Welcome to my blog, discover acupuncture with Dr Maggie Ju

Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences. This blog is for information only.

Saturday, 13 August 2022

How does acupuncture work? Research shows that acupuncture alters brain activities.

Acupuncture is originated from China thousands years ago and has been used since. It is now more popular than ever in all over the world. However mechanisms of acupuncture on the central nervous system (CNS) still remain unclear.

New techniques are invented to study brain including Functional Magnetic Resonance Imaging (fMRI), Positron Emission Tomography (PET), Electroencephalography (EEG), and Evoked Potentials (EP). fMRI can used to measure the brain's neuronal activity and the resulting regional changes in metabolism and circulation.PET can be used to measure the brain's regional blood flow, oxygen, or glucose metabolism and reflect the activity in the according brain region. EEG is used to measure brain activity. EP measurement reflects the number of cortical cells activated and the intensity of the stimulus. These techniques are applied to acupuncture research. Using these technologies, researchers are able to examine the acupuncture process in the brain noninvasively and provide scientific evidences how acupuncture works.

Using biochemical approach, researchers found that acupuncture analgesia might be induced by the release of endogenous opioids, as well as by modulating other signalling systems such as the adrenergic system/the serotonin signalling system/the N-methyl-D-aspartic acid/AMPA/kainate signalling system etc. Recently by using neuroimaging techniques researchers found that acupuncture modulates brain networks such as brain resting state networks; acupuncture modulates a wide network of brain areas including cortical, subcortical/limbic, and brainstem areas; acupuncture can enhance functional connectivity among different brain regions.

References

Scheffold BE et al Evid Based Complement Alternat Med (2015) 2015:641742

Dermal fillers VS facial acupuncture-beauty treatment

Dermal fillers or injectable fillers are soft tissue fillers which can be injected into the skin to help fill in facial wrinkles and restore a smoother appearance. Most of the fillers are temporary because they are eventually absorbed by the body. The effect lasts for about six months or longer. There are many different types of fillers; some are natural and some are synthetic, but they all work in similar way to improve the appearance of skin aging. They fill in wrinkles including fine lines and deep creases on the face or lips. plump up the cheeks and contour the face such as jaw line. Common side effects of dermal filler procedure include bruising, redness, pain or itching. Less common side effects include infections or allergic reactions, which may cause scarring and lumps that may require surgical correction. Serious side effects include such as blindness due to retrograde embolization into the ophthalmic and retinal arteries; delayed skin necrosis as a complication of embolization.


Facial rejuvenation acupuncture which is acupuncture as cosmetic purpose can eliminate some wrinkles, improve facial muscle tone, improve skin texture with tighter pores, and decrease sagging around the eyes, cheecks, chin, lift droopy eyelids, face and mouth and clear age spots.

Facial acupuncture helps regeneration of healthy skin cells, increase nutrition to the skin's surface, improves the quality of the skin and enhances a healthy glow, stimulates normal breathing of the skin and makes skin healthy and stronger to prevent infections and clogged pores. Good skin circulation takes waste and reduces grease accumulation resulting in deep cleaning of the skin. Acupuncture stimulates the production of collagen and elastin in the skin. Recently research suggested that wrinkles were improved significantly after facial acupuncture treatment and facial elasticity was also improved in women aged 40 and 59 years.

The side effect was mild bruising (20/140 treatment sessions; 14.28%) at the needle site. No adverse events of scarring, nerve damage, or lengthy recovery periods were observed.

References

Yun et al Evid Based Complement Alternat Med (2013) 2013:424313
Barrett Aesthet Surg J (2005) 25:419-24
Imokawa G and Ishida K Int Mol Sci (2015) 16:7753-75

Thursday, 11 August 2022

What do you know about body fat? Lose weight or gain weight?

