August 2019 - LUCY POSTOLOV

Acupuncture option gaining popularity

Lucy Postolov and one happy patient

Journal Review Aug. 19, 2019

Dear Doctor: What do you think about acupuncture for lower back pain? What is it, and how does it work?

Dear Reader: Acupuncture is a key component of traditional medicine in China, but until recently, it was viewed as alternative therapy here in the United States. Then, in 1997, the National Institutes of Health issued a pro-acupuncture consensus statement, acknowledging acupuncture as an effective tool for managing pain and nausea. The agency also recommended that acupuncture be taught in medical schools. As doctors, we both see a role for acupuncture in our practices. Dr. Ko recently finished her training in acupuncture and uses this treatment.

Acupuncture is a centuries-old practice that builds on the premise that the human body contains energy pathways, known as meridians, which are comprised of more than 2,000 specific points. During an acupuncture treatment, a practitioner stimulates certain groups of points by inserting hair-thin sterile needles. The feeling is more of a distinct sensation than actual pain. Acupuncture needles may also be heated during a treatment, or they can be stimulated to conduct a mild electric current. A usual course of treatment typically includes multiple sessions that can continue for weeks or months.

Despite centuries of use, modern medicine doesn’t really understand how this ancient technique works. One theory ties the stimulation of acupuncture points to the release of specific biochemicals, which play a role in healing, as well as physical and emotional well-being.

A study published in 2014 used advanced 3D imaging techniques to examine acupuncture points at the cellular level. The researchers found that, unlike neighboring tissues, acupuncture points contained a high density of micro-vessels and other vascular structures. Not a definitive answer to the mysteries of acupuncture, but certainly an intriguing start.

Clinical studies have shown the value of acupuncture for pain relief, nausea, headache and osteoarthritis. A growing number of medical insurance plans cover acupuncture treatments. The U.S. armed services now use acupuncture as a form of pain management. And the Centers for Medicare & Medicaid Services is considering a proposal to cover acupuncture treatments for patients with chronic lower back pain participating in certain clinical trials.

If you do decide to try acupuncture, please be sure to find an experienced practitioner. As with many integrative therapies, licensing requirements vary from state to state. If you live in an area that doesn’t have licensing requirements or oversight for acupuncturists, consider looking for a practitioner certified by the National Certification Commission for Acupuncture and Oriental Medicine, a national oversight and advocacy organization. You can find more information at nccaom.org. www.lucypostolovacupuncture.com

alternative2019-08-26T10:17:15-07:00August 26th, 2019|

Acupuncture Is More Popular Than Ever—Here Are 4 Proven Benefits to Know About

Written by Claudia Fisher for Real Simple

Lucy Postolov applying needles to a patient

More people than ever swear by acupuncture for everything from alleviating chronic pain to tempering stress. Here’s what the pros have to say about this alternative remedy’s most common benefits.

Even if you’re scared of needles, the thought of acupuncture has probably crossed your mind at least once during a bout of anxiety, a wellness kick, after an injury, or myriad other common conditions people have sought out the treatment to alleviate.

Acupuncture is the 2,000-year-old practice of inserting very thin needles through the skin to stimulate specific points of the body, called acupoints. According to the Traditional Chinese Medicine (TCM) practice, there are hundreds of acupoints on the human body, each connected to a meridian, or energy pathway, that runs through our bodies. The idea is that by stimulating the chi—or energy—at these specific points, we can prompt our bodies to heal themselves. Two of the most multitasking areas for acupuncture are the Zusanli (below the knee) and in your ear because both spots are believed to treat a wide range of issues, including anxiety, chronic pain, headaches, sleep troubles, and digestive problems. The practice has evolved with scientific advancement, with research itself showing continuous improvements of acupuncture in China over the past 10 years.

Despite long being considered more of an outlier or complementary remedy to mainstream medicine, acupuncture has also attracted a fair amount of attention in the scientific community. Many studies now link the treatment to major health concerns, like diabetes and heart disease.

Earlier this summer, Medicare even began covering the traditional Chinese practice for patients participating in a certain pain study. While Medicare coverage is limited only to this use case right now, the goal is to determine whether acupuncture is effective enough to treat chronic lower back pain and, hopefully, find a reliable alternative to narcotic pain killers as a result. Some healthcare providers outside of this Medicare example already include acupuncture in coverage plans, so this new study is just more fuel to the already growing fire—and by “fire,” we mean body of research exploring whether or not acupuncture is a viable addition to certain treatment plans.

