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Ask an expert - general

160 questions

Q: I have hypothyroidism and am taking a 100 dose of thyroxine daily.
Since being diagnosed 10 years ago my weight went from 10stone to 12 stone over the first 3 years and has been steady at 12stone ever since. I do not eat sweets etc and have a pretty good diet. I know I am overweight and need help do you think acupuncture could be the answer. I have faith in it as I had a course to relieve severe hip pain some years ago and it worked wonders. I am a 65 year old female.

A:  We are always a mite cautious in answering questions about the management and effects of thyroid problems. Our clinical experience is that it can often take patients a considerable time to achieve a good balance of thyroxine, and one of the consequences of using acupuncture is that it can boost residual functions across the whole system. When people have limited function in the thyroid, and also in the pancreas and other endocrine glands, we are always concerned that we might just prompt the whole system to work better and cause fresh problems.

The first thing we would want to check is whether your thyroxine dose is precisely matched to your needs. Fluid retention and subsequent weight gain would be a sign of hypothyroidism, and it may just be that the dose you are taking is not quite meeting your current needs. On the assumption, though, that we can rule this out, the advice we give to people about acupuncture and weight loss is consistently the same - unless there is clear evidence that there are functional disturbances from a Chinese medicine point of view which might be causing some of the weight gain, we would never recommend acupuncture as a general treatment for weight loss. While our underlying belief is that a system in balance will perform better in all respects, and might in theory bring weight under control, the evidence from research and from our clinical practice is not that favourable.

One of the problems, of course, is that when we treat people for weight loss, it is rarely the only thing they are doing, and as people who go to Weightwatchers and similar organisations know from their initial briefing, after a short period of rapid loss every pound takes time, with targets set very low at a pound every two weeks or so. It is very difficult with this kind of time frame in mind to be able to determine whether acupuncture works or not, and whether it is having a direct effect or simply helping to maintain someone's determination to carry on.

That said, there are a number of syndromes recognised in Chinese medicine where we can and do give advice, and sometimes treatment, which can have an effect. Chinese dietary advice is always to eat more at the beginning of the day than later, and to avoid certain types of food. There was a saying used in this country 'breakfast like a king, lunch like a lord and dine like a pauper' which expresses well the best pattern of eating to fit in with the body's natural rhythms. Our digestive functions are far better in the earlier part of the day, and meals taken in the evening are never digested as well.

The main Organs of digestion, the Stomach and Spleen (we capitalise them to denote the Chinese medicine understanding), also work better when the food is fit for purpose. The Spleen is said to like warm dry food, and if it is over-loaded with cold and damp food, it under-performs and can lead to a condition the Chinese call Dampness which can mean an accumulation of fluids, especially in the middle third of the body and lower limbs) and a general feeling of sluggishness. When you think that the usual reaction to weight problems is to eat lots of salad, raw fruit and raw vegetables, it is not hard to see how things can easily get worse rather than better. This doesn't mean not eating all of these foods; they are still a healthy diet. It means rather to balance the coldness with something either physically hot or spicy hot. You rarely see cold food in a Chinese restaurant; even fresh vegetables are stir-fried to retain the crispness but lose the coldness.

What we sometimes advise prospective patients to do is to begin with a number of small dietary changes, and perhaps have a number of acupuncture treatments to see what happens. If the system is waterlogged this can sometimes mean that there is an immediate response to treatment and better dietary patterns. We have to be realistic insofar as people can't always change their eating patterns in one go, and we also need to be able to distinguish between what we do and what the dietary change is doing. However, if there seems to be some progress, then we usually discuss regular but spaced out treatment to keep the system working towards a better overall balance.

As always, it is best to visit a BAcC member local to you for a brief chat about what may be possible. Whatever we say here it will never be as accurate as what someone can tell you even from a brief look at diagnostic signs.

A:  It came as a surprise to us that there have been a number of studies of teeth grinding/bruxism. One example of this is

http://www.ncbi.nlm.nih.gov/pubmed/15108607

and another

http://www.researchgate.net/publication/235768598_Acupuncture_as_therapeutic_resourcein_patient_with_bruxism

although it has to be said that this is an unusual approach, not drawing on traditional acupuncture but on auricular acupuncture which is a much more modern development.

