PEM): a delayed worsening of symptoms—fatigue, cognitive dysfunction (“brain fog”), pain, sleep disturbance, autonomic and flu-like symptoms—after physical, cognitive, or emotional stress. Many patients experience orthostatic intolerance (e.g., POTS or neurally mediated hypotension), unrefreshing sleep, and cognitive impairment, among other symptoms. The illness exists on a spectrum of severity, from reduced activity to housebound or bedbound states. There is currently no single diagnostic test or disease-modifying cure; care focuses on accurate diagnosis, energy management (pacing), treating comorbidities, and mitigating symptom burden.
Western frameworks emphasize standardized diagnostic criteria and symptom-based management, with growing recognition of immune, autonomic, and metabolic abnormalities. The Fukuda criteria (1994) historically informed research but underweighted PEM. The Canadian Consensus Criteria (2003) and the U.S. Institute of Medicine/National Academy of Medicine report (2015) elevated PEM as essential and reframed the condition (SEID—systemic exertion intolerance disease). In 2021, the UK’s NICE guideline NG206 recognized PEM as central, reversed prior endorsements of graded exercise therapy (GET), and advised against any program that pushes patients to increase activity beyond their energy envelope. Evidence for GET was driven largely by the PACE trial (2011), which later drew substantial methodological criticism and reanalysis indicating far more limited benefits than originally claimed. Current best practice centers on pacing—patient-led activity regulation to prevent PEM.
Pharmacologic strategies are symptom-targeted. Sleep aids (e.g., low-dose tricyclics like amitriptyline or doxepin
Moderate Evidence
Pain
Chronic pain is pain lasting beyond normal tissue healing time (often defined as 3 months or more) and affects roughly one in five adults worldwide. It is increasingly understood as a biopsychosocial condition with multiple mechanisms: nociceptive (tissue/inflammatory), neuropathic (nerve injury/dysfunction), and nociplastic/central sensitization (altered pain processing without clear peripheral damage), with many patients exhibiting a mixed picture. Effective care prioritizes function, quality of life, and risk reduction rather than complete pain elimination.
Western medicine emphasizes careful assessment: clarifying pain type, ruling out red flags, gauging functional impact and mental health comorbidities, and avoiding unnecessary imaging. First-line nonpharmacologic strategies include education, graded exercise/physical therapy, cognitive behavioral therapy (CBT) and other psychological therapies, and complementary options such as acupuncture and mindfulness with growing evidence for several pain conditions. Pharmacologic therapy is typically stepped: topical agents and NSAIDs or acetaminophen for nociceptive pain; serotonin-norepinephrine reuptake inhibitors (e.g., duloxetine), tricyclics, and gabapentinoids for neuropathic/nociplastic pain; and muscle relaxants short term if spasm is prominent. Interventional procedures (e.g., joint/soft tissue injections, radiofrequency ablation for facet-mediated pain, neuromodulation in select refractory cases) may help carefully selected patients. Opioids are now used far more judiciously due to limited long-term benefit and substantial risks; guidelines emphasize nonopioid and nonpharmacologic care as the foundation.
Eastern and traditional approaches add modalities with varying supportive evidence. Acupuncture has one of the stronger evidence bases among complementary therapies, showing clinically meaningful but modest benefits for chronic musculoskeletal pain (low back, neck, shoulder), osteoarthritis, and headaches,,
Moderate Evidence
Mental health
Depression (Major Depressive Disorder, MDD) is a common, potentially severe mood disorder marked by persistent low mood and/or loss of interest or pleasure, along with changes in sleep, appetite, energy, concentration, and thoughts of worthlessness or suicide. In Western medicine, MDD is diagnosed using DSM-5 criteria: at least five of nine symptoms present for two weeks or more, causing distress or impairment, with one being depressed mood or anhedonia, and not better explained by substances, a medical condition, or bipolar disorder. Severity ranges from mild to severe and may include specifiers (e.g., melancholic, peripartum, seasonal). Effective care is guided by symptom severity, patient preference, medical comorbidities, and past treatment response.
Western approaches are highly evidence-based. Psychotherapies such as cognitive behavioral therapy (CBT), behavioral activation (BA), and interpersonal therapy (IPT) have strong support, particularly for mild to moderate depression; BA can be as effective as CBT and is often more scalable. First-line medications include selective serotonin reuptake inhibitors (SSRIs) like sertraline and escitalopram due to favorable tolerability; serotonin–norepinephrine reuptake inhibitors (SNRIs) are also common. Alternatives such as bupropion or mirtazapine can be chosen based on symptom profile (e.g., low energy or insomnia). In treatment-resistant depression (often defined after at least two adequate medication trials), evidence-based options include augmentation strategies (e.g., lithium or certain atypical antipsychotics), electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), and ketamine/esketamine. A stepped-care model is widely endorsed: start with low-intensity interventions for mild cases, step up to combined psychotherapy and pharmacotherapy as needed, and use somatic treatments for resistant or severe illness—always with ongoing symptom monitoring (e.g., PHQ-9) and safety checks.
