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Treating Stress with Acupuncture

My work with acupuncture brings me all types of patients with all kinds of health complaints. What is very common however is the theme of palpable stress in people’s lives. So often I am told ‘I didn’t use to be like this’.

I think of it as ‘stress syndrome’, or a variety of symptoms that are caused by the pressure of life in this corner of the world.

Some people describe stress like a clock sitting on their shoulder, constantly telling them they’re running out of time. For others it feels like a crushing weight on their chest. Somebody described their stress to me as being like a drug; a powerful influence that makes you lose perspective and burn-out, yet they return to it time and again.

From my work with patients, I see stress as a perceived inability to cope with how much we have going on in our lives, a pressure to ‘keep-up’. It’s a desire to keep all the plates spinning that we worked so hard to get, but the struggle to maintain them gets too much. As we get older the stakes get higher and it takes more work than ever to maintain what we’ve got.

Physical signs of stress

Acupuncturists practice pulse taking, not just feeling for the pulse-rate but also the quality. Often in highly stressed-out patients the pulse will take on a wiry quality, feeling much like a guitar string, taught. Over the course of acupuncture treatment I often feel this change and the pulse softens. This is a simple investigation but one of many which uncovers the telltale signs of stress.

Stress can be insidious when it comes to our health. It’s a palpitation on the way to a meeting, losing your appetite when there’s a deadline or getting a migraine when there’s a last minute change of plans. This is our body’s way of letting us know we need to take a step back. When the symptoms become chronic, the stress has gotten too much and it’s time to get help.

For some people, stress eventually becomes a default setting. The behaviours they develop in the face of mounting stress work their way into their persona, to the point where they prepare to find stress in every situation. This is what’s often referred to as ‘adrenal fatigue’. We can become constantly ‘switched-on’ to stress. If you think this is you, read my article, E=MC²: Adrenal Fatigue and Traditional Chinese Medicine, for tips on how to interrupt the cycle.

Anxiety is the manifestation of stress in our behaviour. When we have been exposed to severe stress (this is relative to the individual) over time we can develop unhealthy coping behaviours, such as shallow breathing, compulsions and negative thinking. Childhood exposure to adults who are stressed can leave a lasting impression too and can lead to anxiety in the child, which is normally where therapy becomes very important.

Stress leads to anxiety and furthermore it often leads to bad habits. There may be alcohol or drug dependence, chain smoking or comfort eating, amongst many others habits in an effort to switch off from the stress. Hand in hand with these go lifestyle-driven health complaints such as weight gain/loss, itchy skin lesions, chest infections and headaches and nervousness from withdrawal.

How acupuncture is used

I use acupuncture, the insertion of very fine needles at strategic points on the body, to support each stage of the treatment of stress which often involves:

  • Treating withdrawal from caffeine, nicotine, alcohol, drugs and food
  • Treating sleep disturbance
  • Treating continuously for anxiety while lifestyle changes are being made in terms of hours worked, place of work, family dynamics etc.
  • Treating alongside counselling or CBT

I will normally see the patient no less than weekly and encourage them to commit to at least 8-10 sessions to achieve the cumulative benefits of acupuncture.

Acupuncture releases beta-endorphin into the bloodstream, an important pain-killing and mood-enhacing chemical. When we get enough of this endorphin release, in a setting where we feel relaxed (cue the dimly-lit room and candles) our bodies are much better equipped to make use of it. It is effective in dampening the effect of stress hormones in the body, particularly cortisol. Repeated sessions of acupuncture are proven to have a cumulative effect, but they should be regular and carried out at a time in the week that you can relax.

Acupuncture is relaxing for most people at the time that the needles are in, and often they will go home to a markedly better night’s sleep. Sleeping well is often the first step to change.

The research 

The following is a briefing of the research that supports the use of acupuncture to help stress and it’s associated symptoms, as published by the British Acupuncture Council on their website, where you can view the full research paper sources.

  • Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety and worry (Hui 2010; Hui 2009);
  • Improving stress induced memory impairment and an increasing AchE reactivity in the hippocampus (Kim 2011);
  • Reducing serum levels of corticosterone and the number of tyrosine hydroxylase-immunoreactive cells (Park 2010);
  • Regulating levels of neurotransmitters (or their modulators) and hormones such as serotonin, noradrenaline, dopamine, GABA, neuropeptide Y and ACTH; hence altering the brain’s mood chemistry to help to combat negative affective states (Lee 2009; Cheng 2009; Zhou 2008);
  • Stimulating production of endogenous opioids that affect the autonomic nervous system (Arranz 2007). Stress activates the sympathetic nervous system, while acupuncture can activate the opposing parasympathetic nervous system, which initiates the relaxation response;
  • Reversing pathological changes in levels of inflammatory cytokines that are associated with stress reactions (Arranz 2007);
  • Reducing inflammation, by promoting release of vascular and immunomodulatory factors (Kavoussi 2007, Zijlstra 2003);
  • Reversing stress-induced changes in behaviour and biochemistry (Kim 2009).

