Tag Archives: Acupuncture

About Chinese Medicine. Part I. “So, what is it that you do?”

I have often been asked this question, as one does, on social occasions and so on. To be honest these moments are one of the very rare occasions when I wish I was still working as a Western Doctor. It would be so much easier to say “I am a Paediatrician” or “I am a Urologist”. People know what those are; there are no awkward moments, unlike when I say “I’m a Chinese Medicine Practitioner”. (Oh, that’s interesting, so you stick needles in people?) Yes, pretty much, I stick needles in people for a living. You can see why it somehow makes me feel a bit uncomfortable. Of course, Chinese medicine is much more than that: an established and extremely clever, beautifully constructed, multi faceted way of understanding everything about human health and sickness. It covers every aspect of health, physically, mentally and emotionally. It possesses a deep understanding of the processes of health and illness. It understands the factors that affect our health such as lifestyle, emotions, food, weather and so on. It is of course much too complicated to convey all of this in conversation over a dinner party. Usually, if I try, I soon have to stop as I can detect the puzzlement in the eyes of the person I’m chatting to.
“You need to write about it in your blog” my daughter told me. Yes, that makes more sense. I won’t have anyone’s confused look to stop me in my tracks, so I am going to give it a go. I will try to simplify things as much as possible, whilst still doing justice the important principles of T.C.M. (traditional Chinese medicine). Like everything in Chinese medicine it is all about keeping the balance.

The main parts of T.C.M. are Acupuncture, Chinese herbal medicine and Tuina, which is the physiotherapy of Chinese medicine. Other associated methods are exercise, like QiGong and Tai Chi, nutrition, and lifestyle advice. All are very important and are used in my clinic, individually or in combination, according to the needs of each individual case.

Trying to simplify things (again) I will mainly discuss Acupuncture and herbal medicine, focusing in this first post of the series on general principles. But first: how did it all begin?

This is one of the most commonly asked questions, and justifiably so. Who came up with this crazy idea of sticking needles into people to make them feel better? The disappointing answer to this question is that we don’t know. Acupuncture was practised well before written history began. There has been no evidence found to help solve the mystery. The most likely theory is the idea came about when someone was accidentally stabbed by a sharp object, and experienced the unexpected effect of some sort of symptom being relieved. From that point onward began a patient process of trial and error to identify all the acupuncture points on the human body. It became clear that most of these points are located on a network of lines on the human body. They realised these lines (termed meridians) are the main pathway of the body’s energy (termed the Qi). Now, as long as the Qi energy is strong and is free to flow along the Meridians, all is good, we feel well and in good health. However, if the Qi is weak or blocked we will develop problems. Now, what can cause the Qi to struggle? Before I attempt to answer this question I would like to pause for a moment. Starting to talk about Qi and Meridians usually makes some people (particularly people with a scientific background) switch off. I can understand that, after all I used to think just like that myself in my early academic life. I would like to point out all of this knowledge regarding TCM theory is based on knowledge accumulated through trial and error, and careful observations over hundreds of years. It is not just a strange idea someone thought up in the shower. It is based on simple facts that are tried and tested, and that is one of the main reasons it is so effective!

As well as Acupuncture, the same is true for Chinese herbal medicine. We often hear in the media that Chinese people believe that this herb is good for that, and so on. Actually, it has nothing to do with belief and it has everything to do with sound science. The basic assumption was that since humans are part of nature, made of the same materials and using the same energy as the rest of nature, then there must be materials in the natural world that can help us when we get ill. How this works is explained more in my next blog, but a summary is that everything in nature exists in perfect balance, and so it is in the human body. If for some reason this balance has been disrupted we will feel it as an illness or as a symptom. The assumption was that there must be materials out there in nature which can redress these imbalances that are making us ill. With this in mind a great search began.

The ancient Chinese doctors have tried absolutely everything in the natural world to see the effect on the human body: plants, minerals and animals. More than that, when they tried a plant they tried the different parts of the plant separately: the roots, the stalk, the bark, the leaves, the flowers, the fruit (immature then mature), the peel, the stones- and so on. Then each of these can be prepared in a different way to achieve different effects. For example, it can be taken raw or dried or fried or fried in honey/vinegar/wine and so on. The same goes for animals. Every animal and every different part of every animal has been tested to see its effect on the human body. From this you can start to comprehend the huge variety of material tested over the years: hundreds of thousands, probably millions of substances. Out of these the Chinese medicine materia medica has been established, in which over 5000 materials have been identified as having a medicinal property.

A very important fact about this process of creating the materia medica is that these materials have been always tested by ancient doctors themselves and usually on themselves. Famous ancient TCM practitioners used to try new materials on themselves and report the effects. They used to go through hundreds of different materials and it wasn’t surprising that some of them got ill and even died in the process. It sounds terrible, but due to the sacrifices of these brilliant ancient scientists we have this enormous body of knowledge, regarding the effect of these herbs on the human body, and their ability to heal diseases and ease symptoms. The fact those doctors tested the herbs on themselves made the information much more reliable. Modern medicines are tested on animals. Very commonly they show a good result when tested on rats or monkeys but when they are used in humans problems start to appear.

To sum up this point: the use of Acupuncture needles and herbal medicine to help people with their medical problems is often viewed, in the West and in particular by the scientific establishment, with great suspicion. It is often referred to as: an untested and unproven method of treatment. This description could not be further from the truth in regard to Chinese medicine. Actually, the truth, as is often the case, is the complete opposite. Chinese medicine has been tried, tested and proven much more thoroughly than any modern method of treatment has. It is based on careful and patient observations and an accumulation of experience over hundreds of years. That is the reason why, despite never having the scientific knowledge and technology available to modern medical science, TCM is still much safer and, in many cases, a much more effective method of treatment than modern medicines!

Now, as we put this important point to bed, we can move on to trying to explain how it all works, and what is the logic behind it.

In my next blog I will try and do just that. I will try and make sense of terms like Qi, balance, yin, yang, heat and dampness. Hopefully then TCM will start to make more sense.

Have a good week,
Ilan

How much does Medical Science actually know?

