yungcin – American Institute of Acupuncture

The Treatment of Polycystic Ovarian Syndrome (PCOS) with Traditional Chinese Medicine

yungcin — Sun, 04 Sep 2011 00:25:35 +0000

Overview of Healthy Ovarian Physiology

The ovaries are two organs on each side of the woman’s uterus which contain follicles, tiny fluid filled sacs (also called cysts), that hold the eggs. Each month approximately twenty eggs start to mature but usually only one egg fully matures; when the fully mature egg is ready, the follicle breaks open to release it. The fully mature egg then travels through the fallopian tube to the uterus for fertilization and implantation.

Overview of Women with PCOS
In women with polycystic ovarian syndrome (PCOS), the ovary doesn’t make all of the hormones it needs for any of the eggs to fully mature. Follicles may start to grow and build up fluid but no one follicle becomes large enough. Instead, some follicles may remain as sacs/cysts. Since no follicle becomes large enough and no egg matures or is released, ovulation does not occur.

The distinctive appearance of PCOS is a thick, shiny, white coating overlying many rows of cysts on the surface of the ovary. These ovarian changes give PCOS its name (“poly” = many, “cystic” = cysts). PCOS is believed to be the most common hormonal abnormality in women of reproductive age and affects approximately 1 in 10 women (an estimated 5 to 7 million women in the United States).

Have you been diagnosed with polycystic ovarian syndrome?
Call Acuherb Clinic for your free 15 minute consultation.
281-461-6499

What are the Causes of PCOS?

The cause(s) of PCOS is unknown at this time; research suggests that many women with this condition may have decreased sensitivity to insulin. When cells are resistant to insulin it means that the effect of insulin on sugar, and other functions, is deficient. More insulin than normal is required to be produced to ensure that the body cells absorb enough sugar. This leads to high insulin levels in the blood stream which, among other effects, make the ovaries overproduce male hormones, called androgens, leading to hormonal imbalances that lead to symptoms of PCOS.

What are the Signs and Symptoms of PCOS?
PCOS is considered a syndrome because it has a number of unrelated symptoms. For this reason, PCOS often goes undiagnosed or misdiagnosed.

Symptoms include:

Irregular menstrual cycle (infrequent menstrual periods, no menstrual periods, and/or irregular bleeding)
Infrequent or no ovulation
Weight gain or obesity
Increased levels of male hormones, called androgens, which may lead to excessive hair growth on the face +/or body (especially the face, chest, abdomen, nipple area, or back)
History of diabetes, over-production of insulin, and inefficient use of insulin in the body
Acne, oily skin, or dandruff
Patches of thickened and dark brown or black skin on the neck, groin, underarms, or skin folds
Skin tags, or tiny excess flaps of skin in the armpits or neck area

How Does PCOS Contribute to Infertility?

In short, if you are not ovulating regularly every month, the chances of fertilizing the egg are reduced. Because the egg is not released, there is no egg ready for fertilization and implantation in the uterus. Because PCOS affects the quality of the follicle and the state of the endometrium, the result will be that menstrual cycles become more erratic and less predictable. Women with PCOS will often very long cycles and very heavy bleeding, amenorrhea (missed periods), or anovulation (no ovulation) with scanty bleeding. Acupuncture and Chinese herbs help to regulate the menstrual cycle and harmonize the hormonal cycles of the body.

How Do Acupuncture and Chinese Herbs Help PCOS?
Acupuncture and Chinese herbs provide a safe, effective, drug-free and natural whole body approach. This natural approach helps strengthen and (re)balance the hormonal systems of the body, encouraging conception and a healthy pregnancy.

Etiology of PCOS in Chinese Medicine

In traditional Chinese medicine, the treatment of PCOS is seen as an excess condition, a deficient condition, or clinically PCOS is seen as more of a combination of both an excess and deficient condition*.

Excess conditions:

Phlegm dampness
Liver qi stasis
Blood stasis

Deficient conditions:

Kidney yang deficiency
Kidney yin deficiency
Spleen qi deficiency

*It is important to note that most women will have both excess and deficient conditions as their root cause of PCOS.