If you are suffering from anxiety, stress or burn-out I would recommend acupuncture. It’s a highly unique technique for healing ourselves, naturally, with no side-effects or hangovers. If you are taking a prescription medication and want to try to reduce the dosage (with the input of your GP) you should consider acupuncture weekly.

I am an overseas member of the British Acupuncture Council. I hold clinics in Dublin Holistic Centre and Conscious Health in the centre of the city.

Call 085 153 7089 or email info@jennymeagor.com for appointments.

 

 

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Sleeping On Empty: How Acupuncture Treats Insomnia

Most of my patients have the same response to acupuncture – a better night’s sleep. The sleep is better quality, deeper and more refreshing. I ask every patient how they sleep after acupuncture because the results are so consistent, but word is slow in getting around. What follows is an uncharacteristic criticism of medical drugs, but I feel obliged because this is one area where pills are routinely and unfairly overprescribed despite clear iatrogenic risks.

Our healthcare system – a druggy place to be

Most patients I see for insomnia have already tried a sedative and are looking for a healthier solution: drug-free, side-effect free and hangover-free. There is little awareness about the benefits of acupuncture for insomnia, in my view.

Most of us look to our GPs for guidance about the best treatments. Fact is, GPs (with some exceptions) very rarely refer for acupuncture. This isn’t news. The drugs available for insomnia are big business, there is no acupuncture on the medical card and traditional medicine is too ‘on the fringe’for most doctors. GPs ultimately practice pharmaceutical medicine rather than healthcare, where ‘do-no-harm’ is still the first principle. The research behind acupuncture for sleeplessness is impressive (see below), even on meta-analyses, but this is largely ignored by GPs, in favour of medicines.

The better GPs are more informed about wellbeing and want the best for their patients, they don’t rush to prescribe. They don’t risk further the health of the patient if there is a better place to start. The side-effects of drug therapy for insomnia are as bad a the problem itself. Common side-effects include daytime drowsiness, stomach pain, shaking and mental slowness or memory loss. I meet people who have been on medication for years and still suffer both insomnia and extreme withdrawal symptoms if they try to taper off their medication.

Sleeping on empty

Sleep is produced by a healthy body, not out of exhaustion but out of good function. If you view sleep as the last thing you do at the end of the day when you have nothing left in you, then it’s time to change your mindset. Essential homeostatic processes are reserved for sleep, because they operate under a lower heart rate, lower body temperature or lower rate of agitation in the muscles. This is not a coincidence, it’s the way we are programmed. Your body is busy at night, mostly with hormonal and immune activity, and it still requires some fuel in the tank.

As most sufferers of insomnia will tell you, being exhausted does not ensure you a good night’s sleep. Exhaustion causes our body to rely on our reserves, our adrenals, for the inertia to carry on. This releases cortisol, a stress hormone, which disrupts many other hormonal processes. The end result is poor health and a diminished capacity for the body to heal itself by sleeping well. So it follows the key to resolving insomnia is to correct imbalance by day rather than inducing sleep with medication at night.

Chinese Medicine and sleep: A different view

We put a lot of emphasis on sleep hygiene these days. Turn off your phone, avoid the blue screens, don’t eat late. Of course we need to do these things too but we’re missing the bigger picture. If you are already developing sleeping problems, you have to find out where the imbalance is in your health.

Absence of sleep at any stage of the process, from the initial attempt to drop off to the finishing mark in the morning, represents an imbalance in our health. Chinese Medicine, from which acupuncture is derived, views the characteristics of our sleeping patterns, conceptually, as reflective of different aspects of our health. (TCM practitioners will appreciate the simplified concepts to follow)

Difficulty getting to sleep is seen as a problem of ‘excess accumulation of heat’. Heat in Chinese Medicine produces a subjective sensation of heat, inflammation, constipation or dryness of the skin and fever. Heat rises in the body, as in nature, and agitates the mind, producing restlessness. This is counterproductive agitation and hence a delay to shutting down. An important note about heat, it is often produced by emotional excess and irregular lifestyle factors, essentially we are talking stress.