I was presented with this question by my Brother-in-law during a wedding meal. Danny is a deep thinker and his mind is preoccupied with these sorts of interesting questions, although his timing can sometimes be awkward. Working hard for many years in the financial sector probably created the need for his mind to wander towards more philosophical questions. My first reaction was to say: that is actually a very good question Danny. I meant it. In one form or another, this is an issue that I myself have been thinking about a lot. His actual words were: “what is the percentage of knowledge modern medicine possesses regarding the human body and human health in relation to the complete picture”? Under the circumstances I didn’t have much time to think it through. I just said 70:30- 70% known, 30% unknown. Ten, Danny replied, 10% known, 90% unknown. His complete self-confidence about the issue initially made me feel a bit uncomfortable. There I am, probably the person most qualified to answer this question. As a medical doctor I have a comprehensive understanding of modern medical science. On the other hand, practising Chinese medicine for 22 years now has made me acutely aware of the deficiencies and holes in the scientific medical understanding of the human body and of human health. Danny, however, is not a medical doctor and neither does he have any qualifications which relate in any way to the modern science of medicine. How can he be so confidant in his assessment of 90% / 10%? I passed these thoughts on to him, in a polite manner of course, so as not to create an insult. Luckily he wasn’t insulted at all, but he stuck to his assessment and gave me all sorts of explanations to support it. I am not sure that I understood (probably my concentration was waning away at that stage) but to my surprise, over the next few days, this question kept on popping into my head and I found myself increasingly preoccupied with it. I felt my initial assessment was probably biased. It has been influenced by an innate sense of respect for science. It seems incomprehensible to claim that scientific knowledge about the working of the body and the mechanism of disease and ailments is just a fraction of reality but is it? Most doctors believe that medicine and science know pretty much everything about the human body. On one level this is true. The knowledge about the chemical structure of the human body is almost complete and on that level we know exactly what we are made of and how we work.
However, if this is the whole picture then how come modern medicine can only cure a very small percentage of the diseases, ailments and symptoms that affect us? Most medical conditions can only be helped by suppressing symptoms. Medicine that actually has a beneficial effect on the progress of any chronic conditions is rare. Most of the medicines given for chronic conditions can help a bit with the symptoms but long term will do much more damage than good! If doctors have such a complete understanding of the human body then how come they can’t cure or even slow the progress of most chronic ailments? Something that Danny said came back to me then:10% is the fraction of diseases that doctors can actually cure. That’s where the figure of 10% knowledge came from. I remember studying pathology in medicine school. It was the first time the limitation of modern medicine started to hit home. I was reading the text book and was very surprised to see that with almost all the medical conditions under the title of aetiology (the cause of the condition) you can find a few entries, usually about six to eight. There was the Viral theory, the Environmental theory, the Lifestyle theory, the Genetic theory and so on. So which one of these is the cause of the condition? It has suddenly dawned on me that modern medical science simply doesn’t know, in most cases, why we are getting ill. Yes it can give a very accurate description of what is happening to the body when the disease is already active but the reason, the cause, the process that led to the rising up of the condition, is largely unknown! It wouldn’t be a great leap of logic to make the connection between the lack of knowledge about the aetiology of a condition and the lack of ability to find a cure for it. In other words, if you can only see the symptoms then you can only treat the symptoms.
The more I was thinking about it the more I was realising that the percentage of knowledge figures in my mind are gradually moving more towards Danny’s estimate of 10:90 and away from my over trusting 70:30. On top of the almost complete ignorance regarding the cause of disease there is the whole area of subtle influences on the human body- the movement of energy, heat, cold, dryness and dampness-these are basic considerations in my clinic on a daily basis yet are completely unknown to modern doctors. There is the subtle working of the organs e.g. the connection between the liver and the mood. Then there is the huge effect of the emotions and stress on our bodily function and health, and the link between spirituality and health. I am sure there are many other aspects that we don’t even know about. All have a massive importance in determining human health yet all are completely ignored by modern medical science. The list goes on and on. It is very clear to me that, regarding modern medical knowledge, the unknown is much bigger than the known. I wouldn’t like to put a figure or a percentage on it and of course I can’t be that accurate, but I think the principle is important. I always say that doctors are very important but they will be even better if they are more humble and honest with themselves regarding their limitations. The attitude of “I know everything there is to know about human health and therefore can and should treat every patient that is coming to my clinic” is, frankly, dangerous and damaging. It probably causes many unnecessary sufferings and deaths. Most modern medical treatments have, unfortunately, a wide range of side effects and should, in my opinion, be used only if other safer and less damaging treatments have not worked.
I feel this is why this question is so important. It has far reaching implications. Modern doctors should be educated to understand the fact that existing medical knowledge, as vast and impressive as it is, is far from being complete. They should be brought up to be humble and open in their approach to understanding and restoring human health. Most importantly they should be very aware of the damage caused by medications and procedures and of the fact that there are safe and effective alternatives.
These issues didn’t get a mention during my years in medical school and I suspect they don’t feature in current medical school curriculum’s. We can only hope this will change as people’s awareness and knowledge grows.

Best of health everyone,
Ilan

The Pain

“Popular painkillers useless for backache” declares a headline in the Daily Mail. The Science Correspondent explains that Australian researchers found the use of non-steroidal anti-inflammatory drugs (NSAID) for back pain (like Ibuprofen and Nurofen) is not effective and is dangerous due to side effects. The research was a review study, looking at and analysing data from many independent trials on the subject. This means its conclusion is much more reliable than an independent study and should be taken seriously.
I think the Daily Mail headline was exaggerated (what’s new?) –of course NSAID are not useless. They have their place and in some situations are needed and can be effective. I do, however, also think that they are colossally overused by GPs.

The basic problem with NSAID is similar to that of other modern medicines,they are:
a) Only treating the pain and not treating the problem that causes the pain. Therefore if the condition is chronic, the patient will need to continue taking the medicine for life, which leads us to:
b) These medicines can have unpleasant and even dangerous side effects. Around three thousand people die in the UK every year as a result of NSAID! So, why are they so commonly prescribed by GPs? The simple but surprising answer is that in the NHS framework they don’t really have many other options available to them. At the current time, if a patient is going to present to a GP with chronic pain (this can be from a joint or a muscle, a tendon or a ligament, it can be from osteoarthritis, chronic inflammation, organ malfunctions or any other reason) he has to follow certain guidelines. He will start with simple painkillers like Paracetamol, then progress to NSAID. If needed then stronger pills will be prescribed like Codeine, then neurological agents like Amitriptyline and Gabapentin and eventually opiates like Tramadol and Morphine. The stronger the drugs the more dangerous the side effects and, as mentioned earlier, none of these actually treat the problem that causes the pain and will therefore need to be taken continuously. Another increasingly used treatment for chronic pain is the steroid injection- exactly the same problems apply here as well.