In “e
Well-Studied
Endocrine/Metabolic
Diabetes management aims to prevent symptoms and long-term complications by maintaining near-normal glycemia while addressing cardiovascular, renal, eye, nerve, and foot risks. Western medicine defines diabetes biologically and relies on standardized diagnostics and evidence-based care pathways, including lifestyle, medications, and ongoing monitoring. Eastern and traditional systems such as Traditional Chinese Medicine (TCM) and Ayurveda conceptualize diabetes through pattern diagnoses (e.g., yin deficiency with heat; Madhumeha) and emphasize constitutional balance, diet, herbs, acupuncture, yoga, and mind–body practices. An integrative approach can combine the strengths of each: the proven risk reduction from Western protocols with patient-centered lifestyle, stress management, and culturally congruent dietary and herbal therapies when safe and appropriately monitored.
In Western care, diagnosis uses objective criteria: HbA1c ≥6.5%, fasting plasma glucose ≥126 mg/dL (7.0 mmol/L), 2-hour OGTT glucose ≥200 mg/dL (11.1 mmol/L), or random glucose ≥200 mg/dL with classic symptoms. HbA1c guides longitudinal control and risk; targets are individualized (often <7% for most adults, tighter or looser based on comorbidities, hypoglycemia risk, and life expectancy). Management prioritizes medical nutrition therapy (Mediterranean/plant-forward patterns, carbohydrate quality/quantity, and energy deficits for weight loss), physical activity (≥150 minutes/week moderate intensity plus resistance training), sleep, and smoking cessation. Pharmacologic therapy is tailored to cardiorenal risk: metformin is common first-line unless contraindicated; GLP-1 receptor agonists and SGLT2 inhibitors provide cardiovascular and renal protection independent of metformin; dual GIP/GLP-1 agents and insulin are used when needed. Monitoring includes HbA1c every 3 months until stable, self-monitoring of blood glucose or continuous glucose monitoring (CGM), annual kidney (eGFR, albuminuria), eye, and
Moderate Evidence
Dermatology
Eczema (atopic dermatitis, AD) and psoriasis are chronic inflammatory skin diseases that share some management principles (moisturization, anti‑inflammatory therapy, and trigger control) but differ in immune pathways, clinical appearance, and many treatment choices. In Western medicine, diagnosis is clinical: AD often begins in childhood, with pruritic, eczematous patches in flexural areas and a relapsing course, accompanied by xerosis and personal or family atopy. Validated criteria include Hanifin–Rajka and the UK Working Party. Psoriasis typically presents with well‑demarcated erythematous plaques with silvery scale on extensor surfaces, scalp, and sometimes nails or joints; severity and response are tracked with tools like PASI and DLQI. Standard care emphasizes barrier repair (emollients), topical anti‑inflammatories (a potency ladder of corticosteroids; non‑steroidal options like calcineurin inhibitors or PDE‑4 inhibitors), phototherapy (narrowband UVB), and systemic/biologic agents as severity escalates. For AD, newer small‑molecule JAK inhibitors have expanded options for moderate‑to‑severe disease. For psoriasis, highly targeted biologics against IL‑17 or IL‑23 pathways have transformed outcomes for many patients. These approaches are guideline‑driven and supported by strong evidence, but they are not curative, responses vary, and long‑term safety, cost, and access are practical constraints.
Eastern and traditional modalities frame these conditions differently. In Traditional Chinese Medicine (TCM), eczema and psoriasis reflect internal imbalances such as “blood heat,” “blood dryness,” or “damp‑heat,” inferred from the lesion character (weeping vs dry), color, and systemic patterns. Therapy aims to clear heat, resolve dampness, nourish blood, and calm wind, often combining individualized herbal formulas with acupuncture and dietary guidance. Several randomized trials—including classic UK studies of standardized CHM formulas for atopic eczema—suggest short‑
Well-Studied
Chronic pain / Rheumatology
Fibromyalgia is a chronic, centralized pain condition characterized by widespread pain, fatigue, nonrestorative sleep, cognitive symptoms (“fibro fog”), and sensory hypersensitivity. Modern understanding emphasizes central sensitization—heightened pain processing in the central nervous system—along with autonomic dysregulation, stress-axis changes, and overlapping conditions (e.g., irritable bowel syndrome, migraine, temporomandibular disorders, and mood and sleep disturbances). Diagnosis is clinical, using validated symptom indices rather than tender-point counts. Management focuses on education, self-management, graded physical activity, psychological therapies, and selected medications. Strong evidence supports aerobic and resistance exercise, cognitive-behavioral therapy (CBT), and mind-body practices. Pharmacotherapy can help a subset of patients but typically yields modest benefits, and guidelines discourage long-term opioid therapy.
