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Ask an expert - general

162 questions

Q:  I have had 4 treatments with acupuncture over the last 6 weeks for menopause symptoms.   My last period was two years ago but I have two small bleeds over the last week and I am concerned. Could acupuncture have triggerd this off?

A:  It is always possible that acupuncture treatment may cause the body's systems, especially hormonal, to re-activate to a degree. This is why we always take great care when treating people with a stable thyroid or Type-2 diabetic medication routine, in case the treatment triggers any residual function and destabilises the regimen.

In cases like yours this is always possible, and even without treatment it is possible to have occasional small bleeds around the menopause, often at long and unpredictable intervals. The occurrence of a bleed now could, indeed, be entirely coincidental. However, if you are at all concerned, you should visit your GP. It is a part of our training to encourage patients to visit their GP for any unexplained or unusual bleeding.

This is quite often a difficult message to get across without being alarmist, as you might imagine. In the vast majority of cases it proves to be completely unexceptional. However, in the rare event that there is something more significant going on, it is better to find out and address it immediately rather than take a 'wait and see' approach.

You might also want to have a chat with your practitioner to see if there is anything in your case history or treatment to date which suggests that this is or has been likely. Some treatments are quite expulsive by nature, and can often cause a kind of cleansing effect on the system. A great deal would depend on the nature and quality of the bleed.

We think, though, that a routine check with your GP would probably be the first and best option. 

A:  This is quite a difficult question to answer without knowing a little more about the swelling. There are all sorts of reasons why a thyroid gland can swell, from a benign cyst which can be drained through to the goitres one would associate with Hashimoto's Disease or Graves Disease. If we are talking about the latter, where the swelling is a part of a larger pattern of pathological changes in the body, then acupuncture may be more relevant but the advice less specific.

If this is a pattern of thyroid enlargement causing hyperthyroidism (over-active thyroid) then the evidence from research for the use of acupuncture is not that encouraging or plentiful. Our factsheet

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

cites three studies which address some of the more common manifestations of hyperthyroidism, but while the results are quite positive the samples are too small to generalise.  there are some Chinese studies of the treatment of benign thyroid nodules, and these again, while encouraging, are quite small.

However, one of the great dangers in trading in symptoms from a conventional medical perspective is that it does not do justice to Chinese medicine theory which has developed over 2500 years. Thyroid problems are not new, and although the ancient Chinese would not have understood hormone levels and thyroid function as we know it, they would certainly have made sense of all of the symptoms associated with thyroid hyperactivity, and would have been able to address them within the system of medicine. That does not mean that they would always be able to treat them successfully, and we have to be very careful not to let our maxim of 'treating the person, not the disease' lead people to believe that anything is possible. However, it does mean that there is a chance of bringing the symptoms under control.

However, without more specific information we would struggle to say more. It may simply be a benign swelling, in which case there may be more cause for optimism about what treatment can achieve. What we always say, though, is that if you are on medication for thyroid malfunction we always tread with great care. It can take a long time to achieve a good working balance from a diseased thyroid, and treatment can affect a good balance which has taken months of establish. We tend to work as closely as we can with a patient's medical team to ensure that everything is managed to maintain a good and stable pattern.

The best advice we can give is that you pop along to see one of our members local to you. This will give you the best chance to describe in greater detail what is going on and to be able to get from them a better idea of what may be possible. 

Q: I catch too many viral illnesses/flu like illnesses, about 6 or 7 a year. I am fit and well in between and not chronically ill, I am a 60 year old lady and my only other problem is asthma which is well controlled with inhalers. Could acupuncture help?

A:  You have probably heard people talk about a weakened immune system; in fact, it is a rather over-used term in modern times. However, it does sound as though this really is the case for you, especially if you are relatively fit and healthy the rest of the time.

From a Chinese medicine perspective the point of greatest interest is that you have asthma. Although it may be well-controlled it does show that there is probably some weakness in the Lung energy. We cannot be absolutely certain from the name alone; there is no direct correspondence between symptoms and disturbance in the function of an Organ (capitalised to denote the Chinese understanding of an Organ), and quite often a named condition can have its root elsewhere. However, in the majority of cases the Lung energy is involved, and this is of particular interest because the Lung is closely associated with what is called in Chinese the Wei Qi, the defensive energy of the body. If the Lung is weakened or weaker, then it is less able to circulate the defensive energy, and in theory the body is then less well protected from what the Chinese call external invasion.

Of course, being a 2500 year old tradition there is always room for plenty of disagreement about where Wei Qi develops or is generated, but most writers seem to agree that the Lung is primarily involved in its effective circulation. Boosting this energy may have an impact on improving your defences. We would be more cautious about making any claims about your asthma. The evidence is not as strong as for some named conditions which we treat, and we find that many doctors strongly advise patients against interfering with patterns of treatment which maintain good control over the condition.

