Hidden Rhythm Acupuncture in Tempe

Craig Amrine, L.Ac. is the owner of Hidden Rhythm Acupuncture in Tempe, Arizona and is a licensed acupuncturist and expert in cold-laser therapy.

Acupuncture in the Treatment of Type-2 Diabetes Mellitus

by: Craig Amrine

â??A Spoonful of Sugar Helps the Medicine Go Downâ?

While its a catchy phrase made popular in the Disney movie, â??Mary Poppinsâ?, it is now considered almost anathema in the modern medical community.  Along with a sedentary lifestyle, the consumption of sugar in the form of soda-pop, sports and energy drinks, even simple white breads play a large part in the meteoric rise in obesity among both children and adults.

This has become such a huge trend in the United States that an entire culture has grown along side it encouraging people to be more accepting of obesity and that itâ??s â??OK to be bigâ?.  The danger of such a trend is that it pointedly ignores the dangerous health risks of obesity; one of the biggest and most predominant being Diabetes.  This connection was confirmed in a recent study published in Science Daily in 2009.  Specifically, it proved how fat cells release a unique protein that causes liver and muscle cells to become de-sensitized to insulin(1).

So how big is the problem of diabetes in the United States?  According to the CDC (Center for Disease Control), 25.8 million people or 8.3 % of the population has diabetes.  In 2007, diabetes was the 7th leading cause of death according to the posted causes on death certificates.  Direct medical costs of diabetes in 2007 was $116 billion.   Total costs (direct and indirect) of diabetes in 2007 was $174 billion(2).

In this paper we will be discussing Diabetes and how acupuncture and Traditional Chinese Medicine can be used to treat it.  Before we do that, however, letâ??s get a better understanding of Diabetes.




The Two Types of Diabetes:

 Diabetes Insipidus is a rare condition where a lack of anti-diuretic hormone (ADH) also known as Vasopressin in the brain causes the kidneys to release excess water and results in extreme uncontrolled thirst. 

Diabetes Mellitus is a much more common disease indicating a higher-than-normal level of sugar (glucose) in the blood due to a disfunction of insulin.

In this article we will be focusing only on Diabetes Mellitus.   Before we go into Diabetes Mellitus in greater detail, letâ??s get a better understanding of the role of what happens when sugar enters our blood-stream. 

Sugar comes from many sources but eventually breaks down into itâ??s most simple form called glucose.  It is a critical ingredient in the Krebâ??s Cycle used to produce ATP (adenosine-triphosphate).  ATP is the fundamental energy unit used for practically all cellular processes.  This conversion from sugar into usable energy takes place within the cells.  Before it can do this, however, we need to get the glucose INTO the cells.

Sugar is transported into the cells with the help of a hormone called insulin.  Beta-cells in the pancreas release insulin into the blood and encourage adsorption of the glucose into cells (mostly muscle and fat cells).  It also directs the liver to convert and store excess sugar in the form of glycogen.  The intent of insulin is to LOWER blood sugar to a target level.

In times of greater need where our blood sugar runs low, alpha-cells of the pancreas secrete a hormone called glucagon.  Glucagon directs the liver to convert the stored sugar (glycogen) back into glucose where it can travel to the cells that need it.  The intent of glucagon is to INCREASE blood sugar to a target level.  If everything is functioning normally, there is an ideal balance where there is enough sugar in the blood to feed the cells and is adjusted by levels of insulin and glucagon.  Blood sugar levels are monitored in different ways.  An FBS test or â??fasting blood sugarâ? measures the amount of glucose in your blood after waiting at least 8 from your last meal.  Normal levels are around 70-99 milligrams per deciliter (3.9-5.5 mmol/L).  Levels of 126 or higher can indicate a problem.

The second test is the 2 hour postpradinal test where blood glucose levels are measured 2 hours after eating a meal.  Normal levels in this test are around 70-145 mg/dL (3.9-8.1 mmol/L).  Levels of 200 or higher can suggest a problem (3).

Diabetes Mellitus can be broken down into Type 1 and Type 2.  Type 1 indicates that a disfunction in the b-cells of the pancreas lead to problems producing enough insulin.  Diagnosis is typically made at an early age and is treated with supplemental insulin injections.

Type 2 also known as â??insulin resistantâ? diabetes indicates a problem where the cells do not respond to the released insulin.  Insulin is properly released by the pancreas, but for some reason it no longer facilitates the adsorption of glucose into the cells that need it.  Since the cells are now starving for glucose, they trigger the pancreas to release even greater amounts of insulin.  This results in abnormally high levels of both glucose AND insulin in the blood.

We will be focusing on this Type 2 version because it is the most common. 

Why does this happen?  What causes this insulin resistance?  The exact mechanism leading to insulin resistance is not very well understood, but several factors have been identified that can increase the risk of Type 2 Diabetes:

Genetics:  Certain cultures have been found to be more vulnerable to Type 2 Diabetes including African Americans, Native Americans, Hispanic Americans, and Japanese Americans.  Even among caucasian cultures, there are simply some people who are more pre-disposed to diabetes than others (3).

Lifestyle:  
High blood triglyceride (fat) levels
High blood pressure
High-fat diet
High alcohol intake
Smoking cigarettes
Sedentary lifestyle
Obesity or being overweight

Other factors that studies show increase insulin resistance include glucocorticoids (also known as cortisol), free fatty acids, and growth hormones.  Glucocorticoids (also known as cortisol) is a stress hormone that has been connected to a large number of health problems.  Free-fatty acids are byproducts when fat is broken down and released into the bloodstream.  Obese people, especially those high in belly-fat are at greater risk of releasing high-concentrations of these free-fatty acids (4).

While we cannot change our genetic make-up, we have complete control over our lifestyle choices.  Simply choosing to live healthier through exercise and moderate intakes of quality foods can not only lower risk of getting Type 2 Diabetes, they can actually REVERSE the progression of the disease (5).

So I have high blood sugar levels.  Whatâ??s the big deal? 

Aside from the fatigue resulting from cells craving sugar and not being able to get it, the high glucose concentrations in the blood can cause very serious health problems around the body.  A small representative of a very large list is shown below:

Eyes:  Damage to the retina.  This is called diabetic retinopathy and is the leading cause of blindness in the U.S.

Kidneys:  Thickening and scarring of the glomerulus (the filters in the kidneys) causing the whole filtering action of the kidneys to become impaired and eventually fail.

Nerves:  Nerve damage can lead to impaired healing responses.  The most common result are â??diabeticâ? ulcers on the feet and legs, often leading to amputations.

Atherosclerosis:  Higher chance of forming fatty plaques in the blood vessels.  This leads to higher chance of decreased circulation in the arms and legs (peripheral vascular disease), strokes, and heart attacks.

People may have diabetes for many years before they show enough symptoms to trigger an investigation and diagnosis.  Some of the more common symptoms, however include:  Fatigue, excessive weight-loss, excess thirst, excessive hunger, excessive urination, poor wound healing, lots of infections, blurry vision, and altered mental state (6).

High Insulin Levels:

Since this type of diabetes is considered â??insulin-resistantâ? diabetes, there is an abnormally high concentration of insulin in the blood along with the high glucose levels.  These high insulin levels can cause their own problems on the body.  Problems due to prolonged high insulin concentration include: increase in belly-fat, increase in blood pressure, increased chance of osteoporosis, increased risk of cancer, and increased levels of homocysteine which are associated with high risk of heart disease, stroke, and birth defects (7).  Of course, eventually, the pancreas can become depleted of insulin leading to insulin deficiency problems.

These wide-ranging effects reflect the complex relationship and influence that blood sugar and insulin levels have on our health.

Drugs to Treat Diabetes:

There are several types of medication used to treat diabetes.  The majority of these are designed to do one or more of the following:
Stimulate the release of insulin
Inhibit the release of glucose from the liver
Improve the cells sensitivity to insulin.
Slow the breakdown of starches and sugars to glucose.

Of course, the side-effects of these drugs can have their own risks.  Some of the more common reported side-effects include:
-Hypoglycemia (low blood sugar)
-Weight gain
-Nausea
-Headaches
-Upper respiratory tract infection
-Heart failure, attack, or stroke
-Liver disease
-Kidney damage (8)

What Can You Do to Avoid or Reduce Risk of Type 2 Diabetes?

Before relying on these drugs and their health risks, people can explore much safer (and cheaper) alternatives.  The combination of quality diet and exercise should be the absolute first line of defense in battling Type 2 diabetes. 

In regards to diet, we are not focusing on â??low-fatâ? diets.  Instead we urge people to cut back the amount of sugar they eat.  Aside from the classic sweets, sodas and energy drinks, sugar comes from the breads, pastas, corn, potatoes, and starchy foods that are such a huge part of the American diet.  These â??carbohydrate-richâ? foods are broken down very quickly into the simple sugars that trigger a big surge of insulin.  How quickly these break down into simple sugars like glucose is described in the term â??glycemic-indexâ?.  On a scale of 1-100, high values indicate the food that breaks down very quickly and causes a rapid rise in blood sugar (resulting in a rapid release of  insulin).  On this scale for example, raw glucose would have a value of 100.  In contrast, oatmeal has a score of 49.  A low number suggests that the food breaks down more slowly, leading to a much more gradual rise in blood sugar and a result, requiring much less insulin to be released from the pancreas (9). 

Charts showing the â??GIâ? number for common foods are easily found all over the web.  The goal is to avoid high GI foods (with a score above 70) and thus avoid the rapid rise in blood sugar and thus large insulin release.  

The goal to eating lower â??GIâ? foods (with a score below 55) is that we avoid the huge spikes of sugar and insulin response inherent in a high â??GIâ? diet.   Probably one of the most destructive diets is where a person skips breakfast, causing a lower-than normal blood sugar level, then splurges on a huge lunch full of the high â??GIâ? foods.  This results in a rapid jump in blood sugar and a massive surge of insulin.  The extreme yo-yo effect on blood sugar and insulin levels is thought to be one of the causes of Type 2 diabetes.

A Brief Comment on Blood Sugar Levels and Obesity.

â??The only real way to lose weight is to burn more calories than we intake.â?  Itâ??s a simple matter of reducing calories!â?.  This is an â??old-schoolâ? concept and is simply WRONG.  Naturopathic Doctors and Chinese medical doctors have discovered long ago that itâ??s not just calories that make people fat.  Itâ??s the form of the calories that is important.  Calories from fats, proteins, and carbohydrates affect the body differently.  Foods that trigger higher insulin releases (high glycemic-index foods) are more prone to cause obesity than lower glycemic-index foods.  So, the goal is to eat foods that cause slow and gradual changes in insulin levels rather than rapid changes (10).  Fortunately, this greater understanding of nutrition, weight loss, and insulin release is gaining a foothold across the entire medical community.