With Medicare and researchers delving more into the science of why acupuncture works and trendy treatment facilities opening in major cities, it looks like acupuncture’s popularity has nowhere to go but up. Acupuncture may have been associated with specific demographics and age groups before, but Google searches for “acupuncture near me” have grown dramatically over the past five years, suggesting people aren’t just curious about the treatment, but actually trying it. As the wellness industry continues to boom, it makes sense people both young and old would seek out clinics like this to complement their athleisure-leaning lifestyles. (Believe it or not, you can even get acupuncture for dogs and cats now—and if that doesn’t show a changed public perception, we don’t know what does.) So, what are all these people turning to acupuncture for?

“The most common conditions we see people for are stress and anxiety, women’s health (pregnancy, fertility, painful periods, and more), pain relief, and workout recovery,” says Shari Auth, a holistic health practitioner in New York and co-founder of WTHN, a New York City acupuncture studio.

If you’re still feeling a little unsure about what all the acupuncture hubbub is about, we did the research and spoke to the experts on acu (as they call it) to find out everything you need to know about this treatment and its associated benefits. Here are four ways the mind and body can benefit from acupuncture, according to pros.

Acupuncture for Anxiety and Stress

“Acupuncture lowers cortisol levels, ‘your stress hormone,’ and increases your serotonin and dopamine levels, your ‘happy hormones,’ to treat stress, anxiety and depression,” Auth says. “Acupuncture also balances our two nervous systems, the sympathetic and parasympathetic, to promote a feeling of well-being.”

Researchers in a 2013 study conducted at Georgetown University Medical Center in Washington, D.C., observed four groups of rats over a 10-day period, looking for changes in stress as a result of acupuncture. The researchers measured the rats’ blood hormone levels associated with stress, mood, digestion, and energy, as well as the secretion levels of peptides associated with the fight or flight response after the rats received acupuncture.

“Our growing body of evidence points to acupuncture’s protective effect against the stress response,” Ladan Eshkevari, the study’s lead author, explained. The research still needs to be replicated in humans, but the results help elucidate the “how” behind “why” acupuncture may work to treat anxiety and stress.

Most studies reviewed by Psychology Today note a generally positive effect of acupuncture on anxiety and depressive moods, too, though more research is also needed here to confirm the results after study flaws were identified.

Acupuncture for Chronic Pain

As mentioned earlier, acupuncture is a promising area for the treatment of back pain, and many migraine sufferers also seek out the treatment. “Acupuncture is a natural anti-inflammatory that relieves pain from head to toe,” Auth explains. “Acupuncture can increase circulation to soothe tight muscles, decrease inflammation, and boost the production of your body’s natural pain-killers, known as endorphins and enkephalins.”

Research also supports the use of acupuncture for pain—specifically when the needle is inserted at the Zusanli, one of the most frequently used acupoints, below the knee. The Zusanli is attached to the stomach meridian, making it a common acupuncture spot for improving digestive issues as well.

Based on scientific studies, the NIH has stated that acupuncture “appears to be a reasonable option for people with chronic pain to consider.” After examining the body of research on the subject, the organization specified neck, lower back, headaches, and knee/osteoporosis pains can be alleviated by the TCM.

Acupuncture for Women’s Health

Issues related to pregnancy, fertility, and painful periods frequently motivate people to seek out acupuncture, and WTHN’s treatment menu, Auth explains, caters to “some of the key health conditions for acupuncture—pain relief, women’s health, digestion, and sleep.”

For period cramps, acupuncture has been shown, in small-scale studies, to reduce peak menstrual pain over time and with consistent treatment. According to the NIH, acupuncture also has the potential to significantly alleviate menopausal symptoms, like the severity of hot flashes, trouble sleeping, memory loss, anxiety, and other physical implications of hormonal changes.

While research hasn’t laid definitive evidence that acupuncture can increase a woman’s chances of getting pregnant, scientists have suggested the needling practice can help people cope with related problems during fertility treatments, like the emotional and psychological repercussions.

Acupuncture for Mental Clarity

“Acupuncture is a natural nootropic—it enhances cognition to give you greater focus,” Auth explains. “In fact, a recent science analysis showed that acupuncture is more effective in treating Alzheimer’s than conventional Western medicine.”