Together with changes in diet and exercise, acupuncture treatments and Chinese herbs are empowering women with PCOS to lead healthier and more satisfying lives. For women trying to become pregnant, either naturally or through IUI/IVF treatments, treating PCOS will help with fertility and overall balance through harmonizing hormones and regulating the menstrual cycle. While there is still no cure for PCOS, the good news is that Chinese medicine offers many effective ways to treat polycystic ovary syndrome!

Hyperthyroidism Workup

yungcin — Tue, 30 Aug 2011 18:56:52 +0000

Approach Considerations

The most reliable screening measure of thyroid function is TSH level. TSH levels usually are suppressed to immeasurable levels (< 0.05 Â IU/mL) in thyrotoxicosis. Third-generation TSH assays are recommended for screening purposes.

The most specific autoantibody test for autoimmune thyroiditis is an enzyme-linked immunosorbent assay (ELISA) test for anti-TPO antibody.

Hyperthyroidism in older patients often presents with atrial arrhythmias or CHF. Electrocardiography is recommended if an irregular heart rate or CHF is noted upon examination.

TSH and Thyroid Hormone Levels

Although measurement of the TSH level is the most reliable screening method for assessing thyroid function, the degree of thyrotoxicosis cannot be estimated easily in this way; thyrotoxicosis must instead be measured using an assay of thyroid hormone levels in the plasma. Thyroid hormone circulates as T_3Âand T₄, with 99% bound to protein.

Only the free, unbound thyroid hormone is biologically active. T_3Âis 20-100 times more biologically active than T₄. Of patients with thyrotoxicosis, 5% have only elevated T_3Âlevels. Therefore, measuring FT_4Â(and FT₃, Â if FT_4Âlevels are normal) is recommended in patients with suspected thyrotoxicosis when TSH is low.

Many laboratories do not measure free FT_4Âdirectly, instead using a calculation to estimate the FT_4Âlevels. The free thyroxine index (FTI) is equal to total T_4Âmultiplied by the correction for thyroid hormone binding, such as the thyroid hormone ? binding ratio (THBR) or T_3Âresin uptake [T_3ÂRU]). A similar calculation can be used with total T₃.

Subclinical hyperthyroidism is defined as a suppressed TSH level (< 0.5 ?U/mL in many laboratories) in combination with serum concentrations of T₃and T_4Âthat are within the reference range.

Other Laboratory Tests

As previously mentioned, the most specific autoantibody test for autoimmune thyroiditis is an ELISA test for anti-TPO antibody. The titers usually are significantly elevated in the most common type of hyperthyroidism, Graves thyrotoxicosis, and usually are low or absent in toxic multinodular goiter and toxic adenoma. A significant number of healthy people without active thyroid disease have mildly positive TPO antibodies; thus, the test should not be performed for screening purposes.

TSI, if elevated, helps to establish the diagnosis of Graves disease. A positive anti-TG antibody test does not predict the development of thyroid dysfunction, so the test should not be used.

Scintigraphy

If the etiology of thyrotoxicosis is not clear after physical examination and other laboratory tests, it can be confirmed by a iodine-123 (^123ÂI) uptake, as in the images below. Values are elevated in patients with Graves disease and toxic multinodular goiters.Â ¹²³I and technetium-99m (^99mÂTc) can be used for thyroid scanning, which provides anatomic information on the type of goiter (eg, diffuse vs nodular). Scans essentially are pictures of the thyroid and do not necessarily confirm or refute the presence of hyperthyroidism per se; only¹²³I uptake provides information in this area.

Graves disease is associated with diffuse enlargement of both thyroid lobes, with an elevated uptake. A toxic adenoma demonstrates a solitary hot nodule with suppression of function in the surrounding normal thyroid tissue. A toxic multinodular goiter demonstrates an enlarged thyroid with multiple nodules and areas of increased and decreased isotope uptake. (See the first 2 images below.) Subacute thyroiditis usually demonstrates very low¹²³I isotope uptake. (See the third image below.)