Exercise, Exercise...and... Exercise!!!

Letâ??s face it, working-out takes WORK.  Rigorous exercise  leaves you an exhausted and sweaty mess.  The physical and emotional health benefits are so extensive, however, that we cannot list them all in this article.  But what about its specific benefits regarding insulin and diabetes?  Studies show that even just one session of rigorous exercise can increase insulin sensitivity among patients for up to 16 hours (11)(12).
While the data is encouraging, it also suggests that there is definitely more going on than was first thought.  A wonderful paper discussing this mechanism(s) in greater detail can be found here (13).

The combined evidence describing how exercise increases insulin sensitivity along with the research suggesting how fatty tissue releases a protein that decreases insulin sensitivity supports the idea that the combination of exercise and weight loss can be a very powerful tool to combat Type-2 diabetes (14).

These studies are just a small sampling confirming how effective healthy living through good diet and rigorous exercise can control Type 2 diabetes.  But what if this simply isnâ??t enough?  Are there other tools that we can use to help?

Natural Medicine and Traditional Chinese Medicine offer several herbal solutions that have been clinically proven to have a strong effect on lowering blood sugar levels (15)(16). 
Since this article is focused on acupuncture, however, we are going to focus more on the effect of acupuncture on blood sugar levels and secondary symptoms of diabetes mellitus. 

How Does Traditional Chinese Medicine View Diabetes?

While diabetes is much less common in China when compared to the United States, it has been recognized for over 2000 years and was described in some of the earliest texts on TCM and acupuncture (15).

In terms of Traditional Chinese Medicine (TCM), we identify the disease by how the disease manifests.  In other words, we treat it based on what symptoms are present.
As weâ??ve already mentioned, some of the more common symptoms include excessive thirst (polydipsea), excessive hunger (polyphagia), and excessive urination (polyuria).

In TCM this is known as â??Xiao-keâ? or â??wasting thirstingâ? disease.  It is also known as â??Tang-niao-bingâ? or â??sugar urine illnessâ?.   We can then break this down into which area of the body is showing symptoms.  Upper Xiao-ke (excessive thirst) is attributed to a Lung Yin Deficiency.  Middle Xiao-ke (excessive hunger) is attributed to a combination of Stomach Heat and Stomach/Spleen Yin Deficiency.  Lower Xiao-ke is due to Kidney Yin Deficiency (17). 

While there are several clinically proven Chinese herbal solutions to address these issues, this article will focus on how acupuncture can help.

Since these excessive thirst, hunger, and urination problems are due to high blood sugar levels, we are going to discuss how acupuncture is proven to lower blood sugar levels.  We will also discuss how acupuncture can also help with diabetic neuropathy (pain in the extremities)

Several animal studies have confirmed that acupuncture and electro-acupuncture can lower blood sugar by increasing insulin sensitivity in artificially induced diabetic Type 2 rats (18).  It was concluded that increasing insulin sensitivity and lowering blood sugar levels using electro-acupuncture was done by lowering free-fatty acid concentration and recovering expression of insulin signaling protein (IRS1 and the glucose isoform protein (GLUT4) that are found in skeletal muscle cells.

Another study reported in a journal, â??Neuroscience Lettersâ?, concluded that electro-acupuncture increased  insulin sensitivity and thus glucose adsorption by additional mechanisms including the extra stimulation of acetylcholine (Ach) in the liver and nitric-oxide (NO).  These substances seem to play an additional role in reducing free-fatty acid concentration (19). 

Thatâ??s All Very Interesting if we are Treating Rats, But What About People?

Along with the numerous animal studies proving how acupuncture can lower sugar levels and increase insulin sensitivity, several trials have now shown how acupuncture can lower blood sugar levels (plasma glucose) levels in human patients with Type 2 diabetes mellitus.  This significant drop in blood sugar levels was more pronounced with increasing treatments.  After 3 months of treatment,  acupuncture caused a drop in blood sugar levels in both glucose fasting state  (8 hours after last meal) AND in the post prandial state ( 2 hours after last meal).   The average glucose fasting levels dropped from 146+/-9.7 down to 111+/-8.3.  The average post-prandial glucose levels dropped from 207+/- down to 155+/-8.7.

Interestingly, the study also looked at lipid profiles (cholesterol), and body-mass index (fat content).  After three months of acupuncture, the average Total cholesterol dropped from 158+/- 8.4 down to 140+/- 8.7.  HDL-cholesterol (the good kind) increased from 39+/-1.1 up to 43+/-2.7. while the LDL-cholesterol (the bad kind) decreased from 91+/-8.8 down to 76+/-7.3.

Lastly, the study showed that body mass index  (kg/m2) dropped from 26+/-0.89 down to 25+/-0.77.  To put it simply, the patients become less fat. (20).

While the blood-sugar lowering effects in humans are not completely understood, we assume that the models are similar to what was observed in rats; free-fatty acid levels decrease thus lowering insulin resistance.  This particular study was conducted with well-documented body acupuncture points known for their blood-sugar lowering (hypoglycemic) effects.  Most animal studies have shown that electro-acupuncture at 15 Hz gives a  stronger effect than non-electro acupuncture.  It would be interesting to see some human studies using electro-acupuncture rather than non-electro acupuncture to induce even stronger effects.  Is this one study a fluke?  Is this too good to be true?  The current research says no.  Based on recent literature reviews by the British Acupuncture Council (21), a study published in the American Journal of Chinese Medicine (22), and a report from the International Journal of Obesity(23) acupuncture has a significant influence in 1) Lowering blood sugar levels of Type-2 Diabetes patients, 2) Decreasing or eliminating diabetic neuropathy pain, 3) Lowering cholesterol levels 4) Decreasing free-fatty acid levels 5) Lowering body-mass index (obesity).

Diabetes in its several forms is a complex and very dangerous disease.  Several factors including genetics, diet, exercise, and stress all can influence the likelihood to get diabetes, especially Type 2 Diabetes Mellitus.   While itâ??s impact is growing at a frightening rate around the world, there is hope!  Simple life-style changes including diet and rigorous exercise have been clinically proven to stop and even reverse diabetes symptoms.  Now with acupuncture, however, we have another powerful tool proven to help with several factors of diabetes.   Itâ??s safe, inexpensive, and  most importantly, proven to work.


(1) http://www.sciencedaily.com/releases/2009/07/090708090917.htm

(2) http://www.cdc.gov/chronicdisease/resources/publications/AAG/ddt.htm

(3) Robert Ferry Jr., MD, Diabetes, EMedicineHealth, May 31, 2012 http://www.emedicinehealth.com/diabetes/page2_em.htm

(4) http://www.medicinenet.com/script/main/art.asp?articlekey=52045

(5) http://www.eurekalert.org/pub_releases/2006-01/aps-tds010606.php

(6) http://www.emedicinehealth.com/diabetes/article_em.htm

(7) http://www.healingdaily.com/detoxification-diet/insulin.htm

(8) https://www.mayoclinic.com/health/diabetes-treatment/DA00089

(9)  http://www.diabetesnet.com/food-diabetes/glycemic-index

(10) Robert Lustig, The Real Cause of Obesity, November 3 2011 11:22 http://www.dietdoctor.com/the-real-cause-of-obesity

(11) Borghouts LB, Keizer HA., Exercise and insulin sensitivity: a review Int J Sports Med. 2000 Jan;21(1):1-12. http://www.ncbi.nlm.nih.gov/pubmed/ 1068309

(12) Goodyear LJ, Kahn BB, Exercise, glucose transport, and insulin sensitivity, Annu Rev Med. 1998;49:235-61  http://www.ncbi.nlm.nih.gov/pubmed/9509261

(13) http://www.medscape.org/viewarticle/438372


(14) http://www.monash.edu.au/news/releases/show/1303


(15) Subhuti Dharmananda,TREATMENT OF DIABETES WITH CHINESE HERBS AND ACUPUNCTURE, INTERNET JOURNAL OF THE
INSTITUTE FOR TRADITIONAL MEDICINE AND PREVENTIVE HEALTH CARE, Jan 2003    http://www.itmonline.org/journal/arts/diabetes.htm

(16) John G. Connor, Diabetes,March 3, 2011 http://compassionateacupuncture.blogspot.com/2011/03/diabetes.html

(17) Maggie B. Covington, MD, Traditional Chinese Medicine in the Treatment of Diabetes, Diabetes Spectrum August 2001 vol. 14 no. 3 154-159
http://spectrum.diabetesjournals.org/content/14/3/154.full

(18) Rong-Tsung Lin, Chung-Yuh Tzeng, Yu-Chen Lee, Wai-Jane Ho, Juei-Tang Cheng Jaung-Geng Lin and Shih-Liang Chang* Acute effect of electroacupuncture at the Zusanli acupoints on decreasing insulin resistance as shown by lowering plasma free fatty acid levels in steroid-background male rats, BMC Complementary and Alternative Medicine 2009, 9:26 http:// www.biomedcentral.com/1472-6882/9/26


(19)  Rong-Tsung Lina, Ching-Yuan Chen, Chung-Yuh Tzeng, Yu-Chen Leee, Yu-Wen Cheng Ying-I Chen, Wai-Jane Hoh, Juei-Tang Chengi, Jaung-Geng Linâ??, Shih-
Liang Chang, Electroacupuncture improves glucose tolerance through cholinergic nerve and nitric oxide synthase effects in rats, Neuroscience Letters 494 (2011) 114â??118
http://ir.cmu.edu.tw/ir/bitstream/310903500/40315/1/20110510165925.pdf

(20) P. V. Ingle, N. R. Samdani, P. H. Patil, M. S. Pardeshi, S. J. Surana Application of Acupuncture Therapy in Type 2 Diabetes Mellitus Patients, Pharma Science Monitor Vol-2, Issue-1, 2011, http://www.pharmasm.com/pdf_files/02_ingle.pdf

(21)  http://karenjeffery-acupuncture.com/test/wp-content/uploads/2012/01/
Diabetes_type_2_July_2011.pdf

(22) Mehmet TugË?rul CabıogË?lu, Neyhan Ergene, Electroacupuncture Therapy for Weight Loss Reduces Serum Total Cholesterol, Triglycerides, and LDL Cholesterol Levels in Obese Women, The American Journal of Chinese Medicine, Vol. 33, No. 4, 525â??533
http://www.encognitive.com/files/Electroacupuncture%20Therapy%20for%20Weight %20Loss%20Reduces%20Serum%20Total%20Cholesterol,%20Triglycerides,%20and %20LDL%20Cholesterol%20Levels%20.pdf

(23)  Cho SH, Lee JS, Thabane L, Lee J.,Acupuncture for obesity: a systematic review and meta-analysis, Int J Obes (Lond). 2009 Feb;33(2):183-96. Epub 2009 Jan 13
http://www.ncbi.nlm.nih.gov/pubmed/19139756

Craig Amrine, L.Ac. is the owner and operator of Hidden Rhythm Acupuncture in Tempe, AZ and a leading authority of Cold Laser Therapy. He can reached through his website at www.hiddenrhythmacupuncture.com

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Acupuncture for the Treatment of Menopause

 

Men, please donâ??t read this article.  But if you do, I urge you for YOUR safety to keep your opinions to yourself and simply listen.   Every month we know know that our female friends, lovers, girlfriends, wives go through a temporary metamorphosis where they...change.  Women become extraordinarily moody, their ankles swell, and flannel pajamas or sweatpants become the accepted form of bedroom attire.  We are indeed talking about a womenâ??s menstrual cycle.

