Acupuncture boosts the immune system

What is the immune system in the body? Why it is important? The immune system is a defense system in the body containing many organs and cells against diseases such as viral and bacterial infections. Sometimes the immune system does not work well; it can either be underactive or overactive or attack the wrong targets. If the immune system is underactive and low functioning, you could get frequent infections such as viral infection, fungal infection or chronic inflammation in the body such as aching or pain somewhere in the body or IBS, tiredness etc. If the immune system is overactive you could get diseases such as allergy, hay fever, eczma, athma etc. If the immune system targets your own organs you could get autoimmune disorders such as rheumatoid arthritis. Recent research has shown that acupuncture can help regulate immune system function. For example, a study involved in 34 female patients aged 30-60 with impaired immune function. The result has shown that the improvement of immune function of acupuncture on immune function started from 72 hours after the first acupuncture session and persisted when follow-up time of a month after a year treatments. The impaired immune system in the group was improved significantly to the same level with healthy control group.

References
Arranz L et al Am J Chin Med (2007) 35:35-51

Suffering from fibromyalgia, acupuncture can help

Fibromyalgia, also called fibromyalgia syndrome (FMS), is a long-term condition that causes pain all over the body. It is a chronic disorder characterized by chronic, diffuse and widespread musculoskeletal pain, and its cause is still not clear. Patients with fibromyalgia have increased sensitivity to pain. In addition to widespread pain, there are other symptoms present including debilitating fatigue, sleep disturbance, jointstiffness, headaches and irritable bowel syndrome. People with fibromyalgia have often had depression and anxiety. The cause for fibromyalgia is unknown, but is believed involving psychological, genetic, neurobiological and environmental factors. In fibromyalgia, pain processing and neurotransmitter releasing in the brain are altered leading to lower pain thresholds. Fibromyalgia affects up to 4% of population. The main aims of therapy for this condition are to reduce pain and other symptoms and improve function. Painkillers, antidepressants and antiepileptics are commonly used. As fibromyalgia has a variety of symptoms, no single treatment will work for all of them. You need to find a treatment that suits you. Acupuncture is recommended as an effective option for reducing the pain sensitivity and improving quality of life. There are some evidences emerging showing that acupuncture is a useful treatment option for patients with fibromyalgia and acupuncture may have a great benefit when applied together with medication or other therapeutic options. More recently, Iannuccelli C et al showed that acupuncture could not only control pain but also improve associated symptoms and quality of life. There was a report about the effectiveness of acupuncture on patients with fibromyalgia. These eight women with fibromyalgia received a course of 2 months acupuncture treatments. After the course of acupuncture treatments there was a reduction in the pain threshold and sensitivity and improvement in the of anxiety and depression and quality of life.

A new research has shown that acupuncture is effective on fibromyalgia and the related mechanism. This is randomized controlled clinical trial. 775 women with fibromyalgia participated the study. Treatments were applied twice a week for four weeks. The serum levels of serotonin and SP were evaluated before and after the eight sessions. Patients were clinically assessed by visual analog scale (VAS), the number of tender points (NTP), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), and Nottingham Health Profile (NHP) at baseline, after the last treatment, and one and three months after completion of all treatments. The results have shown that serum serotonin values increased significantly and SP levels decreased after treatment. Significant improvements were found in almost all clinical outcomes after treatment. These continued for three months (followup period) after treatments. They concluded that acupuncture may lead to long-term improvements on clinical outcomes and pain neuromediator values.

How does acupuncture work? Acupuncture stimulates nerve endings leading to releasing endorphins and other neurohumornal factors and changing the processing of pain in the brain and spinal cord; acupuncture reduces inflammation by increasing production of vascular and immunomodulatory factors; acupuncture improves muscle stiffness and joint mobility by increasing local microcirculation.

References
Iannuccelli C et al Clin Exp Rheumatol (2012) 30:112-6
Karakay S et al Pain Med (2017) Dec 6. doi: 10.1093/pm/pnx263. [Epub ahead of print]

Acupuncture is effective for constipation

Chronic constipation is a common symptom that affects nearly 16% of the world population. It has big impact on the patient’s quality of life. Acupuncture is used to treat constipation in China. Recent research has also shown that effectiveness of acupuncture on constipation. For example, there was a research involved in 1075 patients. These patients were divided into two groups: acupuncture group and sham acupuncture group. The study lasted for 20 weeks. The improvement started from 1-8 weeks. 72% patients had improvements in week 9. The response lasts for 12 weeks after the treatment period. Patients with increasing age and coexisting illness may be less likely to respond to acupuncture.

Reference
Yang X et al Plos One (2017) 12:e0187723.

Acupuncture is effective to treat endometriosis

Endometriosis is a chonic inflammatory, gynaecological condition that can result in long-lasting visceral pelvic pain and infertility. Also women with more advanced degrees of endometriosis showed higher CA-125 levels in both serum and peritoneal fluid. Much research has shown that acupuncture could be an effective treatment for endometriosis and may relieve pain. Recently a review has analyzed the effect of acupuncture on endometriosis. 10 studies involving 589 patients were included in the review. The main outcomes assessed were variation in pain level, variation in peripheral blood CA-125 level, and clinical effective rate. The result has shown that acupuncture has significant effect on pain reduction, lowing blood CA-125 and increased clinical effective rate compared to the control. Current research has suggested that acupuncture could be an effective way to treat endometriosis and help release the pain and decrease the blood CA-125 level.

Acupuncture releases pain by increasing pain thresholds in human subjects, and it would appear to activate analgesic brain mechanisms through the release of neurohumoral factors, including adenosine, γ-aminobutyric acid, opioid peptide, acetylcholine, nitric oxide, noradrenaline, dopamine) and others. Acupuncture also enhances the ability of the immune system to more actively eliminate malignant cells by increasing the ability of NK cells to kill cancer cells.

References
Xu Y et al Plos One 2017 Oct 27;12(10):e0186616.

Acupuncture reduces jaw joint pain and improves jaw joint movement

Temporomandibular disorder can cause pain in the jaw joint and the muscles that control jaw movement. This is a common condition of chronic jaw joint pain. The aim of the treatment is to reduce pain and increase the motion of the joint. Butts R et al reviewed the non surgical treatments for this condition. Based on the research evidence they suggested that acupuncture can help to release the pain and improve the joint movement. For example a study by Gonzalez-perez et al investigated the effect of needling on temporomandibular disorder. 48 patients were divided into two groups needling group and medication group. Dry needling acupuncture was applied once a week for three weeks and assessment was carried out before and after treatment. They found that needling group has better pain reduction than medication group. Pain reduction, maximum mouth opening, laterality and protrusion movements compared with pre-treatment values had significant improvement. There was no side effect found in the needling group.



References
Butts R et al J Bodyw Mov Ther (2017) 21:541-548
Gonzalez-Perez LM et al Med Oral Patol Oral Cir Bucal (2015) 20: e326-33

Osteoarthritis and acupuncture

There are growing acupuncture use amongst people with osteoarthritis. Recent research from Australia has studied acupuncture use in people with osteoarthritis. In this study 403 Australia women aged 45 or over with osteoarthritis participated. Analysis revealed that 7.7% of women reported using acupuncture in the previous 12 months for their osteoarthritis. Acupuncture use is positively associated with women experiencing longer duration of time since initial diagnosis of osteoarthritis.

References
Yang L et al Int J Clin Pract (2017) Nov 3. doi: 10.1111/ijcp.13040. [Epub ahead of print]

Rib pain and muscle cramps around the rib cage

Rib cage known as thoracic cage is formed by vertebral column, ribs and sternum. It encloses the heart, big blood vessels and lungs and protects them from damage. There are 24 ribs in human. Rib cage is attached by muscles of the neck, thorax, abdomen and back and covered by the fascia and the skin.

Rib cage pain can happen. The pain can be sharp, dull or achy. It can be caused by heart and lung conditions, fracture of ribs and other bone conditions. If you have rib cage pain, you need to see doctor to find out the underlying causes. Rib cage fascia inflammation and muscle spasm are a common cause of rib cage pain.

Muscles attached rib cage

Intercostal muscles are the muscles between ribs. They move rib cage and play an important role in breathing. Other muscle attached the ribs include that the serratus anterior muscle is a broad, curved muscle located on the side of the chest; the pectoralis minor muscle is the smaller of the two sets of muscles that connect the bones of the chest to the shoulder and upper arm; the external abdominal obliques have their origins along the lateral ribs 5 through 12 and internal abdominal obliques.

The sternum or the breastbone, is a long, narrow flat bone at the front of the rib cage. The muscles attached the sternum include the sternocleidomastoid, pectoralis major, sternohyoid, and sternothyroid muscles. The xiphoid process is the lower end of the sternum provides an important attachment point for the tendons of the diaphragm, rectus abdominis, and transverse abdominis muscles.

Acupuncture can help rib cage pain and rib cage muscle spasm.

Masseter muscle and tooth pain

One of the strongest mastication muscles is masseter muscle. It consists of two heads: superficial head starts from the maxillary process of the zygomatic bone and the anterior two thirds of the inferior border of the zygomatic arch and inserts into the angle of the mandible and inferior half of the lateral surface of the ramus of the mandible; the deep head starts from the posterior third of the lower border and from the whole of the medial surface of the zygomatic arch and inserts into the upper half of the ramus of the mandible. This muscle involves jaw movement. It could be a source of toothache and tooth hypersensitivity to stimuli such as heat and cold. Also the pain over the eyebrow, ear and sinusitis can be caused by masseter muscle. Acupuncture can help release the pain.

Abdominal muscles

The rectus abdominis muscles are a pair of long flat muscles lie vertically along the middle line of abdomen. Each muscle is divided by narrow bands of tendon into four muscular bodies. It originates from the edge of the pubis bone and thepubic symphysis in the pelvis and ends at the inferior edges of the costal cartilages of the fifth through seventh ribs and at the xiphoid process of the sternum. The rectus sheath is a covering connective tissue surrounding the rectus abdominis muscles where the internal and external oblique muscles attach. The linea alba a thick mass of white fibrous connective tissue is in the mid line of the abdomen and joins the two rectus abdominis together. The important function of rectus abdominis muscles is to flex the spine when they contract. Contraction of the abdomen results in increased pressure within the abdominopelvic cavity and is useful to push substances out of the body during exhalation, defecation, and urination. It helps delivering a baby. If there are trigger points present in these muscles, you could feel the pain at the abdomen, lower and mid back region. The symptoms include pain at the low abdomen, period pain, stomach cramping, heart burn chest pain, indigestion, nauseas, vomiting bloating, genital pain, bladder problem, low and mid back pain etc. Acupuncture is the effective treatment to get rid of the trigger points and release the symptoms.