Eastern and traditional systems frame fibromyalgia through functional patterns. In Traditional Chinese Medicine (TCM), common patterns include qi and blood stagnation, liver qi constraint, spleen qi deficiency, and kidney yang deficiency, often linked with cold, dampness, and stress. Treatment uses acupuncture (including electroacupuncture), moxibustion, cupping, tuina, and individualized herbal formulas. Evidence for acupuncture is moderate, with several trials and reviews showing short- to medium-term improvements in pain and function, particularly with electroacupuncture. Ayurvedic perspectives often attribute symptoms to vata aggravation and ama (metabolic/toxic) accumulation; therapies include Abhyanga (warm oil massage), Swedana (steam/sudation), Shirodhara, Panchakarma detoxification procedures, and adaptogenic herbs such as Ashwagandha. Clinical evidence in fibromyalgia specifically is limited, though some components (e.g., massage, stress reduction, sleep support) have broader supportive data.
Mind-body practices bridge
Well-Studied
chronic-pain
Fibromyalgia is a chronic, centralized pain syndrome characterized by widespread musculoskeletal pain, fatigue, nonrestorative sleep, cognitive complaints (“fibro fog”), and sensory hypersensitivity. Modern understanding emphasizes central sensitization—an amplified pain processing state with altered pain modulation and increased neural network reactivity. The condition often coexists with mood disorders, irritable bowel syndrome, temporomandibular disorder, headaches, and sleep disturbances, and it disproportionately affects women. Diagnosis is clinical and does not rely on inflammatory or structural abnormalities; laboratory testing is used primarily to exclude other explanations when history or exam suggest them. The 2016 revisions to the American College of Rheumatology (ACR) criteria incorporate a Widespread Pain Index (WPI) and Symptom Severity (SS) scale and require generalized pain in at least four of five regions for at least three months.
Western evidence strongly supports a multimodal approach, with graded exercise (aerobic and resistance training) and patient education as first-line, complemented by cognitive behavioral therapy (CBT) for pain and coping skills, structured sleep management (including CBT for insomnia), and selective use of centrally acting medications. FDA-approved options—duloxetine, milnacipran, and pregabalin—offer modest average benefits for pain and function, while tricyclics (e.g., low-dose amitriptyline) and cyclobenzaprine may improve pain and sleep in some patients. Long-term opioids are discouraged; guidelines favor nonpharmacologic strategies with targeted pharmacotherapy for residual symptoms. EULAR’s management recommendations emphasize individualized, stepped care anchored by exercise and psychoeducation, adding psychological therapies and medications as needed, and considering complementary options with supportive evidence.
Traditional Eastern approaches conceptualize fibromyalgia through functional imbalances. In Chinese
Moderate Evidence
Gastroenterology
Gastroesophageal reflux disease (GERD) is a chronic condition in which gastric contents reflux into the esophagus, producing symptoms such as heartburn and regurgitation and, in some cases, esophagitis or complications like strictures and Barrett’s esophagus. Western medicine focuses on careful symptom-based diagnosis, judicious use of acid suppression, lifestyle measures, and escalation to surgical or device-based therapy for refractory disease. Eastern and traditional modalities view GERD through pattern-based frameworks (e.g., Traditional Chinese Medicine) or constitutional imbalances (e.g., Ayurveda), and they emphasize regulating motility, soothing and protecting mucosa, dietary harmony, and mind–body balance. Many patients benefit from a pragmatic, integrative plan that uses the strong evidence base for conventional care while drawing on complementary tools to address residual symptoms, medication tapering, and overall well-being.