 

To put it simply, a womanâ??s menstrual cycle involves the building and ultimate shedding of the the endometrial lining of the uterus.  This coincides with the development and release of the egg from the ovaries.  All of this is dictated by a complex release of hormones that can have a wide range of physical and emotional effects on the body.  The first half of the menstrual cycle is called the follicular phase where a follicle containing an egg grows in the ovaries and the endometrium (lining of the uterus) begins to thicken.  This is spurred by (relatively) increased levels of FSH (follicle stimulating hormone) from the pituitary and estradiol (estrogen) from the ovaries.  After 14 days or so, the egg is released into the fallopian tubes from the follicle in the process called ovulation.  This is accompanied by a jump in luetenizing hormone from the pituitary and a surge in progesterone from several sources including the corpus luteum.  The corpus luteum is the residual follicle after it released the egg.  This second half of the cycle is called the luteal phase.  If conception has not occurred, the shedding of the endometrium (lining of the uterus) occurs at the end of this cycle and typically lasts for 5-7 days.  The overall levels of hormones are dictated by a complex feedback loop involving the hypothalamus (part of the brain), the pituitary gland, the adrenal glands, and the ovaries.  Upsetting one of these levels can have dramatic side-effects

 

Yes, this is a very simplified version of the menstrual cycle.  Entire books and university courses are written on this subject and the problems that can arise.  So, if you want more detail, please refer to books and articles specifically written on this topic.

 

Acupuncture and Traditional Chinese Medicine have become extremely well established and proven in their role to increase fertility, induce labor, and increase libido, but what can acupuncture do when the menstrual cycle stops?  Yes, itâ??s a natural process that virtually all women will go through and is not itself considered a health issue.  The problem is that the ending of the menstrual cycle can lead to a large number of secondary symptoms.  These symptoms may vary greatly and can include hot flashes, night sweats, insomnia, loss of libido, depression, and osteoporosis.  While hot-flashes may appear simply inconvenient or embarrassing, osteoporosis can be much more serious and lead to higher chance of bone fractures.

 

What is Menopause?

 

Menopause can simply be defined as the loss of a menstrual period.  Specifically, itâ??s the cessation of the menstrual period for at least one year.  It usually happens between the ages of 49-51 for most women.    This is due to the fact that women are born with a limited supply of ovarian follicles (precursor to eggs).  Over time, the follicles are lost through ovulation or they simply die off.  The decrease in activity within ovaries coincides with a decrease in the release of ovarian estrogen.   Since estrogen levels are part of the complex feedback loop mentioned earlier, the brain  gets confused, resulting in the release of abnormally high levels of FSH (follicle stimulating hormone) and LH (lutenizing hormone).  Physicians will often use these high levels of FSH and LH as chemical markers to gauge the health and longevity of a womenâ??s ovaries.  In addition, levels of progesterone, testosterone, and androstenedione also dramatically change^1,2.

 

So whatâ??s the big deal?  Itâ??s a process that virtually every woman will undergo, sooner or later.  Unfortunately,  these changes in hormone levels can result in several side-effects; some are simply inconvenient while others can be more serious.  Side-effects can include: Hot flashes, night sweats, heart palpitations, vaginal dryness or itching, insomnia, irritability, anxiety, depression, loss of libido, and loss of bone density (osteoporosis).  The severity of symptoms can greatly vary based on life-style and hereditary factors².

 

Why is Menopause a Problem?

 

The two most common concerns are hot-flashes and osteoporosis.  Hot flashes are thought to be the result of problems with the temperature regulatory centers in the hypothalamus (part of the brain).  These centers control vasodilation/vasoconstriction (opening or closing of blood vessels) and sweating.  A loss of circulating estrogen is thought to cause problems with this temperature feedback loop, leading to periodic and and intense flashes of heat and sweating².

 

Osteoporosis (bone-loss) is defined as a loss of bone-density that often accompanies menopause.  It is thought to be due to the decrease in estrogen.  Estrogen effectively mediates or controls  the activity of specific cells designed to break down bone.  The cells called osteoclasts are designed to break down bone to allow more calcium into the blood.  These osteoclasts take their orders from chemical messengers called cytokines (IL-1, IL-6, and TNF).  A drop in estrogen seems to cause an increase in concentration of these osteoclasts because it is no longer there to mediate these cytokines, resulting in higher cytokine concentration, and ultimately more osteoclasts ¹⁴.

 

Treatments For Menopause

 

The conventional treatment methods include hormone replacement therapy, antidepressants, blood pressure medication, bisphosphonates, and even anti-seizure medications such as Gabapentin.  These drugs have been found to reduce hot-flashes and even prevent or reduce bone-loss.  The problem with virtually all of these conventional therapies is the risk of very serious side-effects.  For example, hormone replacement therapy has been proven to be linked to higher rates of breast cancer, heart attacks, and strokes³.

 

Alternative herbal therapies including phytoestrogens (substances that ACT like estrogen on estrogen receptors in the body) such as isoflavones in Soy, along with herbs such as black cohosh have been proven to help with menopausal symptoms including hot flashes.  However, they are not perfect because they may have their own potential side-effects.  For example, black cohosh can possibly cause headaches, rashes, possible weight gains, and vaginal spotting ^7,8.  Some believe it may increase chance of liver damage, but more evidence is needed to substantiate this. 

 

The loss of bone density (osteoporosis) due to menopause has spurred itâ??s own category of drugs such as bisphophonates (Fosamax, Boniva).   These drugs are designed to slow down the rate of bone thinning and even increase bone density. 

 

Ironically, these drugs have several very serious side-effects.  The most serious  being that they stunt the formation of new osteophytes (cells designed to create new bone).  This leads to osteonecrosis, or â??rotting of boneâ?.  There are SEVERAL thousands of lawsuits alleging these drugs cause â??Dead Jawâ? syndrome where the jaw fails to heal after common dental procedures including extractions, root canals, and crowns.  This can often lead to jaw infections, and severe disfigurement ^4,5.  The FDA has recently also issued a warning that these types of drugs increase the chance of femoral fractures (broken leg)⁵.  Despite the increasing evidence against this drug, it continues to be marketed very heavily and is still prescribed by doctors.  Other side-effects have been reported including stomach problems, rashes, difficulty breathing, back pain, muscle pain, joint pains, digestive problems, headaches, upper respiratory infections, bronchitis, urinary tract infections, and high cholesterol ⁶.  So, if you are thinking of or are already taking these drugs to fight osteoporosis, STOP!

 

So What are your options?

 

In general, the more natural herbal of botanical alternatives to hormones have much less severe side-effects than conventional drug therapies, but as described above, side-effects do indeed exist.  If women were seeking an herbal solution, Iâ??d recommend either a Chinese herbalist or a Naturopathic Doctor.

 

Itâ??s also well documented that exercise and weight training can reverse bone-loss due to osteoporosis ¹⁷.

 

Menopause from a Traditional Chinese Medical Perspective

 

Before we look at how Traditional Chinese Medicine (TCM) and acupuncture can treat menopause symptoms, letâ??s discuss how menopause is viewed in TCM.   Keep in mind this is a very basic description in TCM terms and is not designed to be a full lecture on TCM theory.  Suffice it to say that TCM considers menopause the result of a decline in the vital substance known as â??Jingâ? (Essence).   Stored in the kidneys, Essence is responsible for growth, development, maturity, and our overall constitutional vitality.  It is also considered a precursor to all the other vital substances (Qi, Blood, Shen, etc.).   We are born with a limited supply that cannot be recovered once it is gone.  However, it can be â??fortifiedâ? and nourished a bit through exercises such as Tai-Chi and Qi-Gong.  It is the underlying foundation for hormone production, bone growth, and reproductive health.  According to the classic TCM literature, the growth, maturation, and decline of Jing takes place in 7 year cycles for women (and 8 year cycles for men).  At the 7th cycle (age 49), the Jing declines and womenâ??s menstrual cycle stops ¹. 

 

At the heart of TCM lies the very basic concept that good mental and physical health relies on the balance of Yin and Yang within the body.  Yin is considered the substantial; the â??stuffâ? that circulates within the body and has a cooling nature.  Yang is considered the function or energy used to circulate the â??stuffâ? and has a warming nature.  At menopause the Yin/Yang balance is dramatically upset due to a corresponding decline in Kidney Yin (estrogen).  Without the cooling nature of Yin, the warm nature of Yang will dominate, giving rise to warmth as seen in hot-flashes.

 

As we mentioned earlier, Jing/Essence dictates bone growth.  According to TCM, the Kidneys also play a role in bone growth and development.  A weakening of the Kidneys and decline in Jing that inevitably come with aging will eventually lead to problems with bone growth and repair, eventually leading to bone-thinning.  In Western terms, this manifests as osteoporosis.  

 

Kidneys control bone growth?  On the surface, anyone with at least a rudimentary understanding of anatomy could say that TCM was way off in this regard.  If you begin to think about it, however, maybe they were a bit closer to the truth.  We know that part of the  calcium adsorption/excretion process takes place in the Kidneys.   We also know that the adrenal glands sit on top of the kidneys and play a huge role in hormone production responsible for all stages of growth and development.  Historically speaking, TCM viewed the adrenal glands as part of the kidneys.  Itâ??s fascinating that over 2000 years ago, Chinese physicians already knew that this kidney/adrenal region was strongly connected to growth/development/sexual development and overall vitality.

 

So What can Acupuncture Really Do? 

 

Previous articles Iâ??ve written cited several studies describing how acupuncture can have profound effects on hormones, neurotransmitters, and cytokines in emotional, immune, and inflammatory processes (see â??published articlesâ? page on my website).  We now know that this influence also affects those hormones and cytokines responsible for womenâ??s health and menopause.