Transverse abdominis muscle is the deepest muscle on the front and side abdominal wall. It lies between the rib cage and pelvic bone. It starts from the back thoracolumbar fascia, from the top inner surface of the lower six ribs, from the bottom front of the iliac crest and inguinal ligament and it ends at the front abdominal midline called linea alba. It is a very important core muscle in compressing the abdomen, providing thoracic and pelvic stability and supporting abdominal visera. It maintains good posture and help to deliver a baby for pregnant women. Trigger points in transverse abdominis could contribute to the abdominal pain and low back pain. Acupuncture can help release the pain.

The external abdominal oblique muscles are a pair of muscles that lie on the lateral and anterior sides of the abdominal wall. They are broad, thin and on the top layer of the abdominal muscles. They start from ribs 5-12 and end at the midline of the abdomen, pubis and iliac crest of the hip bones. Contraction of this muscle makes lateral bend and rotation of the spine, flexes the spine and also pulls the chest downwards and compress the abdominal cavity.

The internal abdominal oblique muscles lie on the lateral and anterior sides of the abdominal wall just underneath the external abdominal oblique muscles and above the transverse abdominal muscle. It bends the spine forward and bring the shoulder of the side forward and it also bend the spine sideway and rotates it. It compresses abdominal contents and assists digestive process and breathing. If trigger points are present in these muscles, the pain can be felt in following area, in the side, the waist area, the groin area, the low abdomen, across the upper back below shoulder blades, across the low back just above hips, stomach pain, testicle pain, pelvis pain bladder pain. Acupuncture can help to release the pain.

Dermal fillers VS cosmetic acupuncture

Dermal fillers VS cosmetic acupuncture

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.

Cosmetic acupuncture 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.

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 a 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

Postpartum genital pain and pelvic pain

Genital pain and pelvic pain are common in the early postpartum period and the pain can last much longer. A recent research has shown that 50% of the participants with genital or pelvic pain last three or more months. 10% continued to experience pain that had begun after they last gave birth. This pain was described at various locations (e.g., vaginal opening and pelvic area), as moderate in intensity and unpleasantness, and most often as burning, cutting, or radiating. Although it was triggered by both sexual and nonsexual activities, none of the mothers affected were receiving treatment. They concluded that postpartum genital and pelvic pain persists for longer than a year for a significant percentage of mothers. Women with a history of other chronic pain appear to be particularly vulnerable to developing persistent genital or pelvic pain. Do you know acupuncture can help this condition? Why live with the pain without treatment?

References
Paterson lq et al J Sex Med (2009) 6:215-21

How the body heal itself? Acupuncture accelerates the process

Connective tissues in the body

Connective tissue is the tissue between organs and tissues and it provides structural and metabolic support for other tissues and organs. It links whole body together. All connective tissue consists of three main components: elastic and collagenous fibers, ground substance and cells. Cells are spread through an extracellular fluid. Variations of the fibers and ground substance determine the property of the tissues. For example, Bones, tendons, cartilages have specific forms of fibers and ground substance. There are three types of connective tissues: loose connective tissue, dense connective tissue and special connective tissue such as bone, cartilage adipose, reticular connective tissue and blood etc. Loose connective tissue contains many cells, a loose arrangement of fibers and moderately viscous fluid substance such as the tissue in lymph gland. Dense irregular connective tissue contains a dense network of collagenous fibers arranged irregularly, for example the tissues in joint capsules and muscle fascia are this type of tissue. Dense regular connective tissue which is a special connective tissue contains cells and all aligned fibers and it is found in tendons and ligaments.

Loose and dense irregular connective tissue provides a medium for oxygen and nutrients to diffuse from capillaries to cells and carbon dioxide and waste substances to diffuse from cells back into capillaries. They protect organs from stretching and tearing forces. Special connective tissue’s function depend on the types of the tissues.

Fascia is connective tissue made up with collagen. Fascia can be seen between muscles, bones, ligaments and other internal organs.

The deep fascia is a highly vascular structure with a superficial and a deep layer, each with an independent rich vascular network of capillaries, venules, arterioles, and lymphatic channels. The presence of mast cells in deep fascia suggests a protective role similar to other connective tissues. The deep layer has few elastin fibers but does have myofibroblasts, suggesting contractile ability. Any active contraction would need to be controlled by a nerve supply and, indeed, one finds myelinated and unmyelinated nerve axons and Schwann cells in these deep fascial layers.

Any active contraction would need to be controlled by a nerve supply and, indeed, one finds myelinated and unmyelinated nerve axons and Schwann cells in these deep fascial layers. The deep fascia is not just a tough barrier structure of collagen and elastin, but is a metabolically active vascular layer which provides gliding and protective functions(16). Deep fascia has parallel longitudinal collagen bundles and rudimentary elastic laminae, giving it both high tensile strength and elasticity. At the junction between the deep fascia and the muscle, without any special secretory cells, the fascia is able to maintain a lubricating layer of hyaluronic acid (hyaluronan) which, like a hydraulic fluid, allows sliding between the fascia and neighboring muscle. However, when the epimysium is disrupted in surgery, overlying fascia does not remain distinct and does not create a gliding layer over the scar(17). More recent findings show that while hyaluronic acid is a lubricant, breakdown products of this large molecule are themselves tissue irritants(18), and fragments from collagen, elastin, and laminins in the extracellular matrix also modulate activities of inflammatory cells

The architecture of the fascia allows continuity of nerves, blood, and lymph vessels between the sliding tissues. With trauma to the muscle, the overlying fascia no longer produces the sliding layer of hyaluronan. Restoring this natural sliding mechanism becomes the next task for the manual therapist.

Fascia, meridians and acupuncture

Under the skin there is a sheet of connective tissue called fascia. Fascia is mainly made up of collagens and it surrounds the muscles and other internal organs. It can be seen between muscles, bones, ligaments and other internal organs. There are three types of fascia, superficial, deep and visceral fascia. Fascia are flexible and are resistant to tension force, this is because the collagen fibers produced by fibroblasts in the fascia are arranged in a wavy manner. Because of the fascia flexibility, it can transmit mechanical force throughout the body and prevent the body from injury. Fascia also provides support to the nerves and blood vessels in the fascia. Fascia is innervated by sensory nerve endings. If fascia is damaged and/or inflamed, it will lose its wavy pattern and flexibility, fasical adhesion and scaring will cause stiffness and pain.

In Chinese medicine, there is a concept of meridians through which the energy will flow throughout the whole body, but the anatomical basis of meridians is not resolved. The recent research data from scanning connective tissue has suggested that fascia network is clearly matched with meridian network. Disruption of fascia can trigger local inflammation and block energy flow causing pain. Acupuncture can reduce inflammation and unblock the meridians improving energy flow.

Chronic pain recovery, fascia remodelling and acupuncture

Nerve endings are surrounded by fascia tissue and play an important role in pain regulation. Disruption of fascia can stimulate pain receptors and provoke inflammation. Recently chronic low back pain has been suggested starting from the fascia inflammation. Pain-related fear leads to a decreased movement, connective tissue remodeling, inflammation, nervous system sensitization and further decreased mobility. The Lumbar Fascia cross the entire lower back region, and is a key component. The lumbar fascia is thickened in patients with chronic low back pain leading to stiffness of the back. Fascia remodelling is a healing process of recovery. Application of acupuncture helps fascia remodelling and reversing the abnormality of fascia.

How the body heals itself

Tissue repair is involved in the healing process which allows restoration of injured tissue. There are four phases during the healing process: blood clotting, inflammation, tissue growth (proliferation) and tissue remodeling (maturation). Blood clotting is initiated within a few minutes of injury. Plate. The inflammatory phase begins with damage to the capillaries, which triggers the formation of a blood clot and the various recruited cells to migrate into wound, such as inflammatory cells (neutrophils and macrophages), fibroblasts and endothelial cells and damaged tissue and cells, bacteria and other debris are cleared out. In proliferation phase, new blood vessels are formed and new tissue cells are crawling onto the top of the wound bed. Meanwhile the wound contract by gripping the wound edge to reduce the size of the wound and bring the tissues closer; new capillaries deliver nutrients and oxygen for the development of granulation tissue and proliferation of fibroblasts. Fibroblasts differentiate to myofibroblasts which have contractile properties containing stress fibres. The last phase of healing is regeneration and scar formation which is involved in a progressive remodelling of the granulation tissue. In this phase many enzymes and their inhibitors play a major role. Vascular cells and myofibroblasts are reduced in numbers. In the final stage, there are two separate processes: regeneration and replacement. In regeneration process, the new tissue completely restored the portions of damaged tissue to their normal state. collagen is realigned and cells no longer needed are removed. In replacement type of healing, severely damaged tissues are replaced by connective tissue forming scarring.

The healing process can become abnormal. These abnormal repair processes are the result of an impaired remodelling of the granulation tissue. If there is the noxious stimulus, excessive extracellular matrix deposition and the continued presence of myofibroblasts is observed. This excess of extracellular matrix deposition leads to the development of organ fibrosis. The installation and persistence of fibrosis is the consequence of an imbalance between extracellular matrix synthesis and degradation by myofibroblasts.

Acupuncture can stimulate normal healing process and restore the balance.

Acupuncture helps with tendon injury

Acupuncture is used to treat tendon injury and it improves pain and functional activity in patients with tendinopathy. This is suggested that acupuncture can modulate both anti-inflammatory and mechanotransduction molecular pathways which can increase type I collagen synthesis. Collagen synthesis is the main factor that influences tendon biomechanical properties. Therefore one reason of acupuncture for tendon healing is that acupuncture increases synthesis and subsequent reorganisation of type I collagen during tendon healing process.

References
Ludovic Micallef etc Fibrogenesis & Tissue Repair20125(Suppl 1):S5
Yu Bai et al Evidence-Based Complementary and Alternative Medicine
Volume 2011 (2011), Article ID 260510, 6 pages
Yu Bai et al Evidence-Based Complementary and Alternative Medicine
Volume 2011 (2011), Article ID 260510,
Almeida Mdos S et al Acupunct Med (2014) 32:178-82.

Beta endorphins, chronic fatigue and acupuncture

β endorphins are endogenous opioid neuropeptides and peptide hormones or endogenous morphine like substance originated from within the body. β endorphins are produced in the brain. Recent research suggested that cells of the immune system are also capable of beta-endorphin synthesis. In the peripheral nervous system (PNS), beta-endorphins produce analgesia by binding to opioid receptors and then inhibiting release of substance P, a key protein involved in the transmission of pain. In the central nervous system, beta-endorphins similarly bind opioid receptors. However, instead of inhibiting substance P, they exert their analgesic effect by inhibiting the release of GABA, an inhibitory neurotransmitter, resulting in excess production of dopamine. Dopamine is associated with pleasure. They decrease feeling of pain and produce a feeling of euphoria. They also modulate appetite, release sex hormones and enhance immune response. Stress and pain are the two most common factors leading to the release of β endorphins. They act on the opiate receptors in a similar way to morphine and codeine, but endorphins don’t have addiction or dependence effect. With high endorphin levels, we feel less pain and fewer negative effects of stress. The body produces endorphins by responding to exercises. Endorphin release varies among individuals, which means that two people who exercise at the same level or suffer the same degree of pain will not necessarily produce similar levels of endorphins. Acupuncture stimulates β endorphins release and reduces pain feeling and stress.