So what is the reason we feel pain? Physical pain is most probably a feeling we developed through evolution to warn us about impending or actual tissue damage. If we are in a situation where tissue damage is impending or occurring we need to know about it so we can hopefully do something to stop, or at least reduce, the damage. Just as in some other ancient evolutionary mechanisms (stress for example), this one is a double edged sword- on the one hand it can save us from great tissue damage. On the other hand, in some cases of chronic pain, it is pretty much useless and causes a great deal of suffering without really having much benefit to our health or to our survival prospects. It is a bit of a conundrum as to why this may be but the reality is we are kind of stuck with it. Therefore, when chronic pain strikes, we need to try and understand it and its cause in any given case, so we can treat the cause as well as the pain itself whenever possible.

There are many different causes of chronic pain, but in order to keep things simple I am going to focus on musculoskeletal pain and its causes, and possible effective and safe treatments! In Chinese medicine, pain is felt when there is disturbance in the free flow of the body energy (Qi) and /or blood. Blocked Qi or blood causes pain. Acupuncture is highly effective in freeing the flow of blocked Qi and blood and therefore in improving pain but that is not enough. In every individual case of pain we have to look at what is the cause of the blockage. Let’s take a painful joint like the knee. The cause of pain (blockage) can be heat in the joint. When inflammation is present the knee then will feel hot. It can be an accumulation of fluid in the knee- in this case the knee will be swollen and stiff. It can be due to cold invading the knee- in these cases the pain will increase when exposed to cold weather. Another common cause of knee pain is weakness of the joint and this is usually due to weak kidneys. In this case it is common to also be suffering from low back pain and possibly other joint aches and general symptoms like tiredness or bladder symptoms. In each of these cases it is not enough just to free the flow of Qi and blood in order to relieve the pain, we also have to deal with the cause of the blockage as well. A good Acupuncturist will do just that and by so doing will achieve effective and long-lasting improvement in the pain.

This was just an example of the way Acupuncture treats pain and it applies to all types of pain. Whether it originates in the digestive system, gynaecological system, headaches and so on, the principle stays the same: treat the cause of the pain as well as the pain itself. By applying this principle Chinese medicine is a very effective treatment for most cases where the main symptom is pain. There are other therapies that must be mentioned particularly in the context of musculoskeletal pain. When the pain originates from problems in the alignment of the spine or the pelvis then a Chiropractor or an Osteopath will be very helpful. If the problems arise from particular muscle weakness or stiffness then stretching and/or strengthening exercises given by an experienced physiotherapist are important. For general maintenance of a healthy musculoskeletal system I warmly recommend regular pilates classes.

Whichever of these ways you choose to deal with your pain problems it must be a more intelligent solution than taking painkillers long-term from the Doctor. These therapies are very effective, extremely safe, can save lives (by avoiding the dangers posed by chronic use of painkillers) and much suffering. In most cases there is really no need to put poisonous medicines into your body

Is Complementary Medicine suitable for children?

 

 

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I recently came across a headline in the paper which shouted “Children should never take complementary medicine”. I noticed that the story made it to other newspapers and to the evening news. The story was of a child who had been prescribed a mix of vitamins and herbal medicines by a so-called complementary medicine practitioner in London. The practitioner told the parents to continue with the medicine despite the fact that the child was getting increasingly ill and eventually ended up in hospital with dangerously high levels of calcium in his blood , probably due to overdosing on vitamin D. The story is shocking and is highlighting a problem in giving a child a high dose of vitamins. However, to jump from this to a conclusion that children should never take complementary medicine is very wrong. Actually, I believe the truth to be the complete opposite. Everything that makes me believe that people should use less medications and more natural cures is true for the treatment of children just as it is in the case of adults. Problems like toxicity, addiction and dependency  are just as bad, if not more so, when the children are patients. The fact that most of the medicines prescribed by Doctors are for the symptoms only and have no effect on the progress of a condition is the same for children.  It is therefore common sense to try and save our children from the use of medicine, where possible, by treating them with a natural, healthy and safe treatment.

 

 

However, I am completely aware of the sensitivity when it comes to children, and also of the problems and fears parents have regarding taking their child to a practitioner who is not an NHS Doctor.

 

 

So, is there a real problem with the use of complementary medicine (CM) with children? I have to admit that my research into the matter brought up some unpleasant revelations. I found a few documented cases where children who had been treated with CM ended up very ill. There were even two cases of death. After a closer look at these cases a clearer picture started to emerge. Almost all of these children were very young (under 2 years old). A few of them had a very serious medical condition to start with (this includes the two cases of mortality). In many cases, the reason for the children’s deterioration was considered to be the fact that that they had stopped their conventional medication, prescribed by the doctor and not the CM medicines (also here the two cases of mortality are included). In all the cases I looked at the practitioner who treated the children was described as an Complentary Medicine Practitioner.

 

 

Looking at these horrifying cases how can I still justify my earlier statement that children should be treated with complementary medicine? To try and explain let’s look back at these cases. There are a few very important points:

 

  1. a) The numbers: These cases are extremely rare in comparison to the number of children who suffer serious reactions and death as a result of the use of conventional medicine prescribed by the Doctors. In the paper article the eminent doctor declared “Complementary Medicine is not completely safe”. Of course it’s not. Nothing is completely safe-but it’s still a lot safer than conventional medicine.

 

  1. b) In most of these cases the children were very young (under 2 years old). We have to be more careful treating babies. The smaller the body the bigger the risk if there is an adverse reaction to a treatment. In Chinese Medicine the treatment of children carries a different set of rules and considerations to the treatment of an adult. I would suggest to parents who are considering taking their babies for a treatment to choose their practitioner carefully. Only take your baby to a practitioner who is well qualified and has a vast experience in treating young children and babies.

