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Q:  This is quite different from the usual enquiries about weight loss!

A: However, the first thing we would want to know in any case like this is what conventional medical investigations had been done, especially checks on many of the hormones of the body, to see if there are any major issues about uptake of nutrients or excessive burning off through, for example, an elevated thyroid function. We would also need to ask, as delicately as possible, whether there were any issue with food in the background, periods of anorexia in teenage years, from which the system has not yet fully recovered and re-balanced. And, of course, we would always ask about the rest of the family - it used to be said that oaks beget oaks, and willows beget willows. If someone comes from a family who are all slightly under-weight according to the charts which people use as a defining standard, then the chances are that this is a normal state for them.

 We would also want to ask a great many questions about food intake and appetite. Many people eat their meals at the wrong time of day, and often have foods which do not suit them, and this could well reduce their chances of gaining weight. This is much more likely to result in the opposite phenomenon, though, and we have to be honest and say that we have not come across people who have lost weight through eating the wrong types of food at the wrong time of day.

 The best that we can say, really, is that if the system is in balance, then unless there are physical reasons which prevent someone reaching a target weight they should be able to achieve some weight gain by the simple expedient of eating more. When looking at someone's digestion from a traditional Chinese medicine perspective we would be looking at their digestion, distribution and absorption processes to see if there were any signs that these were not working as they should. Such is the nature of Chinese medicine that this in itself would not be enough. It is critically important to see these functions within the context of the whole system, and that is why twenty people with the same symptom may be treated in twenty entirely different ways - we treat people, not conditions.

 The best advice we can give, however, is to visit a local practitioner to seek face to face advice about what is going on. If they can see something straight away which might indicate that there was an issue in your system that might be addressed and help your problem that would be a good basis to give treatment a try. Even if there weren't treatment of the person as a whole to re-balance everything can have a remarkable effect. What we advise people to avoid, though, is getting drawn into prolonged treatment at great expense without any real results.

 In your case, it would be important to establish what a reasonable target weight was, and also to research what kind of pace this change would need using conventional methods, i.e. not just gaining weight but doing so in a way which was sustainable and good for the body. This 'expert' could gain five pounds this weekend  by eating cream cakes but not in a way which was good for the body, or its shape. This would/could determine how much treatment might be necessary and over what period. If the desired change could take six months it might be unrealistic and unnecessary to have weekly treatment. It'a a bit like watering a plant; the plant has to have time to absorb and can't simply be watered daily to make things happen faster.

 We hope that this helps, and are sorry we can't be more specific, but this really is one of those cases where we would actually need to see what is going on to give more specific advice.


A:  This question illustrates the problems we have with published research and its use and interpretation. There is a systematic review published a little while ago

 http://www.ncbi.nlm.nih.gov/pubmed/26502548

which appears to be quite encouraging, citing as it does the cumulative results of 13 studies. While we would normally be quite positive about this, making our usual comments  about this bearing out our clinical experience, the reality is far more complex.  In fact, the Cochrane database assessment of the value of acupuncture treatment is far less encouraging

 http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0014639/

 Many of the cases we see and have seen are very complex, and some of the manifestations of what can often be a very broad brush clinical definition are a great deal easier to treat than others. In all cases, though, it is making sense of the symptoms within the overall presentation which matters, and the labelling of all sorts of presentations under the one diagnostic banner headline can be misleading.

 That said, paediatric acupuncture is an area of specialism within traditional acupuncture where some of the postgraduate training has reached a stage where it may be formally recognised as the basis for claiming expert practice. In the source texts used by the courses there are several clearly identified syndromes which fall under the general heading of ADHD and some well tried treatment protocols, along with lifestyle advice, which may be beneficial.

 Rather than say blithely 'it will work' we would advise you to try to find someone in your area who has undertaken this postgraduate training and ask their advice. If it is you own child who has the problem then we would recommend that you try to arrange a brief face to face consultation to see what may be possible. Our internal procedures don't allow us to make individual recommendations, but if you use the google search terms 'acupuncture children' and the town where you live we strongly suspect that you will find someone who has undertaken training with some of the well established postgraduate courses. That is not to say that any of our members may not be able to help, but children are not simply small adults, and there are specific problems which they face which may require slightly more fine tuning than is found in ordinary generalist practice.

   

 

A:  There is a surprising amount of research information for the acupuncture treatment of dry eye syndrome. The last time we reviewed this condition there seemed to be one or two studies, but two have been published recently, along with a review article.

 The two studies

 http://www.ncbi.nlm.nih.gov/pubmed/21138389

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3355143/

 show very encouraging results, and the review

 http://www.ncbi.nlm.nih.gov/pubmed/21138389

concludes that acupuncture treatment is better than the use of artificial tears for the condition. Of course, this falls a long way short of the amount and quality of evidence which would enable us to give an unqualified recommendation, but it is nonetheless very encouraging.

