It is one of the cardinal principles of natural medicine that treatment should aim not only to treat illness but also to enhance wellness. According to this ideal, a proper course of treatment should improve your sense of general well-being, enhance your immunity to illness, raise your physical stamina, and increase mental alertness, as well as resolve the specific condition you took it for.
Unfortunately, while there can be little doubt that this is a laudable goal, it is easier to laud it than to achieve it. Conventional medicine tends to focus on treating diseases rather than increasing wellness, not as a matter of philosophical principle, but because it is easier to accomplish.
Probably the strongest force affecting wellness is genetics. Beyond that, common sense steps endorsed by all physicians include increasing exercise, reducing stress, improving diet, getting enough sleep, and living a life of moderation without bad habits, such as smoking or overeating.
Beyond this, however, it is difficult to make strong affirmations, and the optimum forms of diet and exercise and other aspects of lifestyle remain unclear. In fact, they may always remain unclear, as it is impossible to perform double-blind, placebo-controlled studies on most lifestyle habits. (For information on why such studies are irreplaceable see "Why Does This Database Depend on Double-blind Studies?")
In order to function at our best, we need good nutrition. However, the modern diet often fails to provide people with sufficient amounts of all the necessary nutrients. For this reason, use of a multivitamin/multimineral supplement might be expected to enhance overall health and well-being, and preliminary double-blind trials generally support this view.
For example, in one double-blind study, 80 healthy men between the ages of 18 and 42 were given either a multivitamin/mineral supplement or placebo and followed for 28 days.1 The results showed that use of the nutritional supplement improved several measures of well-being.
Furthermore, several, although not all, studies have found that multivitamin/multimineral supplements can improve immunity in older people.3-9 General nutritional supplements may also help improve response to stress.10
For more information, see the article on General Nutritional Support.
The herb Panax ginseng has an ancient reputation as a healthful “tonic.” According to a more modern concept developed in the former USSR, ginseng functions as an “adaptogen.”
This term is defined as follows: An adaptogen helps the body adapt to stresses of various kinds, whether heat, cold, exertion, trauma, sleep deprivation, toxic exposure, radiation, infection, or psychologic stress. In addition, an adaptogen causes no side effects, is effective in treating a wide variety of illnesses, and helps return an organism toward balance no matter what may have gone wrong.
From a modern scientific perspective, it is not truly clear that such things as adaptogens actually exist. However, there is some evidence that ginseng may satisfy some of the definition’s requirements.
Several studies have found that ginseng can improve the overall sense of well-being. For example, such benefits were seen in a 12-week, double-blind trial that evaluated the effects of Panax ginseng extract in 625 people.11 The average age of participants was just under 40 years old. Each participant received a multivitamin supplement daily, but for one set of participants, the multivitamin also contained ginseng. Level of well-being was measured by a set of 11 questions. The results showed that people taking the ginseng-containing supplement reported significant improvement compared to those taking the supplement without ginseng.
Similarly positive findings were reported in a double-blind, placebo-controlled study of 36 people newly diagnosed with diabetes.12 After 8 weeks, participants who had been taking 200 mg of ginseng daily reported improvements in mood, well-being, vigor, and psychophysical performance that were significant compared to the reports of control participants.
A 12-week, double-blind, placebo-controlled study of 120 people found that ginseng improved general well-being among women age 30-60 years old and men age 40-60 years old, but not among men age 30-39 years old.13 This finding is possibly consistent with the traditional theory that ginseng is more effective for older people.
Other results suggest this as well: a double-blind, placebo-controlled trial of 30 young people found marginal benefits at most,14 and a 60-day, double-blind, placebo-controlled trial of 83 adults in their mid-20s found no effect.15
In addition, ginseng has also shown some potential for enhancing immunity, mental function, and sports performance, all effects consistent with the adaptogen concept. For more information on these possibilities, as well as dosage and safety issues, see the full Ginseng article .