 

  1. c) A large number of the children who had a serious reaction to CM treatment had a serious medical condition. Children with a serious medical diagnosis, in my opinion, should only be treated with CM by a Practitioner who is also a Medical Doctor in order for them to have a good understanding of their condition.

 

  1. d) In many of these cases the reason for the deterioration was in stopping the conventional medicine given by the Doctor. I cannot stress it enough: a CM Practitioner should NEVER stop a patient taking his medication, prescribed by his G.P. or specialist, unless the CM Practitioner is a medical doctor himself. I am a medical doctor and still I will not make my patients stop taking their medicine without the agreement of their G.P.

 

  1. e) This point may sound strange but I think it is actually very important. In all the cases I was looking at, the practitioner who was treating the child was described as a Complementary Medicine Practitioner. I don’t really know what that means and I am not sure that something like this actually exists – and if it does I most certainly would not let one treat my child. Complementary medicine is a whole range of different disciplines; a practitioner can be a Homeopath, Herbalist, Chiropractor, Acupuncturist, and so on. They all belong in the general field of CM but are completely specialised and different to each other. To paint them all as being the same with sentences like “children should never be treated with complementary medicine” is absurd. It shows a lack of understanding and respect of the issue and it is also extremely unscientific. On the other hand there may actually be people who describe their practice as CM Practitioners: again, I’m not sure what it is but I will stay well away.

 

To sum up: I definitely think that treating children with different types of complementary medicine is a very positive thing as long as we follow some common sense guide lines: make sure the practitioner is well-qualified, registered and experienced in working with children. Children with serious medical conditions should only be seen by a practitioner who is also a medical doctor and never stop prescribed medicine unless instructed to do so by a doctor. If you follow these guidelines I am sure your child will benefit from safe and effective treatment. I have often used CM with my children over the years- they have had treatment with homeopathy, Chinese herbal medicine, acupuncture and chiropractic, all with great results. For small children I am particularly fond of homeopathy, being gentle and being tasteless make the medicines very easy to administer to children.

 

I hope this post will help to dispel any fears arising due to medical science ignorance of the subject. Our children deserve it.

 

Ilan

 

 

 

The Miracle of Fertility and the Mystery of Infertility Part 3: Recurrent Miscarriage and IVF.

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Today I am going to discuss both recurrent miscarriage and IVF and how Chinese medicine can help.  The two are not necessarily related and the reason they are both discussed in the same post is that they are probably too small to fill a post by themselves.
I will start with the heart-breaking condition of recurrent miscarriage. It is defined as having more than two miscarriages without the presence of a medical condition to explain them. In some cases, when the miscarriages are late in the pregnancy, the doctor can help with a procedure that tightens up the cervix. In cases where Auto Immune factors are suspected the doctor will prescribe steroids to calm down the over-active immune system. In the cases where blood clotting problems are thought to be the cause, the doctor’s treatment will be with blood thinners like Aspirin or Clexane. Those treatments can be helpful at times but often they can not. Another problem is that often the lady won’t be suffering from any of the above but still won’t be able to keep a healthy pregnancy. For a woman it is an extremely frustrating and upsetting situation. In Chinese medicine, as it is in the case of infertility, we have a much more subtle understanding of recurrent miscarriages. Practically all of the women I have seen over the years with this problem did not have any medical diagnosis to explain their predicament and therefore weren’t offered any treatment from the doctor. Most of them were able to have a healthy pregnancy and birth after a course of treatment with Chinese medicine! How come? Again, as is the case in the treatment of infertility, we first try and identify the reason for the recurrent miscarriages from a Chinese medicine point of view. The most common cause for “unexplained” recurrent miscarriages is weakness of the kidney energy (Qi). This energy is crucial in our ability to nourish the foetus and in maintaining pregnancy. Women with low kidney Qi will often feel very tired when pregnant with a tendency to low back pain and to feeling cold. However, sometimes there will be no symptoms except the miscarriage. Another problem with recurrent miscarriage due to weak kidney Qi is that every miscarriage by itself drains a lot of the kidney energy. This causes a vicious circle in a way in that the more you try the worse it gets. Since after every miscarriage it gets worse then, in these situations, our only choice is to stop trying for at least 6 months. During this time the patient will take a course of Chinese herbs and acupuncture specifically to strengthen her kidneys’ energy. This situation can be a bit tricky. Understandably it is often hard for the patient to stop trying to conceive for 6 months. The biological clock is ticking and time is so precious but, in this situation, it is the only way to allow the kidney Qi to recover with the help of Chinese medicine. There can be other causes of recurrent miscarriage such as circulation problems, overheating or weakness of the blood. In each of these cases accurate diagnosis and choosing the correct treatment is crucial. This treatment is often successful.
IVF and Chinese medicine:
The effectiveness of Acupuncture in increasing the success rate of IVF is well established. A comprehensive review study has concluded that Acupuncture Treatment increases the chances of successful IVF by nearly 70%. The scientists who conducted the study remarked that they didn’t really understand in what way the Acupuncture helps but they made a guess that it is probably through improving the blood circulation to the womb. They weren’t that far off.
 So, how is it that Acupuncture helps IVF? When treating an IVF patient, the body’s regulation of hormones, which is so important for fertility, becomes insignificant. The reason for this is that during the month leading up to the IVF the doctor will completely take over the control of the hormones. The body has nothing to do with it anymore. In the case of IVF the best thing we can do to help is to help with the quality of the Endometrium, which is the covering of the Uterus. It tends to be extremely rich in blood vessels. If we can improve the supply and the movement of blood in the Uterus we will improve the endometrium quality and that will allow a much better chance for successful implantation of the fertilised egg which has been put back in the womb. So, blood is the focus. There are, however, other areas which can improve-such as the temperature of the womb, the movement of the energy (Qi) and the kidney energy which is so important in conceiving and the development of the baby in the uterus. With an IVF patient we are going to work on and improve all of these factors in the run-up to the IVF. The results are a near 70% rise in IVF success.
This is the last post in the series about fertility. I would just like to add that there is nothing that gives me more joy, during work at the clinic, than hearing a fertility patient telling me that they are pregnant. There is something very special about helping to bring new life into this world. I remember when I used to work as a doctor in the hospital-most hospital wards were places full of misery and suffering. There was just one ward that had a lot of joy and happiness on a regular basis: it was, of course, the Obstetrics ward. In my clinic I treat couples for fertility problems on a regular basis but I always feel I would like to help more. I am concerned about ladies who have not received any help and would recommend for any couples experiencing problems with fertility to have a course of Chinese medicine. You do, however, have to be a bit careful with your choice of Practitioner. It is a fairly specialised subject so you want to make sure that your TCM practitioner is qualified and experienced in treating infertility.
Good luck with it,
Ilan

Hormone Replacement Therapy – The consequences and the alternatives.