Waking during the night and waking early is often viewed as a deficiency syndrome, where there are insufficient reserves to maintain or hold sleep, often related to weak blood. Patients may have poor circulation, headaches, muscle cramps and poor appetite to accompany their insomnia. By comparison with the above this is a problem of ‘cold’ in the body (contracting, drawing down) but which normally progresses to a ‘heat’ syndrome (expanding and rising) over time and will lead to difficulty falling asleep.

Both syndromes represent the internal struggle for the body to reach balance. Yin Yang theory, which is the philosophical underpinning of all Chinese Medicine, is exactly that struggle between heat and cold in the body, excess and deficiency, off mode and on mode.

Lifestyle: Regularity, Reduction, Balance

Where to start the process of change? Firstly, regularity is all important and probably the most difficult change to get to grips with. Keeping regular mealtimes, bed times and working  hours are essential to getting better. By doing this you are teaching your body that you are taking control, you don’t need an adrenaline infusion because you skipped lunch and are working late to cover someone else. Over days and weeks your cycles will adapt to your routine and your energy will start to pick up. Learn to say no to people when it means it breaks your routine, at least until you recover your sleep.

Sometimes we over complicate insomnia because it is such a distressing disorder. But it is exactly that, a disorder that needs reordering, not throwing lots of new ingredients into the mix. Sleep music, scented candles and expensive sheets make us feel relaxed and help us sleep but the question is, why are we feeling tense? Get to the root of the emotion and deal with it as best you can directly. Reduction is breaking away from the habits and paraphernalia of insomnia (focussing on coping) and putting the emphasis back on our health (focussing on the problem). Reduce the problem back to the root cause.

Balance means something different to every person and only you know where you lost it. How well do you know yourself and your body? Some work too much, others spend all day on the couch. Some eat late, some have no appetite. Can you pick an aspect of your life you are unhappy with and put a simple measure in place to combat it – and stick to it? It’s the sticking to it part that’s hard. This is really where acupuncture works to support recovery.

Acupuncture saves the day – and night!

The following research summary, as published by the British Acupuncture Council on their website, uncovers the mechanisms at work when we have acupuncture, which is seen to stimulate nerves in the muscles, triggering chemical responses and:

  • increasing nocturnal endogenous melatonin secretion (Spence et al 2004).
  • stimulating opioid (especially b-endorphin) production and µ-opioid receptor activity (Cheng et al 2009).
  • increasing nitric oxide synthase activity and nitric oxide content, helping to promote normal function of brain tissues, which could help to regulate sleep (Gao et al 2007).
  • increasing cerebral blood flow (Yan 2010)
  • reducing sympathetic nervous system activity, hence increasing relaxation (Lee 2009a)
  • regulating levels of neurotransmitters (or their modulators) such as serotonin, noradrenaline, dopamine, GABA and neuropeptide Y; hence altering the brains’s mood chemistry to help to increase relaxation and reduce tension (Lee 2009b; Samuels 2008; Zhou 2008).
  • Acupuncture can be safely combined with conventional medical treatments for insomnia, such as benzodiazepines, helping to reduce their side effects and enhance their beneficial effects (Cao et al 2009).

See the full details of each study here

Acupuncture points have been developed over thousands of years of clinical observation. Though science can now tell us what is happening in our brains when we have acupuncture, the end results are consistent with what Chinese Medicine has taught since the classics.

Acupuncture is intensely relaxing, due to the release of endorphin (our mood enhancing and pain killing chemical) from having the tiny needles inserted. It is completely unique as a treatment, as it has no side-effects that endanger our health and it is minimally invasive, yet it stands up to randomised controlled trials, the gold standard in medical trials.

Acupuncture for severe or long term insomnia should be used intensively in the early stages of treatment, at least twice a week in my opinion. Once sleep recovery has started, sessions can be reduced slowly. Many attend for acupuncture after sleep has normalised for maintenance or to combat stress.