Iodine 123 (123I) nuclear scintigraphy: 123I scans of a normal thyroid gland (A) and common hyperthyroid conditions with elevated radioiodine uptake, including Graves disease (B), toxic multinodular

goiter (C), andtoxic adenoma (D).Scan in a patient with a toxic multinodular goiter. The 5-hour iodine uptake was elevated

at 28%. Note the multiple foci of variably increased tracer uptake.Absence of iodine 123 (123I) radioactive iodine uptake in a patient with thyrotoxicosis and subacute painless or lymphocytic thyroiditis. Laboratory studies at the time of the scan demonstrated the following: thyroid-stimulating hormone (TSH), less than 0.06 mIU/mL; total thyroxine (T4), 21.2 mcg/dL (reference range, 4.5-11); total triiodothyronine (T3), 213 ng/dL (reference range, 90-180); T3-to-T4 ratio, 10; and erythrocyte sedimentation rate (ESR), 10 mm/h. The absence of thyroid uptake, the low T3-to-T4 ratio, and the low ESR confirm the diagnosis of subacute painless thyroiditis.

If a dominant nodule is found upon examination of a patient with thyrotoxicosis, obtain an^123ÂI thyroid scan to assure that the dominant nodule is functioning. If the nodule is cold, perform a biopsy on the nodule by fine-needle aspiration to exclude concomitant malignancy.

Are there risks or side effects to acupuncture?

yungcin — Fri, 19 Aug 2011 04:17:17 +0000

Are there risks or side effects to acupuncture?

Usually not. Acupuncture is a very safe method of encouraging the body to promote natural healing and improve function.

Done properly, acupuncture rarely causes serious side effects. Many people feel a brief stinging sensation, like a pinprick, during insertion of the needles. Others experience a dull ache around the needle after it goes in.

Other problems documented by researchers resulted from mistakes made by the acupuncturists. For example, some have failed to refer their patients for other kinds of treatment that might be more effective for their illness. Others have spread serious infections by using needles that weren’t sterile. A handful have injured patients by pushing a needle into a vital organ such as a lung. But overall, as the National Institutes of Health recently concluded, acupuncturists have an extremely good safety record.

A side effect that I have seen in my own practice is the original symptoms worsening for a few days after an acupuncture treatment. Sometimes other general changes in appetite, sleep, bowel or urination patterns, or emotional state may be triggered. These should not cause concern, as they are simply indications that the acupuncture is starting to work. My teacher explained it to me like this: Acupuncture is smoothing out blocked Qi (energy) that is stuck in areas of your body. When a garden hose gets a kink in it, the water stops flowing. When you straighten the hose, the built up pressure makes the water burst out in the beginning. This is what can happen when you first have acupuncture.

It is also common with the first one or two treatments to have a sensation of deep relaxation or even mild disorientation immediately following the treatment. These effects should wear off within 24-48 hours.

Please discuss what you have been experiencing with your acupuncturist. Your comfort is a priority. The more you communicate with the practitioner, the more he or she will be able to help you.

A few people have reported more serious reactions, such as dizziness, sweatiness, or nausea, according to a November 1999 issue of theArchives of Family Medicine. There have even been some cases reported where patients lost consciousness. However, these problems usually clear up on their own within a few minutes, without lasting harm to the patient.

While Acupuncture is an extremely safe form of physical medicine, here are some rarely seen contraindications and risks.

Precautions & Contraindications:

It is contraindicated to needle the abdomen and lumbosacral areas of pregnant women
Avoid blood vessels to prevent bleeding
Points on the chest and back should be carefully needled to avoid injury to organs

Risks: (Some of the risks mentioned below are EXTREMELY RARE!)

Bruising
Fainting
Muscle Spasms
Bleeding
Nerve Damage
Punctured Lung
Accidental Injury to organs (Brain, Spinal Cord, Heart, Liver, Spleen, Kidney)

Combating Feelings of Holiday Stress, Anxiety and Depression with Acupuncture and Chinese Medicine

yungcin — Fri, 19 Aug 2011 04:15:39 +0000

While the holidays are depicted in movies as a time of idyllic serenity and joy, we have all felt the realities of holiday stress. Financial concerns, gift giving, busy schedules, family obligations, weight gain and lack of exercise all play into the holiday cheer. Â These pressures can affect us physically, emotionally and spiritually often leading to anxiety and depression. Â Acupuncture and Chinese medicine provide a unique perspective and intervention for these common seasonal difficulties.