Acupuncture may enhance your focus directly, but another reason the treatment could make you feel more alert is that it’s often used to combat sleep-related issues, like insomnia and chronic fatigue. If your brain fog is caused by a lack of sleep or general drowsiness, acupuncture may boost your energy levels by treating the root of such problems and getting you a better night’s sleep.

Does acupuncture hurt?

A practitioner, or “healer,” at WTHN says that the needles she uses are so small, 30 can fit into one needle at the doctor’s office. While some spots can pinch a little as the needle goes in, acupuncture is not typically associated with a lot of pain when done correctly. In fact, Auth says, “it’s common for people to fall asleep on the table because acupuncture is so relaxing.”

What are the potential risks?

There aren’t many potential side effects of acupuncture, but Psychology Today identified some mild adverse reactions that can happen: bruising, nausea, and fatigue. In extremely rare cases, needles administered incorrectly or not sterilized have been reported to cause collapsed lungs, infections, punctured organs, and damage to the central nervous system, the NIH’s National Center for Complementary and Integrative Health cautions. Similar to how you would vet a traditional doctor, you should check the credentials of an acupuncturist before you visit the clinic. Standards and requirements to practice acupuncture vary state-by-state, but most practitioners are required to have a diploma from the National Certification Commission for Acupuncture and Oriental Medicine to grant a license.

Acupuncture May Not Work If…

Research has suggested that acupuncture is ineffective at treating pain when mixed with caffeine, so you might have to forgo your daily coffee or matcha habit to reap the full benefits of the treatment. Auth does “not recommend acupuncture if you’re intoxicated or have a bleeding disorder.” To prepare as best you can for a successful acupuncture appointment, she recommends “eating something within six hours of your acupuncture session and drinking water after your session.”

alternative2019-08-23T12:46:58-07:00August 23rd, 2019|

Dr. Sanjay Gupta: Why I Changed My Mind on Weed

Dr. Sanjay Gupta

Dr. Sanjay Gupta and is an American neurosurgeon and news reporter who wasn’t always in favor of cannabis . In 2013 he wrote:” We have been terribly and systematically misled for nearly 70 years in the United States. He created a 3 part documentary series #weed, presenting compelling evidence that #marijuana has real #medical value. Gupta’s stance is now in favor of using the #plant as a #medicine. #integrativemedicine #chinesemedicine #pain #headache #lowbackpain #cannapyhealth #womensupportwomen #womenempowerment #health #healing #lucypostolovacupuncture

Over the last year, I have been working on a new documentary called “Weed.” The title “Weed” may sound cavalier, but the content is not.

I traveled around the world to interview medical leaders, experts, growers and patients. I spoke candidly to them, asking tough questions. What I found was stunning.

Long before I began this project, I had steadily reviewed the scientific literature on medical marijuana from the United States and thought it was fairly unimpressive. Reading these papers five years ago, it was hard to make a case for medicinal marijuana. I even wrote about this in a TIME magazine article, back in 2009, titled “Why I would Vote No on Pot.”

Well, I am here to apologize.

I apologize because I didn’t look hard enough, until now. I didn’t look far enough. I didn’t review papers from smaller labs in other countries doing some remarkable research, and I was too dismissive of the loud chorus of legitimate patients whose symptoms improved on cannabis.

Instead, I lumped them with the high-visibility malingerers, just looking to get high. I mistakenly believed the Drug Enforcement Agency listed marijuana as a schedule 1 substance because of sound scientific proof. Surely, they must have quality reasoning as to why marijuana is in the category of the most dangerous drugs that have “no accepted medicinal use and a high potential for abuse.”

They didn’t have the science to support that claim, and I now know that when it comes to marijuana neither of those things are true. It doesn’t have a high potential for abuse, and there are very legitimate medical applications. In fact, sometimes marijuana is the only thing that works. Take the case of Charlotte Figi, who I met in Colorado. She started having seizures soon after birth. By age 3, she was having 300 a week, despite being on seven different medications. Medical marijuana has calmed her brain, limiting her seizures to 2 or 3 per month.