 

E=MC²: Adrenal Fatigue and Traditional Chinese Medicine

Adrenal fatigue is the modern stress syndrome nobody talks about. We look at the Chinese Medicine view of this problem.

fatigue

Feeling wired, stressed and burned out all at the same time? Do you have secondary symptoms that seem unrelated like soreness in the lower back, tinnitus or thinning hair? Chinese Medicine recognises this as the symptoms of an internal imbalance involving the kidney system and in Western Medicine we refer to it as adrenal fatigue. Whatever name we give it, the symptoms are the same and left unaddressed, adrenal fatigue will give rise to chronic ill health. In this article we will explore a little Chinese theory and discover why we should ditch fruit juice in favour of chicken soup with this condition…

E=MC²

In Traditional Chinese Medicine (TCM) the Kidneys are the seat of ‘original qi ‘in the body. Qi is our universal vital life-force, élan or energy. Qi is the force behind our cellular activity and can be somewhat likened to our mitochondria in Western Medicine. Without our qi we are inert. We are born with a reserve of qi in the Kidneys and we deplete that reserve over our lifetime. This original qi is not replenished over our lives, but we can slow the burn. Remember this is a concept, rather than a quantifiable substance in the body, so we have to use a measure of self-awareness to understand the theory. Western Medicine recognises this same function in the body as that of the adrenals, the little pyramid shaped glands that sit atop the kidneys. (Nb. Those more familiar with TCM theory here will appreciate the simplified view provided above, where Kidney yin or Kidney yang deficiency are more likely diagnoses.)

The adrenals are definitely the unsung heroes of the endocrine family. So often the rebellious thyroid and bossy hypothalamus steal the show. These hard-working glands are responsible for our stress responses, the big stresses and the daily, low-level constant ones.

Cortisol is a key adrenal hormone, known as the ‘stress hormone’ and serves a vast array of functions in the body from anti-inflammation to blood sugar regulation. Cortisol also has a hand in many important physical presentations such as fat distribution, gastrointestinal function and immune regulation.

Like other glands in our bodies, the adrenals suffer disease and decay. However this is not recognised well by doctors until the disease represents something that can be treated, medically or surgically. There are only two major diseases of the adrenals which are routinely treated, Addision’s disease (chronic adrenal insufficiency) and Cushing’s disease (more common, chronic hyper-stimulation of the adrenals). These represent either extreme of the malfunctioning adrenals, but what about the bit in between? This is called adrenal fatigue and there is no pharmaceutical medicine for it. Don’t be surprised if your doctor doesn’t recognise it as a condition…

Adrenal Fatigue

Dr James L Wilson is an established authority on adrenal fatigue in the US and has made it his life’s work to raise awareness and support patients who are otherwise marginalised by the medical system. Dr Wilson’s criteria for assessing adrenal fatigue is largely reliant on clinical signs and symptoms. He does advocate tests such as a 24 hour urinary cortisol tests in conjunction with the Adrenal Corticotrophin Hormone test for lab confirmation of this, though this is not really emphasised as necessary and with the lack of support from most GPs in diagnosing this syndrome in the first place, it will likely be viewed as an unnecessary cost.

The symptoms of this syndrome are physical fatigue, difficulty getting up in the morning and not feeling refreshed by sleep, craving salty foods, decreased sex-drive, lower stress-threshold and postural hypotension or faint feelings on standing up. Sufferers report blood sugar metabolism issues, such as critically low energy between 3 and 4pm and a surge of energy after the evening meal. Mood problems are heightened and sufferers experience more irritability, frustration and brain-fog. Visible symptoms include dark circles under the eyes and failing the iris test, which you can find at the end of this article.

Although a lot of the symptoms above will have come to be accepted as part of normal everyday life, collectively these symptoms are indicative of hypoadrenia and you can do something about it. We may choose to live in the rat-race but we can use traditional and natural treatments to bring ourselves back to a place of relative calm and balanced health.

The Mindset Challenge

I WANT MORE ENERGY!

Of course you do! But first, let’s work on the mindset. Let’s think about what measures we impose upon ourselves that bring us stress. Usually this starts with our jobs, then our identity with our age and then it’s the small stuff like bills and health anxiety (tongue firmly in cheek)…

Please ask yourself these questions:

Am I career-driven person and if so, do I get real enjoyment from my career? Or, am I a practical type, happy to have a job that pays my bills and gives me the quality of life I want? Either way, am I happy with my daily job?

Am I where I want to be at this point in my life? Do I consider others my age as having less or more than me? Do I measure my happiness against what other people expect or have themselves?

Do I have boundaries in my relationships with other people? Do I measure my own self-worth by what others think of me and the way I live my life? Do I allow people to talk to me in a way that makes me unhappy? Can I stand up for myself?