When we say fat, one might instantly think of obesity. What is fat? Fat is one of the basic components that make up the structure of the body. It is necessary for normal, healthy body functioning. Body fat can be divided into two types: essential fat and storage fat. Essential fat is necessary for normal, healthy functioning. In men, essential fat is approximately 3% of body weight, while in women it is about 12%. This also depends on age. With increased age, the essential body fat increased. Storage fat is the fat increased when you gain weight and this is the fat that you want to lose when you lose weight. Most of people know that too much fat is not healthy. Too much fat increases your risk for developing heart disease, high blood pressure, gallstones, type 2 diabetes, osteoarthritis, certain cancers and for an early death increases.

Do you know too little fat is not healthy either. If a man’s body fat is too low, his health may be compromised and he may become more vulnerable to illness or experience chronic fatigue. If a woman's body fat is too low, her periods may stop and she may experience infertility. Or the other way around if a woman’s periods stops she may have low body fat. Also if a woman’s body fat is too low, the health of her bones, normal hormonal function may be compromised and she may have osteoporosis.

Amenorrhoea is the absence of menstrual periods. Women who are athletes or who exercise excessively on a regular basis are at risk of developing athletic amenorrhoea.

Low levels of body fat and exercise-related hormones, such as beta endorphins and catecholamines, are thought to interfere with the functioning of the sex hormones oestrogen and progesterone. If left untreated, long-term complications include increased risk of broken bones and premature ageing.

For a doctor to diagnose athletic amenorrhoea, all other possible causes, such as certain reproductive disorders, must first be eliminated. Treatment options include exercising less or, in some cases, starting hormone replacement therapy (HRT).

The long-term complications of untreated athletic amenorrhoea include:

Infertility – a woman can’t conceive when she is amenorrhoeic, but athletic amenorrhoea has no effect on long-term fertility once menstruation returns.

High levels of blood cholesterol – are caused by an oestrogen-related fall in the ratio of good cholesterol (high-density lipoprotein or HDL) to bad cholesterol (low-density lipoprotein or LDL).

Osteoporosis – is a disease characterised by brittle bones that break easily.

Premature ageing – the skin loses its elasticity due to low levels of oestrogen.

Unwanted gaining weight, which hormones to check?

If you gain weight unexpectedly and have trouble to lose the weight, you need to get your hormones checked. Imbalanced hormones can make you put on weight. Which hormones do you need to check?

First , thyroid hormones. If your thyroid function is low and you don’t produce enough thyroid hormones, you can put on weight. Thyroid hormone regulates the rate of the metabolism in your body. If it does not work well, you will likely become fat and have low energy. You may have other symptoms of low thyroid including weakness, cold hands or feet, constipation, low immunity and brittle hair.

Second, insulin. Insulin is produced in pancreas and it is a fat-storing hormone released in response to excess blood sugar. If you have insulin resistance, which means that insulin isn't working very well in your body, this leads to weight gain. Apart from weight gain, other symptoms of insulin resistance include excess thirst and urination, hunger and sugar craving, fatigue and poor circulation, cold hands and feet, poor immunity, poor thyroid function, PCOS, heart and liver problem etc. Improving
your insulin response is a great way to reduce body fat, improve energy and overall health.

Third, Cortisol. Cortisol, called stress hormone is produced in adrenal gland. High or low level of cortisol can cause weight gain. High cortisol levels will lead to fat gain around the belly. Low cortisol levels caused by adrenal fatigue will cause weight gain as well. Other symptoms of adrenal fatigue include bloating, fatigue, sleep disturbances, salt cravings.

Finally, Estrogen and others. Estrogen is stored in fat. Excess estrogen stresses the adrenal glands and binds up thyroid hormone, making weight loss very difficult, especially in the hips and thighs.

