The Complete Natural Medicine Guide to Women's Health Sat D. Kaur, ND, Danylak-Arhanic M., MD, and Carolyn Dean, MD, ND. Toronto, Ontario, Canada: Robert Rose Inc; 477 pages, $22.95 (paperback).

The authors have undertaken an extremely ambitious endeavor with their book, The Complete Natural Medicine Guide to Women's Health. Although laypersons are the target audience for this book, health professionals may benefit from reading the text to facilitate communication about natural medicine during patient interactions. In just under 500 pages, the authors have summarized a vast array of information. The book is organized into 6 major "broad content" sections and concludes with a separate area for resources and references.

In section 1, the authors succinctly describe 11 different natural medical traditions including Native American medicine, Ayurvedic medicine, traditional Chinese medicine, conventional Western medicine, Naturopathic Medicine as well as others. The first section concludes with the naturopathic doctor's oath, which mirrors many of the principles followed by allopathic physicians such as "First, do no harm. Treat the whole person. Prevent disease. Educate the patient." The suggested 4 healing steps to optimum health (improve nutrition, restore balance, detoxify and rejuvenate, and integrate body, mind, and soul) make sense and are important in any tradition. In the preface the authors' advice could be misleading to readers in their comment, "If you have a serious illness, such as cancer, try to encompass all of the (4) healing steps-it is possible for you to become well if you do so."

In section 2, the authors propose a feasible plan by adding one recommendation from their comprehensive Women's Health Diet to the reader's diet each week. The women's health diet is thorough and much is supported by scientific evidence (low carbohydrates and lots of vegetables and fruits). The tables on glycemic index, phytochemical sources, fiber content, protein sources for vegetarians, and recommended daily supplements are useful. With rising numbers of women with osteoporosis, probably more emphasis should have been placed on the value of calcium and vitamin D.

Sections 3, 4, and 5 offer the reader unique and interesting information. Living With Nature's Rhythms, integrates health and wellness with biological cycles, hormonal balance, and aging. Restoring Harmony With the Earth's Elements, describes pertinent information about the impact of soil, water, air, and energy on health (such as chemical contaminants), and the impact of pollution on health. In section 5, the authors advise readers to consider Seasonal Cleansing and Rejuvenation Program.

The final section, section 6, on women's conditions, is probably the most clinically relevant component of the book. The authors incorporate a broad spectrum of information on natural medicine into this section with a fairly comprehensive list of specific women's health issues ranging from menstrual conditions to breast and cardiovascular health. The chapters flow easily and are packed with information on how to achieve the 4 healing steps. The authors use many content-laden tables and blank charts/sheets for the reader, which are instructive, accurate, and useful. The anecdotes throughout the text capture one's attention; however, they are anecdotes only-not the conclusive data which readers might expect from the credentials of the authors. There is evidence for and against the use of certain natural therapies that the authors have made no or limited mention. Although the authors note the findings from research articles throughout the text, they do not include any of these scientific articles in their selected reference section of the book. I find few comments on the known potential adverse effects of herbal medicines. For example, black cohosh has been found to be effective for hot flashes in menopause. However, black cohosh can cause nausea, headaches, and weight gain and has estrogenic properties, of which we have no idea of the long-term effects. Conversely, the authors make statements about adverse health effects of certain things such as cell phone use increases the risk of tumors in the head. This risk is quite controversial because there are a number of studies that suggest the claim is unfounded. The authors are clearly knowledgeable about natural medicine and they do not include information on herbal medicines that have been shown to have severe adverse effects, such as kava (which was heavily marketed as a sleep remedy until it was associated with liver toxicity). A useful Web site that the authors could have included is the National Institutes of Health Office of Dietary Supplements (http://ods.od.nih.gov/index.aspx).

One of the concerns about natural medicine is that much of it is not regulated. For example, herbal therapies are not monitored for purity; thus, the potential for contaminants such as lead, mercury, or arsenic exists. In addition, the authors suggest a variety of effective natural remedies to maintain wellness and to treat illness, yet they do not comment on costs. Natural therapies are often expensive and are infrequently covered by health insurance.

The book provides readers interested in alternative approaches to healthcare, with a thorough and practical review of this growing field. Whether most of these theories and therapies will stand the test of carefully controlled clinical trials remains to be seen. By reading this book, practicing health professionals could benefit by achieving a greater understanding of other health traditions as well as enhancing communication about natural medicine with their patients.

-Joslyn W. Fisher, MD, MPH, FACP

Assistant Professor of Medicine and Medical Ethics, Baylor College of Medicine, Houston, Texas