In the Western paradigm, GERD is often diagnosed clinically when typical symptoms improve with an empiric trial of a proton pump inhibitor (PPI). Alarm features (dysphagia, bleeding, anemia, weight loss) prompt earlier endoscopy, and pH or pH–impedance monitoring clarifies the diagnosis in atypical or refractory cases, including preoperative evaluation. First-line therapy includes lifestyle measures—weight loss for those with overweight, head-of-bed elevation, avoidance of late-night meals, and attention to individual trigger foods. Pharmacologically, PPIs are the most effective agents for healing erosive esophagitis and controlling typical symptoms; H2-receptor antagonists can help with mild or nocturnal symptoms or as step-down therapy; and alginate-based antacids provide rapid, on-demand relief by creating a postprandial “raft” barrier. For persistent, objectively confirmed reflux despite optimized medical therapy, antireflux procedures such as laparoscopic fundoplication or magnetic sphincter augmentation (LINX) are options, the
Moderate Evidence
Cardiovascular
Hypertension is a leading modifiable risk factor for stroke, myocardial infarction, heart failure, chronic kidney disease, and premature mortality. Western guidelines (ACC/AHA 2017) lowered the diagnostic threshold to 130/80 mm Hg, reflecting data that cardiovascular risk rises continuously with higher pressures. Diagnosis relies on accurate measurement, confirmation with home or ambulatory monitoring when appropriate, and risk stratification. First-line therapy pairs lifestyle measures—particularly the DASH eating pattern with sodium restriction and regular physical activity—with medications when indicated. Large trials (ALLHAT, SPRINT) shape current practice: thiazide-type diuretics remain foundational and, in high-risk patients, targeting lower systolic pressures can further reduce events, albeit with more adverse effects, underscoring the need for individualized care and close follow-up. Resistant hypertension warrants a systematic approach to adherence, secondary causes, and addition of mineralocorticoid receptor antagonists.
Eastern and traditional systems contribute complementary perspectives. In Traditional Chinese Medicine (TCM), hypertension is framed through pattern differentiation (e.g., liver yang rising, kidney yin deficiency), guiding use of formula-based herbal therapy (such as Tian Ma Gou Teng Yin, which contains Uncaria rhynchophylla/gou teng) alongside lifestyle, stress regulation, and practices like tai chi. Ayurvedic medicine emphasizes constitutional balance and employs botanicals such as Terminalia arjuna (arjuna) and historically Rauwolfia serpentina (source of reserpine, an early antihypertensive), together with diet, yoga, and meditation. Mind–body interventions (yoga, meditation, tai chi) have moderate evidence for small but meaningful blood pressure reductions and also improve adherence and stress resilience. Specific nutraceuticals—including garlic preparations and possibly coenzyme Q10—show small average reductions in systolic and di‑s
Well-Studied
Gastroenterology
Irritable bowel syndrome (IBS) is a chronic, relapsing disorder of gut–brain interaction characterized by abdominal pain associated with altered bowel habits, without structural disease that explains the symptoms. Western medicine classifies IBS using the Rome IV criteria: recurrent abdominal pain, on average, at least 1 day per week in the last 3 months, associated with two or more of the following—related to defecation, associated with a change in frequency of stool, and associated with a change in form (appearance) of stool—with symptom onset at least 6 months before diagnosis. Subtypes are defined by predominant stool pattern: diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), mixed (IBS-M), and unclassified. Pathophysiology is multifactorial: visceral hypersensitivity, altered motility, immune activation and barrier dysfunction, dysbiosis, bile acid malabsorption in a subset, and central modulation via the gut–brain axis. Psychosocial stressors and early life adversity can amplify symptoms through bidirectional brain–gut signaling.
Evidence-based Western management is multimodal and personalized. First-line lifestyle strategies include regular physical activity, sleep optimization, and diet. The low-FODMAP diet—temporary restriction of fermentable oligo-, di-, monosaccharides and polyols—has strong evidence for reducing global IBS symptoms when delivered in a structured elimination and reintroduction program (best studied by Monash University). Soluble fiber (psyllium) is recommended in IBS-C and some mixed phenotypes, while insoluble fiber may worsen symptoms. Pharmacologic options are matched to subtype and dominant symptoms: antispasmodics (e.g., dicyclomine, hyoscyamine) for cramping; loperamide for urgency/diarrhea control (not for global symptom relief); bile acid sequestrants in suspected bile acid diarrhea; non-absorbed antibiotic rifaximin for IBS-D; secretagogues such as linaclotide and plecanatide for IBS-C; lubiprostone (women with IBS
Moderate Evidence
Gastroenterology
Irritable bowel syndrome (IBS) is a chronic disorder of gut–brain interaction characterized by recurrent abdominal pain and altered bowel habits without structural disease. Under the Rome IV criteria, IBS is defined by abdominal pain, on average, at least one day per week in the last three months, associated with two or more of the following: related to defecation, change in stool frequency, or change in stool form; symptoms start at least six months before diagnosis. Subtypes are based on predominant stool pattern: IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), mixed (IBS-M), or unclassified.