 

Hi everyone. The recent study that found an almost threefold rise in breast cancer in women who use HRT is the reason for the break in my fertility-related posts. I just had to write something about it. It demonstrates so much of the wrongs of modern medicine; unfortunately we see this pattern repeat itself again and again. It goes like this: a new medicine comes to the market. Early research claims it is beneficial and effective. Doctors get excited and increasingly prescribe the new miracle drug to unsuspecting patients who are looking for relief from their symptoms. As the years pass, more and more data regarding the use of the medicine becomes available and a fresh picture emerges. The miracle drug may be efficient in reducing the symptoms but it carries a risk of dangerous long and short term side effects. This was the case in many of the well known and widely used medicines such as aspirin, omeprazole, diclofenac and many others.

HRT was introduced in the eighties and quickly became a hit. Books were written at the time claiming that Oestrogen can give you back your youth and people genuinely believed that it stopped the aging process; the list of health and well-being benefits grew by the day! The idea was, since the level of Oestrogen tends to suddenly drop around the age of 50 causing all sorts of symptoms, replacing these hormones would turn the clock back. It would make you look and feel young again. Sounds like a perfectly good and sensible idea. The problem here is that the drop in the level of Oestrogen in a woman’s blood around the age of 50 is a natural process; it is part of human evolvement with age. Like other human body processes it has developed through millions of years of evolution for a good reason. If there was any advantage in keeping the level of Oestrogen the same throughout our lives then evolution would have designed us that way.

This actually is another type of pattern in modern medicine: every time we think we are cleverer than nature, that we can change something in the original human design, we ultimately fail. A good example for that is the use of aspirin as a prevention of heart disease. The idea to give aspirin to all people over the age of 50, to prevent heart conditions, lay in the assumption that the normal human blood is too thick and tends to clot and create problems such as heart attacks for example. The idea was to take aspirin to thin the blood which will then make it less likely to clot and therefore prevent heart problems. It took more than 40 years for the scientists to take a good hard look at the data accumulated over the years and to conclude that the use of aspirin in healthy people as a prevention actually causes more deaths from bleeding and kidney problems than it saves from heart conditions.

The position with HRT was similar. There is a sudden drop in the level of Oestrogen in the woman’s blood and therefore it makes sense to give her Oestrogen to supplement the levels. Really they were asking for trouble-and trouble came. In the first few years the good news just kept on coming and it was claimed that the use of HRT not only made you feel better but it also protected you from heart disease, strokes and several types of cancer-a win ,win situation. However, as time passed, more and more worrying reports about possible dangerous effects have surfaced. Here is another massive problem of modern medicine: all (and I mean all) the short and medium term studies into the effects of a new medicine are being conducted by the company that develops the medicine. This company has already invested tens of millions of pounds in their product and are extremely keen for it to pay for their investment and make a handsome profit. These studies are highly suspicious. There are many cases in the past where pharmaceutical companies have been found to hide unfavourable results, to misinterpret data and to design studies in a way that will show favourable results. One famous case that comes to mind is when the American manufacturer of the antidepressant Prozac was taken to court by the family of a man who took his own life and killed a few others whilst on the medicine (it was completely out of character). The family solicitor got a warrant to look around the manufacturer’s paperwork. To his amazement he discovered that studies which had been conducted by the pharmaceutical company showed a significant increase in violent behaviour and suicides in people using this medicine but that these studies had never been published! The pharmaceutical company knew then that their medicine increased suicides and violent behaviour and they actively hid it. Even more disturbingly, these findings were more common in adolescents. This case has sent a shudder through the medicine world, and the prescribing of this antidepressant to teenagers has been stopped. However, shocking as it may sound, this practice is not unusual and can partially explain why the initial studies of a new medicine are so different to the long-term ones! The long-term ones are not being conducted by the pharmaceutical companies but by Epidemiologists. Epidemiologists are specialists in collecting and analysing data from medical institutions and archives; they are usually public workers and are therefore under no pressure or bias regarding the outcome of their study. These types of studies are called review studies and are considered to be the gold standard of Medical Research.

When these studies started to collect and analyse data on HRT treatment the problems started to come out of the woodwork. Almost everything that was claimed at the start with regard to the effects of HRT was shown to be wrong! It was found that there is actually a raised risk of heart conditions, strokes and cancer with the use of HRT. Astonishing.

It may surprise some people but actually I am not completely against the use of HRT or other doctors’ medications for that matter. We often take risks in life and it’s no different in the case of taking modern medicine. It is ok if a person chooses to take the risk of a side effect, as long as they are made to feel better when taking the medicine; but: this patient choice must be an informed one and based on all the information available. When a woman is offered HRT treatment (or any other medicine) she has to be informed on two very important issues:

1) All the possible consequences of taking the medicine (increased risk of cancer, heart problems, etc)-which the doctors never do.

2) There are alternatives to HRT- again, which the doctors never do.

There are safe alternatives to HRT. I treat women with menopausal symptoms on a fairly regular basis, with Chinese herbs and/or Acupuncture, with very good success. I know from my colleague, a Western Herbalist, that her herbs are very effective as well.

There is no need to risk your health in order to feel better. Doctors must give patients all the information as not doing so is, in my view, criminal.