Anxiety comes in a wide range of manifestations, from mild worrying to more physical responses such as nausea, insomnia, shortness of breath and panic attacks. Â Some anxiety is a healthy response to the stress of daily life and new situations; however, anxiety that occurs randomly or excessively is a sign to take notice. Acupuncture and Chinese medicine can help balance both the mental and physical symptoms of anxiety and help to create harmony and spaciousness.

From an acupuncture and Chinese medicine perspective, many manifestations of anxiety can be traced back to the energetic concert between the heart and kidneys. Â The temperament of the heart is fiery, expansive and upward. Â From a Chinese medicine standpoint, it exhibits yang characteristics. Â The dynamic terrain of the kidneys are on the other end of the Chinese medicine continuum. Â The kidneys energetic character is fluid, inward and contemplative, exhibiting a yin nature. Â If there is too much fire, we may experience symptoms of anxiety and agitation of the mind.

It is estimated that 20% of the population is depressed at some point in life. Â Common symptoms of depression during holiday time include a sense of apathy, cynicism or anger toward the holiday season, isolation from festivities and holiday traditions, crying spells and over-consumption of food and/or alcohol. Â Depression may be compounded in some people by SAD, seasonal affective disorder Â a type of depression associated with the low light conditions experienced during the winter months.

In acupuncture and Chinese medicine, the liver’ s job is to negotiate the free flow of energy in the body. Â Impaired liver function can lead to inappropriate jams, limited availability of resources and sluggishness. Â In acupuncture and Chinese medicine this condition is often referred to as liver depression and qi stagnation. Â The Â depression is the body’s reduced ability to move its resources. Stagnation occurs when the lack of energy to circulate needed supplies becomes obstructed. Â This can cause sleep and digestive complaints, musculoskeletal pain and emotional instability. Acupuncture and Chinese medicine offer effective strategies to remedy the depressed energy and to move the resulting stagnation, leading to better health and outlook.

While modern life has helped make so many aspects of daily living easier, many people still suffer from emotional distress especially around the Holiday season. Â Subsequently, anxiety, increased stress and depression are some of the most common conditions affecting individuals during this eventful season. Â Acupuncture and Chinese medicine are effective and safe tools to help smooth and balance what can be a challenging time of the year even under the best circumstances.

Acupuncture for Weight Loss

yungcin — Fri, 19 Aug 2011 04:09:04 +0000

How to Lose the Weight and Keep It Off with Acupuncture and Chinese Medicine.

Weight loss comes under the topic of “Weight Control”, because we are concerned with the loss and MAINTENANCE of loss of weight. This is a multi-faceted problem, and a good program involves diet, exercise and stress reduction techniques. Chinese acupressure and digestive aid exercises are also useful tools in the battle with weight loss.

Acupuncture is an ADJUNCT therapy. It is not a panacea or a wonder cure in the treatment of weight control. But, acupuncture is effective in making it easier to lose and maintain that loss if the patient is willing to change their lifestyle. The exact mechanism by which acupuncture works is unknown but we know that acupuncture needles inserted into specific points on the body and in the ear release endorphins which have a calming and relaxing effect that makes it easier to deal with stress, frustration and anxiety that can trigger overeating and bingeing on fattening foods. Also endorphins affect the digestive and hormonal systems so acupuncture can help rebalance the organ systems that are running too fast- or in this case too slow i.e., the metabolism and the will power.

The Acupuncture Treatment

In order for the acupuncturist to choose the correct points for you, you must first come in for a consultation to discuss your particular pattern of overeating, and let the practitioner know in your intake form if there are any real digestive difficulties. Then the acupuncturist would check your pulse to discern the general state of your energy and measure the health of your stomach energy in particular, and then they would look at your tongue to check for cracks, peeling or puffiness on the stomach area, or a suspicious yellow or thick white coating that might indicate troublesome heat or coldness in the stomach and would provide some clues as to why the person was gaining weight.