If you are tired all the time, you might have low β endorphins in immune cells. A study was involved in 16 patients with chronic fatigue syndrome. They found that β -endorphin concentrations in the immune cells of chronic fatigue patients were significantly lower than in healthy subjects. Another study on patients with chronic fatigue syndrome and fibromyalgia has shown that β endorphins level was significantly lower in these patients. Acupuncture releases β endorphins and is beneficial to patients with chronic fatigue and fibromyalgia.

References
Adam S Sprouse-Blum etc Hawaii Med J 2010, 69:70-71
Conti F et al Clin Exp Rheumatol (1998) 16:729-32
Panerai AE et al Clin J Pain (2002) 18:270-3

Acupuncture in Press

Back pain is a very common condition. Many people take painkillers to help. Do you know that drugs are no longer the first line of treatment for back pain, but acupuncture is? The American College of Physicians (ACP) has announced that drugs should no longer be the first line of treatment. Instead of reaching for paracetamol or ibuprofen, you should try treatment such as heat (superficial), massage or acupuncture.

References
https://www.theguardian.com/lifeandstyle/2017/feb/27/do-painkillers-offer-any-help-for-back-pain

Temporal muscle, jaw pain and acupuncture

The temporal muscle is a broad fan shaped muscle on each side of the head covering much of the temporal bone. It is one of the muscles involved in jaw movement and is the most powerful chewing muscle of the temporomandibular joint. You can see and feel the muscle contracting while the jaw is clenching and unclenching. The muscle is innervated by a branch of trigeminal nerve. This muscle is likely to be involved in jaw pain, teeth pain, facial pain ,migraines and headaches. Dental work and chewing gum can lead to trigger points in the temporal muscle. These trigger points can cause pain in the side of the face in temple region and the pain can radiate to the face, eye brow, jaw, upper teeth, head and neck. Acupuncture can help release the pain.

Fighting fatigue, caffeine vs exercises, acupuncture can help

Many people drink coffee to help them keep their energy level up. A cup of coffee improves attention, alertness, reaction time, and mood, especially when you are tired. Why does coffee have such effect? That is because of the caffeine contained in the coffee. Caffeine can stimulate the brain to make you feel more energetic and more awake; caffeine increases urination, increases release of acid in the stomach and increases blood pressure. There are many side effects of caffeine, such as insomnia, headaches, dizziness, restless, shakiness, anxiety, dehydration, abnormal heart rate. If you stop taking caffeine, you could experience withdrawal symptoms including headaches, drowsiness, fatigue, irritability, difficulty of concentrating, nausea etc. Other risks of taking caffeine include lower risk of type 2 diabetes, high blood pressure, and obesity, but may increase cholesterol bone loss and rheumatoid arthritis.

A brief cardiovascular exercise wakes you up, speeds mental processes, and enhances memory storage and retrieval. Exercise has multiple long-lasting positive effects on physical fitness and function, cognition, mood, and behavior. All of these effect helps reduce fatigue and no side effects.

Life style, fatigue and acupuncture

Apart from physical and psychological causes of fatigue, certain life style can make you feel tired, for instance, drinking too much alcohol, having bad diet, less of sleep, stress. You can help yourself with life style change to gain more energy.

Drink less alcohol, Although a few glasses of wine in the evening helps you fall asleep, you sleep less deeply after drinking alcohol. The next day you’ll be tired, even if you sleep a full eight hours.

Eat healthy diet, eat more fruits and vegetables to intake enough minerals and vitamins which are essential for biochemical reaction in the body. Eat regularly. Five essential group of food: Fruits and vegetable; starchy foods like potatos, bread, rice, or pasta; proteins foods like fish, eggs, meat, beans milk; unsaturated fat, unsaturated oils, omega3 etc; high fiber food like fruits,vegetables, beans, brown rice, whole meal etc.

Sugar and fatigue

There are two types of sugar: simple sugar and complex sugar. Simple sugar is digested quickly and release sugars rapidly into the bloodstream. It gives you a rush of energy which wears off quickly. Fluctuation of blood sugar too much can make you feel tired. Simple sugars are found in foods such as sweets, cakes, biscuits, chocolate, and some fizzy drinks and juice drinks. These are the sugary foods you should cut down on. Sugars also occur naturally in foods such as fruit, vegetables and milk, but you don't need to cut down on these types of sugars. Complex sugars are present in starchy foods such as potatoes, bread, cereals and pasta. They're a good source of energy and the main source of a range of nutrients. They release energy gradually. Starchy foods should make up just over a third of everything you eat.

Drink more water, cut out caffeine, caffeine may make you not sleep well. Cut down caffeine can help you sleep. Dehydration can make you tired. Drinking more water to keep the body hydrated.

Sleep well, go to bed regularly and take some time relax before sleep. These can help sleep quantity and quality.

Lose weight, if you are overweight and you feel tired, you need to lose weight.

Exercises, You might feel too tired to exercise, however in the long run exercise will help with fatigue and make you feel less tired.

Reduce stress, acupuncture is an efficient way to reduce stress.

How your face changes with aging?

Face changes when people grow older. This change starts as early as in 30’s year old. This change not only happens on the surface of the skin, but also underneath the skin surface such as fat, muscle and bone etc. Loss fat volume and muscle mass on the face makes the face loss its fullness. Fat pulls downwards and the skin becomes loose and sagging due to gravity and muscle force. Bone also losses its mass and muscles are shortened and straightened. Corners of the eyes and mouth droop, tip of the nose droops as well and ears become longer. Of course, wrinkles, various spots and pigmentation appear on the face.

Environmental factors can speed up aging process: such as hormonal imbalance, sun exposure, smoking, stress, diet, diseases etc. This makes people look older than their age.

Acupuncture has anti-aging effect and rejuvenates your face. All my patients with facial acupuncture love it.

Skin aging, skin blood flow and facial acupuncture

Skin blood flow significantly decreased with increase in age. Skin blood flow is 40% less at age 65 than at age 25. This is because skin blood flow decreases with decreased pumping blood from heart; skin blood flow significantly decreased with increase in total cholesterol and systolic blood pressure; less blood is redirected to the skin from other part of the body; blood vessel movement is impaired with aging and blood vessels are not relaxed to increase the blood flow.

Acupuncture increases blood perfusion and reduces skin aging

Recent years researchers are trying to find how acupuncture works from a scientific aspect. Many research data suggested that acupuncture improves blood perfusion. For example, there was a study of acupuncture on 140 healthy volunteers. In this study, acupuncture was applied in LI4’ skin blood flow was measured using a Moor full-field laser perfusion imager before and after acupuncture stimulation. Recently study has shown that stimulating LI4 also increased facial blood flow and hand blood flow. After acupuncture of the right LI4 acupuncture the change ratio of mean blood flux in the left LI4 was increased significantly compared with the control group 60 minutes after acupuncture stimulation. Another study has shown that acupuncture at LI4 and LI11 increased blood circulation along the meridian. Study at ST36 point also has suggested increased skin blood perfusion around the acupuncture point in healthy subjects. In 22 healthy volunteers acupuncture at PC6 point increased microcirculation blood perfusion units along the meridian. Increased blood circulation was also seen at the back acupuncture point study. This also demonstrated in some conditions For example, in a study patients with dysmenorrhea were treated with acupuncture. After 10 sessions of acupuncture treatment, microcirculation was increased and the symptom scores, pain index, and visual analog scale decreased significantly in treatment group.

References
Tsuchida Y J Dermatol Sci (1993) 5:175-81

Acupuncture can help to reduce skin aging

Skin blood flow significantly decreased with increase in age. Skin blood flow is 40% less at age 65 than at age 25. This is because skin blood flow decreases with decreased pumping blood from heart; skin blood flow significantly decreased with increase in total cholesterol and systolic blood pressure; less blood is redirected to the skin from other part of the body; blood vessel movement is impaired with aging and blood vessels are not relaxed to increase the blood flow.

Acupuncture increases blood perfusion and reduces skin aging

Acupuncture is used to treat many conditions in China. Its mechanism is based on meridian theory which is not accepted by Western medicine theory. Recent years researchers are trying to find how acupuncture works from a scientific aspect. Many research data suggested that acupuncture improves blood perfusion. For example, there was a study of acupuncture on 140 healthy volunteers. In this study, acupuncture was applied in LI4’ skin blood flow was measured using a Moor full-field laser perfusion imager before and after acupuncture stimulation. Recently study has shown that stimulating LI4 also increased facial blood flow and hand blood flow. After acupuncture of the right LI4 acupuncture the change ratio of mean blood flux in the left LI4 was increased significantly compared with the control group 60 minutes after acupuncture stimulation. Another study has shown that acupuncture at LI4 and LI11 increased blood circulation along the meridian. Study at ST36 point also has suggested increased skin blood perfusion around the acupuncture point in healthy subjects. In 22 healthy volunteers acupuncture at PC6 point increased microcirculation blood perfusion units along the meridian. Increased blood circulation was also seen at the back acupuncture point study. This also demonstrated in some conditions For example, in a study patients with dysmenorrhea were treated with acupuncture. After 10 sessions of acupuncture treatment, microcirculation was increased and the symptom scores, pain index, and visual analog scale decreased significantly in treatment group.

References
Tsuchida Y J Dermatol Sci (1993) 5:175-81

Botox injection vs cosmetic acupuncture

Reduce wrinkles by botox injection

 
Botox is a neuro toxin. It has been used to treat various medical conditions. Recently it was approved for using in cosmetic purpose to reduce wrinkles on the face. This is because botox paralyses facial muscles. Botox injection is a procedure in which botox is injected into the desired area using injected needles. Following the treatments visible result can be seen within days or a couple of weeks. They tend to last for up to three or four months. Botox does not actually erase lines but relaxes them which means that deeper lines will become less deep and superficial lines will nearly disappear. Bleeding, bruising , swelling or redness at the site of injection is short term side effects. Other risks include headache, pain, and flu-like illness. In rare cases, there may be inappropriate facial expression, a drooping lid or eyebrow area, or double or blurred vision, dry mouth, fatigue and allergic reactions. If the toxin could travel back to the central nervous system, this would cause long-term damage.