 

The Miracle of Fertility and the Mystery of Infertility – Part 2: Unexplained Infertility

In my last post I discussed the cases of infertility where there is a medical explanation for the condition. Today I am going to concentrate on the surprisingly common situation where a woman can’t conceive despite all medical tests being normal, the so-called unexplained infertility. Unexplained infertility is what we call a basket diagnosis. It is a similar situation in the case of IBS (Irritable Bowel Syndrome) and in Chronic Fatigue Syndrome. In these conditions the Doctors will throw into the basket any patients who manifest with certain complaints without actually understanding the reason for those complaints. As a result, the patients, who can have different causes for their problems, are all put in the one basket. The problem here of course is that when we don’t know the cause of a problem we can’t treat it effectively. Indeed, the only solution modern medicine offers for unexplained infertility is I.V.F. This means, in a way, that medicine is giving up on trying to cure the problem and is bypassing it instead by doing part of the process in a controlled manner outside of the body. IVF is very important and in some cases will be the only solution. However, many of the women who have been diagnosed with unexplained infertility can conceive naturally following a course of treatment with Acupuncture and Chinese Herbs. I have helped many women who have come to me with this diagnosis. Conceiving naturally will save them the unpleasant, expensive and often unsuccessful process of IVF.

So how does Chinese medicine explain and then treat these cases of unexplained infertility? These women have been through a thorough medical testing. It has been established that the hormone levels are correct, ovulation is regular, follicular tubes are open and there are no anatomical abnormalities. What then is the reason for the difficulty in conceiving? Well, the problem here is usually on a more subtle level. The way Chinese Medicine sees the process of conception is a bit like the process of the sprouting of a seed in the ground. You can put a seed in the ground but if the conditions are not right the seed won’t sprout. If the ground is too cold or too hot it won’t sprout; if it is too dry or too wet it won’t sprout; if there are not enough nutrients in the ground it may sprout but it won’t develop and will die or grow poorly. The human reproductive organs are the same. If the uterus is too hot, too cold, too dry, too moist then pregnancy won’t happen. If circulation of blood or energy (Qi) is poor it won’t happen. The environment in which the egg is fertilised then implanted in the uterus and then developed into a healthy baby has to be perfect or at least near to perfect. At the first consultation at the Clinic it is important to establish, in these cases, which of the above problems is the cause of the difficulties. When we establish a diagnosis then treatment is usually successful. The diagnosis will be made through Chinese Medicine methods such as questioning, observation and tongue and pulse diagnosis, but also through a temperature chart. Taking the body temperature morning and putting it in a monthly chart will give me valuable information about the state of the patient’s reproductive system.

I will try now to give you (without boring you with too much Chinese medicine detail) the most common causes of unexplained infertility.

1) Yin deficiency and heat

Yin is the part of energy in the body that keeps us cool and moist. It is therefore essential for fertility to have strong Yin. Examples of symptoms that can indicate the presence of Yin deficiency are: dry mouth at night or first thing in the morning; night heat and poor night sleep. In the context of fertility the uterus lining can get too hot and dry-this will make implantation difficult. Another possible problem when the Yin is low is that cervical mucus may become too thick and that will block the sperm from entering the uterus. The treatment of Yin deficiency in Chinese medicine is with herbs and acupuncture points that nourish the Yin and reduce heat.

2) Yang deficiency and cold

This situation is the opposite one to the Yin deficiency. Here the body is unable to warm itself properly. The patient may feel cold or have cold hands and feet. In bad cases she may feel coldness in the low abdomen, there is often tiredness and low back pain and low libido is common. Lack of warmth in the uterus will limit the blood circulation and will make conceiving difficult. The treatment is with Chinese herbs and acupuncture points that warm the body and tonify the Yang energy.

3) Kidney Qi deficiency

The kidney is the most important organ in the human body in the context of fertility. Energetically it includes the uterus and the ovaries. When the kidney energy (Qi) is weak it is unlikely that pregnancy will occur. Symptoms of weak kidney may include lower back pain, feeling cold or night heat, tiredness and problems with passing water including frequency, urgency or waking at night to urinate.

4) General Qi deficiency

The main symptom here will often be tiredness and palpitations. Shortness of breath is possible as well. When the Qi is low, on top of a weak kidney (see above), we will have problems with the circulation and pregnancy is unlikely.

5) Blood stasis

Blood stasis means a problem with sluggish movement of the blood. In this situation the quality of the womb lining will be poor and therefore implantation and/or maintenance of the embryo will be difficult. Common symptoms resulting from blood stasis are: period pain and passing of blood clots with the period. The treatment here is with acupuncture points and herbs that improve the circulation.

6) Qi stagnation

Here we have a problem with the free flow of Qi. If the Qi is not flowing freely it often affects the blood circulation and the function of the organs. Qi stagnation often occurs due to high emotions, stress or worry. Common symptoms are: irritability, anger, feeling emotional, headache, bad PMS (pre menstrual stress) and period pains particularly in the first days of the period. The treatment of Qi stagnation will aim to relax and restore the free movement of Qi.

As we can see, each of these imbalances will have a negative effect on the woman’s ability to conceive. In reality it is usually not just one of these imbalances on its own but is more likely to be a combination of two or three and sometimes more. In any case, correcting these problems can significantly increase fertility and the chance of a healthy pregnancy. It is about creating an optimal environment for egg fertilisation, implantation and then growth and development of the embryo. That is really what Chinese medicine is all about when it comes to fertility treatment and that is why it is so successful in treating unexplained infertility!

In my next post, which will be the last in the Fertility series, I am going to discuss recurrent miscarriages and I.V.F., considering the Chinese medicine view and how it can help.

The wonder of fertility and the mystery of infertility. PART 1

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The mechanism of human fertility is a wonder. It is very different to most other systems in our body, in the way our systems function and do what they are supposed to do, in an efficient manner, most of the time unless we are ill. Our fertility system however is different. It seems to be not very efficient, almost a bit clumsy and wasteful. For example, a healthy fertile male needs to produce tens of millions of sperm in order to fertilise one egg. A female is born with millions of eggs that reduce in number and quality at a fast pace through life until only a few viable eggs are left when she is in her forties. Even if both male and female are in good shape from the point of view of egg reserves and sperm quality, it is still likely to take up to 6 months of trying before pregnancy will be achieved.

 

A fertilised egg that has been implanted in the womb and started to develop as a normal pregnancy is not the end of our troubles unfortunately. On average, 25% will miscarry. For those who don’t, there is a long list of possible pregnancy complications such as high blood pressure, diabetes, placental related problems, autoimmune conditions…and the list goes on. It is not a wonder then that so many young people are coming to my clinic seeking help with fertility issues.