 

Acupuncture and Hot Flashes

 

Several studies have shown that acupuncture can significantly lower hot-flash symptoms.  A recent study specifically measured both hormone levels and menopause symptoms as described in the MRS (Menopause Rating Scale) before and after several weeks of acupuncture.  The results were compared to a â??Shamâ? group that received acupuncture in non-related body points.  The results suggested that hot-flashes were significantly lower in the group treated at â??Realâ? acupuncture points.  Interestingly, LH (luetenizing hormone) levels were lower while estrogen levels were markedly higher after acupuncture in the â??Realâ? acupuncture group ¹⁰.

 

Another study compared acupuncture versus Venlafaxine (Effexor) for treatment of hot-flashes (vaso-motor symptoms) and depressive and quality-of-life symptoms of menopausal women.  This study was interesting because it was conducted on women who were survivors of breast cancer.  It is commonly understood that women whoâ??ve already had breast cancer are especially vulnerable to hormone-replacement therapy because it can increase the cancer returning.  As a result, the common solution is to prescribe them Venlafaxine (Effexor).  Effexor has been proven to lower menopause based hot-flashes.  It is a common anti-depressant, however,  with a large list of negative side-effects common to all selective seratonin-reuptake-inhibitors (SSRIâ??s).

 

The study clearly demonstrated that acupuncture was AT LEAST as effective in reducing hot-flashes as Effexor in these patients with breast cancer.  The group receiving acupuncture also noted marked improvements in anxiety, depression, and even an increased sex-drive as compared to the patients taking Effexor ⁹.  In a follow-up analysis one full year after the completion of treatments, hot-flash frequency was still significantly lower in the acupuncture group compared to the Effexor group.  In addition, none of the patients in the acupuncture group experienced several of the negative side-effects reported in the Effexor group including dry-mouth, decreased appetite, nausea, and constipation.

 

Acupuncture and Osteoporosis

 

Acupuncture reduces hot-flashes.  Patients swear by it.  Studies confirm it.  But what about more serious consequences of menopause such as osteoporosis?  While hot-flashes can be inconvenient, loss of bone density leading to fractures is much more serious.  Can acupuncture really stop bone loss or possibly increase bone density?  The answer is YES!  Several studies have been performed on both animals and humans measuring bone density before and after several acupuncture treatments.  The results have uniformly demonstrated that acupuncture increases bone density on post-menopausal patients^{11,12,13, 15, 16}. 

 

So how does it do this?  Earlier in this paper we briefly describe how a chemical messenger called Interleukin-6 (IL-6) has a relationship with cells designed specifically to break down bone to allow calcium to re-enter the blood stream¹⁴.  Acupuncture has already been proven to have a strong effect on IL-6 based on several studies where it lowers IL-6 levels in inflammatory-based conditions ¹⁹.  It now also appears to influence the IL-6 level and itâ??s control over bone dissolving cells.   One particular study looked at this specific relationship by measuring both the levels of IL-6 and myelogenic osteoclasts (cells that break down bone).  This particular study showed a significant decrease in the amount of IL-6 and osteoclasts in patients treated with acupuncture compared to a control group ¹³. 

 

Other Natural Solutions ?

 

Based on these studies, acupuncture is proven to have a strong effect in reducing menopause symptoms including hot-flashes and osteoporosis.  Is there anything else you can do?  As mentioned earlier in this article, there are herbal remedies such as black cohosh that are shown to reduce hot-flashes ^7,8.  Although they are considered â??naturalâ?, they are not completely harmless and I would highly recommend the guidance of a Naturopathic Doctor to discuss both the dose and any possible side-effects of herbal remedies.

 

To help fight osteoporosis, calcium and vitamin supplements are usually recommended.   Up to 1200 to 1500 mg is recommended daily for menopausal women.  Dairy and dark green vegetables are good sources of calcium.  Supplements of Calcium and vitamin D are also good sources.  While calcium carbonate is the most common and cheapest, it is the least easily adsorbed.  I recommend calcium citrate or calcium malate.  While being slightly more expensive, they are more easily adsorbed ¹⁸ . 

 

Probably one of the absolute least expensive way to fight and even reverse bone-loss is through weight training.  Various studies have proven that regular strength-training in post menopausal  women for at least 1 year can increase bone mass from 1 to 9 percent ^7,17. Yes, this regiment does take work, but there are zero side-effects and itâ??s cheap!

 

 

Summary

 

Women who are going or will be going through menopause no longer have to suffer, or anticipate this change with dread.  There are several natural, safe, and effective options including acupuncture to reduce symptoms of menopause.  Acupuncture has been repeatedly proven to lower both intensity of hot-flashes and reverse the effects of osteoporosis.  Itâ??s inexpensive, safe, and proven to work.

 

 

Sources

 

1 Maryanne Travaglione, Menopausal Hot Flashes: A Case Report, Oriental Medicine-A Publication of Pacific College of Oriental Medicine, Spring 2011

 

2 http://en.wikipedia.org/wiki/Menopause

 

3 http://www.cancer.org/cancer/cancercauses/othercarcinogens/medicaltreatments/menopausal-hormone-replacement-therapy-and-cancer-risk

 

4 http://www.webmd.com/drugs/drug-95102-Boniva+IV.aspx

 

5 http://www.fda-reports.com/fosamax/class-action-boniva.html

 

6 http://www.rxlist.com/boniva-drug.htm

 

7 http://www.webmd.com/menopause/guide/8-natural-ways-to-ease-menopause-symptoms

 

8 http://www.webmd.com/vitamins-supplements/ingredientmono-857-black%20cohosh.aspx?activeIngredientId=857&activeIngredientName=black%20cohosh

 

9 Eleanor M. Walker, Alba I. Rodriguez, Beth Kohn, Ronald M. Ball, Jan Pegg, Jeffrey R. Pocock, Ramon Nunez, Ed Peterson, Susan Jakary and Robert A. Levine, Acupuncture Versus Venlafaxine for the Management of Vasomotor Symptoms in Patients With Hormone Receptorâ??Positive Breast Cancer: A Randomized Controlled Trial:  JCO (Journal of Critical Oncology) February 1, 2010 vol. 28 no. 4 634-640

 

10 Didem Sunay, Muruvvet Ozdiken, Huseyin Arslan, Ali Seven, Yalcin Aral,

The Effect of Acupuncture on Postmenopausal Symptoms and Reproductive Hormones: A Sham Controlled Clinical Trial: Acupunct Med (Acupuncture in Medicine) 2011;29:27-31 doi:10.1136/aim.2010.003285

 

11 Zhao LH, Nong ZN, Zhong X, Pang Y, Liang JS, Li XD, Ye FW, Effects of warm needle moxibustion on bone mass density and biochemical indexes of bone metabolism in patients of postmenopausal osteoporosis: Zhongguo Zhen Jiu. 2008 Dec;28(12):897-900,Department of Acupuncture, The First Affiliated Hospital of Guangxi University of TCM, Nanning 530023, China. zhaolh@21cn.com

 

12 Ou-yang, Gang et al, The Influence of Acupuncture on Postmenopausal Female Bone Density, Zhong Yi Za Zhi (Journal of Chinese Medicine), #2, 2001, p. 88

13 Liu X, Shen L, Wu M, Wu B, Gao L, Hu W, Zhang A, Effects of acupuncture on myelogenic osteoclastogenesis and IL-6 mRNA expression, J Tradit Chin Med. 2004 Jun;24(2):144-8.

 

14 Roberto Pacifici, Editorial: Cytokines, Estrogen, and Postmenopausal Osteoporosisâ??The Second Decade, Endocrinology,  June 1, 1998 vol. 139 no. 6 2659-266

 

15 Ma J, Yun-guang H, Zhang DH.Effects of acupuncture on bone metabolism and serum estradiol level in ovariectomy-induced osteoporosis rats, Zhen Ci Yan Jiu. 2008 Aug;33(4):235-9: College of Acu-moxibustion & Massage, Chengdu University of Chinese Medicine, Chengdu 610075, China. doctor_majie@126.com

 

16 Wei YF, Liu YL, Zhang SH, Wang ZO, Liu Y, Wang HC, Yao JF, Li F, Wang CH

Effect of electroacupuncture on plasma estrin and bone mineral density in ovariectomized rats: Zhen Ci Yan Jiu. 2007 Feb;32(1):38-41:  Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China. weiyufang80101@163.com

 

17 Dani Veracity, Bone density sharply enhanced by weight training, even in the elderly, August 06, 2005, http://www.naturalnews.com/010528.html

 

18 http://www.med.umich.edu/1libr/guides/calcium.htm

 

19 Yun-Kyoung Yim1, Hyun Lee2, Kwon-Eui Hong2, Young-Il Kim2, Byung-Ryul Lee2, Chang-Gue Son3 and Jung-Eun Kim1, Electro-acupuncture at acupoint ST36 reduces inflammation and regulates immune activity in Collagen-Induced Arthritic Mice, 1Department of Meridian and Acupoint, 2Department of Acupuncture and Moxibustion and 3East-West Cancer Center of Dunsan Hospital, College of Oriental Medicine, Daejeon university, South Korea, Advance Access Publication 18 August 2006

Craig Amrine, L.Ac. is the owner and operator of Hidden Rhythm Acupuncture, LLC and is a leading authority of Cold Laser Therapy in the Phoenix area.  He can be reached through his website at www.HiddenRhythmAcupuncture.com

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If you've followed my blog posts through the past year, you may have realized how truly versatile and effective Cold Laser Therapy can be for a wide variety of health problems.  We've seen several cases and studies proving how cold-laser therapy can reduce inflammation, control thyroid problems, reduce pain, and accelerate tissue repair including skin, cartilage, and bone.

While we've already proven that Acupuncture can increase athletic performance, a recent study showed how cold laser therapy can increase athletic performance!  The study highlighted in this article HERE showed cold laser therapy treatments increased muscle strength.  Specifically, 36 healthy men were divided into three groups.  The first group (Control) did not exercise at all and received no laser treatment.  The second group involved training in series of Leg-Press exercises over a series of 12 weeks.  The third group involved the same Leg-Press training regime but also received cold-laser therapy on the quadriceps of both legs after each training session.  Cold Laser therapy was done for 140 seconds at 808 nm and 360 mW power. Overall strength was measured  both using a leg-press machine and an isokinetic dynamometry test.

The results were surprising!!  The Group 2  involved in strength training only increased Leg-Press strength by 26% compared to the control group.  No change was detectable in the isokinetic dynamometry test.  Group 3 that received strength training AND cold-laser therapy after each session showed an amazing 55% increase in Leg-Press strength!  Group 3 also showed a marked increase in strength according to the isokinetic dynamometry test.

These results are incredibly encouraging suggesting that cold-laser therapy is not just for the injured!  Athletes take note!  You now have a new safe and effective option for helping increase muscle performance!