Apart from botox injection, there is an alternative way to reduce wrinkles which is by facial acupuncture. Thin acupuncture needles are inserted in acupuncture points on the face. This is a natural way to relax facial muscles and reduce wrinkles. Also skin is better nourished by increased facial blood flow and becomes healthier. There is no side effects for acupuncture treatments apart from a small chance of little bruising which would disappear in a few days time.

What is cosmetic acupuncture, how does it work?

 
Recently, cosmetic acupuncture has been introduced as an intervention for skin rejuvenation. It is a natural and healthy way to look and feel years younger. Why acupuncture can play a role in cosmetic purpose? Treatment benefits include elimination of some wrinkles and decrease in length and depth of others, decrease of facial edema, decrease of acne, improvement of facial muscle tone, improveing skin texture with tighter pores, and decrease of sagging around the eyes, cheeks, chin, and neck, lifting of droopy eyelids, face and mouth, clearing or fading of age spots. Skin becomes more delicate and fair and at the same time overall appearance and health enhanced.

Facial mimetic muscles gradually straighten and shorten with age as a result of increased resting muscle tone and acupuncture can improve the muscle tone. 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 a research suggested that wrinkles were improved significantly after facial acupuncture treatment and facial elasticity was also improved in women aged 40 and 59 years.

Is there side effect of facial acupuncture? A study has shown that the most commonly reported adverse event that was clearly attributable to FCA treatment 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
http://www.netdoctor.co.uk/brain-and-nervous-system/medicines/botox.html
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

Facial acupuncture, a new moisturiser for your face

Nowadays more people have dry skin due to changes in environments such as widespread heating and cooling. This makes skin aging quickly. Moisturising of the skin becomes an important anti-aging skin care. The balance of the water content, oil content and natural moisturising factors in the skin are important factors in maintaining moisturisation. Skin moisturisers are widely used. Skin moisturisers are complex mixtures of chemicals specially designed to make the external layers of the skin softer and more pliable. They increase the skin’s hydration by reducing evaporation. Apart from skin moisturisers is there other way to moisturise skin?

Does facial acupuncture moisturise skin? Is there any scientific evidence for such type of application? A study from Japan has shown that there was increased water and oil content for facial skin after cosmetic acupuncture suggesting that acupuncture can modulate the water and oil content of the skin. Facial acupuncture is a new approach for moisturising your facial skin.

As a result your skin achieves glowing, moisturizing, smooth and healthy, wrinkles disappear and muscles are relaxed. Skin elasticity is also restored. This helps to get rid of the stress and its further impact to the skin. As a result the skin aging slows down.

References

N. Donoyama et al (2012) Acupuncture in Medicine30: 152–153,
http://en.wikipedia.org/wiki/Natural_skin_care

Hypothalamic-pituitary-adrenal axis, adrenal fatigue and acupuncture

Stress causes changes of many systems in the body. In response to stress, the level of various hormones changes, such as glucocorticoids, catecholamines, growth hormone and prolactin. This allows the body to cope with stress situation. Hypothalamic-pituitary-adrenal axis consists of a serial of endocrine organs including hypothalamus, pituitary gland and adrenal glands. In response to stress, this axis is activated to promote survival. Stimulation of this axis results in hypothalamic secretion of corticotrophin-releasing factor (CRF). CRF then stimulates the pituitary to adrenocorticotropin (ACTH), 8-lipotropin and 3-endorphin. Plasma levels of these hormones can increase two- to fivefold during stress in humans. ATCH stimulates adrenal glands to produce glucocorticoids which are a class of steroids. cortisols stimulate the formation of glucose and activates antistress and anti-inflammatory pathways. Stimulation of the pituitary-adrenal axis is also related to release of catecholamines which increased cardiac output, skeletal muscle blood flow etc.

Two small adrenal glands are above the kidneys. These glands produce various hormones. As mentioned above, cortisol is one of them and it helps the body deal with physical and psychological stress. Adrenal fatigue is not a proven medical condition but a description. When you are stressed, your adrenal glands might not be able to work properly. This may cause you to feel very tired. However there is no evidence there is anything wrong with the adrenal glands and also there is no specific investigation or treatment for adrenal fatigue. Adrenal fatigue is a term applied to a collection of nonspecific symptoms, such as body aches, fatigue, nervousness, sleep disturbances and digestive problems etc. Acupuncture can help to improve these symptoms.

If you suspect that your fatigue is caused by adrenal insufficiency, you can get adrenal glands checked by blood tests. Adrenal insufficiency (Addison's disease) refers to inadequate production of hormones by adrenal glands. Signs and symptoms of adrenal insufficiency may include: fatigue, body aches, unexplained weight loss, low blood pressure, lightheadedness, loss of body hair, skin discoloration (hyperpigmentation).

Drowsiness and excessive sleepiness

Drowsiness refers to feeling abnormally sleepy during the day. People who are drowsy may fall asleep in inappropriate situations or at inappropriate times. Many conditions can cause drowsiness, such as, chronic pain, diabetes, insomnia sleep apnea underactive thyroid, depression, anxiety etc. Life style such as night shifts, not sleep long enough, alcohol abuse and stress etc can also cause drowsiness.

Idiopathic hypersomnia (unexplained daytime sleepiness) is a condition in which excessive sleep or sleepiness interferes with everyday life. There is no underlying cause found. People with this condition are sleepy throughout the day, despite sleeping for a very long time at night. They are struggling to stay awake during the day and are usually compelled to take frequent long naps. The excessive sleepiness may have a negative impact on the person's work, relationships and social life, and they may also have anxiety, depression, fatigue mood changes think or speak slowly poor memory and difficulty to concentrate etc. There are no medicines specifically designed to treat idiopathic hypersomnia. Why not try acupuncture?

Lack of concentration, acupuncture can help

Most people have experienced a periodic event of difficulty concentrating. This is often accompanied with tiredness and stress. Many medical conditions can cause lack of concentration such as insomnia, chronic pain, brain trauma, stroke etc. Psychological conditions can also interfere with concentration such as anxiety, depression, emotional trauma, and stress etc. However in most of cases there are no medical reasons found. Prolonged lack of concentration and feeling tired can be very frustrating. People often turn to stimulants like sugar and coffee to help.

There are many things that you can do to help to improve your brain concentrating.

Diet. Consequence of poor diet does not provide enough nutrients to the brain and this would affect brain function. Healthy diet such as nuts with high proteins is good for the brain.

Exercise. Exercise improves circulation and stimulates brain.

Vitamins. Vitamin B12 is needed to make blood cells and maintain healthy brain and nerve function and helps with memory and concentration Vitamin B12 is found in animal products such as meat, shellfish, milk, cheese, and eggs. Make sure you get enough B12 from these foods. Vitamin D also helps to maintain memory and concentration. Vitamin D is created in the skin by the natural sunlight. Make sure get enough sun shine.

Reduce stress and balance hormones. Stress and imbalanced hormones can affect brain function. Acupuncture can help reduce stress and balance hormones, improve concentration and make mind sharp.

Vitmain B12 deficiency and fatigue

Vitamin B12 (B12) is a water-soluble vitamin which means that it does not store in the body for long and is flushed away if there is excessive B12 in the body. Also the body does not make vitamin B12, it has to be obtained from food with B12, or from supplements. B12 is absorbed in distal small intestine called ileum after it is bound to a protein and a gastric intrinsic factor produced in the stomach. The richest natural sources of B12 are liver and kidney. Also B12 is presented in other animal products such as dairy products, eggs, fish, meat, and poultry. B12 plays a key role in the function of brain and nervous system apart from formation of red blood cells. Deficiency of B12 can damage the brain and nervous system. The symptoms include fatigue, weakness, lightheadedness, depression, poor memory, breathlessness, heart palpitations, headache, numbness, tingling, muscle weakness and problems walking, pale skin the smooth tongue etc. In some circumstances, one can have B12 deficiency. For example, with age, it can be harder to absorb B12; after stomach surgery (remove a part of the stomach), it disturbed B12 absorption; other conditions such as atrophic gastritis, small intestine problems can affect B12 absorption.

Vitamin D deficiency and fatigue

The main source of Vitamin D is produced by the skin when it is exposed to sunlight. Vit D is also present naturally in some foods such as some fish, fish liver oils, egg yolks, dairy and grain products. It is essential for strong bones by helping the body absorb calcium from the diet. Low vitamin D leads to bone abnormalities and worsens muscle strength. Fatigue is a common complaint and it is also described as tiredness or low energy. Most patients with fatigue have no obvious cause. The cause can only be found in 5% people with fatigue such as cancer, stroke, heart problems, respiratory conditions, liver problems, anemia, autoimmune diseases, infections etc. Low vitamin D can be the cause of fatigue. If you feel tired all the time, get vitamin D level checked out.

Folic acid deficiency and fatigue

Folic acid or folate is vitamin B9 one of the B vitamins. It is essential for the body to make DNA, RNA and amino acids; and it is essential to make red blood cells. The human body cannot make folic acid, it has to come from the food. It is important to eat food containing folic acid to get enough for the body need. Folic acid mainly contain in dark leafy vegetables, fruits, beans, peas, sprouts, dairy products, poultry, meat and liver. If you don’t take enough folic acid or you have digestive system problem which disturb folic acid absorption, you can have folic acid deficiency. The symptoms of deficiency include feeling tired, heart palpitations, shortness of breath, gray hair, mouth sores, poor growth, and swollen tongue, anemia etc.

Iron deficiency and fatigue

Iron in the human body forms complex compound with oxygen in hemoglobin and myoglobin. Hemoglobin is the iron- and oxygen-binding protein in the red blood cells and myoglobin is the iron and oxygen binding protein in the muscle cells. Iron is important in making red blood cells which carry oxygen around the body. Most people should be able to get all the iron they need by eating a varied and balanced diet. The food in rich of iron includes red meat, liver, beans, peas, leafy vegetables etc. Signs and symptoms of iron deficiency may include brittle nails, swelling or soreness of the tongue, cracks in the sides of the mouth, an enlarged spleen, and frequent infections. Iron deficiency can cause anemia. The signs and symptoms of iron-deficiency anemia depend on its severity. The most common symptom of all types of anemia is fatigue (tiredness). Fatigue occurs because your body doesn't have enough red blood cells to carry oxygen to its many parts. Anemia also can cause shortness of breath, dizziness, headache, coldness in your hands and feet, pale skin, chest pain, weakness etc.