The Acupuncture Points

Then, armed with this information, the acupuncturist would devise a treatment protocol using a combination of ear and body points. Although the Chinese developed the system of auricular (ear) acupuncture a long time ago, as one of the various Microsystems of the body containing all the points relating to the major organs and body parts, a Frenchman by the name of Nogier, discovered many more acupuncture points on the ear that pertain to Western medicine such as points called “Adrenal”, “Pituitary”, “FSH”, “Ovary”, “Thyroid”, etc.

Many of the points from both ear acupuncture systems that are important for weight loss treatments are:

MouthÂ – for the impulsive eater who may also smoke a lot and talk a lot
StomachÂ – for the person who eats even after they’re full or who’s constantly nibbling
HungryÂ – for general appetite control
LungÂ – for food addicts, and people who love chocolate, sweets
ShenmenÂ – a calming point, for the psychology overlay for anxiety, anger, frustration, insecurity
EndocrineÂ – for water retention that’s responsible for some of the weight gain
Adrenal and OvaryÂ – if weight gain is due to menopause or P.M.S.
SpleenÂ – for sugar imbalances and hormonal disturbances
KidneyÂ – for water retention, and nervous system and hormonal imbalances
ThyroidÂ – for slow metabolism

The practitioner chooses two or more of these points for each treatment depending upon the patient’s problem and personality profile regarding overeating.

Next, body points would be selected.

During the first few treatments, most likely the “Four Gate” points (LI 4, Liver3) would be used to circulate the energy throughout the body and calm the nervous system. Ren 12, the front collecting point of the stomach energy would be chosen for many treatments, as would Stomach 36, three inches distal to the eye of the knee that tonifies the energy and helps circulate oxygen and blood of the whole body and of the stomach in particular. Then, based on the diagnosis, the practitioner may add Stomach, 40, the master point for mucous, or Kidney 7 or 10 for edema or water retention.

The acupuncturist may use electro stimulation on some of these acupuncture points to increase the endorphin release and stimulate the metabolism. The needles would be kept in place for around thirty to forty-five minutes depending on how much support was needed for the patient, and after the needles are removed, ear tacs with adhesive on them are often placed in the same spots on the ear to continue the stimulation between treatments. The way it works is this: when the patient feels an urge to eat, s/he applies mild pressure to the point or rubs it back and forth for about 20 seconds. This type of acupressure stimulates the point, causes a mild endorphin release, relaxes the patient and helps them to regain their willpower or resolve about resisting the temptation to eat. The patient removes the tacs at home after three days and throws them away or takes them out sooner if there is any irritation or discomfort. It is a good idea to also remove oneself from the location, person or food that triggers the resistance to the diet or contributes to the breakdown of willpower. For example, one might want to stay away from the kitchen and refrigerator between meals.

The Treatment Plan

The number of acupuncture treatments necessary depends on the patient’s goals for losing weight, the speed at which they want to lose, and their commitment to keeping the weight off. If the overeating is severe, a treatment every day for the first five days is appropriate and can then taper off the second week to every other day and the third week to every three days. For the average patient who wants to lose between five to ten pounds, one treatment every three days or twice a week until they reach their goal is appropriate, and then a booster treatment once every two weeks is optimal. After a few booster treatments, the patient and practitioner will mutually decide when to terminate frequent treatments and then can aim to meet approximately four times a year at the change of seasons when energy levels are unstable and tonification and harmonizing of one’s system is appropriate for everyone.

Nutritional Counseling and Lifestyle Changes

As was mentioned earlier, a good weight loss program includes nutritional counseling and exercise as well as a commitment to make permanent lifestyle changes. The acupuncturist can help with nutritional counseling and can discuss a diet regimen that the patient can live with and maintain for the long term. A diet that is high in fiber and low in fat, with moderate amounts of low-density carbohydrates and low-fat protein is usually the best choice to adopt. With this type of a diet program, the patient can avoid the pit-falls of yo-yo dieting or the tendency to lose weight and then regain it.