Cortisone:  The “other” big C.  It is a common household word.  Nearly all of us have been treated or know someone who has been treated with corticosteroids for some form of inflammation or inflammatory disease.  It is given in one of four forms:

Oral:  Pill, tablet, or syrup.  It is often taken in this form for chronic or systemic problems including Rheumatoid Arthritis and Lupus.  Example = Prednisone

Topical:  Creams and ointments are applied to the skin to treat allergic reactions and surface conditions to relieve itching and irritation.  They can greatly range in potency. Example = Hydrocortisone

 Inhaler or Intranasal Spray:  This form is used to treat asthma and allergic reactions that affect the lungs. Example = budesonide (Pulmicort)

 Injection:  Injecting directly into a joint to reduce inflammation such as tendinitis.  This is a very common technique to treat knee, shoulder, neck, and back-pain.  Example = Celestone

What is Cortisone?

Cortisone falls under the family of chemicals known as corticosteroids.  In it’s natural form (cortisol), it is produced by the adrenal glands located on top of the kidneys.  Cortisol is released in higher amounts in times of stress as part of our “fight-or-flight” response. 

In the short-term, it’s benefits were designed to increase our chance of survival in case of a life-threatening attack.  Chronic high-stress situations, however, produce high levels of cortisol over extended periods of time that can have harmful side-effects; one of which is lowering the immune and inflammatory response.1,2  Doctors have discovered that controlled dosages of corticosteroids can suppress inflammation and consequently relieve symptoms associated with pain due to inflammation.  The idea is that if inflammation can be reduced, pain can be controlled, proper blood flow can be restored, and healing can flourish.  This has become so popular a treatment method that nearly all of us has been treated with corticosteroids in one form another. So, what’s the problem?  Why do some doctors limit the number of treatments?  Before we discuss the health-risks of cortisone or similar products, let’s explore the concept of inflammation.

What is Inflammation? 

Inflammation, or the “inflammatory response” is a natural reaction to trauma or injury.  It is an integral part of the immune response that takes place to heal wounds and fight infection and disease. It’s also involved, however, in a large variety of problems ranging from mosquito bites to asthma to auto-immune diseases like Rheumatoid Arthritis.  So, it’s a double-edged sword.  On one hand, it is critical in wound healing, but un-regulated or “out-of-control” inflammation can contribute to serious health problems including cancer, heart disease, asthma, and auto-immune diseases.

The inflammatory response is part of a complex process involving the release of several types of white blood cells, macrophages, and associated chemicals to both heal damaged tissue and fight off foreign invaders 3,4.  For purposes of this article however, we will ONLY discuss inflammation as part of the wound-healing process resulting from injury. 

The normal cycle of healing involves three phases: I-inflammation phase, II-Proliferative Phase, and III-Remodeling Phase.  Unfortunately, the process can sometimes get stuck in the Inflammation Phase, especially in sports injuries. 

When cells are damaged, they trigger the release of chemicals that increase permeability of the blood vessels near the damaged site and initially cause various types of macrophages and white blood cells (leukocytes) to leave the blood vessels and enter the intra-cellular tissue around the damaged area to both fight off foreign invaders, consume cellular debris, and trigger additional steps of the healing response.  Messengers that act as communication between these different leukocytes and mast cells are a group of proteins called Interleukins.  These messengers are responsible for controlling cellular differentiation and proliferation, inflammation, and histamine release4.  Some of these interleukins are considered “pro-inflammatory” while others are considered “anti-inflammatory”.  Ultimately, The large number of interleukins (at least 35 types) highlight the vast complexity of the immune system 5,6,7.

 So how can this inflammatory response cause problems in healing and lead to joint pain?  As we’ve already mentioned, the immune response triggers capillaries to become more “leaky” and result in a profusion of neutrophils and platelets into the tissue outside the blood vessels.  As this process continues, both vasoconstrictive signals from the leukocytes and simple pressure can dramatically compress tissue and surrounding nerves, and restrict local blood flow; blood flow that is critical for the additional tissue repair process.

Now, we can talk about cortisone treatments in a more educated light.  As we mentioned, corticosteroids can suppress the immune response and thus decrease inflammation and associated inflammatory pain.  It is thought that it prevents neutrophils and monocytes (types of leukocytes) from populating the inflammatory area8. It also lowers the concentration lymphocytes, monocytes, and eosinophils; all subtypes of white blood cells that are critical in the immune and inflammatory response9. 
 
By inhibiting access of these immune cells and associated proteins to the injury site, inflammation is blocked, pain is reduced, and healing can continue.  On the surface, this sounds like a great idea with several years of apparent success in the use of corticosteroids to treat inflammation and joint pain.  Millions of americans have been prescribed steroids to “help” with their pain and discomfort.  It has become such a common treatment that few patients even question the health risks of cortisone shots, nor do physicians discuss the full list of side-effects caused by steroids.

As we’ve already mentioned corticosteroids are the byproduct of the Stress Response.  While increasing the chance of survival from an immediate threat, it has a negative impact on our health during prolonged stress states2.

These side-effects are present regardless whether it’s taken in oral form for systemic inflammation or injected at a very small amount to a local area.  As the history and understanding or cortisone grow, so do the list of negative side-effects.  While cortisone in it’s many forms has several negative side-effects throughout the body14, we will focus primarily on cortisone shots for treating joint pain and inflammation.  A brief summary of the side-effects of cortisone shots are shown below:  (as listed on the Mayo Clinic Website:  Cortisone Shot Risks10)

    •    Death of nearby bone (osteonecrosis)
    •    Joint infection
    •    Nerve damage
    •    Skin thinning around injection site
    •    Temporary flare of pain and inflammation in the joint
    •    Tendon weakening or rupture
    •    Thinning of nearby bone (osteoporosis)
    •    Whitening or lightening of the skin around injection site

What is exactly happening at the injection site?
 
Cortisone inhibits chondrocyte production and the proteins, collagen and proteoglycans that are the building blocks for cartilage and joint repair.  This means that cortisone injections actually PREVENT cartilage and joint repair.  It is also found to weaken ligaments and tendons surrounding the injection site.  A decrease in angiogenesis (new blood vessel formation) in the injection area has also been noted11.

A study on cortisone injections in horses revealed that after only ONE cortisone injection, researchers noted chondrocyte necrosis (death of cells designed to repair cartilage), a dramatic decrease in the number of new chondrocytes, and a decrease in proteoglycan content and synthesis.  This damage to the joint was still present 16 weeks after the single injection12.

What about cortisone for athletes?  I often see patients who have received care and cortisone shots from one of the official doctors of the professional sports teams.  These doctors are supposed to be the experts on fixing athletes...right?  If their treatment and medical care is good enough for professional athletes, it’s good enough for my patients!  The problem with this assumption is that many (but not all, of course) sports physicians are concerned with short-term results only.  Their goal is to get the athlete back on the field as quickly as possible.  While the athlete may not feel pain for a few weeks or months following cortisone injections, the long-term effects are devastating.

Can exercise help?  A study at the Washington University School of Medicine in St. Louise Missouri in 1993 studied the combined effect of cortisone injections AND exercise on joint cartilage.   They examined 3 groups of test subjects: 

Group 1 - Control Group.  Received NO cortisone injections.
Group 2 - Received cortisone injections and and no exercise.
Group 3 - Received cortisone injections with exercise

The results showed that all test subjects who received cortisone injections showed cartilage damage and a decrease in the number of chondrocytes (cells designed to make new cartilage) compared to the control group who received no cortisone.  Astoundingly, the group that received cortisone and exercise showed much greater cartilage damage compared the group that received cortisone damage but no exercise.  Group 3 also showed a marked decrease in the production of glycosaminoglycan:  the substance that gives cartilage it’s “bounce”13.

So, is giving cortisone shots to anyone, whether they are an athlete or not a good idea?  For those of you who have had cortisone shots for joint pain, was ANY of this information discussed with you? 

What are your options?  There are several treatment options that both can both help reduce inflammation AND improve joint healing.  To help reduce systemic inflammation resulting from a wide variety of diseases, treatment modalities including dietary changes  and homeopathy are possible solutions.  For more local joint inflammation both cold-laser therapy and prolotherapy are effective.  Rather than suppressing the immune system, these treatment modalities mediate some of the pro-inflammatory processes yet still encourage and accelerate a healthy immune response. 

What About Acupuncture?

Acupuncture and TCM (Traditional Chinese Medicine) is a comprehensive system of medicine that can be used to treat both systemic (body-wide) inflammation including allergic responses ranging from asthma, edema, sinusitis, and colitis, to more local joint based inflammation such as tendonitis.

In TCM, we don’t see “inflammation” as a distinct disease.  Instead, we examine how the flow of Qi, blood, and water can become blocked.  Normally, these substances flow along the meridians, blood vessels and through the internal organs.  Their role is to nourish the limbs, joints and internal organs to ensure proper day-to-day function.  When their flow is interrupted, health problems occur.  While we acknowledge the local swelling at a given joint as blood or Qi stagnation and possible dampness, TCM also considers the underlying conditions that may have led to the joint damage in the first place.  For example, professional and extreme athletes who undergo prolonged periods of training tend to experience Qi  and Blood deficiencies in the Spleen and Liver/Gallbladder.  Eventually, the immune system can also be depleted as characterized by a deficiency of Wei Qi14.  A typical treatment protocol would be to nourish Qi and blood at the organ level while resolving stagnation at the local area of inflammation.  Along with acupuncture needles, a TCM practitioner would use cupping (for stagnation), moxabustion (to dispel cold and to tonify), and even bleeding ( to move or cool blood and decrease swelling).   Herbs and poultices also play a very big role in treatment, but for now, we will just be focusing on acupuncture-type treatments.  On the surface these tools may seem primitive and even a little barbaric, but they are indeed effective with little to no health risks. 

Does Acupuncture Really Lower Swelling?  The Proof is in the Blood

Aside from testimony from patients and anecdotal evidence, how can we prove that acupuncture does control inflammation?  As we’ve already discussed, the immune response and inflammation is a complex multi-level process.  It relies heavily on chemical messengers called cytokines that help control things like blood vessel permeability (leakiness) and vasoconstriction/dilation at the injury site.  Some of these cytokines promote inflammation such as interleukin IL-6 while others help decrease inflammation such as IL-10.  Several studies reveal that both manual and electro-acupuncture can have a dramatic effect on both leukocytes (white blood cells) and their associated cytokines.  Specifically, acupuncture was shown to decrease IL-6 and increase IL-1016,17

In one study, acupuncture at the point sanyinjiao (Spleen 6) was shown to decrease inflammation induced by carrageenan injections16.  As we’ve mentioned before, inflammation is due in large part to increased blood vessel permeability.  Neutrophils (a type of white blood cell) and other materials slip through the cell walls and migrate to the injury site.  This study directly measured levels of cytokines and determined the level of capillary permeability.  The results showed that acupuncture at Spleen 6 resulted in a dramatic decrease in blood vessel permeability and a significant decrease in inflammation.  Blood analysis showed a large increase in the anti-inflammatory cytokine Interleukin IL-10 in comparison to the non-acupuncture group.
 