Feeling tired, low energy? acupuncture can help

Fatigue is a very common complaint. 36% of fatigue in the general population is associated with unhealthy lifestyle or the coping skill. Recently a study from Germany investigated the relation of fatigue and perceived stress. 2483 people participated this study. 9.7% of individuals reported substantial fatigue lasting six months or longer; 25.9% of male and 34.5% of female respondents reported fatigue during the last 6 months. This study has shown that women have a higher risk of fatigue and higher rates of stress perception. The elderly (over 61 years) had the highest risk of fatigue. Marital status is significantly correlated to both fatigue and stress perception; being divorced or separated increases the probability of both. Employment status contributes only substantially to stress perception not to fatigue. Respondents with a lower socioeconomic status have significantly higher risk for fatigue than those from middle or high social classes. Poorly rated health is strongly associated with both a high stress perception and fatigue. If you feel exhausted, you are not alone. Fortunately it is not anything physically wrong at most of the time. Psychological tiredness is far more common than that caused by a physical problem. It is usually linked with mood and the accumulation of lots of little stresses in life. However before you reach a conclusion, you need to exclude physical reasons that make you tired. Many conditions can cause tiredness, such as anemia, underactive thyroid gland, diabetes, insomnia and many more. Inflammation could be the cause of your excessive tiredness. It may surprise you that you could have a problem with inflammation without knowing it. When there is fatigue, chronic inflammation is usually present somewhere in the body. It could be associated with or without chronic pain. Chronic inflammation is different from acute inflammation. Acute inflammation is characterized with heat, redness, swelling, and pain while chronic inflammation is low grade sometimes unnoticeable. Recent research has shown that the inflammatory markers such as C-reactive protein (CRP), cytokines etc. are linked with excessive fatigue, such as chronic fatigue syndrome and general fatigue. Inflammation also interacts with a part of the brain called basal ganglia and lower basal ganglia activity which makes you tired. Inflammation can affect immune system causing stress response of the body and this makes you feel tired.

Energy resources of the body

Where is energy coming from? It comes from the food we eat. This becomes general knowledge that our body’s energy comes from food we eat. There are three resources of food that provide us with energy: carbohydrates such as sugar and starch, protein, and fat. Carbohydrates are the body’s preferred and principle source of energy and they break down into glucose which is an immediate source of energy or fuel for the body especially for the brain and muscles. Fat is the storage of the energy and is the body’s most concentrated source of energy, providing more than twice as much potential energy as carbohydrate or protein. Protein is used to build, maintain, and repair body tissues, as well as to synthesize important enzymes and hormones. It is only used as small percentage of energy source. In some situations when the glycogen reserve is depleted such as when we eat too few calories daily or not enough carbohydrate, as well as during latter stages of endurance exercise, the body will sacrifice to break down protein to keep constant energy supply.

The brain is a large energy consumer. Although the brain constitutes only 2% of the body mass, it consumes 50% of total body glucose utilization. The brain does not store energy and it needs constant energy supply. On the contrary, the muscles can store energy and use it later on during exercises when more energy is needed.

How much energy does one need? This depends individually. In this case the energy is balanced. What food and how much you eat is a key step to get balanced energy. Healthy diet gives you balanced energy.

Energy balance and acupuncture

Energy balance of the body is the balance of calories obtained through eating and drinking (energy in) compared to calories burned through physical activities (energy out). Weight watch is simple and effective way to know how much energy you need and get balanced energy. If you eat food with more energy than you need, the excessive energy will turn into fat and store in the body and you gain weight. If you eat food with less energy than you need, the body will burn existing body fat to make up for the difference and you lose weight. If you eat the food with energy that equals to what you used, your weight will remain unchanged.

Many people are focusing on what they eat and how much calories are taking in from the food. What you eat is important to get balanced energy. However this is only one aspect. There are many aspects that are equally important as well. For example, food absorption of the body, this is related to digestive system function. If your digestive system is functioning well, all the nutrients can go into the body. Otherwise, the nutrients you eat just pass through without entering the body, in the case of diarrhea, for example. Blood circulates throughout the body and brings the energy to the cells to function. It is also a key step to get balanced energy. If blood circulation is poor, the nutrients will not reach the cells which need energy to do the work. You will see symptoms of blocked energy. Fatigue is a typical symptom of lack of energy.

What is detoxification?

In physiology, detoxification is a process of removal of toxic products in the body. This task is mainly carried out by liver and kidney. There are many metabolic products in the body are toxic to the body if they are accumulated. For example, free radicals reactive oxygen species are generated from normal essential metabolic processes in the body or they can be obtained from external sources such as exposure to X-rays, ozone, cigarette smoking, air pollutants, and industrial chemicals. If free radicals are accumulated in the body, this causes oxidative stress to the body and adversely alters lipids, proteins, and DNA and triggers some many illnesses. A balance between free radicals and antioxidants is necessary for proper physiological function.

Acupuncture improves body energy supply and detoxification by increasing blood circulation

System circulation is the part of the cardiovascular system. Microcirculation is blood circulation in the smallest blood vessels which comprise arterioles, capillaries and venules. Arteriole wall is made up of smooth muscles, while there are no smooth muscles on the capillary and venule wall. Lymphatic circulation consisting of lymphatic capillaries also contributes to the microcirculation function. It carries oxygenated blood away from the heart through the arteries, capillaries to the tissues of the body. It provides the functional blood supply with oxygen and nutrients to the cells to all body tissue. It picks up carbon dioxide and waste products and returns deoxygenated blood through veins back to the heart. Circulation is the key for body function. It provides energy that body needs and detoxifies the body. If some part of the body or whole body circulation is compromised, the body will not function well and illness will occur.

Acupuncture improves blood circulation and this was proved by scientific research. For example, Sandberg et al investigated the effects of acupuncture on skin and muscle blood flow. Blood flow recordings were performed intermittently from 10 min prior to the intervention to the end of the trial. They found that skin and muscle blood flow increased after acupuncture stimulation. Another example Kuo et al also studied the effect of acupuncture on skin blood flow. After acupuncture treatment skin blood flow and skin temperature increased. By increasing blood circulation, acupuncture improves body energy flow and helps with detoxification of the body. Why you are very tired? No medical causes found. Poor circulation is contributing to the fatigue. If microcirculation is poor, the organs don’t get enough oxygen and nutrients and the toxins accumulate in the organs, this could make you tired all the time. Acupuncture improves digestive function and blood circulation to help the body obtain energy and get rid of the tiredness.


References

Sandberg et al Eur Appl Physiol (2003) 90:114-9
Kuo et al Am J Chin Med (2004) 32 :117-29
Fehm HL et al Prog Brain Res (2006) 153:129-40
Kocalevent RD et al BMC Res Notes 2011 Jul 20;4:238. doi: 10.1186/1756-0500-4-238.

What do hormones do to you? balance hormones with acupuncture

What is hormone?

Hormones are produced in the endocrine glands. There are many endocrine glands in the body, such as the pituitary gland, thyroid, adrenal glands, and pancreas, testis in men ad ovaries in women. These glands produce specific chemicals and these chemicals act on the target organs and play a role in body function such as growth, metabolism, sexual function, reproduction and mood etc. Hormones are powerful molecules and only a tiny amount can cause big changes in the body. Too much or too little hormones can cause serious conditions. For example, if ovaries don’t produce enough hormones ie oestrogen and progesterone, it can cause infertility. If pancreas does not produce enough insulin, it can cause diabetes.

Hormonal balance is very important to the health. If the hormones are not balanced, there are many signs to indicate.

Irregular periods and spotting, Women in reproductive ages have regular periods. If the periods are not regular, or there are spotting between periods or missing periods. This indicates that the hormones are not balanced. They should not have vaginal bleeding between the periods, but many women experience spotting (light vaginal bleeding) between their periods sometimes. This is considered not normal. If you have difficulty to get pregnant and you have persistent spotting every month, this could be the problem. One of the common causes of spotting is hormone imbalance. Eostrogen and progesterone levels drop causing uterine lining breaking down which leads to spotting. Chronic acne, chronic acne is caused by excess of adrogens. If your acne does not clear up for long period of time, this indicates imbalanced hormones. Chronic fatigue and headaches, if you always feel tired, this can be caused by imbalanced hormones. Periodic headaches can be caused by imbalanced hormones. Mood swing and depression, hormones imbalanced can affect the brain and cause mood changes and depression, sleep problems and poor memory. Digestion problems such as bloating, diarrhea, stomach pain, nausea, appetite changes etc. Other signs include vaginal dryness, loss of libido and breast changes.

Light period, Periods are menstrual bleeding from the uterus. Every month hormones produced in the ovaries have cyclic changes. These changes cause uterine inner lining shed from the uterine wall and bleeding from the uterus. The normal bleeding days are 5 days from 4-7 days and the normal blood loss during the period is between 20-60 ml. The period with less 20 ml of blood loss is light period. Imbalanced hormones causing thin uterine lining is the common cause for this. Inflammation in and around the pelvis is another common cause and this can cause tension and block the blood flow to the uterus. If your period is too light, this could affect you from getting pregnant, because the uterine lining is not good enough for embryo to implant into the uterus and pregnancy would not occur.

Acupuncture can help improve hormone balance and reproductive blood flow and improve the chance to get pregnant.

Hormones and pain

Many chronic pain conditions have cyclical variation. This variation is related to menstrual cycles. Clearly period pain is a typical one. Other conditions such as chronic pain syndrome, chronic pelvic pain, chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome (IBS), interstitial cystitis (IC) and migraine can also show cyclical variation. Research has shown that chronic pain symptoms occur when oestrogen levels are low or fall rapidly. This supports the use of the combined oral contraceptive pill (COCP) to give a more constant hormonal level can improve pain and other symptoms. β-endorphin produced in the brain had a potent analgesic effect, and up to 33 times more potent compared to morphine on a molar basis. Acupuncture treatment raises β-endorphin level and improves pain.

Oestrogen and menopause

Menopause is when a woman’s periods stop permanently. This could be a life change in the women. As women are approaching menopause, the ovaries function is declining and the body makes less oestrogen and progesterone. Eostrogens are produced in adrenal glands and fat instead of ovaries. The periods become irregular and less frequent and eventually stop. Menopause occurs naturally when a woman is in her 50s, but some women may experience early menopause in their 30s or 40s. Due to hormones change, there are some symptoms associated with it. The most common symptoms is hot flushes --- suddenly feeling hot and going red in the face. These may be associated with bouts of sweating during the day as well as at night. It is also common to find that the vagina feels dry and uncomfortable, which may make sex painful. Other symptoms include tiredness, irritability, trouble sleeping, feeling depressed and less interest in sex.

For most women, menopause is not an illness, but a phase of natural transition in later life. Sometimes the symptoms associated with menopause can be distressing and they may last for several years. If you are bothered by the menopause symptoms, you need to do something to help. Acupuncture is a natural way to help to reduce menopause symptoms such as hot flushes etc.