Besides Panax ginseng (discussed above), certain other herbs are regarded as adaptogens, including Eleutherococcus senticosus ( “Siberian” ginseng), Rhodiola rosacea, ashwagandha, astragalus, suma, schisandra, and the Asian mushrooms maitake, shiitake, and reishi. Meaningful supporting evidence for their benefits, however, is scant. In one of the better studies, a small double-blind, placebo-controlled trial of Rhodiola rosacea, the herb seemed to improve physical and mental performance and sense of well-being in students under stress.16
Although garlic is not generally regarded as an adaptogen, one study found that garlic powder (but not garlic oil) enhanced well-being.17 However, another study failed to find such benefits with garlic powder.25
"Green juices" made from such substances as spirulina and wheat grass are widely marketed for enhancing well-being. A double-blind study found that use of one such product improved general vitality, but so did placebo, and the differences between the outcomes in the two groups were marginal.26
Levels of the hormone Dehydroepiandrosterone (DHEA) naturally decrease with age, and for that reason DHEA supplements have been widely hyped as a kind of fountain of youth. However, at least 8 studies have found that DHEA supplementation does not improve mood or increase the general sense of well-being in older people.18-24,29
In some branches of alternative medicine, low levels of thyroid hormone are believed to be a common cause of impaired well-being. As part of this theory, it is said that the most commonly used medical form of thyroid replacement therapy (thyroxine, also called T4) is inadequate. Supposedly, better results are obtained when T4 is taken in combination with the thyroid hormone known as T3, often in the form of so-called "natural thyroid" extracted from animal thyroid glands. However, a double-blind study of 110 people designed to test this theory failed to find combined T3/T4 more effective than T4 alone.28
Practitioners and other proponents of yoga have long claimed that its gentle stretching exercises, special breathing techniques, and deep meditative states enhance overall health. However, to date, there is only limited evidence that yoga improves general wellbeing and quality of life.31,32
Numerous other alternative therapies are claimed by their proponents to improve overall wellness, including acupuncture, Ayurveda, chiropractic, detoxification, homeopathy, massage, naturopathy, osteopathic manipulation, Reiki, Tai Chi, Therapeutic Touch, traditional Chinese herbal medicine, and yoga. However, there is as yet little meaningful evidence to support these claims.
For a discussion of homeopathic approaches to general wellness, see the Homeopathy database .
1. Carroll D, Ring C, Suter M, et al. The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: a double-blind placebo-controlled trial. Psychopharmacology ( Berl). 2000;150:220-225.
2. Ussher JM, Dewberry C, Malson H, et al. The relationship between health related quality of life and dietary supplementation in British middle managers: a double blind placebo controlled study. Psychol Health. 1995;10:97-111.
3. Girodon F, Galan P, Monget AL, et al. Impact of trace elements and vitamin supplementation on immunity and infections in institutionalized elderly patients: a randomized controlled trial. Arch Intern Med. 1999;159:748-754.
4. Girodon F, Lombard M, Galan P, et al. Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial. Ann Nutr Metab. 1997;41:98-107.
5. Chandra RK, Puri S. Nutritional support improves antibody response to influenza virus vaccine in the elderly. Br Med J (Clin Res Ed). 1985;291:705-706.
6. Chandra RK. Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. Lancet. 1992;340:1124-1127.
7. Jain AL. Influence of vitamins and trace-elements on the incidence of respiratory infection in the elderly. Nutr Res. 2002;22:85-87.
8. Graat JM, Schouten EG, Kok FJ. Effect of daily vitamin E and multivitamin-mineral supplementation on acute respiratory tract infections in elderly persons: a randomized controlled trial. JAMA. 2002;288:715-721.
9. Bogden JD, Bendich A, Kemp FW, et al. Daily micronutrient supplements enhance delayed-hypersensitivity skin test responses in older people. Am J Clin Nutr. 1994;60:437-447.
10. Schlebusch L, Bosch BA, Polglase G, et al. A double-blind, placebo-controlled, double-centre study of the effects of an oral multivitamin-mineral combination on stress. S Afr Med J. 2000;90:1216-1223.
11. Caso Marasco A, Vargas Ruiz R, Salas Villagomez A, et al. Double-blind study of a multivitamin complex supplemented with ginseng extract. Drugs Exp Clin Res. 1996;22:323-329.
12. Sotaniemi EA, Haapakoski E, Rautio A. Ginseng therapy in non-insulin-dependent diabetic patients. Diabetes Care. 1995;18:1373-1375.
13. Forgo I, Kayasseh L, Staub JJ. Effect of a standardized ginseng extract on general well-being, reaction time, lung function and gonadal hormones [translated from German]. Med Welt. 1981;32:751-756.