Other important tools that can aid in weight loss are stress reduction techniques and a moderate exercise regimen. The acupuncturist can suggest various stress reduction methods that may include breathing exercises, Tai Chi, yoga, meditation or biofeedback. And since the goal of a weight program is not only weight loss but the maintenance of that loss, an exercise program that the patient likes is the best one to choose. The patient could try starting a program that includes brisk walking three times a week for forty minutes. After a few weeks when stamina is increased, they could try walking five times a week. After that more aerobic exercise can be added such as the treadmill, stair climber or aerobics classes, cycling or whatever from of rigorous exercise the person enjoys and can maintain for the long term. It is a good idea to use free weights beginning with three pound weights and practicing just two to three sets of arm curls three times a week. Moderate weight training builds lean body mass and helps to reduce body fat as well as strengthen and build bone mass and reduce the risk of osteoporosis.

Chinese Herbal Medicine and Supplements

Next a good individualized nutritional supplement program is important because everyone has a different metabolism and different needs for nutrients. It will include vitamins, minerals, herbs antioxidants, phytochemicals and nutraceuticals. These will support the diet program and balance the blood sugar to help give the body the strength, energy and defense it needs to maintain the healthy life style that s/he has begun.

Many diet and appetite suppression products are available on the market and surprisingly there is a very effective and safe ancient Chinese herbaL formula for digestion that comes in a pleasant tasting chewable wafer form calledÂ BAO HE WAN. The ingredients are:

Shan Zha (Fructus Crataegi) –promotes digestion of meat and fats; dissolves food accumulation
Shen Qu (Medicated Leaven) — digests alcohol, rice and vinegar and dissolves food accumulation
Lai Fu Zi (Semen Raphani) — digests starch (wheat and breads)
Ban Xia (Pinellia), Chen Pi (Tangerine Peel), and Fu Ling (Poria Cocos), — resolve dampness and food accumulations
Lian Qiao (Fructus Forsythiae) — clears stomach heat that may result from accumulated food that dries up the digestive liquids

When this famous herbal formula is drunk as a tea, other herbs may be added if there is gas or abdominal distension such as cardamon or magnolia bark. Or if constipation is a problem a gentle laxative like Semen Pruni or Huo Ma Ren may be used. However an important concept of Chinese medicine is to diagnose properly and treat the patient with the correct herbs so as not to consume body fluids or disturb electrolyte balance. Food accumulation may be due to stomach deficiency so the practitioner may add other herbs such as Codonopsis to tonify the stomach energy so the food could descend properly through the digestive tract.

Breathing and Abdominal Excercises

While the patient is undergoing the behavior modification program and is successfully losing weight, it is a good idea to incorporate a set of deep breathing and abdominal exercises that utilize the acupuncture meridians or energy lines on the body to stimulate relaxation and digestion. If we practice deep abdominal breathing while lying down for a few minutes in the morning before we arise, we will not only take in more oxygen but will stimulate the stomach, spleen, kidney ,and reproductive energy lines that are all located on the center of the torso . Digestion will be improved and all those organs will function more effectively. We will also start the day with more energy and clarity.

Another method of stimulating these same organs in the stomach region is the abdominal finger pressure massage that follows the direction of the large intestines. This massage may also be performed in bed in the morning and evening and will gently stimulate all the points on the central torso and will not only encourage proper digestion but will foster homeostasis or the harmonious balancing of the hormone and endocrine systems of the body.

Pressure Points

Last but not least, three pressure points on the body may be stimulated daily for two minutes each that will promote the general health as well as aid digestion, elimination and relaxation. These points are: Large Intestines 4 (HEGU); Pericardium 6 (Neiguan); and Stomach 36 (Zusanli). The points should be pressed with strong continuous pressure for approximately two minutes each and may be said to comprise a self-healing treatment.

While no guarantee may be given for acupuncture treatments for weight loss, the self-motivated patient who will take the time to practice most of the things outlined here will most likely be pleased with the results that she finds within a reasonable amount of time.