Hot flushes are the most common symptom of the menopause. Three out of four menopausal women have hot flushes. The symptoms include a sudden feeling of heat which can be accompanied sweating, palpitation, red flush, sleep disturbance, and mood changes. The severity varies from woman to woman. Estrogen levels decline in menopause, norepinephrine levels rise, leading to an upregulation of hypothalamic serotonin receptors, which are involved in temperature regulation. However, absolute estrogen levels are not solely responsible for hot flashes, because researchers have found no significant correlation between plasma, urinary, or vaginal estrogen levels and the appearance of this symptom. Instead, it is the relative decline in estrogen levels that appears to mediate these central changes in norepinephrine and serotonin. Significantly lower levels of plasma beta-endorphin levels were found at the onset of the hot flushes than five to 20 minutes before. These changes affect the brain temperature control center causing hot flushes.

Treatment suggested effectively for hot flushes is HRT. Apart from medication, do you know acupuncture can stop hot flushes? Acupuncture is effective for controlling hot flushes by stimulating the body releasing b endorphins It has no side effect and is a safe method to treat hot flushes.

Hot flushes treatment HRT vs acupuncture

Hot flushes are the most common symptoms of menopause. Most women experience hot flushes going through the menopause. Women with hot flushes can have sudden feeling of heat and sometimes a red, flushes face and sweating. If this happens at night, they are called night sweats. It may disturb sleep. The severity varies from person to person. Some women have occational hot flushes, while others have it every hour. Hot flashes happen when the bloodvvessels near the skin's surface dilate to cool, making you break out in a sweat. Some women have hot flushes for a very short period of time during menopause, while others may have it for several years or for the rest of their lives. The cause of hot flushes is not clear. They may be caused by hormone changes affecting the body’s temperature control. Recent study has shown that beta endorphins level is low when women have hot flushes.

Hormone replacement therapy known as HRT is recommended by doctors. It can help with hot flushes in many women and other symptoms including vaginal dryness and mood problems. When you stop HRT treatment the hot flushes may come back. Also there is risk of taking HRT including risk of blood cloting, breast cancer, endometrial cancer.

Hot flush, acupuncture is a good choice of treatment

Due to the risk of HRT, an alternative treatment is a good choice. Acupuncture is an effective treatment for hot flushes and is recognised as an effective way to reduce hot flush and there are no side effects and no risk of cancer. The possible mechanism is that acupuncture releases beta endorphins in the body. Borud et al performed a randomised controlled trial to study effectiveness of acupuncture for hot flush. 10 sessions of acupuncture were given to acupuncture group and advice on self-care was for control group. The results showed that acupuncture group has significant improvements in hot flush, sleep and other symptoms. Borud also analysed 16 clinical trial studies. Some studies showed that acupuncture reduces about 50% in hot flush frequency comparing with no specific treatment; the effect of acupuncture on frequency is smaller than that oestrogen therapy. They concluded that acupuncture reduces hot flush. Sunay D et al carried out a sham controlled clinical trial to investigate effect of acupuncture on hot flush and hormone levels. They not only showed that acupuncture relieved hot flush, but also showed that acupuncture lowered LH levels, increased oestrogen levels.

There are other promising research data supporting the effectiveness of acupuncture in hot flushes in menopausal women. Recently Baccetti et al from Italy conducted a randomized trial to investigate the effect of acupuncture treatment for hot flushes. One hundred women in spontaneous menopause with at least three episodes of hot flushes daily were randomly allocated to two treatment groups (50 per group): Women in group A were given diet, self-massage training, and treatment with acupuncture, and women in group B (the control group) were given the same diet and self-massage training. 6 weeks acupuncture treatments were offered for these women. They found that treatment with acupuncture significantly reduced the occurrence of hot flushes and sudden sweating. They also found that other symptoms including sleep disorders, tightness in the chest, irritability, bone pain, feeling depressed were also significantly improved after acupuncture treatments. They suggested that Acupuncture in an integrated system that includes therapeutic techniques such as diet therapy and Tuina self-massage can be used to treat hot flushes and selected symptoms in postmenopausal women.

A study of acupuncture on hot flushes was performed by Borud EK et al from the National research Center in Complementary and Alternative Medicine University of Tromso Norway in 2006/2007. There were 267 participants with hot flashes. Mean age was 53.8 year old. 134 women were in acupuncture group receiving 10 sessions of acupuncture treatment over 12 weeks. The most frequently used 10 acupuncture points were SP6, HT6, KI7, KI6, CV4, LU7, LI4, LR3, ST36 and KI3. 133 women were in control group receiving self care only. In acupuncture group 67 women responded to the acupuncture treatment. 64 women did not respond to the treatment. There were no serious side effects found in acupuncture treatments.


References

Borud EK et al Acupunct Med (2009) 27:101-10

Borud EK et al Menopause (2009), 16: 484-93

Borud E et al Auton Neurosi (2010), 157: 57-62

Sunday D Acupunct Med (2011), 29: 27-31

Baccetti S et al J Altern Complement Med (2014) May 14

Spine, back pain and acupuncture

Spine

Spinal column or spine provides the main support for the body, allowing the body to stand upright, bend, and twist, while protecting the spinal cord from injury. The spine is made of 33 individual bones (vertebrae) stacked one on top of the other. Strong muscles, flexible tendons and ligaments, and sensitive nerves are surrounding the spine. Any of these structures affected by strain, injury, or disease can cause pain.

Spinal nerves and acupuncture

Spinal nerves are mixed nerves carrying motor, sensory and autonomic nerve fibers and conducting signals to innervate whole body. There are 31 pairs of spinal nerves which are on each side of the spinal column. They are divided into four groups by their location: eight pairs of cervical nerves at the neck, twelve pairs of thoracic nerves at the upper back, five pairs of lumbar nerves, five pairs of sacral nerves and one pair of coccygeal nerves. Motor nerves innervate muscles and bring nerve signals to the muscles to perform motion task. Sensory nerves innervate organs, carry different sensory signals to the spinal cord and the brain. Autonomic nerves innervate internal organs such as smooth muscles and glands and a control system for internal organ function such as cardiac vascular system, respiratory system, digestive system, urinary system and reproductive system. If there is a problem with the neck and back, this may irritate autonomic nerves and have related symptoms, such as abnormal urination, infertility, indigestion, diarrhea or constipation etc.

Muscles, tendons and ligaments problems are very common.

There are two main muscle groups that affect the spine are extensors and flexors. The extensor muscles which are attached to the back of the spine enable us to stand up and lift objects. The flexor muscles which are in the front and include the abdominal muscles enable us to flex, or bend forward, and are important in lifting and controlling the arch in the lower back. The ligaments are strong fibrous bands that hold the vertebrae together, stabilize the spine, and protect the discs. There are two ligaments anterior longitudinal ligament and posterior longitudinal ligaments which located in the front and at the back of vertebras separately and run from the top to the bottom of the spinal column. They prevent excessive movement of the vertebral bones. Between the lamina of each vertebra there are also ligaments attached called ligament flavum. Between adjoining spinous processes of each vertebra thin and membranous Interspinous ligament is attached. They limit the flexion of the spine. Supraspinous ligament lie on the tips of the spinous processes from the seventh cervical vertebra to the sacrum. They continue above seventh cervical vertebra with ligament nuchal. They limit the over flexion of the spine.

How tendon changes with aging

Aging is natural and inevitable. The rate of aging is highly individual and depends on many factors, including genetics, lifestyle, and former disease processes. The degenerative changes can be seen in late thirties. Tendon also has aging changes. There are many cellular and vascular changes within the aging tendon. As a result the aged tendon becomes weaker than it used to be and more likely to tear or get overuse injury, when there is increased stress and strain. With aging process, the density of tendon cells decrease and nucleus becomes bigger, long and thin; cell metabolic activity decreases such as protein and amino acids synthesis. Extracellular changes occur with aging: for example, Elastic fibers and water content decrease which contribute to the tendon stiffness and gliding reduction; collagen content changes little, but the relative amount of collagen, volume density and mechanical stiffness increase due to decrease of water content; collagen synthesis and mechanical properties, solubility decrease. Blood Vessels in tendon change. Tendon blood flow and the number of capillaries per unit of surface area decrease with increasing age. The decreased arterial blood flow and thus decreased nutrition and oxygen transport have been suggested to be the main etiological factors behind the age-related tendon degeneration.

How the spine is related to back pain? There are many structures around spine as mentioned above which can be the source of back pain. For example, nerves around the spine are irritated; muscles are strained; ligaments, bones and joints are injured are worn; disc is slipped etc.

Gravity line and gravity center

The human body encounters gravity constantly in posture and movement. There is gravity line and gravity center of the body. The gravity line is located frontally along a vertical line passing through the middle of the sacrum (lower spine) and perpendicular to the ground, and laterally through a vertical line situated slightly to the rear of the femoral heads. This gravity line must fall within the base of support. The gravity center of the human body is the point where the human body rests under normal conditions without rotating, remaining balanced without active effort to remain upright. This center lies in anterior to the second sacral vertebra and it shifts following the posture and movement to keep the body in balance without falling. When the gravity line falls outside supporting base, compensation is required. Long term compensation can result in overuse the muscles and create inflammation causing pain. Such as low back pain.

Because of pain receptors, it is why you feel the pain. Acupuncture releases pain

Because of pain receptors, it is why you feel the pain. Acupuncture releases pain

If there is injury somewhere in the body, it leads to the feeling of pain. Pain is a vital function of the nervous system. It is both a sensory and emotional experience, affected by psychological factors such as past experiences, beliefs about pain, fear or anxiety. We feel the pain because we have pain receptors in the body. Pain receptors are specialized sensory receptors. They are responsible for the detection of noxious stimuli (including mechanical, thermal or chemical stimuli), transforming the stimuli into electrical signals (these signals will then be conducted to the brain). Inflammatory mediators (such as bradykinin, serotonin, prostaglandins, cytokines, and H+) are released from damaged tissue and can stimulate pain receptors directly. They can also act to reduce the activation threshold of the receptors so that the stimulation required to cause activation is less. This process is called sensitisation. Acupuncture can stimulate the body to release anti-inflammatory substances to reduce the stimulation of the pain receptors and desensitize the pain receptors to release the pain.

Three types of pain

Somatic pain is caused by the activation of pain receptors in either the body surface skin and connective tissues or musculoskeletal tissues. It is usually dull pain or aching. Generally speaking, somatic pain is usually provoked by activity and relieved by rest. It is often caused by inflammation, trauma, excessive activity, vigorous stretching, and muscle contractions etc.