So there they are, the big questions. Society, the rat-race, first world problems, whatever you want to call it, ensure that these questions weigh heavily on our minds. Holistic medicine tells us that our minds and bodies are one, so if one of them is exhausted it predisposes the other. Stress from our jobs, families and finances make sure our adrenals, our stress mediators, are taxed to the max. The pressure we place upon ourselves is immense and until the mindset changes, the adrenals will continue to take a battering, raise your stress hormone (cortisol) levels and make you tired, fat and miserable. From a TCM point of view we are exhausting our qi. We cannot survive if always in fight mode, sometimes we have to take flight.

Do you need to change your mindset?

Sleep and stimulants: Be the slinky

Stimulants. We love them. Coffee, tea, sugar, nicotine, alcohol and drugs. Then there’s deadlines, schedules, commitments and dates. What gives us an adrenaline rush gives us purpose. What’s the opposite of this? Sleep. How often are our days filled with either stimulants or sleep? We are truly living like yoyos.

Take the slinky for an example of an energy-efficient alternative to emulate. Tightly sprung, the slinky will utilise it’s natural environment and operate on a downward slope, optimising it’s own energy potential. It does not defy it’s engineering by turning corners, unless it is about to career out of control and lose inertia.

We need to learn to harvest our own energy by making our bodies run like the machines they are. Just because we are adaptable, intelligent organisms, doesn’t mean we are indestructible. To run like a machine you have to efficiently upcycle and down cycle your batteries. In medical terms this means you have to observe the circadian cycle, go to bed at regular times, around 10.30pm and sleep until 9am as often as possible. This is especially important in those with adrenal fatigue as sleep is incredibly restorative to the adrenals. Sleeping too much is seen to be counterproductive, as it is important to regulate blood sugar by eating breakfast before 10am. Irregular sleep patterns send signals to your body that you are not in control and raises cortisol levels. Listen to your body. Be the slinky that comes to a rest when the energy potential has been realised.

You are what you eat

The bottom line in diet for adrenal fatigue is to choose foods that do not require more of your body’s nutrients than they supply. Processed, artificially coloured or sweetened and chemical laced foods will drain your energy just to get them through your system.

Dr Marylin Glenville’s book Fat Around the Middle details how reducing intake of processed, fatty, sugary and stimulant foods reduces serum cortisol levels and helps patients lose weight that stays off. This is because cortisol tells the body that you are stressed, and in case of impending fight or flight, you retain fat stores for quick energy when the time comes. The need for fuel essentially comes in small bouts, never really requiring the fat that has been stored and there you have it, the spare tyre.

People with true adrenal fatigue are problematically tired during the morning and afternoon, so they choose foods which allow them an energy boost as a survival method. If this is you, Fat Around the Middle should be your bible – even if you are not fat – yet!

Dr Wilson is a nutritional expert on the subject of adrenal fatigue and he highlights dietary fads that contribute to the problem in his book Adrenal Fatigue: The 21st Century Stress Syndrome. He picks up on the trend toward low sodium intake in modern diets, as salt is viewed to be contributory to high blood pressure. In fact, he says, unless your blood pressure is regularly raised above 140/90, adding salt to your diet will benefit you if you have symptoms of adrenal fatigue. Suffice to say, the reason for this is complex, but in brief aldosterone (another adrenal hormone) maintains fluid balance in roughly the same concentration as sea water, with sodium the dominant mineral in the interstitial fluid and potassium the dominant mineral within the cells. The ratio between sodium and potassium is all important. In adrenal fatigue, the lack of adequate aldosterone means the concentration of sodium in the fluids reduces in response to the cellular demand and results in a craving for salt. Dr Wilson also advises against high intake of potassium rich foods, such as bananas, due to this same aldosterone mechanism.

Dr Wilson also highlights the role of good quality, natural protein in the diet to aid adrenal recovery through adequate amino acid intake. He advises against processed meats and substitutes like texturised vegetable protein. He highlights the difficulties faced by vegetarians in taking in sufficient protein to recover from adrenal fatigue and suggests the inclusion of eggs, sea vegetables and yoghurts to help in the challenge.

Also a note about carbohydrates. We know that complex carbs are going to be more beneficial than simple sugar carbs, because we have already seen the impact that adrenal fatigue has on blood sugar levels. Fruit should be taken in moderation and fruit juices avoided where possible, to avoid driving the blood sugar up too quickly (only to have the inevitable crash). But also we need to appreciate that so much of our foods are made with white flour. White flour is a hazard because it represents the tasty, quick fuel, inner part of the grain and none of the starchy shell which slows the delivery of its energy. This is dreadful for adrenal fatigue as it impacts on blood sugar metabolism and slows our digestive processes – and all this at a time when we are trying to recover energy – give us a break!