 

As I have stated a few times in the past, Western medicine has a good yet limited understanding of the workings of the human body and of how and why things go wrong. The situation is not different when it comes to fertility. A large proportion of the couples who come to see me with fertility problems have been classified by the doctors as unexplained infertility. That means that medically nothing has been found to explain their difficulties in conceiving. The uterus, fallopian tubes and ovaries are all functioning, the sperm tests are ok yet no pregnancy month after month, year after year. It is an extremely frustrating and upsetting experience, yet not that uncommon.

 

Despite the lack of medical understanding of these cases the majority of them will achieve a healthy pregnancy after a course of treatment with Acupuncture and Chinese herbs. The reason for this success is that Chinese medicine has a good understanding of the subtle workings of the body and therefore of the subtle reasons stopping a healthy pregnancy. These subtle factors that cause infertility will be the focus of this and following posts.

 

To try and simplify things I’ll divide the infertility into explained infertility and unexplained infertility. Explained infertility means that there is a medical explanation for the problems. Common examples are anovulating, PCOD, blocked fallopian tubes, autoimmune conditions and male factors. Unexplained means that all medical tests are normal and the doctor can’t find an explanation for the infertility. Today I am going to talk about explained infertility.

1) Anovulation

Anovulation simply means that the ovaries are not releasing eggs on a monthly basis as they do in a normally functioning system.  Of course, if there is no egg then there is  no chance of pregnancy. Anovulation is almost always due to hormonal imbalance. The normal process of a monthly ovulation depends on a specific balance between the female hormones (oestrogen, progesterone, LH and FSH). The blood level of these hormones changes in a very specific manner during the monthly cycle in order to prepare the womb and to trigger ovulation about halfway through the cycle. Any change in this specific hormone pattern can cause a failure to ovulate. This hormone imbalance can happen at any age but is more common in young ladies. In fact, in my experience, it is the most common cause of fertility problems in young women. In some cases the ovulation can be partial which means that in some cycles there will be ovulation and in some not. In these instances we can get a positive ovulation test but the chances of conceiving are still low.

 

Now, the question we always like to ask in Chinese medicine is “why?” or “what is the reason for the hormone imbalance?”  Medically, the answer is, almost as usual, unknown! Doctors don’t know why a woman’s hormone imbalance occurs. In TCM however, we know that on the subtle level the organ which is responsible for the hormonal balance is the liver. The liver is very sensitive to stress and emotions. If the young lady tends to live a stressful life, or if she is under emotional strain, then there is a reasonable chance that her liver will suffer and, following that, her hormonal balance as well. In some cases these young women won’t see themselves as stressed-they are just doing the “normal” modern day’s practice of working hard, then exercising, then socialising. It may sound ok but for some livers it will be too much. (Our bodies weren’t designed for this pace of life.) There are some other, less common, causes of liver malfunctioning, like blood deficiency for example. But in any case, the important thing is that it is treatable! Chinese medicine (acupuncture and Chinese herbs) is very effective in restoring ovulation through restoring hormone balance. Actually, these cases tend to react quickly to treatment and pregnancy is often achieved within one to three months!

 

 

 

2) PCOD (Polycystic ovary disease).

PCOD sometimes referred to as PCO or PCOS –these are all slight variations of the same condition. In this condition the ovaries produce a large number of cysts. Those cysts tend to produce a large number of the male hormone testosterone. A high level of testosterone in a woman’s body can cause symptoms like excess growth of hair, acne and weight gain, but more importantly for our subject, it causes a great mess in the normal hormone balance and therefore stops ovulation. PCOD in the context of infertility is a complicated version of anovulation. The Chinese Medicine treatment of PCOD is also a bit more complex than the treatment of simple anovulation. In addition to treating the hormone imbalance we need to treat the underlying cause which is the presence of cysts.

Still, despite the complexity of the condition, in my experience the results are often positive. A few of the ladies I treated for PCOD related infertility have achieved healthy pregnancy.

 

 

 

3) Blocked Fallopian Tubes

The fallopian tubes allow the connection between the ovaries and the uterus. When the tubes are blocked it becomes impossible for the egg to travel from the ovaries to the womb and therefore pregnancy is impossible. In cases where the blockage is complete and solid then the only option for pregnancy is through I.V.F. However, in some cases where the blockage is due to the presence of thick fluids or inflammation in the tube it is possible to clear it with a course of Acupuncture and Chinese herbs. It is important to mention here that even if I.V.F. is needed it is advisable to take a course of Acupuncture at the 3 month mark leading to the I.V.F. It is well established that Acupuncture increases the success rate of I.V.F. by about 70%!

 

 

 

4) Auto Immune Conditions

It’s only recently that the role of auto immune conditions in infertility has come to light. It is estimated that about a third of what was considered an unexplained infertility is actually infertility as a result of Auto immune conditions. Auto immune conditions occur when, for some reason, the immune system starts to produce antibodies that, instead of attacking foreign invaders like bacteria or viruses, are attacking our own body organs. In the case of Auto immune infertility the antibodies can be against the sperm, the embryo or the umbilical cord. Other common forms of auto immune infertility are high blood levels of natural killer cells and Antiphospholipid antibodies (causing blood coagulation problems).

The Western medicine treatment for Auto immune infertility is with Immunosuppressants -mainly steroids. The idea here is that suppressing the immune system activity will suppress the unruly activity of producing Auto Antibodies. The Chinese medicine treatment is medicinal mushrooms. The field of regulating the work of our Immune systems with the use of medicinal mushrooms has progressed hugely over the last 10 years, mainly due to the work of Martin Powell from Pure Health and of Dr Trevor Wing from The Women’s Natural Health Practice in Richmond: Martin Powell for finding and establishing the medicinal mushrooms’ amazing ability to regulate and improve the function of a misfiring Immune system and Dr Trevor Wing for excellent clinical trials on hundreds of cases of Immune related infertility that clinically proved the effectiveness of the medicinal mushroom in these cases. These studies proved that the use of medicinal mushrooms like Mesima and Coriolus , Cordyceps and Ganoderma in women with Immune related infertility will significantly increase the chance of achieving healthy pregnancy. These studies clearly show that the medicinal mushrooms are more effective than steroids in these cases and have far fewer side effects.

