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Ask an expert - general
Q: My daughter has finally been diagnosed as being deficient in T3 and is on Throxine but though her T4 is normal there is no T3 synthesis. She has Hashimoto's Disease which is autoimmune. Can Acupuncture help to stimulate the thyroid to produce its own T4 and T3?
A:We publish a fact sheet
which summarises the current research into the use of acupuncture in this area, but it has to be said that the amount of research is not adequate for us to give an unqualified endorsement of the use of acupuncture for Hashimoto's.
We were asked a similar question last year and we answered as follows:
Q: Can acupuncture be used to treat hypothyroidism ?
A: There isn't a great deal of research to underpin a straight recommendation for the use of acupuncture in the treatment of hypothyroidism.
What there is suggests that acupuncture may be of benefit, but this is a condition for which some form of maintenance medication is often essential and this makes testing it in trial conditions somewhat more difficult.
For the same reason our members are always told to be cautious in treating conditions where someone is on essential medication. Recommending that someone stops their medication is out of the question - only a doctor should be making this decision in the case of essential meds - and there is always an issue about adjustment. If the treatment has the effect of improving someone's thyroid function it may then mean that the dose of medication which they take may no longer be suitable. Since it often takes a long time to achieve a stable balance with the medication in the first place, it is important to avoid as much as possible the kind of yo-yo adjustments which people often experience when they are first prescribed their medication.
That said, the important point to make is that the Chinese would have recognised the symptoms of hypothyroidism two thousand years ago but have no idea about the relationship they had to a thyroid malfunction. The symptoms would have been analysed within the diagnostic systems of Chinese medicine, and a treatment plan devised to help correct them. The Chinese understanding of human physiology was entirely different, and rested on a concept of energy, called 'qi', and its various functions and inter-relationships. The kinds of symptoms which someone experiences with hypothyroidism would be linked to a failure of organic function as understood by the Chinese, and even where there was no explicit correspondence, the underlying premise that where there is balance symptoms disappear would nonetheless apply.
If you are thinking of having treatment it would be good to see if you can discuss your specific presentation first with one of our members, and see if they feel that this is something which they feel would be of benefit to you.
We would not really want to say anything more than this. There is certainly anecdotal evidence of which we are aware that patients have benefited from acupuncture treatment, but equally there is evidence of treatment having little or no effect. Since the essence of Chinese medicine treatment is that it is individualised, in the absence of more research we tend to be more circumspect and recommend that someone gets a face to face assessment of what may be possible.
Q: I am a beauty therapist who would really love to offer Facial/Cosmetic Acupuncture for my clients. however, I am not interested in any other form of acupuncture. Do I still need to do the full university course to learn Body Acupuncture or is there another course I can take that only teaches Facial/Cosmetic Acupuncture?
A: This is a hot potato! And you're probably asking the wrong people - we have a public commitment to degree-leve training as the entry standard to the profession, and a Code of Professional Conduct which forbids our members from training anyone in aspects of treatment unless they are already registered healthcare professionals or existing acupuncture practitioners.
We are duty bound to say that the only training we endorse is a full training. Acupuncture works for a great many problems, and for that reason many people 'cherry pick' small aspects of treatment for use in isolation from an overall understanding of what is happening in the body. This can have two consequences: first, that the treatment will not work because it cannot take into account confounding factors within the whole system; and second, it may actually cause harm for the same reason - local treatment may exacerbate a systemic problem for which the practitioner is unprepared. You can't know what you don't know, and being trained in just a small aspect of treatment is no better than being trained to steer a car in a straight line at 40mph. It's all very well as long as this is all you have to do and nothing pulls out in front of you.
Our primary concern is safety. This is not simply about causing damage with the needles; even in the hands of the poorly trained acupuncture is still remarkably safe. What concerns us is the level of understanding of safe needling and correct disposal of clinical waste. Many of the courses which we see health professionals taking are too short to cover this adequately alongside training in a new skill, and we fear that someone will unwittingly cause infection.
The reality is, however, that any gap in a market soon gets filled and there is a growing number of providers offering training in this area. All that we can tell you is to check their bona fides as health professionals, i.e. are they properly trained themselves, do they have proper insurance cover to offer training, and so n - and then check whether you are properly covered to offer treatment of this kind.
There is also a legal question of whether you need to be registered with your local authority for skin piercing, which this is. Since the adoption of the amendments to Local Government Miscellaneous Provisions Act 1982 in 2006, all cosmetic and body piercing has to be registered with the local Enviromental Health Department, and we are sure that this extends to facial acupuncture. In London, this will mean annual licensing, outside London a one-off registration. In both cases, the penalties for being caught unregistered or unlicensed can be quite severe.
Q: Is there a need for people to practise on. So students get experience. If so how can I offer myself as a person to be practised on.
A: Most of the teaching institutions run college clinics in which patients can get heavily subsidised treatment under the direct supervision of highly experienced acupuncture tutors, but this is not quite the same as being practised on. The nature of acupuncture treatment is that it is evolutionary and dynamic, so a patient would remain under the care of a single practitioner for several sessions while he or she assessed the impact of the treatment and how to refine it. This is essentially a normal course of treatment, and the days of sticking needles in onself, each other or in human volunteers to learn the techniques are largely gone. Many students practise on prosthetic limbs carefully designed to replicate the 'feel' of needling a real human arm or leg.
If the idea of being a patient in a student clinic is one which interests you, however, there is a list of accredited institutions whose graduates are automatically eligible for entry to the BAcC to be found on the website of the British Acupuncture Accreditation Board, http://baab.co.uk/study-acupuncture/Accredited-courses.html.
Q: Is there a treatment for fibrolipoma.(large midline subcutaneous cervico-dorsal lipoma measuring 15.5(cc)x71.(AP)x16.3(Tr)CM in size
A: There is little or no research evidence to suggest that acupuncture treatment can be used with fibrolopomas of this size, indeed little or no evidence for the treatment of fibrolipomas at all. However, this does not mean that they have not been treated, simply that there has been no systematic attempt to gather a trial group together and test acupuncture against a suitable control group.
Traditional acupuncture is premised on the flow of energy, called 'qi', whose flow and balance is seen to be integral to the maintenance of good health and absence of symptoms. Where conditions like fibrolipomas develop, this is generically viewed as a blockage in the flow, and also at a very generic level often seen as an accumulation of fluid, called Damp in Chinese medicine, which has become more solid under the influence of Heat or other factors to form Phlegm, the Chinese name for these kinds of lumps and bumps.
In theory, there are both systemic and local treaments for dealing with these problems, and all of us have good anecdotal accounts of addressing problems like these on a relatively small scale. However, if we have read the dimensions correctly, this is an immense growth, and we would not expect acupuncture treatment to make a great deal of impact on such a lipoma. When things have reached this stage, surgical options may the best thing to consider. It might be worth establishing whether there is an energetic imbalance which contributes to the pattern, so that after surgery there is more chance of ensuring that the fibrolipoma does not return, but we do not think that acupuncture would be a very good primary treatment for the problem.
A: The great majority of traditional acupuncturists work in private practice. You can find them by using the search facility on the BAcC website (for our members) or through the BAcC's Yellow Pages and Yell.Com entries, or through looking at the acupuncture section of your local information networks. Many people now use the internet to locate practitioners near to where they live or work.
Finding acupuncture treatment inside the NHS is more difficult. Doctors and physios are limited to treating conditions for which there is a NICE guideline or for which there is a body of evidence which meets western standards. This can quite difficult to track down, and is usually quite limited as far as the number of sessions is concerned.