How does one's defensive energy become weakened? Well, there are many ways in which one can interpret the balances of energies in the body, and in many diagnostic systems there is not necessarily a correspondence between where a symptom turns up and its originating cause. A skilled practitioner should be able to make sense of the overall pattern, but may well find out that there is a hereditary element to the problems. Our health is determined to a very large extent by the energy of our parents who create us and also by their health at the time of our conception. If this has been at all compromised on either front, then it may leave a legacy of under-performance which might make someone more vulnerable as time goes by to opportunistic viral infections. This is something which we believe can be helped by treatment.

All of this, of course, is speculation based on very little information! The best advice we can offer, given that we think there may be some benefit from treatment, is to visit a BAcC member local to you for an informal chat about whether acupuncture is likely to help. Most members are happy to give up a little time without charge, and face to face it will be far easier to offer an individualised opinion about the possible benefits.

Q:  I have been diagnosed with Mal de Debarquement disorder with going on 2 1/2 months of balance issues. Have tried physical therapy, chiropractic, and now acupuncture. My acupuncturist has dealt with dizziness, but no one with this disorder. Any advice to share? We have worked on the sinus, ears, etc. 

A:  MdDS is quite a rare condition, although the overlap with a number of better documented problems such as Meniere's Disease or vertigo could mean that it is under-reported. As is always the case with relatively rare conditions there is hardly any research, even in conventional medical literature.

We searched for whatever we could find, and there are certainly a number of anecdotal accounts from people with this condition who have found acupuncture in combination with some fairly low level medications has done the trick. This sample is self-selecting, though; there is less chance that someone who hasn't found it useful will post the bad news.

For problems like this we have to say that the way that Chinese medicine works, interpreting the symptoms against a completely different theoretical framework and supplementing what is reported with findings from, for example, looking at the tongue, taking the pulse at the wrist and other clinical observations, can sometimes generate solutions where conventional medicine cannot. Chinese medicine is based on an understanding of energy, called 'qi', and its flow, rhythm and balance in the body. The flow is affected both functionally by weaknesses in the Organs of the body which sustain it, and also positionally because of local blockage and disturbance. It is probable that a practitioner may find evidence of changes or blockages in the flow, and by re-aligning these start to reduce the symptoms. This is certainly the case with other balance problems, where the evidence for the effectiveness of acupuncture treatment, while not conclusive, is certainly encouraging enough to suggest that treatment is worth a try.

The best advice we can give is that you visit a BAcC member local to you and seek a brief face to face assessment. We are confident that in person they will be able to offer a much better view of what may be possible. The only caution we have is that conditions can become more difficult to treat the longer they have been entrenched, and a fifteen year history suggests that improvements may take a while. However, life is full of surprises, and we have seen longstanding problems vanish almost overnight, so the best idea is probably to have no expectations either way.

We have checked the databases to see what else might have been published since we wrote this in 2014, but apart from a 2013 study which uses a form of magnetic therapy

http://www.ncbi.nlm.nih.gov/pubmed/23202153

we have not found anything else which would affect what we have said either way.

The only addition we would make to this answer is to mention that there are one or two other forms of treatment, notably cranial osteopathy, which might also offer some relief and improvement. Although the evidence for acupuncture and MdDS is a bit thin, there is a considerable amount of good quality research on vertigo and other balance problems like Menieres and labyrinthitis. From a Chinese medicine perspective, the disease labels of western medicine are less interesting to us than the functional disturbances which a patient reports. We have ways of interpreting these within the conceptual grid of Chinese medicine which makes direct equivalences hard to establish - some presentations with different western names are the same as far as we are concerned, and twenty people with the same named presentation may be treated twenty different ways.

Hopefully a practitioner will find something which makes sense of your problem and can give you a much clearer idea than we can here of the potential for treatment with acupuncture.

We publish a fact sheet on menopause

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

which is refreshingly candid about the chances of treating menopausal symptoms, and refers to a number of papers which seem to provide encouraging results. One of the main reasons which bedevils the results of research is that the treatment is often compared to a 'sham' treatment, and both generate better results than the control group. As a consequence the treatment is said to be 'no better than sham' and all down to a placebo effect. We, however, would say that there is no such thing as 'sham' acupuncture; sticking needles anywhere will generate a result, and it's the difference between good and better treatment. As one of our medical colleagues said, if sham treatment is better than conventional treatment, who cares how it works, just use it!

In  essence, though, we have to say that traditional Chinese medicine has been addressing the problems of the menopause for over 2000 years, and over that time has looked in enormous detail at the kind of energetic changes which occur at this time of life. Interpreting these against the backdrop of the patient's constitutional energy is where the skill of the practitioner lies. This is more than just deciding out of the five causes for a symptom which specific treatment will work best. Chinese medicine treats the person, not the condition, and simply picking off the symptom while leaving the overall balance untreated will in many cases mean that the symptom returns. This is why we are quite concerned about people learning formula treatment for named conditions; sometimes they work, sometimes they don't, and when they don't people wrongly conclude that acupuncture treatment does not work.

The best advice we can offer is that you visit a BAcC member local to you for a brief face to face assessment of what may be possible. Most members do not charge for a short interview, and face to face they can give you a much better idea than we can at a distance of what may be possible. A postcode search facility on our home page will identify the practitioners nearest to where you live and work.

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