Western medicine frames IBS as a multifactorial condition involving disordered gut–brain signaling, visceral hypersensitivity, altered motility, immune activation, psychosocial stressors, and microbiome perturbations. Evidence-based care is individualized and multimodal. Diet is foundational: the low-FODMAP diet—developed and validated by Monash University—has strong evidence for improving global IBS symptoms when delivered in a structured, three-phase format (short-term elimination, personalized reintroduction, and long-term adaptation). Pharmacotherapies target stool form and pain: antispasmodics (e.g., hyoscine, dicyclomine) can reduce cramping; rifaximin is effective for IBS-D; and secretagogues such as linaclotide and plecanatide are effective for IBS-C. Low-dose tricyclic antidepressants (TCAs) and, in selected cases, SSRIs modulate the gut–brain axis to reduce pain and normalize bowel habits. Psychological therapies—especially gut-directed cognitive behavioral therapy (CBT)—have strong support for improving global symptoms and quality of life. Emerging approaches include selective probiotics, postbiotics, and microbiome-directed therapies; evidence is mixed and evolving, and current guidelines are cautious about routine probiotic use for global IBS symptoms due to heterogeneity.
Eastern and traditional systems conceptualize IBS through functional patterns.
Moderate Evidence
Autoimmune/Rheumatology
Systemic lupus erythematosus (SLE) is a chronic, relapsing-remitting autoimmune disease that can affect skin, joints, kidneys, blood, lungs, heart, and the nervous system. Its clinical expression and severity vary widely—from photosensitive rash and arthritis to life‑threatening nephritis or neuropsychiatric involvement. Because there is no single definitive test, diagnosis is based on characteristic clinical features supported by autoantibodies and complement abnormalities. Modern Western management focuses on controlling immune overactivity, preventing organ damage, and reducing cardiovascular and infection risks. Hydroxychloroquine is considered a cornerstone for nearly all patients, with immunosuppressants and biologics tailored to organ involvement and disease severity. Sun protection, vaccines, and close monitoring are essential.
Eastern and traditional approaches frame SLE within broader mind-body and constitutional paradigms. In Traditional Chinese Medicine (TCM), SLE patterns often include yin deficiency with heat and blood stasis; therapy aims to restore balance through individualized herbal formulas, acupuncture, and lifestyle measures. Ayurveda often views autoimmunity as arising from accumulation of “ama” (toxins) due to impaired digestive fire (agni), with treatments emphasizing anti‑inflammatory botanicals (e.g., turmeric), cleansing, and stress reduction (yoga, pranayama, meditation). Nutraceuticals from both traditions—curcumin, green tea catechins, and omega‑3 fatty acids—have been investigated to varying extents for anti‑inflammatory effects in SLE, with the strongest human data favoring omega‑3s and selected mind‑body interventions for quality of life and fatigue. Acupuncture has small but encouraging trials for pain and fatigue in SLE; meditation and cognitive-behavioral strategies reduce stress and may help mitigate flares, though evidence on flare reduction is still emerging.
An integrative plan keeps conventional immunosuppression central—v
Moderate Evidence
Women’s Health
Menopause represents a natural transition marked by declining ovarian follicular activity, fluctuating then falling estradiol and inhibin, and compensatory rises in FSH/LH. Clinically it spans perimenopause (irregular cycles with vasomotor, sleep, and mood changes) to postmenopause (12 months of amenorrhea). Symptoms cluster into vasomotor symptoms (VMS: hot flashes/night sweats), genitourinary syndrome of menopause (GSM: vaginal dryness, dyspareunia, urinary symptoms), mood and cognitive complaints, sleep disturbance, and weight/body composition changes. Long-term health considerations include accelerated bone loss and shifts in cardiometabolic risk.