The Acupuncture Effect

Chinese Medicine teaches us to have regularity in our daily habits, to perform them with a calm spirit and enjoy the simplicity of sleep and food when taken in moderate amounts. Anything short of or in excess of this will deplete qi. It is not complex and perhaps that is why we get it so wrong, we are hard-wired to see life as a challenge.

We as a society are now hungrily seeking out practices from the East. Yoga, tai chi and qi gong have never been so popular and are practically available on every street in central Dublin where I practice acupuncture, which is also incredibly popular. These health systems each have a philosophical underpinning – that living with nature is to learn from what we see around us and that we are materially connected with the world, which just like us, is cyclical and habitual in nature.

Acupuncture helps those suffering with adrenal fatigue by normalising the HPA (hypothalamic – pituitary – adrenal) axis via the regulatory effect on neurotransmitters and neurohormones, affecting our brain chemistry. We get an endorphin release from the insertion of the very fine needles, which promote relaxation and pain relief.

My patients with adrenal fatigue are told to stop and review their lives, identify the stressors and follow the regularity approach to sleeping and eating. They are advised to exercise in moderation and not to the point of exhaustion. They are encouraged to come down from the stimulants and attend for regular acupuncture to support the process. I always advise making bone broth soup, which is a Chinese Medicine health food for nourishing the Kidneys (Western adrenals).

So if you are crying out ‘I WANT MORE ENERGY!’ and you can identify with the symptoms mentioned above, it’s time to put a sound strategy in place. Come to see me in one of my my clinics, 19 Pembroke Road, Dublin 4 or Dublin Holistic Centre, South William Street, Dublin 2. Appointments 085 153 7089. I am here to help.

See here a link to Dr James Wilson’s iris test for adrenal insufficiency. Dr Marylin Glenville’s stress supplements can be found here.

 

 

 

 

 

 

 

 

 

 

What Traditional Chinese Medicine can teach us about women’s fertility

Are you trying to get pregnant or thinking about starting your family in the near future? Traditional Chinese Medicine (TCM) teaches us the importance of taking some time to get healthy and ‘on-track’ before getting pregnant, to reduce the chances of failed attempts and early miscarriages, which can take its toll on any couple trying to conceive. I provide a simple intro to some basic TCM theory here.

It is indeed common nowadays for couples to experience trouble conceiving. I have treated many couples at different stages of planning, from those in their 20s trying to get as healthy as possible before trying, to those in their 40s undergoing their third round of IVF. Acupuncture has a role in every pregnancy.

The so called ‘beautiful cycle’…

period-cycle1

Let’s start by looking at the menstrual cycle from a TCM perspective. Keep in mind the yin-yang symbol, left. Day one is the first day of the period. Day one is when the build up of the uterine wall, in the absence of a pregnancy, begins to break down and exit the system. It is the end of the yang cycle in the body, characterised by body heat and fullness, and the beginning of the yin cycle, the cooler phase physiologically, characterised by nourishing processes that build the follicles and blood.

Yang is the warmer, expansive outward force in TCM, yin is the cooler, underlying strength. Yin is the root or the bulb which has the nutrients and yang is the flower or the shoot, both mutually dependent. Where ovulation happens, there is a dramatic change from yin influence in the body to yang and this is represented by a stark rise in body temperature.

What causes the yin phase to change to yang, or the follicular phase into ovulation and the luteal phase, is a complex cascade of hormonal interactions and, in the case of infertility, the internal struggle for the balance of heat and cold, blood and qi (the vital energy). One thing for sure is that the change (from yang to yin around day 14 and yin to yang on day one) can be the catalyst for days of mood swings, pain, nausea and sleep disturbance…for starters!

Charting for victory…

In brief, the TCM view is that by charting temperature changes in the body, analysing the cervical mucous changes and by checking the pulse changes, a good picture of the woman’s overall cycle can be obtained. This should take place over three cycles (three months) prior to trying for a pregnancy. My best advice to couples who are experiencing miscarriage or anovulation early in their efforts to get pregnant, is to consider taking time out to get the cycle in order and reduce stress.

ovulation-temperature-tracking

I help women through temperature charting and try to give insight into the functionality of the cycle. It can be an obsessive phase that drives some people to distraction, but ultimately narrows down a part of the cycle that is failing. If  the body temperatures are too low or high at any point in the cycle we will plan our acupuncture sessions to take place at that time the following month.