Low AMH to get pregnant, acupuncture can help

Anti-Mullerian Hormone (AMH) is a substance produced in small ovarian follicles less than 4 mm which are so small that they can not be seen by ultrasound. Production decreases and then stops as follicles grow. There is almost no AMH made in follicles over 8mm.Therefore, the levels are fairly constant. Since AMH is produced only in small ovarian follicles, blood levels of this substance have been used to attempt to measure the size of the pool of growing follicles in women. The size of the pool of growing follicles is deeply influenced by the size of the pool of remaining ungrowing follicles. Therefore, AMH blood levels are thought to reflect the size of the remaining egg supply - or "ovarian reserve". Because of the constancy, the AMH test can be done on any day of a woman's cycle. Women with few remaining follicles have low AMH. With increased age, AMH decreases. AMH can only indicates the remaining quantity of eggs that a woman has, but it does not indicate the quality of those eggs. Female age is a very important consideration when estimating the probability for conception because it is a strong determinant of egg quality. Low AMH levels (alone) do not predict low IVF success rates in women under 35. In age-related low AMH, the quality of the eggs may also be affected, as eggs accumulate mutations over time. When there are fewer developing eggs in the ovaries, the chance of a mature and healthy egg being released and fertilised decreases. This may mean that the chances of abnormal fertilisation and miscarriage are increased. Acupuncture can help improve blood circulation to help follicles development and increase the chance to get good quality of eggs.

Wednesday, 10 August 2022

How to get rid of tension headaches?

A tension headache is the most common type of primary headache accounting for about 90% of all headaches. It tends to start from the back of the head and moves forward to the top of the head. The exact causes are not clear. It is often linked to sensitivity to pain, stress and tension. It can be triggered by stress, anxiety, fatigue; and/or holding your head at one position for a long time, such as working on computer all day. The pain is bilateral and the head is like being squeezed or stabbed and the eyes are strained; The pain could be dull and feels like a band surrounding your head. Pain may involve the back part of the head or neck. A tension headache can be episodic lasting for days or become chronic. It can be debilitating, impacting our quality of life, lifestyle, mood and daily activities.

Do you know acupuncture can release tension headache effectively? Here is some research evidence for it.
More recently Granato et al analysed the current data about the effectiveness of acupuncture on tension-type headache. There were 11 trials involved in 2317 patients. Two trials compared acupuncture wit routine care only or treatment of acute headache only with a 3 month follow-up. Both studies measured responder rate, headache frequency, pain intensity and pain killer intake. They suggested that effect of acupuncture was better controls. There were five trials compared effect of acupuncture with that of sham acupuncture. Four trials had 6 month follow-up and one trial had 12 months follow-up. Numbers of headache days were significantly decreased in acupuncture group. Headache intensity and frequency of taking pain killers was significantly reduced in acupuncture group compared with sham acupuncture group. Three of the four trials compared the effect of acupuncture with physiotherapy, relaxation. Their conclusion is that there was short term benefit by adding acupuncture to routine care and acupuncture could be a nonpharmacological tool for treating patients with tension-type headache.

Schieapparelli P et al also support the effectiveness of acupuncture in treating primary headache particular tension-type headache and migraine. They suggested that acupuncture is an effective and valuable option for patients suffering from frequent tension-type headache and migraine; also acupuncture is cost-effective treatment.

Hao XA et al analysed five high quality trials. The results suggested that needle retention with 30 minutes was better than no needle retention; twice a week treatment was better than once a week treatment.

A research paper reviewed the effects of acupuncture for headaches. In this review, at least eight weeks of observation period is required, and twelve trials are included. There were 2349 participants. In two large high-quality trials with 1265 and 207 participants, acupuncture was compared with routine care or treatment of acute headaches. Results have shown that the proportion of participants experiencing at least 50% reduction of headache frequency was much higher in groups receiving acupuncture than in control groups. In seven good quality trials acupuncture group had high reduction of headache frequency compared with sham acupuncture. Withdrawals were low: 1 of 420 participants receiving acupuncture dropped out due to adverse effects.The conclusion from the data suggested that acupuncture is effective for treating frequent episodic or chronic tension-type headaches.

References
Granato A et al Neuroepidemiology (2010) 35:160-2
Schiapparelli P et al Neurol Sci (2011) 32 Suppl 1:S15-8
Hao XA et al J Alterm Complement Med (2012)

What is happening in the body, when you have pain?