The problem of bruxism is usually described as multifactorial, arising from a combination of causes and very often having a mental and emotional causes as well as arising as a consequence of conditions like sleep apnoea and from some forms of medication. Some of these causes are very commonly treated by acupuncture, as our factsheet on anxiety, for example, shows

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

The only way to get a clear answer, though, would be to visit a BAcC member local to you for a brief informal assessment of what treatment may be able to offer. The main purpose of seeing you face to face would be to check whether this was a stand-alone symptom, or whether there were other factors involved. In Chinese medicine diagnosis it is rare to find a single free-standing symptom. Most symptoms are evidence of a functional disorder within the system as a whole, and the Organs of the body (capitalised to distinguish what this means from the western concept of an organ) have a range of functions which means that a single one out of kilter might generate several symptoms manifesting on different levels. The skill of the practitioner lies in getting information from patients about their overall functioning and making sense of the various ways in which these depart from their normal range.

If the practitioner can see immediate connections which point to straightforward treatments, they will be able to give you a good idea of how successful treatment may be. Even if there are no obvious connections it does not mean that treatment may not work; the most ancient systems were asymptomatic, driven by the simple belief that a symptom in balance did not generate symptoms and that these would lessen and go. Versions of this style of treatment are still very popular and successful today.

You can find a list of practitioners close to where you live by using the postcode search function on our home page.  

Q:  What can I do to help a alleviate the pain at the needle insertion site between thumb and finger, it's normal reaction but lasts several days

A:  The use of this particular acupuncture point should not leave a sensation for several days, so we would be reluctant to classify what's happening to you as 'normal'. What this suggests is that the needle is being used slightly too vigorously for your physical structure in that area and causing deep bruising which may not be apparent on the surface. We have come across cases where points like this can have an enduring energetic effect lasting two or three days, but usually only when they are first used. The body often gets used to the treatment and accommodates the effect of the needles more easily as time goes on.

If there is bruising in the deeper tissues we are aware that many of our patients use preparations like arnica cream to help, but we obviously cannot recommend something like this because it lies outside our scope of practice. If the effect is felt on one side only, then there may well be some advantage to massaging the same place on the other hand. The channels are bilateral and have a close reciprocal relationship of which we take full advantage when we needle one limb to help the other when we cannot needle the site itself (because, for example, it is bandaged or in a cast). There are also points at the other end of the body which may be massaged to good effect. In this case, it might be useful to massage a point on the opposite foot between the big toe and first toe at the tip of the 'V' which if felt as the finger is drawn up toward the ankle. This reciprocal relationship between points on the opposite limb in roughly equivalent locations is also one of the more unusual treatments visitors to China often see (such as needles in the wrist to treat a twisted ankle).

From our perspective, however, if a patient came back and told us that a point was painful for several days after a session, and that this had happened more than once, we would be inclined to needle more gently or to choose another point which had less enduring impact. If the patient said they did not mind, we might still be inclined to do something different. Pain in any form is a sign of blockage or disruption to the flow, and if this is a clear cause/effect relationship, we would be wondering why this carried on.

A:  From a Chinese medicine perspective the $64,000 question is what is causing the fluid retention, and your question illustrates perfectly how difficult it is to take a symptom by itself and offer a view about its treatability. There are a number of reasons in Chinese medicine why someone might start to retain fluid, many of which track back to under-performance in one or two organs (we capitalise the word because an organ in Chinese medicine is not simply a physical object but a description of a range of functions in body, mind and emotion). The fact that we can then say that a spleen or kidney is under-performing leads to the next level of questioning: what is it about
the overall balance in the person's system which causes this part to malfunction? Is the problem in the organ itself, or is it caused by another organ not working well and having a knock-on effect?