https://www.cannapyhealth.com/

alternative2019-08-21T10:50:51-07:00August 21st, 2019|

Dr. Jasmin Hurd and her stance on CBD

Dr. Yasmin Hurd

Yasmin Hurd is a professor of Neuroscience, Psychiatry, and Pharmacology and Systems Therapeutics at the Icahn School of Medicine at Mount Sinai in New York City, was interviewed by New York Times. “The #brain is about a #symphony and #cbd brings the entire symphony into #harmony “ #healing #neuroscience #mountsinaihospital #mountsina #askdrsuzanne #cannapyhealth #womenempowerment #womensupportwomen #newyorktimes #lucypostolovacupuncture

alternative2019-08-21T10:51:53-07:00August 21st, 2019|

Acupuncture And Herbs Alleviate Diabetic Neuropathy

Courtesy of Health CMI-August 5, 2019

Acupuncture and herbs are effective for the treatment of diabetic peripheral neuropathy. Gansu Hospital of Traditional Chinese Medicine (endocrinology department) researchers conducted a controlled clinical trial comparing drug therapy with acupuncture and herbs. Patients receiving both acupuncture and herbal medicine had a total effective rate of 96.67%. Patients receiving Chinese herbal medicine monotherapy had a 73.33% total effective rate. Drug therapy patients had a 53.33% total effective rate for the alleviation of DPN (diabetic peripheral neuropathy). [1]

All patients were monitored throughout the investigation for adverse effects, including liver and renal function tests. No serious adverse effects were reported in any of the clinical trial groups, indicating a high degree of safety for all three treatment protocols. Outcome measures for the study included nerve conduction tests, TCM (traditional Chinese medicine) syndrome scores, and treatment efficacy rates.

Results
Nerve conduction tests were conducted on the common peroneal nerve (along the lateral aspect of the calf) and the median nerve (medial aspect of the forearm). For the common peroneal nerve, mean pre-treatment scores were 29.91 m/s in the drug monotherapy group, 29.91 m/s in the herbal medicine monotherapy group, and 29.90 m/s in the acupuncture plus herbs group. Following treatment, scores increased to 32.22 m/s, 36.62 m/s, and 39.92 m/s respectively.

For the median nerve, mean pre-treatment scores were 34.60 m/s in the drug monotherapy group, 34.60 m/s in the herbal medicine monotherapy group, and 34.56 m/s in the acupuncture plus herbs group. Following treatment, scores increased to 35.52 m/s, 36.52 m/s, and 39.60 m/s respectively. All groups demonstrated significant improvements. The acupuncture plus herbs group had the greatest improvements (p<0.05).

TCM syndrome scores were calculated by the participants subjectively rating symptoms including dry mouth and thirst, fatigue and lack of strength, shortness of breath and dislike of speaking, sweating, insomnia, limb numbness, and formication (the sensation of insects crawling on the skin). Each symptom was rated on a scale of 0–3, with higher scores indicative of severe symptoms. Mean pre-treatment TCM syndrome scores were 16.78 in the drug monotherapy group, 16.85 in the herbal medicine monotherapy group, and 17.54 in the acupuncture plus herbs group. Following treatment, scores fell to 13.47, 12.74, and 9.68 respectively. Improvements were the greatest in the acupuncture plus herbs group (p<0.05). Treatment efficacy rates were calculated for each group. Patients whose self-rated symptoms had fully resolved and whose reflexes were normal, with nerve conduction test improvements of ≥5 m/s, were classified as recovered. For patients whose self-rated symptoms and reflexes had clearly improved, with nerve conduction test improvements of 2–5 m/s, the treatment was classified as effective. For patients with no clear changes in their condition, the treatment was classified as ineffective. In the drug monotherapy group, there were 2 recovered, 14 effective, and 14 ineffective cases, giving a total effective rate of 53.33%. In the herbal medicine monotherapy group, there were 5 recovered, 17 effective, and 8 ineffective cases, giving a total effective rate of 73.33%. In the acupuncture plus herbs group, there were 11 recovered and 18 effective cases, with 1 ineffective case, yielding a total effective rate of 96.67%. Design A total of 90 DPN patients were recruited for the study and, using a random number table, were assigned to either the drug monotherapy group, the herbal medicine monotherapy group, or the acupuncture plus herbs group. The drug monotherapy group was treated with epalrestat, an aldose reductase inhibitor used in the treatment of DPN. The herbal medicine monotherapy group was treated with Tao Hong Si Wu Tang. The acupuncture plus herbs group was treated with Tao Hong Si Wu Tang in combination with acupuncture. Baseline The drug monotherapy group was comprised of 16 male and 14 female patients, ages 40–74 years (mean age 57.60 years). The participants in this group were diagnosed with diabetes for 5.5–21 years (median duration 9.8 years) and suffered from DPN for 1.2–6.8 years (mean duration 4.3 years). The herbal medicine monotherapy group was comprised of 16 male and 14 female patients, ages 41–72 years (mean age 57.03 years). The participants in this group were diagnosed with diabetes for 5–18 years (median duration 9.6 years) and suffered from DPN for 1.5–7.0 years (mean duration 4.3 years). The acupuncture plus herbs group was comprised of 17 male and 13 female patients, ages 40–75 years (mean age 59.03 years). The participants in this group were diagnosed with diabetes for 5–20 years (mean duration 9.5 years) and suffered from DPN for 2–7 years (mean duration 4.5 years). There were no statistically significant differences in baseline characteristics between the three groups (p>0.05).