Visceral pain is pain coming from the internal organs. It is deep, dull or dragging pain. It can be associated with autonomic changes such as nausea, vomiting, and changes in heart rate or blood pressure. It can also evoke strong emotional responses. Visceral pain is triggered by smooth muscle distension or contraction, stretching of the capsule surrounding an organ, ischaemia and necrosis, or irritation by chemicals produced during inflammatory processes. Referred pain could occur at a site distant from source of the pain. It is due to the convergence of different afferents on to the same dorsal horn neurones in the spinal cord.

Neuropathic pain is caused by damage to nerves in the central or peripheral nervous system. For example, trauma, diabetes mellitus, ischaemia etc can cause the damage. Pain is burning or like an electric shock. Pain is likely spontaneous.

Acute pain vs chronic pain

Acute pain usually comes on suddenly and goes away a few weeks to a few months, if the cause has gone and is treated properly. For example, sudden pull of the back muscles causes back muscles damage and acute back pain. The pain could be severe and accompanied by anxiety and emotional distress. It goes within a few days to a week time. If acute pain persists, it can become chronic. Chronic pain is pain that usually lasts longer than six months, such as headache, back pain, neck pain, and shoulder pain. Chronic pain can cause stress on the body and mind, such as tense muscles, limited ability to move around, a lack of energy and fatigue, anxiety, change of mood, depression and agitation etc.

Acupuncture can help both some acute and chronic pain.

Muscle tone, muscle aging and acupuncture

Muscle tone and muscle tension

When one relaxed, one must think the muscles must completely rest without any activity. Actually this is not the case. Muscles in the body are constantly in contracted state which creates muscle tone. Muscle tone is formed from the continuous and passive partial contraction of the muscles at resting state. Because of the muscle tone, muscles are resistant to passive stretch. It helps maintain posture, balance and respond to sudden pull and stretch. If a sudden pull occurs, the muscles are automatically increased the tension to prevent the body from danger. Generally speaking, low tone increases flexibility and decreases strength and high tone decreases flexibility and increases strength. However there are many exceptions. For example, if the muscle becomes cramped, it loses its strength. Poor posture can result in high muscle tones in related group of muscles.

Muscle tension is formed when muscles remain semi-contracted involuntarily for a period time. Muscle tension can be caused by stress and inflammation. One can feel headache, muscle pain, muscle tightness and stiffness. Muscle tension is a condition in which some muscles of the body remain semi contracted status. It is typically caused by the physiological and/or psychological stress. The tension could happen anywhere in the body. Face and back are common places of accumulation of tension. You may feel tightness and tension or you may not feel anything. Factors affect muscle tension: lack of sleep, excessive nervous system activity such as too busy schedule, excessive exercises, expose to the cold, too much coffee, smoking, chronic inflammation, fatigue, poor posture, anxiety etc.

Muscle changes with aging and muscle tightness, acupuncture can help

With aging changes in the skin and hair are common and more noticeable. People might not realise that muscles are also changing with aging. This change could start at age 30 and accelerate at age 50. Muscle fibres reduce in number and shrink in size. Muscle tissue is replaced more slowly and lost muscle tissue is replaced with a tough, fibrous tissue. Also changes in the nervous system cause muscle to lose tone and ability to contract and become rigid. Muscle loses strength because of a decrease in the production of anabolic hormones such as testosterone, growth hormone and insulin-like growth factor-1 and impairment of protein production. This can contribute to fatigue, weakness and reduced tolerance to exercise. The types of muscle fibers are affected by aging as well. The numbers of muscle fibers that contract faster decrease much more than the numbers of muscle fibers that contract slower. Thus, muscles are not able to contract as quickly in old age.

With aging bone has changed as well. Bones lose calcium and other minerals and become less dense. This change becomes dramatic after menopause due to hormones change in both female and male. With aging joint movement becomes stiffer and less flexible because the amount of lubricating fluid inside the joints decreases and the cartilage becomes thinner. Ligaments also tend to shorten and lose some flexibility, making joints feel stiff. Also the connective tissue within ligaments and tendons becomes more rigid and brittle. This change also limits the range of motion of joints.

What to do?

Exercise can prevent many age-related changes to muscles, bones and joints – and reverse these changes as well. Exercise can make bones stronger and help slow the rate of bone loss; muscle-strengthening can increase muscle mass and strength; Stretching helps maintain joint flexibility; walking is a good exercise for maintenance of bone mass.

Acupuncture is a good way to release muscle tension. Acupuncture helps improving blood circulation and improves nutrition and oxygen supply to the muscles and bones and improves metabolism of muscles and bones. Acupuncture helps reduce inflammation, release and repair any damage of the tendons and ligaments.

Muscles tightness, acupuncture can help.

Muscle tightness is that muscles feel tight and stiff which is caused by muscle contractions. Some people feel pain of muscles. Muscle tightness often develops from overuse, trauma, stress or illness. Muscles shorten over time and they become weaker over time. Muscle contraction leads to ischemia and degeneration of the muscle fibers which further weaken the muscles. Loss of balance can occur. Muscle tightness also increases the risk of muscle strain or tearing of muscle fibers during activity. It is important to maintain flexibility to relieve muscle tightness and reduce risk of injury.

Fascia is dense connective tissue sheets and it plays an important role in transmitting force in human posture and movement regulation. Fascia is usually seen as having a passive role, transmitting mechanical tension which is generated by muscle activity or external forces. However, there is some evidence to suggest that fascia may be able to actively contract in a smooth muscle-like manner and consequently influence musculoskeletal dynamics. Myofibroblast cells are a special type of cells with smooth muscle like contractility. These cells are present at skeletal muscle tendons, ligaments and many organ capsules. They are also reported in fascia. The density is higher in younger people. Fascia contraction contributes to the tension and stiffness of the muscles, such as back pain, frozen shoulder and headaches etc. Releasing fascia contraction could improve muscle tension and stiffness.

Tendon also has aging changes. There are many cellular and vascular changes within the aging tendon. As a result the aged tendon becomes weaker than it used to be and more likely to tear or get overuse injury, when there is increased stress and strain. With aging process, the density of tendon cells decrease and nucleus becomes bigger, long and thin; cell metabolic activity decreases such as protein and amino acids synthesis. Extracellular changes occur with aging: for example, Elastic fibers and water content decrease which contribute to the tendon stiffness and gliding reduction; collagen content changes little, but the relative amount of collagen, volume density and mechanical stiffness increase due to decrease of water content; collagen synthesis and mechanical properties, solubility decrease. Blood Vessels in tendon change. Tendon blood flow and the number of capillaries per unit of surface area decrease with increasing age. The decreased arterial blood flow and thus decreased nutrition and oxygen transport have been suggested to be the main etiological factors behind the age-related tendon degeneration.

As mentioned above that acupuncture can release muscle tightness and relax your muscles.

Muscle knots and muscle pain, acupuncture can help

Muscles in the body are connected and overlapped. This brings the body moving around and doing various activities without problem. Sometimes the muscles can lose some mobility and flexibility. Injury and overuse are common cause for muscles problems. For example muscle knots are one of the common problems. It can happen to any muscles.

Muscle knots are initially formed by muscle fiber contraction or spasm. This is commonly caused by acute injury or chronic overuse. The muscles knots are very sensitive causing stillness and pain. Severity of the pain varies. If the knots are not treated properly, inflammation can persist, and adhesion and scar tissues make the knots and related muscles lose elasticity and the knots become harder and more difficult to get rid of.

Do you know acupuncture can help to get rid of muscle knots effectively?

References

Allen RE and Kirby KA Am Fam Physician (2012) 86:350-5

R. Schleip et al Medical Hypotheses (2005) 65, 273–277

How does acupuncture help IUI?

What is intrauterine insemination (IUI)? IUI is a procedure which is used to help people with infertility. In this procedure, good quality of sperm is selected and placed into the woman’s uterus in the middle of the monthly cycle when egg is released from ovary. In order to process IUI unblocked tubes are essential. IUI may be one of the options for you if you have unexplained infertility or you have ovulation problems or your partner experiences impotence or premature ejaculation or you don’t have a male partner and are trying for a baby using donated sperm. For women, each cycle of IUI is timed to fit with the woman’s natural menstrual cycle. You will only be able to receive one cycle of IUI treatment a month. If you have ovulation problems, you can choose to use fertility drugs to stimulate ovulation. The sperm sample will be taken on the day of the treatment and washed. Good quality of sperm will be selected and placed in the uterus through a thin, flexible tube called a catheter. This process is mostly painless, although some women may experience mild cramping, similar to period pains. The success rate per cycle is up to 15% depending on women’s age. As with most other types of fertility treatment, the younger a woman is, the greater her chance of having a successful pregnancy. Other things that can affect the success of IUI include sperm count and sperm quality – using fresh sperm is associated with higher conception rates than frozen and thawed sperm; technical aspects of IUI, such as working out the time of ovulation correctly.

How can acupuncture help IUI? Acupuncture before IUI could help improve egg and sperm quality in both female and male by helping hormonal balance and improving local microcirculation. Acupuncture could also help uterine inner lining development and ready for implantation. Acupuncture could also help relax fallopian tubes and uterus for eggs, sperm and embryo passing through and embryo implantation. Acupuncture could help reducing stress, any inflammation in the body to improve fertility.

Fertility acupuncture for women and men

Acupuncture is used to treat infertility for women and men

Infertility is a disorder of reproductive system and it is when a couple failed to achieve a clinical pregnancy after 12 months or more of regular unprotected sex. Getting pregnant for some couples is natural, but for others it becomes difficult. Due to delayed child bearing age, environmental changes, and other reasons, one in seven couples have difficulty to conceive in the UK. After years of trying and no cause found, they could be put on IVF treatment straight away. In 2011, 48,147 women had a total of 61726 cycles of IVF or ICSI in the UK. Is there any other less invasive treatment available to help these couples to conceive?

Acupuncture is an alternative way to treat couples with infertility. Acupuncture is called ancient art. The use of acupuncture treatment in couples seeking fertility care is dramatically increased in last decades. A survey in the US has shown that one in five couples with infertility have tried acupuncture over 18 months of observation period. In the UK treatment for infertility with acupuncture increased fivefold in 10 years time. In Switzerland, Germany and Austria, one third of the fertility centres offer acupuncture treatments. If you are seeking IVF treatment for your fertility, acupuncture treatment as an adjunct treatment helps you to achieve best IVF success rate.

Fertility acupuncture, how does it work?

Is there scientific ground for the application of acupuncture on infertility treatment? Or is it only based on ancient theory? Or is it like some people thinks: acupuncture will work, if I believe it. As a matter of fact, there were many research data available to support this application. Since 1990s, much research has been done in animal experiments and clinical trials. Based on recent research evidences, it is suggested that for women acupuncture mediates endogenous opioid peptides in the central nervous system affecting fertility hormone balance; it increases uterine artery blood flow; it reduces inflammation; and it reduces stress which affects fertility hormone balance. Acupuncture also relaxes fallopian tubes. As a result, it could help improving egg production and egg quality and improving uterine receptivity and embryo implantation. Consequently reproductive health is improved and there is better chance to get pregnant. Acupuncture also helps improving men’s fertility. Research data on this aspect start emerging and suggested that acupuncture can increase sperm counts and improve sperm quality by improving testicular blood flow and reducing inflammation.