Pain is a general term that describes uncomfortable sensations in the body and can be described as sharp stabbing, dull ache, throbbing, stinging, sore, and pinching.   It can range from uncomfortable to debilitating and can be consistent or on and off. Pain is highly subjective. People respond to pain differently. Some people have a high tolerance for pain, while others have a low tolerance.

Pain starts from activation of the nervous system. There are 9 steps of the pain circle:

Step 1: Local inflammation. There are injury, surgery, infection causing local inflammation.

Step2: Peripheral sensitization. Local inflammation irritates the nerves lowering the pain threshold causing peripheral sensitization.

Step3: Central sensitization. Nerve signals are transmitted to the brain causing central sensitization.

Step4:  Pain sensation. The brain tells you that there is pain in the body somewhere.

Step5: Pain cognitive processes. The brain where is sensing the pain connects other part of the brain where controls emotion causing emotional and behaviour changes.

Step6: Depression and anxiety. The brain where controls emotions is affected by the pain signals and alters its function causing depression and anxiety

Step7: Cortical reorganization. The brain reallocates its task to different parts of the body to reduce pain sensation and help replace the lost function.

Step8: Avoidance and disability. The body will respond the brain demands to redistribute the work causing avoidance and disabililty.

Step9: Muscle spasm deconditioning. Injured and related muscles become spasmed to protect the body from moving and feeling the pain causing muscle waste.  

Acupuncture is a therapy in which thin needles are inserted into the body to relieve the pain. 

Tuesday, 9 August 2022

What is piriformis syndrome? Low back pain? Can acupuncture help?

Piriformis syndrome is an uncommon neuromuscular disorder. In this condition the sciatic nerve is compressed by piriformis muscle which is a flat, band-like muscle located in the buttocks near the top of the hip joint. This muscle is important in lower body movement and it is used in almost every motion of the hips and legs. Through the piriformis muscle sciatic nerve passes and goes down the back of the thigh and leg. The spasm of the piriformis muscle can compress the nerve to cause some symptoms which include pain, tingling, or numbness in the buttocks. The pain can be sever and spread down to the leg and foot. The pain can be triggered by sitting for long periods of time, climbing stairs and running.

Management of piriformis syndrome include avoiding positions that trigger pain. Rest, ice and heat may help reduce symptoms. Exercises and stretches may help reduce sciatic nerve compression reducing symptoms. Pain killers, muscle relaxants or local injection with corticosteroid or anesthetic may help with reduction of pain.

Acupuncture can be helpful. There were case reports showing effectiveness of acupuncture for priformis syndrome. For example, Liu JM et al observed 80 patients with piriformis syndrome. They found that after a course of acupuncture treatments, the pain threshold values were improved significantly. Another study by Chen RN and Chen YB has shown similar results that acupuncture reduced pain instantly in patients with piriformis syndrome. Shu also reported a case study. In this study there were 39 males and 36 females, at the age of 22-85; they suffered piriformis syndrome for from 3 days to 10 years. After acupuncture treatments, symptoms and signs of pain in the hip and thigh disappeared and the patient can move freely in 55 patients. Symptoms were obviously reduced, and signs were partially improved with basically normal walking and movement, but there was still pressure pain on piriformis in 24 patients. There was no effect in 2 patients. Here was a typical case in this study: A 71 year old lady had pain on her back for 10 months and the pain spread to her hip and thigh. The pain severity changed from mild to severe. There was tender point on the piriformis muscle. After 3 sessions of acupuncture treatments, the pain was reduced significnalty. Followed another 5 sessions of acupuncture, the pain was completely disappeared.

References

Liu JM et al Zhongguo Zhen Jiu (2013) 33:422-5

Chen RN and Chen YB Zhongguo Zhen Jiu (2009) 29:550-2

Shu H J Tradit Chin Med (2003) 23:38-9

How does acupuncture work? Research shows that acupuncture alters brain activities.

Acupuncture is originated from China thousands years ago and has been used since. It is now more popular than ever in all over the world. Ho...