How acupuncture works…

How acupuncture is seen to work on a physiological level is to stimulate the nerves in the muscles. Different acupuncture points have been seen to promote different reactions in the brain on fMRI testing and influence various functions in the body. This is very well documented in TCM clinical texts but in the West we are just catching up in the efforts to produce gold standard research. Having needles placed in the body during acupuncture also releases endorphins, the body’s favourite pain-killing and mood enhancing chemicals, therefore it has a helpful role in the treatment of many different health conditions.

In infertility the research shows that the body has an array of different responses to acupuncture. The easiest place to start is to understand is that stress responds to endorphin release and thus it can be helpful in the promotion of ovulation, because the release of the egg can be significantly influenced by stress levels. On a more complex level, acupuncture has been proven in the following research areas

  • regulating fertility hormones – stress and other factors can disrupt the function of the hypothalamic pituitary-ovarian axis (HPOA). Acupuncture promotes the release of beta-endorphin in the brain, which regulates gonadatrophin releasing hormone from the hypothalamus, follicle stimulating hormone from the pituitary gland, and oestrogen and progesterone levels from the ovary (Anderson 2007).
  • increasing blood flow to the reproductive organs (Ho 2009, Anderson 2007), which can improve the thickness of the endometrial lining, so increasing the chances of embryo implantation.
  • increasing egg production (Jin 2009) and improving oocyte quality (Chen 2009), which could increase the chance of fertilisation.
  • enhancing luteal function (Huang 2009)
  • regulating follicle stimulation hormone-receptor expression (Jin 2009).
  • normalising cortisol and prolactin levels on IVF medication days (Magarelli 2008); reducing stress (Anderson 2007)
  • promoting embryo implantation (Liu 2008).

References and further information on these studies here.

When it’s time for IVF

If the above explanation of acupuncture research looks nice and black and white or in any way straightforward, let me correct myself. It is not straightforward! Life is busy, families are demanding and we often put ourselves last on the list of priorities. Acupuncture is not a miracle cure and it certainly doesn’t turn back the body clock.

When it is time for IVF however, acupuncture has been shown to be a very useful treatment in aiding clinical pregnancy rates. IVF offers a 30% chance of a pregnancy, a statistic that can be hard to swallow. Stress and worry about the outcome, the health of the baby and the significant finances involved can put unprecedented pressure on couples, so it is important to build relaxation techniques into your daily routine. Acupuncture is, in my opinion, one of the best relaxation techniques you can choose. My patients across the board report better quality sleep and less anxiety, without the hangover that medication comes with.

The research into acupuncture and it’s role in IVF is impressive, especially for a natural therapy with very little funding behind it by comparison with pharmaceuticals. The link above details some of the most useful evidence that has been published. There are a number of well established protocols for treatment with acupuncture that have been put to the test in the last 20 years. One of the most referenced and repeated studies is the Paulus study (known as the German study), involving 120 women who had treatment on the day of embryo transfer and which showed a statistically significant improvement in pregnancy rates at 42.5%, compared to 26.3% in the non acupuncture group. The authors of the study explained the principle of the treatment was calm the patient and to stimulate the uterus and endocrine system.

So what Chinese Medicine really tells us about fertility is that we need to watch and wait and be patient. It tells us that we can influence our health using natural techniques. It tells us that stress is a major factor in infertility.

I am here to help…

If you are experiencing difficulty getting pregnant or you are going through IVF I am here to help. I am a member of the British Acupuncture Council, the largest organisation of acupuncturists in the UK and Ireland, and I am a member of the specialist group, the Acupuncture Fertility Network. I can be contacted at the Dublin Holistic Centre on 01 6330063 or directly on 085 153 7098. All enquiries are treated as confidential and I offer a free 10 minute telephone call if you wish to discuss your case prior to your consultation.

Migraine watch: Keeping up with the most current research for acupuncture

A PubMed search of findings published in peer-reviewed journals shows that dedicated research is being actively carried out worldwide to establish acupuncture’s role in treatment, from mechanisms of action, to safety studies to comparison with medications. Click on the linked numbers to see the extracts.