Diagnostics
Diagnostic criteria included a previous history of diabetes with signs of DPN present either at the time of (or after) diagnosis, signs and symptoms consistent with a diagnosis of DPN such as pain, numbness, formication (the sensation of insects crawling on the skin), and other abnormal sensations. The participants’ reflexes were tested including the ankle jerk reflex and responses to needle pain, vibration, pressure, and heat. In the absence of clinical symptoms, two of the above reflexes were required to be abnormal for inclusion in the study.

Further inclusion criteria included the age range of 40–70 years with a clinical diagnosis of DPN, fasting blood glucose levels of ≤8.0 mmol/L, postprandial blood glucose levels of ≤10.0 mmol/L, diastolic blood pressure of 60–90 mm Hg, and systolic blood pressure of 90–140 mm Hg. All patients were required to give informed consent to participate in the study. Exclusion criteria included infections, external trauma, chronic alcoholism, malnutrition, drug-induced nerve dysfunction, concurrent cardiovascular, respiratory, digestive, neurological, hematologic, immune, endocrine, or psychological disorders, pregnancy, or simultaneously participating in other clinical trials.

Acupuncture, Herbs, And Drugs
All patients received appropriate dietary, exercise, and health education with the aim of regulating blood glucose levels. Any patients taking medications for blood pressure, cholesterol, or coronary heart disease maintained their original treatment and dosage throughout the study period.

Participants in the drug monotherapy group were treated with epalrestat, an aldose reductase inhibitor drug commonly used in the treatment of DPN. A 50mg dose was prescribed, to be taken three times each day. Participants in the herbal medicine monotherapy group were prescribed Tao Hong Si Wu Tang comprised of the following herbs:

Dang Gui 15g
Bai Shao 15g
Chuan Xiong 10g
Shu Di Huang 15g
Tao Ren 15g
Hong Hua 15g

The herbs were decocted in water daily and were split into three doses to be taken morning, noon, and evening. Participants in the acupuncture plus herbs group were prescribed the above herbal formula and also received acupuncture treatment administered at the following acupoints:

Sihua points: Geshu (BL17), Danshu (BL19)
Feishu (BL13)
Pishu (BL20)
Shenshu (BL23)
Yanglingquan (GB34)
Sanyinjiao (SP6)
Quchi (LI11)
Bafeng (MLE8)
Baxie (MUE22)

Needles were inserted using the standard method and, after the arrival of deqi, were manipulated for 30 seconds using a balanced reinforcing-reducing method comprised of twisting, rotating, lifting, and thrusting. Manipulation was repeated at 10-minute intervals and needles were retained for a total of 30 minutes. Treatment was administered daily.

All three treatment groups received two full courses of treatment, with each course comprising two weeks. During the treatment period, patients were advised to avoid cold temperatures and drafts, emotional stress, and overexertion, while refraining from smoking, drinking alcohol, and eating spicy, fatty, or greasy foods.

The results of this study indicate that acupuncture combined with herbal medicine is a safe and effective treatment for DPN and its associated symptoms. Acupuncture and herbs outperformed epalrestat and all treatment modalities used in the study had a low risk of adverse effects.

Reference:
1. Wu Guannan, Meng Caizhou, Zhang Dinghua (2019) “Randomized controlled study of acupuncture combined with Taohong Siwu Decoction in the treatment of diabetic peripheral neuropathy” Journal of Gansu University of Chinese Medicine Vol. 36 (1) pp. 64-67.

alternative2019-08-21T10:52:23-07:00August 12th, 2019|