What About Acupuncture Compared to Steroids?

In this same study, some of the test subjects with the carrageenan induced inflammation were injected with dexamethasone (DEXA), a powerful synthetic steroidal anti-inflammatory.  Much like the acupuncture group, the blood-vessel permeability and inflammation was significantly reduced.  Interestingly, DEXA did not affect IL-10 levels.  Instead, DEXA decreased levels of pro-inflammatory cytokines (IL-1beta and TNF-alpha).  IL-1beta is a pro-inflammatory cytokine while TNF-alpha is both a pro-inflammatory and helps prevent tumor growth and viral replication.  Subjects treated with the acupuncture at Spleen-6 showed NO changes in these pro-inflammatory cytokines16 but did cause an increase in anti-inflammatory IL-10.  These revealing results show how different mechanisms are used to control inflammation between acupuncture and steroid treatments.   It’s also a fascinating lesson showing how acupuncture can be an anti-inflammatory but NOT be an immunosuppressant! 

Another study highlighted the benefit of electro-acupuncture over regular acupuncture to treat inflammation.  An acupuncture needle was inserted at Zu San Li (Stomach-36).  Electrodes were connected to the acupuncture needle and a simple conduction pad at point Stomach-41. Treatment was done at 3 times per week for several weeks.  Blood tests revealed that electro-acupuncture was more effective than manual acupuncture in reducing pro-inflammatory cytokines IL-6, IFN-gamma, and TNF-alpha within test subjects that have collagen-induced arthritis and inflammation17.

While these studies were relatively simple and use standardized single-point protocols, they clearly show that acupuncture does in fact have a powerful effect on inflammation. 

Blood analysis is one thing, what about real-world injuries?

As we’ve mentioned before, inflammation can play a role in a wide range of diseases.
An article summarizing acupuncture studies for the treatment of asthma, rhinitis (stuffy nose), inflammatory bowel disease, and rheumatoid arthritis showed mixed results.  Some studies showed clear signs of improvement using acupuncture while other studies suggested no significant improvement with acupuncture18. 

An article in the journal of Medical Acupuncture reviewed several studies on the effectiveness of acupuncture for sports injuries; scenarios that would often leave the patient looking at cortisone injections as a solution.  Conditions including osteoarthritis, patellar tendonitis, plantar faciitis, and frozen shoulder were examined.  The results were encouraging in that most of these conditions showed positive results with acupuncture treatments19.  In other words, acupuncture was successful in decreasing pain and increasing functionality in its test subjects.  A few of the studies suggested, however, that acupuncture didn’t appear to help. 

While this may seem confusing at first, it simply reveals the difficulty in conducting high-level quality studies with acupuncture on people.  Why is this?  Unlike animal studies, it’s difficult to have complete control of all variables involved in human test subjects.  Factors including diet, lifestyle, history of old injuries, and day-to-day stressors all play a strong role in our over-all health, well-being, and rate of healing.  As we’ve discussed through this and previous articles, the mechanisms of acupuncture work by “encouraging” or accelerating the body towards healing while having a “moderating” effect on body systems that appear to be out-of-control.  In contrast, most conventional treatments use drugs that work by either killing or blocking a chemical response and suppressing a natural body process; often with serious health-risks and negative side-effects. In short-term testing, this later method is much easier to prove with repeatable results.

Our immune system is both a complex and ingenious method to keep us healthy in a hostile world full of foreign invaders and physical trauma.  For the most part, it works.  Sometimes, however, our immune system can “get in it’s own way”, get out of control, and lead to problems such as inflammatory diseases, allergies, and inflammatory joint pain.  Fortunately, we have several tools including acupuncture and natural medicine that can reduce the inflammation without compromising our immune system20.  Before you take the next round of corticosteroids for your allergies, skin condition, or joint pain, ask your physician for a  complete list of side-effects and health risks.  Natural medicine and acupuncture could be a better choice.  They have little to no side-effects and are proven to work.

Author’s Note:  After reading this article, it’s tempting to think we are bashing conventional Western medicine and saying that conventional medical doctors care little about the health of their patients.  This is not true.  For the most part, doctors are sincerely interested in getting their patients better.  The challenge is that conventional doctors have access to a very limited number of tools.  They are both unaware and untrained in the use of Traditional Chinese or Natural Medicine.  So, they do the best with the tools they are given.  There is a time and place for all forms of medicine.  The key is to find the best tool for the job.  It’s the responsibility of both the patient and the health care provider to investigate all possible solutions and discuss in detail both the benefits AND the risks.

About the Author:

Craig Amrine, L.Ac. is a licensed acupuncturist and expert in cold-laser therapy.  He can be reached through his website at www.HiddenRhythmAcupuncture.com

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Resources:

1 Elizabeth Scott, M.S., Cortisol and Stress: How to Stay Healthy
Cortisol and Your Body, February 05, 2008, http://stress.about.com/od/stresshealth/a/cortisol.htm

2 Renew - Stress on the Brain, Franklin Institute, 2004  http://www.fi.edu/learn/brain/stress.html

3 http://www.gluegrant.org/inflammation101.htm

4 Robert F. Diegelmann 1, and Melissa C. Evans 2, Wound Healing: An Overview of Acute, Fibrotic, and Delayed Healing, 1 Departments of Biochemistry, Anatomy, Emergency Medicine and 2 Pediatric Critical Care, Medical College of Virginia, Virginia Commonwealth University, Richmond Virginia, [Frontiers in Bioscience 9, 283-289, January 1, 2004

5 http://www.ebioscience.com/ebioscience/whatsnew/pdf/Cytokines.pdf

6 http://www.web-books.com/MoBio/Free/Ch2G1.htm

7 http://en.wikipedia.org/wiki/Interleukin

8 Anthony S. Fuaci, MD; David C. Dale, M.D. James E. Balow, MD; Glucocorticosteroid Therapy: Mechanisms of Action and Clinical Considerations, Annals of Internal Medicine, March 1, 1976 vol. 84 no. 3 304-315,.

9 Jess D Salinas Jr, MD, Medical Director, Lake Mary Clinic, National Pain Institute, LLC; Associate Medical Director, Winter Park Clinic, National Pain Institute, LLC?Coauthor(s): Jerrold N Rosenberg, MD, Director of Rehabilitation Services, Providence Veterans Hospital; Clinical Assistant Professor, Departments of Orthopedics and Rehabilitation, Rhode Island Hospital, Brown University, Corticosteroid Injections of Joints and Soft Tissues Sep 27, 2010,  http://emedicine.medscape.com/article/325370-overview

10 http://www.mayoclinic.com/health/cortisone-shots/MY00268/DSECTION=risks

11 Ross Hauser, MD, Knee Injury and Cortisone Oak Park, Illinois.  http://www.caringmedical.com/sports_injury/knee_injury_and_cortisone.asp

12 Chunekamrai, S. Changes in articular cartilage after intra-articular injections of methylprednisolone acetate in horses. American Journal of Veterinary Research. 1989; 50:1733-1741

13 Gogia, P. Hydrocortisone and exercise effects on articular cartilage in rats. Archives of Physical Medicine and Rehabilitation. 1993; 74:463-467

14 Carl Sarnacki M.D, Killer Cortisone Turns 60 and Going Strong, June 3, 2009, http://americanacupuncture.blogspot.com/2009/06/killer-cortisone-turns-60.html


15 Kevin Young , Sports Injuries and TCM, Journal of Chinese Medicine • Number 78 • June 2005

16 Morgana Duarte da Silva1, Giselle Guginski2, Maria Fernanda de Paula Werner2,3, Cristiane Hatsuko Baggio3, Rodrigo Marcon2 and Adair Roberto Soares Santos1,2,*, Involvement of Interleukin-10 in the Anti-inflammatory Effect of Sanyinjiao (SP6) Acupuncture in a Mouse Model of Peritonitis1Departamento de Cieˆncias Fisiolo ´gicas, 2Departamento de Farmacologia, Centro de Cieˆncias Biolo ´gicas, Universidade Federal de Santa Catarina, Campus Universita ´rio, Trindade, Floriano ´polis, SC and 3Departamento de Farmacologia, Setor de Cieˆncias Biolo ´gicas, Universidade Federal do Parana ´, Curitiba, PR, Brazil, eCAM, doi:10.1093/ecam/neq036

17 Yun-Kyoung Yim1, Hyun Lee2, Kwon-Eui Hong2, Young-Il Kim2, Byung-Ryul Lee2, Chang-Gue Son3 and Jung-Eun Kim1, Electro-acupuncture at acupoint ST36 reduces inflammation and regulates immune activity in Collagen-Induced Arthritic Mice, 1Department of Meridian and Acupoint, 2Department of Acupuncture and Moxibustion and 3East-West Cancer Center of Dunsan Hospital, College of Oriental Medicine, Daejeon university, South Korea, Advance Access Publication 18 August 2006

19 Alec Meleger, MD Joanne Borg-Stein, MD, Acupuncture and Sports Medicine:  A Review of Published Studies, Medical Acupuncture:  A Journal For Physicians By Physicians, Fall 1999 / Wiinter 2000- Volume 11 / Number 2

18 Freek J Zijlstra, Ineke van den Berg-de Lange, Frank J P M Huygen, and Jan Klein Anti-Inflammatory Actions of Acupuncture, Department of Anesthesiology, Erasmus Medical Centre, Centre location, Rotterdam, The Netherlands.  Mediators Inflammation. 2003 April; 12(2): 59–69

20 John G. Connor, M.Ac., L.Ac, Inflammation and its Role in Disease, June, 2010 http://www.compassionateacupuncture.com/Inflammation%20and%20Its%20Role%20in%20Disease.htm

One of the earliest contraindications (warnings) in using cold laser or low level laser therapy was to AVOID treating the thyroid gland.  Why?  The theory was that we may actually affect thyroid gland function.   Several months ago I questioned the wisdom of this warning.  What if someone's thyroid gland was not functioning properly?  Can't we possibly restore function?  This question burned me for several months and I even contacted the manufacturer of my laser system to ask if they had heard of any studies done on this subject.  Well... the universe has a funny way of  providing.  The manufacturer (Apollo) just released news citing an article from a journal (Lasers Surg Med. 2010 Aug;42(6):589-96) answering this exact question.