In March 2015 the Michigan Head Pain and Neurological Institute report findings that ‘acupuncture seems to be at least as effective as conventional drug preventative therapy for migraine and is safe, long lasting, and cost-effective. It is a complex intervention that may prompt lifestyle changes that could be valuable in patients’ recovery’. (1)

Also in March 2015, in China Zhongguo et al. publish their research, concluding ‘the effect of point selection along affected meridian could be achieved possibly by regulating the MME gene expression.’ (2)

Again in April 2015, an Australian randomised controlled trial carried out by a research team comprised of the Health Innovations Research Institute, the Department of Medicine, Royal Melbourne Hospital and the School of Mathematical and Geospatial Science, RMIT University reports ‘manual acupuncture was an effective and safe treatment for short-term relief of frequent migraine in adults. Larger trials are warranted’. (3)

In April 2015, the Department of Neurology and Stroke Center, Dongzhimen Hospital report findings in the Chinese Journal of Integrated Medicine, ‘acupuncture treatment could increase the functional connectivity of brain regions in the intrinsic decreased brain networks in MWoA [migraine without aura] patients. The results provided further insights into the interpretation of neural mechanisms of acupuncture treatment for migraine. (4)

In June 2015, Zhou et al. report in the same publication that ‘The activation of MLCK [myosin light chain kinase] in the middle meningeal artery was increased by acupuncture at Fengchi (GB 20), indicating its effectiveness in preventing and curing on acute migraine attacks.’ (5)

In 2014 Gündüztepe et al. report in Acupuncture and Electrotherapeutics Research ‘acupuncture treatment appeared to be effective by lowering the levels of serum nitric oxide and acupuncture has cumulative effects. Although there are earlier studies showing the effect of NO in migraine, this has been the 1st study in this field, which shows the effect of acupunctureon NO in migraine patients’. (6)

Evidence collected from trials involving acupuncture over the last twenty years have established   acupuncture can help in the treatment of migraine by:

  • Providing pain relief – by stimulating nerves located in muscles and other tissues, acupuncture leads to release of endorphins and other neurochumoral factors and changes the processing of pain in the brain and spinal cord (Zhao 2008, Zijlstra 2003, Pomeranz, 1987)
  • Reducing inflammation – by promoting release of vascular and immunomodulatory factors (Kim 2008, Kavoussi 2007, Zijlstra 2003).
  • Reducing the degree of cortical spreading depression (an electrical wave in the brain associated with migraine) and plasma  levels of calcitonin gene-related peptide and substance P (both implicated in the pathophysiology of migraine) (Shi 2010).
  • Modulating extracranial and intracranial blood flow (Park 2009).
  • Affecting serotonin (5-hydroxytriptamine) levels in the brain (Zhong 2007). (Serotonin may be linked to the initiation of migraines; 5-HT agonists (triptans) are used against acute attacks.)

Published by the British Acupuncture Council

The National Institute for Clinical Excellence already recommend up to 10 sessions of acupuncture over 5-8 weeks for tension type headache, so I sincerely hope it will be only a matter of time before it is recognised as a mainstream treatment for migraine too, considering the great body of evidence now available. Nevertheless, thousands of people in the UK are seeking private treatment with acupuncture.

References:
Da Silva. Acupuncture for migraine prevention. Headache. 2015 Mar;55(3):470-3. doi: 10.1111/head.12525. Epub 2015 Feb 16.
 Zhongguo Zhong Xi Yi Jie He Za Zhi. Effect of acupuncture along affected meridian on the MME gene expression of migraine patients without aura of gan-yang hyperactivity syndrome. 2015 Mar;35(3):294-8.[Article in Chinese] Huang YL, Wan MY, Liang XS, Liang FR.
Wang Y, Xue CC, Helme R, Da Costa C, Zheng Z. Acupuncture for Frequent Migraine: A Randomized, Patient/Assessor Blinded, Controlled Trial with One-Year Follow-Up. Epub 2015 Apr 28.
Zhang Y, Li KS, Liu HW, Fu CH, Chen S, Tan ZJ, Ren Y. Acupuncture treatment modulates the resting-state functional connectivity of brain regions in migraine patients without aura. Department of Neurology and Stroke Center, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, 100700, China. Chin J Integr Med. 2015 Apr 6. 

Zhou P, Wang A, Li B, Liu C, Wang Y. Effect of acupuncture at Fengchi (GB 20) on the activity of myosin light chain kinase in the middle meningeal artery of migraine modeled rats.J Tradit Chin Med. 2015 Jun;35(3):301-5.

Gündüztepe Y, Mit S, Geçioglu E, Gurbuz N, Salkaci O, Severcan C, Cevik C. The impact of acupuncture treatment on nitric oxide (NO) in migraine patients. Acupunct Electrother Res. 2014;39(3-4):275-83.
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