 We have to remember, though, that from a Chinese medicine perspective a symptom seen in isolation from the system as a whole is not that informative. There are all sorts of functional disturbances from this perspective which might lead to this symptom, and the key concern is to try to remove its causes as much as to simply try to stop the symptom alone. Sometimes this will be enough, but more often if the underlying patterns of imbalance are not addressed it will ultimately return, and that does not do justice to what acupuncture may be able to offer. A skilled practitioner will be able to make sense of why this symptom has appeared in you as a unique individual, and will use all sorts of other information to get a sense of how the whole system is functioning.

 The best advice which we can give is to visit a local BAcC member for a brief face to face consultation. This will be far more informative than we can be at this range, and most of our colleagues are usually willing to give up some time without charge to assess whether acupuncture is the best treatment option. This also has the advantage of meeting the practitioner and seeing where they work before committing to treatment.

 

Can you advise if it is necessary to have a specialist for depression to treat with accupuncture. 

There is no need to seek out a specialist to treat depression with acupuncture. We are all generalists who treat people rather than conditions, and the huge strength of Chinese medicine is that it looks at the unique and individual presentation of every patient. It would not be unusual for twenty people with the same named condition to be treated in twenty entirely different ways. The practitioner will work to find out exactly what 'depression' means for someone - it's a name that covers a huge range of possible disturbances of the system - and then look at why these problems have arisen in these individuals.

 

There has been a fair bit of research into the use of acupuncture to treat depression, as our factsheet shows

 

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/depression.html

 

but by far the most interesting result was a study recently conducted by one of our leading researcher/practitioners

 

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001518

 

which showed some very positive outcomes. Hugh has also written several follow-up articles looking at the data he and his colleagues collected, but these are a little on the scholarly side.

 

Most of us have treated people with depression as a primary referral because friends, family and colleagues who have come for a problem like backache or headache have found that acupuncture has helped depression too, and have referred on friends for whom depression is the main issue. The only time any of us might be cautious in taking on a case would be if someone's depression was linked to a serious psychiatric illness. Here we do recognise that there are special skills which might be needed, but there are very few patients in this category who present for treatment.

 

Sadly we can't recommend individual practitioners - we have no criteria to go for one over another - but also it follows from what we have said is that we think all of our members are suitably qualified to address the problem you have. If you use the postcode search facility on our home page you will find a number of people who are geographically closest, and most are willing to give up a little time, often without charge, to discuss whether acupuncture treatment is the best option for you. This also has the advantage that you can meet them and see where they work before committing to treatment. 

I am a licensed acupuncturist in the U.S. I'm wondering what I would need to do to work in the UK?  I would appreciate any insight and guidance

In the absence of statutory regulation (SR) for acupuncture in the UK there are very few restrictions on acupuncture practice. There have been several working groups in the last fifteen years which have recommended SR, and with it protection of title and recognised training standards, but SR on the UK is now mainly risk-based, and the truth is that we are a very safe profession compared to conventional medicine. As such there is no enthusiasm to commit public funds to an unnecessary process.

The only regulation which affects most practitioners is the registration or licensing process enacted by local authorities to regulate skin piercing activities, which means that we are regulated alongside tattooists and body piercers! There are different pieces of legislation in place across the UK. In Greater London there is an annual licensing procedure from which SR professionals (physios, osteos, etc) are exempt, as well as voluntary organisations such as the BAcC which have met certain criteria. Elsewhere in the UK another form of one-off registration exists for every practice in which someone works. In Scotland there is annual licensing with exemptions only for SR professionals.

Although the legislation does not set standards of training, many authorities have added their own requirements to be able to knock back people who have done very short training or are not able to demonstrate some level of competence. The level of training in the US is probably of a slightly higher standard than required in the UK , so there should be no problem in convincing a local authority of your bona fides.

You will obviously need indemnity insurance, and although this is freely available for not a great deal (£100 a year, whatever that means in the current post-Brexit exchange rate), the BAcC provides insurance as a part of its membership package, and we always recommend that anyone setting up in the UK investigates what the offers are from various professional bodies because membership of such is a pretty important investment. Obviously we like to think of ourselves as the lead body, accredited as we are by the Professional Standards Authority and with nearly 3000 members, but there are others whom we meet on a regular basis who can be trusted.

Other than that it's really a matter of visas and work permits but we tend not to make pronouncements about these - they vary so much according to someone's unique personal circumstances that it would be unwise for us to say too much for fear of getting it wrong.

And that's about that. Our experience is that in these post-recessionary times it can take as much as two to three years to build up a self-sustaining practice, but we have seen dynamic individuals get full to capacity in six months, so again it depends on the individual.

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