Hashimoto's Disease or Chronic Thyroiditis is the most common cause of hypothyroidism.  A hypothyroid condition is characterized by a thyroid gland that  produces too little thyroid hormones (T3 and T4).  Both T3 (triiodothyronine) and T4 (thyroxine) are responsible for controlling metabolism throughout the body.  Virtually Every cell in the body depends upon thyroid hormones for regulation of their metabolism.  So, this process is obviously incredibly important.

Hashimoto's Disease is an auto-immune disease where the thyroid gland is attacked by the body's own immune system.  In doing so, the thyroid gland becomes enlarged, and it's function is impaired.  The result is hypothyroidism.  Symptoms of hypothyroidism include fatigue, weight gain, cold intolerance, joint and muscle pain, constipation, dry thinning hair, heavy or irregular periods, depression, and anxiety.  It can be confirmed through blood tests showing high levels of TSH (thyroid stimulating hormone) and low levels of T3 and T4.

About 14 million people in the U.S. suffer with hypothyroidism.  It affects about 7 times more women than men.  Common treatment methods include supplemental thyroid medication such as Armour Thyroid, Nature-Throid, Levothyroxine (LT4), and Synthroid.

In our clinic we've found that acupuncture is beneficial in some cases of hypothyroidism.  Now, however, we have evidence that our cold-laser therapy treatments can also  be incredibly effective in treating Hashimoto based hypothyroidism!  The study as referenced HERE was conducted to test if laser treatments directly on the thyroid gland can eliminate or reduce the need  for supplemental thyroid medication (Levothyroxine).  The results suggested that even 9 months after a 10 week treatment session, the need for supplemental thyroid (Levothyroxine) can be reduced or even completely eliminated!  The study continues to suggest that one of the markers  reflecting the autoimmune aspect of the disease (thyroid peroxidase-TPOAb ) can also be reduced!

So, now we have both acupuncture AND cold laser therapy to effectively treat hypothyroidism / Hashimoto's Disease.

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Craig Amrine, L.Ac. is licensed acupuncturist and expert on cold-laser therapy.  He can be reached through his website at www.hiddenrhythmacupuncture.com

Craig Amrine, L.Ac. is a licensed acupuncturist and can be contacted through is website at www.hiddenrhythmacupuncture.com

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The following link references a recent article I published discussing how acupuncture can significantly increase the amount of immune cells in our body.  It highlights how our treatments may play a role in helping the fight against cancer and infectious diseases.   You can either click to the link HERE or read the article below:  Enjoy!

The Effect of Acupuncture on the Immune System:  Part 1 - A Western Medical Perspective

Cancer.  The big “C”.  There are few words more effective in filling us with fear or dread.  Virtually all of us have either been directly affected by cancer or have had someone very close to us affected by cancer.  The word “cancer” is an umbrella term describing a large variety of diseases all with one thing in common;  a “growth” or “neoplasm” characterized by abnormal or uncontrolled growth of cells within the body.  For various reasons, the standard cell growth and death cycle gets out of control and these abnormal cells may spread throughout the body (metastasis) and infect other cells.

While reported cases are still on the rise for certain cancers, increased vigilance and advanced treatment protocols have vastly increased the survivability of most cancers.  Specifically, detection and treatment in the early stages have played a large role in surviving cancer.

Normally, we are constantly bombarded with any number of bacteria, viruses, and parasites.  Internally, we have a standard number of abnormal cells that may, if left unchecked, ultimately manifest as cancer.  Fortunately, our immune system is usually effective in fighting and destroying these invaders or rogue cells.  Our bodies are battle grounds of sorts.  Fortunately....most of the time....our bodies are victorious; our immune system destroys the invaders or cancer cells and we go on with our daily lives.

When we get sick, however, it is most commonly the result of our immune system becoming overwhelmed.  Either the invading virus, bacteria, parasite, or cancer cells proliferate at such a rapid rate that our immune response is unable to match the onslaught, or our standard immune response has been compromised/altered.....either by the invading cells/antigens themselves or by some other factor such as prolonged stress.

Conventional therapies for fighting cancer including chemo-therapy that are designed to kill very rapidly dividing cells...such as cancer cells.  The problem however, is that chemo-therapy is not too specific and will also target virtually ANY rapidly dividing cells including both white and red blood cells as well as hair follicles.  Ironically, this can lead to lowering the immune system and thus lead to a large host of other health-risks.

Cancer Treatments: Treatment and prevention of cancer, be it through conventional as well as non-conventional treatments is a HUGE topic.  There are medical doctors, oncologists, naturopaths, and experts of Traditional Chinese Medicine who spend their entire careers on this.  Entire medical journals are dedicated to new breakthroughs in cancer treatment.  One such technique involves regional hyperthermia to treat local neoplasms.  The thought is that heating a tumor up to 113 F will kill cancer cells but leave healthy cells relatively intact.  This is often combined with radiation and/or chemotherapy.  For this article however, we will simply talk about the role of acupuncture in this battle.

So, where does acupuncture fit in?  Can acupuncture help in the fight against cancer and other diseases?  Before we discuss that, listed below is a (very) brief list of some of our cells that are involved in our immune system⁶

WHITE BLOOD CELLS

Granulocytes

Neutrophils = Most abundant type of white blood cell.  Become phagocytic when encountering infectious materials; meaning they eat foreign, infected, or dying cells.

Eosinophils = Weakly phagocytic.. Very effective against parasites (worms).  Ingest antigen/antibody combinations.  They also moderate histamine induced allergy and inflammatory responses.

Basophils = They release histamine, an enzyme that is triggered by cell damage.

Histamine is responsible for increasing blood flow to a target area, increasing permeability of blood vessels to promote fluid to flow from blood vessels to surrounding tissue spaces resulting in swelling.  It is secreted by basophils, mast cells, and platelets and is responsible for much of our undesirable allergy symptoms when left unchecked.

Natural Killer Cells (NK) = These cells directly attack and kill infected and cancer / tumor cells.  They don’t have to rely on any prior “conference” or anti-body based reactions, although they do respond to “some” instructions from other immune cells.  They are considered the “shock-troops” of this defensive battle.

Agranulocytes

Phagocytes = Derived from monocytes; a type of white blood cell... wander through connective tissue.  There are “free” macrophages that include dendritic cells of epidermis and alveolar cells of lungs search for cellular debris or  foreign invaders.  There are also “fixed” macrophages such as Kupffer cells (liver) and microglia (brain)

Lymphyocytes = Responsible for developing cell immunities.

T Lymphocytes = These cells can either directly kill certain tumor or virally infected cells (CD8+ or “cytotoxic” version) or they can secrete factors that activate other white blood cells (CD4+ or  “helper” version).  There are several other subtypes of T-lymphocytes that I didn’t include in order to keep this article at a reasonable a length.

B Cells = The main function of these cells is to secrete antitbodies; specific markers for one particular antigen.  These antibodies serve as markers on the infected cell to trigger other types of white blood cells to attack and kill it.

Cytokines = Proteins secreted by various white-blood cells that act as messengers and mediators during the immune response.  They are often responsible for both enhancing or modulation inflammation, fever, and immune responses led by white-blood cells. There are SEVERAL sub-types of cytokines including Interleukins (IL-1, IL-2 subfamily, IL-10 subfamily), Interferon (IFN), and lymphokines.

The overall immune response mechanism (both cell-mediated and humoral immunity) is an ingenious and complex dance that involves all of these cell types listed above as well as several other cells and processes designed to provide an effective but regulated defense against bacteria, viruses, parasites, and cancer.  Imbalance in this process can lead to, on one extreme, a weak immune system where we are left vulnerable to any external or internal invader.  On the other extreme, imbalance can lead to a situation where the immune system is too active and will attack healthy body tissue and undigested proteins as characterized by several types of auto-immune disorders.

What can acupuncture do?  Can acupuncture actually affect the number of leukocytes and cytokines responsible for our immune system?  The answer is without a doubt YES!

Acupuncture and Immune Cells:  A brief literature review

Several studies were conducted on both healthy adults as well as adults afflicted with malignant tumors.  Blood analysis was taken on both control groups as well as groups treated with acupuncture.  In some of the studies, acupuncture was conducted several times, in other studies, acupuncture was performed just once.

The first study¹ showed how a single acupuncture session treated at various points showed show no changes on relative amounts of certain lymphocytes but also showed statistically significant increases in several types of cytokines, interferon, and NK-cells.  The temporary increase returned to normal levels, however, after about 30 days.  While this study provided detailed blood analysis of its subjects before and for several intervals after the acupuncture treatment, it lacked important details that could have provided even more powerful conclusions such as a “control” group or a “sham” group where patients were treated with acupuncture points NOT designed for boosting immune function.

Another study² comparing T-lymphocytes showed how acupuncture treatments on patients with malignant tumors showed statistically significantly increases in T-lymphocyte subsets OKT3+, OKT4+, OKT8+.

A third study³ investigated levels of T-lymphocytes subgroups (CD3+, CD4+, CD8+), soluble interleukin-2 receptor (SIL-2R) and beta-endorphin in the peripheral blood of patients with malignant tumors. Half of the group received NO acupuncture (control Group).  The other group received daily acupuncture treatments for 10 days (treatment group).  After 10 daily acupuncture treatments, remarkably significant increases in peripheral blood plasma levels of CD3+, CD4+, CD8+, and beta-endorphin were noted.  Interestingly, a remarkable decrease in levels of SIL-2R was also measured.  No changes were noted in the untreated (control) group.  Serum sIL-2R level is a sensitive marker of circulating peripheral blood mononuclear cell activation or specific tumor cell growth including non-Hodgkin's lymphoma (NHL)⁴.  In other words,  lower levels of SIL-2R is a good thing.  Studies suggest that lower levels of SIL-2R indicate increase chance of surviving certain types of cancer.

The final article I want to mention is  a wonderfully written paper that references several studies examining the effect of acupuncture on levels of NK (natural killer cells) ⁵.  Within this paper, one study examined cytotoxicity levels of NK cells in both healthy women as well as a group of women with high levels of anxiety.  Interestingly, the women with chronic anxiety showed 3-fold lower NK cell activity than those with no reported anxiety.  After 10 acupuncture treatments however, the anxious women showed a full restoration of NK-cell activity back up to normal levels!

An interesting observation is how both presence of malignant tumors AND stressed emotional states (anxiety) have been shown to lower the levels of immunity enhancing cell activity such as NK-cells.  Remarkably, acupuncture treatments have consistently been shown to counteract the negative impact of emotional (anxiety) and physical (cancer) states on the immune-cell quantities and function.

This paper further references several other studies highlighting how acupuncture treatments (most often referencing acupuncture  point zusanli) have resulted in remarkable increases in NK-cells, Interferon-gamma, and interleukine-2 (IL-2).  Some of these studies do, in fact, utilize “sham” points and control groups to further strengthen the argument that specific acupuncture points are directly responsible for these increases in immune function

These studies provide an overwhelming body of evidence that acupuncture does have a strong effect in enhancing immune-cell function in the body, even in those with immunocompromised conditions.