Western medicine defines staging (e.g., STRAW+10), assesses symptom burden and risks, and individualizes therapy. Hormone therapy (HT) remains the most effective treatment for VMS and GSM and can help prevent bone loss. The contemporary interpretation of the Women’s Health Initiative (WHI) and subsequent analyses support the “timing hypothesis”: for most healthy women younger than 60 or within 10 years of menopause onset, benefits of appropriately selected HT generally outweigh risks, particularly with transdermal estradiol and micronized progesterone. HT is not indicated for primary prevention of cardiovascular disease, and risk assessment (breast cancer risk, VTE history, stroke risk, migraine with aura, liver disease) guides choice. Nonhormonal options have advanced: the neurokinin-3 receptor antagonist fezolinetant directly targets thermoregulatory dysfunction and reduces VMS frequency/severity; selective SSRIs/SNRIs (e.g., low-dose paroxetine, venlafaxine, desvenlafaxine, escitalopram) and gabapentin also help, especially when sleep is affected. For GSM, local vaginal estrogen, vaginal DHEA (prasterone), or the SERM ospemifene provide effective, often low-systemic-exposure relief. Bone health requires lifestyle, calcium/vitamin D adequacy, and when indicated, pharmacotherapy (bisphosphonates, denosumab, SERMs,
Well-Studied
Neurology
Migraine is a common, often disabling primary headache disorder characterized by recurrent attacks of moderate to severe head pain with sensory hypersensitivity (photophobia, phonophobia), nausea, and in some cases transient neurologic symptoms (aura). Diagnosis is clinical using ICHD-3 criteria, distinguishing episodic from chronic migraine (≥15 headache days/month for >3 months, with ≥8 days meeting migraine criteria). Western medicine emphasizes stratified acute therapy to rapidly abort attacks, preventive therapies to reduce monthly migraine days and severity, and identification of comorbidities and triggers (sleep disturbance, stress, hormonal shifts). Neurobiologically, migraine involves altered brainstem/trigeminovascular processing and neuropeptides (notably calcitonin gene-related peptide, CGRP). Over the last decade, migraine care has been transformed by targeted CGRP therapies and noninvasive neuromodulation devices alongside time-tested approaches (triptans, beta-blockers, topiramate, amitriptyline) and behavioral therapies.
Eastern and traditional systems conceptualize migraine through different frameworks. Traditional Chinese Medicine (TCM) uses pattern differentiation (e.g., liver yang rising, blood stasis, phlegm-dampness) and treats with acupuncture, herbal formulas, and lifestyle harmonization. Acupuncture for migraine prevention has among the strongest evidence bases of any complementary therapy, with reductions in attack frequency comparable to standard preventives and fewer adverse effects. Ayurveda frames migraine (Ardhavabhedaka/Sooryavarta) within doshic imbalance and employs cleansing and local therapies (nasya, shirolepa) along with diet and daily routines. Mind–body modalities such as biofeedback, progressive muscle relaxation (PMR), and yoga address stress reactivity and autonomic balance with randomized data supporting reduced frequency and disability. Nutraceuticals like magnesium and riboflavin bridge paradigms and have guideline-end0
Well-Studied
musculoskeletal
Osteoarthritis (OA) is the most common arthritis, driven by age, mechanical loading, prior injury, obesity, and genetics. It features progressive cartilage loss, subchondral bone changes, synovial activation, and periarticular muscle weakness. Patients typically report activity-related joint pain, stiffness (often <30 minutes in the morning), reduced function, and sometimes swelling or crepitus. Knees, hips, hands, and spine are most affected. Diagnosis is clinical, supported by radiographs showing joint-space narrowing, osteophytes, and sclerosis; MRI is rarely required for routine care.
Western management prioritizes nonpharmacologic strategies with the strongest, most consistent benefits across guidelines: education, exercise therapy (aerobic, strengthening, neuromuscular/balance), and weight reduction for those with overweight/obesity. Topical NSAIDs are recommended as first-line pharmacologic therapy for knee and hand OA, with oral NSAIDs used when needed and appropriate. Acetaminophen has diminishing evidence of benefit. Duloxetine can help chronic OA pain, particularly knee OA. Intra-articular corticosteroid injections offer short-term relief; hyaluronic acid remains controversial with mixed evidence. Platelet-rich plasma (PRP) injections are emerging but heterogeneous and not yet guideline-endorsed broadly. Joint replacement is highly effective for end-stage disease.
Eastern and traditional approaches conceptualize OA differently but often converge on movement-based and symptom-relieving therapies. In Traditional Chinese Medicine (TCM), OA commonly maps to Bi syndrome (painful obstruction) with patterns such as wind-cold-damp Bi, blood stasis, and kidney (shen) deficiency. Treatment may include acupuncture (including electroacupuncture and warm-needle techniques), moxibustion, topical herbal liniments (e.g., capsicum), tuina/manual therapy, and herbal formulas (e.g., Du Huo Ji Sheng Tang). Acupuncture for knee OA is among the best-studied TCM applications,
Well-Studied
Endocrine and Reproductive
Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic condition affecting 8–13% of reproductive-aged women and people assigned female at birth. It is characterized by a triad of ovulatory dysfunction, hyperandrogenism, and polycystic ovarian morphology and is strongly linked to insulin resistance, weight gain/obesity, dyslipidemia, and elevated cardiometabolic risk. Symptoms can include irregular or absent menses, infertility, acne, hirsutism, alopecia, weight gain or difficulty losing weight, and mood disturbances such as anxiety and depression. Long-term risks include type 2 diabetes, nonalcoholic fatty liver disease, endometrial hyperplasia/cancer (from chronic anovulation), and sleep apnea. Presentation varies by phenotype and across the life course; adolescents require careful diagnostic interpretation due to pubertal overlap with PCOS features.