14. Ellis JM, Reddy P. Effects of Panax ginseng on quality of life. Ann Pharmacother. 2002;36:375-379.
15. Cardinal BJ, Engels HJ. Ginseng does not enhance psychological well-being in healthy, young adults: results of a double-blind placebo-controlled, randomized clinical trial. J Am Diet Assoc. 2001;101:655-660.
16. Spasov AA, Wikman GK, Mandrikov VB, et al. A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of Rhodiola rosea SHR-5 extract on the fatigue of students caused by stress during an examination period with a repeated low-dose regimen. Phytomedicine. 2000;7:85-89.
17. Santos OS de A, Johns RA. Effects of garlic powder and garlic oil preparations on blood lipids, blood pressure and well-being. Br J Clin Res. 1995;6:91-100.
18. Wolf OT, Neumann O, Hellhammer DH, et al. Effects of a two-week physiological dehydroepiandrosterone substitution on cognitive performance and well-being in healthy elderly women and men. J Clin Endocrinol Metab. 1997;82:2363-2367.
19. Barnhart KT, Freeman E, Grisso JA, et al. The effect of dehydroepiandrosterone supplementation to symptomatic perimenopausal women on serum endocrine profiles, lipid parameters, and health-related quality of life. J Clin Endocrinol Metab. 1999;84:3896-3902.
20. Flynn MA, Weaver-Osterholtz D, Sharpe-Timms KL, et al. Dehydroepiandrosterone replacement in aging humans. J Clin Endocrinol Metab. 1999;84:1527-1533.
21. van Niekerk JK, Huppert FA, Herbert J. Salivary cortisol and DHEA: association with measures of cognition and well-being in normal older men, and effects of three months of DHEA supplementation. Psychoneuroendocrinology. 2001;26:591-612.
22. Kudielka BM, Hellhammer J, Hellhammer DH, et al. Sex differences in endocrine and psychological responses to psychosocial stress in healthy elderly subjects and the impact of a 2-week dehydroepiandrosterone treatment. J Clin Endocrinol Metab. 1998;83:1756-1761.
23. Arlt W, Callies F, Koehler I, et al. Dehydroepiandrosterone supplementation in healthy men with an age-related decline of dehydroepiandrosterone secretion. J Clin Endocrinol Metab. 2001;86:4686-4692.
24. Wolf OT, Naumann E, Hellhammer DH, et al. Effects of dehydroepiandrosterone replacement in elderly men on event-related potentials, memory, and well-being. J Gerontol. 1998;53:M385-M390.
25. Peleg A, Hershcovici T, Lipa R, et al. Effect of garlic on lipid profile and psychopathologic parameters in people with mild to moderate hypercholesterolemia. Isr Med Assoc J. 2003;5:637-640.
26. Boon H, Clitheroe J, Forte T. Effects of Greens+: a randomized, controlled trial. Can J Diet Pract Res. 2004;65:66-71.
27. Hvas AM, Juul S, Nexo E, et al. Vitamin B-12 treatment has limited effect on health-related quality of life among individuals with elevated plasma methylmalonic acid: a randomized placebo-controlled study. J Intern Med. 2003;253:146-152.
28. Walsh JP, Shiels L, Lim EM, et al.. Combined thyroxine/liothyronine treatment does not improve well-being, quality of life, or cognitive function compared to thyroxine alone: a randomized controlled trial in patients with primary hypothyroidism. J Clin Endocrinol Metab. 2003;88:4543-50.
29. Dayal M, Sammel MD, Zhao J, et al. Supplementation with DHEA: Effect on muscle size, strength, quality of life, and lipids. J Womens Health (Larchmt). 2005;14:391-400.
30. Rayman M, Thompson A, Warren-Perry M, et al. Impact of selenium on mood and quality of life: a randomized, controlled trial. Biol Psychiatry. 2005 Sep 19. [Epub ahead of print]
31. Oken BS, Zajdel D, Kishiyama S, et al. Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life. Altern Ther Health Med. 2006;12:40-47.
32. Kjellgren A, Bood SA, Axelsson K, et al. Wellness through a comprehensive Yogic breathing program—A controlled pilot trial. BMC Complement Altern Med. 2007 Dec 19.
Last reviewed December 2015 by EBSCO CAM Review Board
Last Updated: 12/15/2015
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