What does this mean to my health?

Now, the big question is: Does acupuncture shrink tumors?  Does it prevent cancer? Does it prevent infectious diseases like the flu? The common cold?  As of yet, I haven’t been able to be find any studies specifically measure the tumor reducing effects of acupuncture.  That doesn’t mean they don’t exist, it just means I’ve been unable to find them.   But, we can safely conclude that acupuncture can affect our immune system in a “positive” way.  It can be used as another weapon in our fight against disease and cancer, both as a preventative as well as an adjunctive therapy for current cancer treatments. I can also say with confidence that patients who see me on a regular acupuncture schedule will claim to get far fewer colds and flus during their course of treatments.  They also seem to recover much faster and suffer far fewer symptoms flu-like symptoms including fever, aches, and sinus congestion.

Stay tuned for the follow-up article to understand how immune function, cancer, and infectious diseases (such as influenza) are viewed from a Traditional Chinese Medical perspective.

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Sources:

Nobuo Yamaguchi et. al. Acupuncture Regulates Leukocyte Subpopulations in Human Peripheral Blood, Department of Fundamental Research for Complementary and Alternative Medicine, University of Oriental Medicine, Kyoto, Japan, eCAM 2007;4(4)447–453

Yuan J, Zhou R., Effect of acupuncture on T-lymphocyte and its subsets from the peripheral blood of patients with malignant neoplasm [Article in Chinese] Zhen Ci Yan Jiu. 1993;18(3):174-7.

Wu, B. "Effect of Acupuncture on the Regulation of Cell-Mediated Immunity in Patients With Malignant Tumors." Chen Tzu Yen Chiu. 1995. 20(3):67-7

Kono N, Kanda Y, Yamamoto R, Chizuka A, Suguro M, Hamaki T, Arai C, Matsuyama T, Takezako N, Miwa A, Togawa A. Prognostic significance of serum soluble interleukin-2 receptor level in non-Hodgkin's lymphoma: a single center study in Japan.  Department of Hematology, International Medical Center of Japan, Tokyo.  Leuk Lymphoma. 2000 Mar;37(1-2):151-6.

Michael Francis Johnston1, Elizabeth Ortiz Sánchez2, Nikola L. Vujanovic3,* and Wenhui Li4,* Acupuncture May Stimulate Anticancer Immunity via Activation of Natural Killer Cells.1Department of Medicine, University of California, 2Division of Surgical Oncology, Department of Surgery, University of California, Los Angeles, CA, 3University of Pittsburgh Cancer Institute, Departments of Pathology and Immunology, University of Pittsburgh, Pittsburgh, PA and 4Department of Chemistry, University of California, Los Angeles, CA, USA, eCAM Advance Access published online on February 1, 2010

6)  http://uhaweb.hartford.edu/bugl/immune.htm#adapt

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Lets face it.  Most of us drive cars to get around.  And despite how perfect we all are as drivers, accidents happen.  Many of us are left with (besides a damaged car) a sore neck or back.  In more severe cases, this neck soreness is called "whiplash".

The common source of whiplash is a sudden collision from behind.  The impact causes a rapid extension and then flexion of the neck, leading to cervical sprain or strain. The resultant damage can include ruptured/herniated discs as well as strained or torn ligaments in the neck, shoulders,  or back.   This can lead to headaches, dizziness, nausea, and of course, severe pain in the neck, shoulders, and back.  Severe spasms of the muscles often accompany the localized damage.  In some cases, victims can also experience tingling, numbness, or weakness in the arms and fingers.  This is due to impingement of the nerves in the hands that originate at the neck bones C5, C6, and C7.

What do you do if you ever get in a car accident?  The most important thing is to NEVER admit that you're fine.  And NEVER EVER sign any document saying that you're OK and have no injuries.  Why?  Most neck and back injuries from car accidents don't fully manifest until at least 1 month after the accident.  By the time patients seek medical care for the injury, it's too late to seek help from insurance companies involved in the accident.   I recommend that patients get at least an x-ray as soon as possible following the accident.  I then suggest anywhere from 5 to 10 acupuncture treatments with cold-laser therapy.  In my experience, neck pain is very easily treated with acupuncture.  Our treatments can effectively eliminate the spasming, decrease inflammation, and dramatically decrease the associated pain.

The most common scenario at my clinic is patients seek my help after spending several months and thousands of dollars under chiropractic care, often getting adjustments 2-3 times per week for several months.  After several months of treatment, they admit that it's not working and seek me out.  In MOST cases, significant progress is made between 5 to 10 of my treatments.  This is not to say that chiropractic care is not appropriate.  I will often recommend patients to see a chiropractor immediately following the accident to address any subluxation (dislocation) of the spine.  After the initial adjustment, however, I suggest that patients work with an acupuncturist trained in traditional chinese medicine.   Acupuncture is proven to reduce pain, increase functionality and accelerate healing of whiplash.

The neck and back are ingenious designs that give us both skeletal support and amazing mobility.  They are also, however, frustratingly vulnerable to all sorts of injuries that can lead to years of suffering if left untreated.  Fortunately, acupuncture is almost tail0r-made to address these problems.

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Craig Amrine, L.Ac. is a licensed acupuncturist and can be contacted through his website at www.hiddenrhythmacupuncture.com

I often hear commercials on the radio talking about the latest medical breakthroughs to treat back-pain: Decompression therapy, non-steroidal injections, laser-surgery.... the list goes on. These latest "breakthroughs" are in response to recent findings that traditional back surgery (discectomies, spinal-fusion therapies) doesn't necessarily improve pain.  While listening to these commercials, I find it fascinating that none of them mention acupuncture.

At least 50% of my patients originally come to me for back pain.  While the underlying reasons for their pain may vary, I'd say my success rate in either completely eliminating or vastly relieving their back pain is around 90%.  The most recent example is of a gentleman in his late 20's who arrived at my clinic needing a cane to walk.  After having back surgery 2 years ago to address a disc herniation, his pain returned with such intensity it left him unable to even get out of  his car without assistance and was leaning heavily on a cane to walk into my office. He was extremely skeptical about acupuncture, but was willing to try "anything". After his first treatment, he no longer needed his cane.  He was completely speechless how much better he felt after the treatment.  After his second treatment, he is walking almost completely normal; no cane, no lean, and no drugs.   Is there a secret formula or technique I"m using to treat back-pain?  Not really.  While I think I'm good at what I do, this story is more to demonstrate simply how powerful and effective acupuncture is in eliminating back pain.  Additional information on back pain can be found through my recently published article HERE.

So, if you are struggling with back-pain, try acupuncture.  It's a safe treatment that has been proven to work for the past 4000 years.  Honestly, what other medicine has such a long and successful track record?

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Craig Amrine, L.Ac., is a licensed acupuncturist and can be reached through his website at www.hiddenrhythmacupuncture.com.

Many of my patients ask me how my cold-laser therapy treatments compare to ultra-sound treatments.   Theoretically, ultra-sound treatments are supposed to stimulate injury repair and accelerate healing.   Cold-laser therapy is claimed to also accelerate wound healing.  Several studies, however, prove that cold-laser therapy is FAR more effective in wound-healing than ultra-sound.  The most recent study as published HERE compared ultra-sound and cold-laser therapy treatments on bone-defects in mice.  The study showed that compared to both control groups and groups treated with ultra-sound, mice treated with cold-laser therapy showed intense bone formation surrounded by highly vascularized tissue.  In contrast, the group exposed to ultra-sound therapy showed no difference in bone repair compared to the control group.

This latest study again shows how truly powerful and effective cold-laser therapy is for accelerating tissue repair.

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Craig Amrine, L.Ac. is a licensed acupuncturist and expert in cold-laser therapy and can be reached through his website at www.hiddenrhythmacupuncture.com

This  past week in Arizona has reminded us that summer has indeed arrived.  Temperatures are already well above the 100 degree mark until well after sunset.  Living in these conditions pose unique health risks that require special precautions.  The most common health risk is heat exhaustion that can be characterized by heavy sweating, irritability, headaches, paleness, nausea, muscle cramps, and fainting.  Treatment of heat exhaustion includes drinking cool NON-alcoholic or caffeine beverages, finding shade, taking a cool shower or bath, and finding an air-conditioned environment.  If left untreated, heat exhaustion can lead to heat stroke.   Heat stroke is considered a medical emergency and can be fatal if not treated properly.  Symptoms of heat stroke include red or flushed skin, lack of sweating, headache, nausea, difficulty breathing, hallucinations, cramping, seizures, and coma.  The lack of sweating indicates severe dehydration where the body can no longer adequately cool itself and can lead to elevated body temperatures (hyper-thermia).  While waiting for 911 response, the same treatments can be applied as in heat exhaustion.  Additionally, ice packs can be applied to the armpits, groin, and the back of the neck.  Re-hydration is critical in either condition.  Drinking too much water and electrolytes too quickly, however, can result in severe stomach cramping, so frequent small sips are recommended.

From a Traditional Chinese Medical perspective, these conditions are the result of a Yang-based summer-heat or pathogenetic heat invasion.  This heat attack can quickly burn up the Yin and fluids of the body and lead to an attack of the heart.  Acupuncture treatments for either condition involve using acupuncture points to specifically clear heat.  Bleeding certain points including the jing-well points, ear apex, and UB40 (back of the knee) is also a common protocol.

Prevention of either condition involves the classic common sense advice that we've been taught (but often forget) for most of our lives.  These include staying hydrated, find shade, and avoid being outside in the heat of the day if we can avoid it.

Probably the MOST important prevention that a person can do, however, is to simply cover their head.  A hat.... ANY hat.... that adequately covers the top of the head can greatly improve our resistance to heat-related illnesses.  From a TCM perspective, most pathogenic wind-invasions, whether it's hot or cold, enter the body at either Du14 or Du20.  From my experience, wind-cold invasions are more likely to attack Du14, while wind-heat invasions attack Du20.  Du14 is located at the back of the neck between the C7 and T1 vertebrae.  Du20, however, is located at the very top of the head.  So, simply covering Du 20 with a hat is a cheap and effective way to help fight off heat-related illnesses.  This advice applies to EVERYBODY.  Regardless whether you have dark or light skin, have a full mop of hair or are bald.

So, next time you decide to hike in the Arizona sun, bring plenty of water, and bring 2 hats...one for you, and one for your friend who insists that he/she is fine and doesn't need one.

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Craig Amrine, L.Ac. is licensed acupuncturist and be reached through his website at www.hiddenrhythmacupuncture.com