 

 

5) Male Factors

Here we are simply referring to a low quality sperm. One of the mysteries of modern day medicine is the dramatic decrease in human sperm quality over the last 50 years. A few theories have been suggested to explain this phenomenon. The most likely is the usual combination of: environmental factors (toxins), diet and stress. The presence of oestrogen in drinking water and many modern processed foods is also probably an important factor. The important issue here is what can we do when the male has poor sperm? From a Western medicine point of view the answer is absolutely nothing. It may sound surprising but there is no medicine or procedure the doctor can offer to improve sperm quality. The only thing that is on offer in these cases is I.V.F.  Fortunately, in Chinese medicine there is much we can do to help. As usual, it starts with understanding what is causing the problem. Without getting into too much Chinese medicine detail, the main reasons for poor sperm production are too much heat or too many toxins in the man’s reproductive system or weakness of the kidneys or the QI (body energy). After finding out the cause in each individual case, the treatment with Chinese herbs and Acupuncture to correct these causes is usually very effective. Most causes of poor sperm will improve with TCM treatment; however, in some cases, e.g. when the problem is due to defective genes, there is not much we can do.

 

 

 

I hope I have given you a better understanding of this side of fertility problems and of how Chinese medicine can help. In my next post I am going to discuss unexplained fertility. It is a very common situation where a couple can’t achieve healthy pregnancy despite all the medical tests coming back normal. About 50% of my fertility patients belong to this category.

 

 

Ilan

 

How to stay healthy and live long according to ancient Chinese knowledge-Part Three: The Spleen

SPLEENFirstly I would like to apologise for the long time since my last post. The reason for the delay is simply the fact that my clinics are incredibly busy. The clinics are busy because many people are in despair with the doctors’ cluelessness regarding their symptoms and so they are looking for a therapy that will understand the workings of their body and the reasons for their ailment. They are not just looking for understanding of their suffering but also for an effective treatment. Naturally they follow recommendations and come to Chinese medicine.

As promised in my last post regarding diet and health, in today’s post I am going to discuss the most important aspect of our quest for achieving health through nutrition: the spleen. The spleen in Chinese medicine does not refer only to our physical spleen; it is an energetic concept that, on the physical level, includes the spleen, the pancreas, the duodenum and some functions of the small and large intestines. The spleen is directly responsible for the transformation and transportation of food through our digestive system. It is also responsible for the production of energy through the digestion process. Other important functions of the spleen are keeping the strength of the immune system and also the strength and tone of the muscles and blood vessels. Mentally the spleen allows us to organise and control our thoughts. Emotionally a strong spleen will allow us to stay strong and happy.

From all of this we can see why a weak or under-functioning spleen can cause symptoms like fatigue, physical emotional and mental tiredness, weakness and achiness of the muscles, a weak immune system, digestive problems and bleeding. Keeping our spleen strong and healthy is very important for our health and wellbeing in general and for our digestive system in particular. This is a very important concept to understand. I have seen many people with digestive system disorder. These days a lot of people and practitioners believe that the digestive symptoms are a result of allergy to some food or maybe a bacterial overgrowth or presence of candida in their digestive tract. What people often don’t understand is that the presence of candida or bacterial overgrowth or an intolerance to certain foods is just a result of a weak or malfunctioning digestive system. In the case of intolerance (or as many people say: allergy) to certain foods, the spleen is simply not strong enough to digest that food. In the case of candida or bacterial overgrowth it is an accumulation of fluids which is the result of an ineffective digestion process creating a damp environment in the GI tract which is ideal for candida or bacterial growth. The importance here is that unless we are going to strengthen the spleen and restore the function of the digestive system then these problems are not going to go away. They may improve temporarily with a change of diet or anti-candida drugs etc but without fixing the digestive system function these solutions tend not to last and the problem tends to come back. It is the usual problem of treating the symptoms but not the core of the problem.

So how do we keep our spleen strong and our digestion functional? In order to simplify a complicated subject I will divide the issue into a few different levels and/or aspects:
On the physical level the spleen likes exercise in general and stretching in particular. A sedentary lifestyle and lack of movement damages the spleen. Do exercise but remember extreme physical exertion also is harmful to the spleen.
On the mental level the working of the spleen can easily be disturbed by worrying and over-thinking. Try and take things easy. Try and balance the usual headrush with time to relax, exercises and fresh air.

When eating:

a) Enjoy your food. A happy relationship with your food is important for the work of your spleen. Have a positive attitude towards what you eat: you made your decision about what to eat so have no regret, enjoy it and feel that this food is good for you!

b) Relax. Don’t mix food and work, make sure you have enough time to eat peacefully. Have a minute to relax before you start and a few minutes after!

c) Sit comfortably whilst eating.

d) Chew well.

e) Don’t overeat. It is just a bad habit of modern days to overeat. It is unhealthy and damaging for the spleen. Try and put a bit less on your plate, don’t have more food around for second helpings. You will be surprised how well you’ll feel.

f) Eat mainly warm food. Long-term consumption of raw and cold food will weaken the spleen.

g) Don’t overdrink during a meal. During a meal a small amount of warm drink is just enough.

h) Don’t eat too late. Have your main meal early, your spleen is going to sleep with you!

i) Eat a balanced diet. According to my favourite Chinese medicine dietitian, Daverick Leggett, the perfect balance is:

vegetables and fruits 40-60%
grains 20-40%
beans, dairy, meat , nuts 10-20%

j) Preparation of food. Our stomach is turning our food into a warm soup. It is ready then for the spleen to make use of the food essences to build our body, our energy and our immunity. Soups and stews are the cooking methods that most resemble the stomach action. It supplies the spleen with a mix that is easy to work on. A small amount of pungent herbs cooked with the food, as well as a small amount of pickled vegetables after a meal, will aid digestion.

k) Herbs. I always recommend you go and consult an experienced TCM herbalist for herbs to support the spleen. However, a few herbs are available over the counter if you wish to try first. The most effective of these are Astragalus, Ginseng and Hawthorn.

In this post I have focused on general measures of helping our spleen to maintain a functional and healthy digestive system. A healthy spleen will keep us energetic, healthily toned and focused.

In cases where ailments or symptoms are already present then diet in TCM has to be directed more specifically towards the imbalance in our body which has caused the problem.

More on that in my next post. Meanwhile have a great and healthy week.

Dr Ilan Shahor