If you are interested in TCM (Traditional Chinese Medicine) idea, any blockage of Qi in the body will cause illness in TCM theory. Acupuncture acts at the specific acupuncture points in the meridians and clears off the blockage and makes Qi flowing freely in the body, as a result the organs will function well again. This improves your fertility as well as your overall health.

Acupuncture helps your fertility return after stop contraception methods

Women are fighting not to get pregnant and then fighting to get pregnant. When you start using contraception methods do you ever think about that your fertility will return when you stop? What is the chance to get pregnant, if you want to? A research has shown that women who stopped using a barrier method to achieve a planned pregnancy conceived most quickly: 54% were delivered after one year vs 39% of intrauterine device and 32% of oral contraceptive users. There was no association between fertility and duration of oral contraceptive use: However, short term intrauterine device users (< 42 months) showed a fertility pattern more favourable than seen in those discontinuing oral contraceptives, with increasing duration of intrauterine device use being associated with decreasing fertility. The fertility of women who had used the intrauterine device for 78 + months was the most impaired (28% were delivered by 12 months vs 46% of short term users). What is the chance to get pregnant, if you don’t have fertility problem? 92% will get pregnant during one year at ages 19-26 and 82% will get pregnant during one year at ages 35-39.

Do you know that acupuncture improves ovarian and uterine blood circulation and helps with your return of fertility, after you stop discontinuing contraception methods?

Stress affects fertility in both female and male and acupuncture reduces infertility related stress

Psychological stress is strongly associated with infertility. Infertility itself is stressful, due to the pressures, testing, diagnosis, treatments, failures, endless waitings and associated economic costs. There is an association between stress and infertility. Infertility causes stress and stress (both acute and chronic) may cause infertility. Stress can increase after diagnosis of infertility, follow-up appointments, and failed IVF treatments. Coping with various life styles also affects fertility.

Psychological stress affects 30% of women who attend infertility clinics, possibly due in part to infertility diagnosis and treatments. Women with infertility experience emotional stress. They tend to keep things to themselves and delay starting the treatments because of a desire to conceive naturally. This does not happen and makes them very stressed which turn to have negative impact to their fertility. There is a link between infertility and psychological distress. Greil et al studied the variation of fertility specific distress (FSD) associated with different types of infertility. They found that women with infertility have intention to have a child and seek treatment have higher levels of FSD than those women without intention to have a child and don’t seek treatment. Women with primary infertility (They have no prior pregnancy) have higher level of FSD than those women with secondary infertility (They have had at least once prior pregnancy with or without live birth. Older women with infertility tend to have higher distress level than younger women. General distress doesn’t vary between different types of infertility. A study of 430 couples on association between stress and conception showed that decreased conception occurred in those most stressed women. Women received treatment showed less stress and more hopeful. Fertilization of oocytes also decreased when stress increased. Stress acts through different mechanisms, not only by inhibiting the HPA axis but also by altering the concentration of fertility hormones (FSH, GnRH and LH) as well as other substances such as cortisol, opioids and melatonin. It alters the follicular levels of glucocorticoid hormones. The blood flow in the fallopian tubes could be reduced.

Males who experienced more than two stressful life events before undergoing infertility treatment were more likely to be classified below WHO standards for sperm concentration, motility, and morphology. Stress such as a job, life events, and even social strain were seen to have a significant impact on sperm density, total sperm counts, forward motility and morphology. Semen parameters may potentially be linked to stress. Actively coping with stress, such as being assertive or confrontational, may negatively impact fertility by increasing adrenergic activation, leading to more vasoconstriction in the testes. This vasoconstriction results in lower testosterone levels and decreased sperm production. Stress and depression are linked to reduce testosterone and luteinizing hormone (LH) pulsing, disrupt gonadal function, and ultimately reduce spermatogenesis and sperm parameters.

Very recently there was a study about stress on male fertility. This study evaluated the effect of psychological stress on male fertility hormones and seminal quality in male partner of infertile couples. Seventy male partners of infertile couples were evaluated for level of psychological stress using Hospital Anxiety and Depression Score (HADS) questionnaire, serum total testosterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH) by electrochemiluminescence assay and serum GnRH by ELISA. Seminal analysis was performed. 27% of them had HADS anxiety and depression score ≥8 which was abnormal HADS score showing stress condition. The persons having abnormal HADS had lower serum total testosterone, higher serum FSH and LH than those of persons having normal HADS. Serum total testosterone correlated negatively with HADS. Sperm count, motility and morphologically normal spermatozoa were lower in persons having abnormal HADS. Abnormal sperm motility and morphology were related to lower testosterone and higher LH and FSH levels. This study suggested that psychological stress affects male fertility and sperm quantity and quality.

Stress is also accompanied with fertility treatment. Before start of treatment such as IVF, fear of failure makes women stressed. Unsuccessful treatment raised stress level, while success treatment makes negative emotion disappeared. Studies found that high stress level reduced IVF success rate and live birth rate. Higher stress level during egg collection and embryo transfer was found in women failed IVF cycles than those who achieved pregnancy in IVF cycles. As mentioned above stress affects women’s fertility. Stress affects the hypothalamic-pituitary-adrenal axis (HPA) altering hormones including CRH, ATCH and cortisol production. These hormones also mediate hypothalamic-pituitary-gonadotropic axis (PG) which is an axis regulating sexual hormone secretion. As a result follicle stimulating hormone (FSH) and luteinizing hormone (LH) level decreased which affects fertility. Coyle M and Smith C conducted a survey to study the health status for women undergoing ART and examined the relationship between health status, traditional Chinese medicine (TCM) and Western medicine diagnosis underlying the cause for their infertility. Women with infertility undergoing ART were recruited and health was checked by TCM and western medicine questionnaire. They found that mental health status not physical function for these women was lower than that for general population. For TCM diagnosis, Qi and blood stagnation was common. And these women tend to have low score in the health questionnaire.

Stress management and stress reduction should be an important part of the infertility management. Lower stress levels improves female and male natural fertility and lower stress levels result in better fertility treatment outcome. Acupuncture is a useful treatment for reducing fertility related stress in female and male.

In vitro fertilisation (IVF) provides great chance for those couples who have difficulty to conceive. However IVF does not always produce pregnancy, actually the success rate is not high. It can be physically and emotionally challenging. Isoyama et al studied the effect of acupuncture on symptoms of anxiety in women undergoing IVF. 43patients participated in the study. 22 patients were in acupuncture group while 21 patients were in the control group. The anxiety level of each patient was analysed before and after treatment. Four weekly sessions were performed. Acupuncture points including HT7, PC6, CV17, GV20 and Yingtang were used for the needling. Their result showed that after 4 week treatment the anxiety score for acupuncture group was significantly lower than for the control group. This indicated that acupuncture can reduce anxiety symptoms in women undergoing IVF.

There is perceived stress on the day of embryo transfer (ET). Balk J et al in University of Pittsburgh studied effect of acupuncture on perceived stress and pregnancy rate on the day of ET. In this study, 57 patients with infertility and undergoing IVF or IVF/ISI were involved. These patients were undergoing ET with or without acupuncture as part of their standard clinical care. The result showed that women who received acupuncture treatment achieved 64.7% pregnancy rate while those who didn’t receive acupuncture treatment had 42.5% pregnancy rate. Women with acupuncture had lower stress score both pre-ET and post-ET compared to those without acupuncture. Women with lower stress score had higher pregnancy rate. They concluded that acupuncture reduced stress both before and after ET and it is the possible reason for improving pregnancy rate. Lower perceived stress on the ET may improve pregnancy rate.

Smith CA et al studied the effect of acupuncture on psychological distress for women with infertility. They run a pilot randomized controlled trial to investigate effectiveness of acupuncture for reducing infertility related stress. They found that 6 sessions over 8 weeks of acupuncture could reduce infertility related stress. Women in acupuncture group have less social and relationship concerns. They have improved self efficacy and less anxiety compared to waiting-list control group. Women described the experience and impact of acupuncture as positive relating to a sense of relaxation and time out, the engagement with the practitioner, and an intervention that had very few negative side-effects. Changes were also perceived after treatment with women describing a physical and psychologic sense of relaxation and calmness, and a changed perspective in relation to coping. This suggested that acupuncture may be a useful intervention to assist with the reduction of infertility-related stress.

Polycystic ovary syndrome (PCOS) is characteristic of polycystic ovaries, hyperandrognism, irregular menstrual cycles, and abnormal metabolism including insulin resistance and obesity. PCOS increases risk of depression and anxiety and negatively affects health-related quality of life. Life style change on diet and exercise is essential and proved that this decreased depression and improved quality of life. E Stener-Victorin et al studied the effect of acupuncture and exercises on depression, anxiety and impaired quality of life in women with PCOS. 72 women with PCOS were recruited in the study. 28 women were offered acupuncture and 29 women were offered physical exercise and 15 women were assigned with no intervention. The treatments were lasted for 16 weeks for different interventions. Acupuncture was given twice a week for 2 weeks, once a week for 6 weeks and once every other week for 8 weeks. Total 14 treatments over 16 weeks were offered. Physical exercise program included regular exercise, such as walking, cycling or any other aerobic exercise at a self-selected pace. The frequency of exercise was at least 30 min and at least 3 times a week. This lasted 16 weeks. The assessment was at the end of 16 week treatment and 16 week follow-up after the last treatment. The results showed that depression and anxiety scores were reduced at the end of the treatment and the follow-up in the acupuncture group; the quality of life such as physical, energy/vitality, general health perception and the mental component was also improved in the acupuncture group. The quality of life such as general health perception, physical functioning and emotion was improved in exercises group.

References

Doll H et al BJOG (2001) 108:304-14

http://www.nhs.uk/chq/Pages/2295.aspx?CategoryID=54

Campagne Hum Reprod (2006) 1651-8

Smith et al J Altern Complement Med (2011) 17:923-30

Bhongade MB et al Andrologia (2014) 10.111and 12268

Sharma R et al Reprod Bio Endocrinol (2013) 11:66

Greil AL et al Hum Reprod. (2011) 26:2101-12

Balk J et al Complement Ther Clin Pract (2010) 16:154-7

Isoyama D et al Acupunct Med (2012) 30:85-8

Coyle M, Smith C Acupunct Med (2005) 23:62-9

E Stener-Victorin et al BMC Complement Altern Med (2013) 13:131