This again leads to questions about the person's lifestyle and daily routines. As an example, many cases of fluid retention track back to the Spleen, which in Chinese thought is responsible both for sending fluids around the body and also for holding things up, a sort of internal gravity. When it does not work well, fluids gather and tend to sink, so many people end up with swelling in the middle and lower part of the body and then related problems like varicose veins. The Spleen does not thrive on cold and damp conditions, so a diet rich in raw fruit and vegetables, dairy produce and other cold, damp foods will already put pressure on the Spleen even if it is healthy,
and in one which is already under-performing push it a stage further into malfunction. Treatment might then be supplemented by dietary advice.

However, this is jumping the gun! The very first thing that a practitioner might do would be to look at the circulation in the area, not just the blood circulation from a western point of view but the energy circulation from a Chinese medicine perspective. There are often functional disturbances behind problems like this, but there can also be much simpler superficial disturbances, the treatment of which can be much more straightforward.

To have a really good idea of what is going on, and to avoid guessing at how problems like this might respond to treatment it is always best to trot along to a local BAcC member who with very little investigation will probably be able to offer you a reasonably accurate estimate of what may be possible after looking at your feet and asking you a number of questions. Crucially they will also be able to take the pulse at the wrist and look at the tongue, both Chinese methods of diagnosis that can very rapidly point to major areas of disturbance and change. On this basis they are likely to be able to give you a fairly good idea of what may be possible.

A:  As you can imagine, this is a topic which pops up relatively frequently, and a typical answer we have given in the past is:

Weight loss was the subject of some critical scrutiny a decade ago, and the conclusion drawn at the time was that acupuncture did not have any significant effect on
weight loss. However, trying to test whether acupuncture can help someone to reduce their weight is likely to be a difficult matter; there are dozens of reasons in Chinese medicine why someone's weight may be increasing. Trying to group together a sufficiently large number of patients whose western problem
and eastern diagnosis are the same is extremely difficult.

In one or two cases there is a very direct correlation between someone's weight and their underlying imbalances from a Chinese medicine perspective. Correcting these may have an immediate impact on, say, the amount of fluid someone is carrying, and that could create a 3-5kg loss very quickly.

However, all of the best dietary programmes say that after the initial and often quite dramatic week or two most good weight loss programmes at best will see someone
lose only a pound or two every month, and in fact, there is discouragement from trying to do more in order for the body's system to keep pace with the change.
Acupuncture may well have been used successfully alongside some fairly strict dietary rules, and from a patient's perspective it would be very difficult to say whether the acupuncture treatment added value to what someone was doing already.

The bottom line is that there are are no 'magic' points which reduce someone's weight without effort, and the effect of acupuncture may be no more than to give
someone the support and commitment to keep trying with diet and exercise programmes. However, if someone remains motivated as a consequence of acupuncture
treatment that itself would be a very positive outcome.

There is nothing that we would add to this advice other than to beware of anyone making promises they cannot keep about what acupuncture treatment can deliver. Some of the less reputable high street shops still appear to be making claims of a fairly speculative nature without any evidence which supports what they claim.

This is probably the best advice that we can give. Our clinical experience is that their are often subtle emotional and spiritual issues underpinning the loss of control which people have of their weight, and some of these are amenable to acupuncture treatment. We have answered many questions on anxiety and depression, and we find quite often that a response to depression is to comfort eat. Helping with the depression may well reduce the desire to use food in this way.

One has to be realistic, however. Some of the psychological issues are not best suited by long term acupuncture treatment and really do need to be addressed directly by
someone skilled in this area. There are also many occasions when the 'habit energy' to eat is so well entrenched that a direct intervention like hypnotherapy or cognitive behavioural therapy is appropriate because it goes straight to the point. We also have to tell some patients, sensitively we hope, that oaks breed oaks and willows breed willows. If a family are all size 18, then the chances are that trying to be a size 8 is not going to be likely.

The best advice we can give is that visiting a BAcC member local to you will be able to provide you with advice based on a brief face to face assessment. This is very
likely to offer you the best range of options for you. All of our members are concerned to ensure that a patient gets the help they need, which is not always what they have to offer. We often refer to other colleagues if we feel something would work better. Each patient is unique, and finding what works for each individual case is the best guarantee of success.

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