Western medicine uses standardized criteria to diagnose PCOS after excluding other causes (e.g., thyroid disease, hyperprolactinemia, nonclassic congenital adrenal hyperplasia, androgen-secreting tumors). Management is goal-directed: restoring menstrual regularity and ovulation, addressing hyperandrogenic symptoms, optimizing metabolic health, preventing endometrial pathology, and supporting mental well-being. Lifestyle modification is first-line for nearly all, as modest weight loss (5–10%) and regular physical activity improve ovulation, insulin sensitivity, lipids, and quality of life. Pharmacologic therapies include combined oral contraceptives to regulate cycles and lower androgens when pregnancy is not desired; metformin to improve insulin resistance and metabolic outcomes (and sometimes cycle frequency); and antiandrogens such as spironolactone for hirsutism/acne (with reliable contraception). For those seeking pregnancy, letrozole is the preferred first-line ovulation induction agent and is superior to clomiphene for live birth. Dermatologic measures (eflornithine cream, laser/IPL hair reduction) can
Well-Studied
autoimmune/rheumatologic
Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune synovitis that, without timely control, leads to pain, progressive joint damage, disability, and increased cardiovascular risk. Western medicine defines RA by characteristic clinical patterns, serologic autoantibodies, and inflammatory markers, and prioritizes early, aggressive disease modification using a treat‑to‑target strategy. This approach, guided by rigorous randomized trials and international guidelines, has transformed outcomes—many patients can now achieve low disease activity or remission and preserve function.
Diagnosis in Western practice uses ACR/EULAR classification criteria that integrate joint involvement, rheumatoid factor (RF) and anti‑cyclic citrullinated peptide (anti‑CCP) antibodies, acute‑phase reactants (ESR/CRP), and symptom duration. Imaging (ultrasound/MRI) can detect subclinical synovitis and erosions early. Management begins promptly—ideally within weeks of symptom onset—because early window therapy improves long‑term trajectories. First‑line conventional synthetic disease‑modifying antirheumatic drugs (csDMARDs) include methotrexate (anchor), sulfasalazine, hydroxychloroquine, and leflunomide. If targets (remission/low disease activity) are not met, biologic DMARDs (e.g., TNF, IL‑6, T‑cell costimulation, anti‑CD20) or targeted synthetic JAK inhibitors are added or substituted, with iterative monitoring every 1–3 months and shared decision‑making. Short glucocorticoid courses are sometimes used as a bridge, while NSAIDs treat pain but do not alter disease course. Safety monitoring, vaccination, infection screening, and comorbidity risk reduction (e.g., cardiovascular prevention, bone health, smoking cessation, exercise, rehabilitation) are integral.
Eastern and traditional systems conceptualize RA differently but share aims of reducing pain, swelling, and functional limitations while preventing chronic deterioration. Traditional Chinese Medicine (TCM) frames RA within “Bi” (B
Moderate Evidence
Sleep disorders
Sleep apnea—most commonly obstructive sleep apnea (OSA)—is a disorder of recurrent upper‑airway collapse during sleep that leads to intermittent hypoxemia, fragmented sleep, and day‑to‑day symptoms (sleepiness, non‑restorative sleep, morning headache) along with long‑term cardiometabolic risks. Western medicine defines and stages OSA using polysomnography or home sleep apnea testing, quantifying the apnea‑hypopnea index (AHI): mild (5–14), moderate (15–29), and severe (≥30 events/hour), with diagnosis at AHI ≥15 or ≥5 with typical symptoms/comorbidities. Continuous positive airway pressure (CPAP) remains the gold standard therapy across severities because it pneumatically splints the airway, reliably normalizing respiratory events when used. Alternatives and adjuncts include mandibular advancement oral appliances, positional therapy, targeted surgeries (from uvulopalatopharyngoplasty to maxillomandibular advancement and hypoglossal nerve stimulation), weight reduction, and management of nasal obstruction. Evidence for cardiovascular event reduction with CPAP is nuanced: while it improves sleepiness and blood pressure, the large SAVE trial did not show fewer major cardiovascular events in largely non‑sleepy patients with suboptimal adherence, underscoring that benefits track with hours of nightly use. Weight management is a powerful disease modifier; intensive lifestyle programs and, more recently, anti‑obesity pharmacotherapy (for example, tirzepatide) can substantially reduce AHI, sometimes independent of CPAP.
Eastern and traditional perspectives frame OSA through different lenses but increasingly target similar mechanisms: collapsible airway, altered neuromuscular tone, and excess weight/kapha or phlegm‑damp accumulation. In Traditional Chinese Medicine (TCM), common patterns include phlegm‑dampness obstructing the oropharynx and spleen‑qi deficiency failing to transform fluids; treatment uses acupuncture (often with electroacupuncture) at local and systemic acu
Moderate Evidence
Sleep and Circadian Health
Sleep disorders encompass a broad set of conditions that disrupt sleep quality, timing, or duration, impairing daytime function. Common categories include insomnia disorder, obstructive sleep apnea (OSA), restless legs syndrome/periodic limb movement disorder (RLS/PLMD), narcolepsy and central hypersomnolence disorders, parasomnias, and circadian rhythm sleep-wake disorders. Western medicine relies on standardized diagnostic criteria (ICSD-3) and objective testing when indicated, and offers behavioral, circadian, device-based, and pharmacologic treatments. Among these, cognitive behavioral therapy for insomnia (CBT-I) is the gold-standard, first-line treatment for chronic insomnia. Pharmacologic options exist for select indications and short-term relief but carry important limitations. Circadian science underpins interventions such as timed light exposure and melatonin, which can be effective when precisely scheduled. Sleep studies (polysomnography, home sleep apnea testing, actigraphy, MSLT/MWT) help differentiate phenotypes and guide targeted care.
Eastern and traditional approaches frame sleep through distinct models. In Traditional Chinese Medicine (TCM), insomnia may reflect disharmony among organ systems (notably the Heart–Kidney axis) and disturbance of shen (mind/spirit). Acupuncture is commonly used and shows moderate, though heterogeneous, evidence for improving sleep quality and insomnia severity compared with waitlist or some active controls; evidence versus sham controls is mixed but trending favorable in newer reviews. TCM herbal strategies often include jujube seed (Suan Zao Ren) and formulae; broader Western herbal traditions use valerian and passionflower, and magnolia bark is sometimes included in stress/sleep formulations. The human evidence base for individual botanicals ranges from mixed (valerian) to emerging (passionflower, jujube seed, magnolia), with issues of standardization and study quality. In Ayurveda, healthy sleep (nidra) is a core
Well-Studied
Endocrine
Thyroid disorders encompass underactive thyroid (hypothyroidism), overactive thyroid (hyperthyroidism/thyrotoxicosis), structural changes (goiter, nodules), and autoimmune conditions (Hashimoto’s thyroiditis, Graves’ disease). Western medicine defines and monitors thyroid status biochemically—principally using TSH, free T4, and when indicated, total/free T3 and thyroid antibodies (anti-TPO, anti-thyroglobulin, and TSH receptor antibodies [TRAb]). Imaging (ultrasound) and functional tests (radioactive iodine uptake [RAIU]) help characterize nodules and distinguish causes of thyrotoxicosis. Treatment decisions weigh severity, etiology, symptoms, pregnancy status, age, and comorbid risk (cardiovascular, bone).
Hypothyroidism is most often autoimmune (Hashimoto’s) in iodine-sufficient regions. The gold standard treatment is levothyroxine (synthetic T4), titrated to normalize TSH and alleviate symptoms, with rechecks 6–8 weeks after dose changes and at steady state. Debate persists about adding liothyronine (T3) for persistent symptoms despite normalized TSH; current guidelines reserve combination therapy for carefully selected, monitored trials after ruling out other causes. Subclinical hypothyroidism (elevated TSH, normal FT4) management is individualized: treatment is favored when TSH ≥10 mIU/L, in pregnancy or infertility, with significant symptoms, goiter, positive TPO antibodies, or in younger patients planning conception; watchful waiting is often reasonable otherwise. Special attention to drug and nutrient interactions (iron, calcium, proton pump inhibitors, soy, high-fiber diets) and conditions that impair absorption (celiac disease, H. pylori, atrophic gastritis) is essential.
Hyperthyroidism most commonly arises from Graves’ disease, toxic multinodular goiter, or a toxic adenoma. First-line options include antithyroid drugs (methimazole; propylthiouracil [PTU] in the first trimester of pregnancy or for thyroid storm), radioactive iodine ablation, and thyroid
Well-Studied
