Salads, exercise and sex-when East and West clash

What is good and healthy for us? What to do, what not to do? What to eat, what not to eat? There is so much advice available out there and much of it is contradictive. Personally, I tend to stick with Chinese Medicine wisdom. After all, it has been tried and tested for many hundreds of years. However, there are three areas where the difference of opinions regarding what is healthy and what is not is stark: exercise, salads (raw vegs) and sex. In today’s post we are going to analyse these differences of opinion between Traditional Chinese Medicine and modern medicine. I think in many ways it demonstrates the general difference of approach between the two, but even more it demonstrates the difference between olden and modern living. We’ll try and understand the reasoning behind these opinions and , of course, how it is right and how it is wrong.

So, for those who at this stage are asking themselves “what the hell is he talking about?”, here is an overview: generally speaking, modern Western medicine sees exercising, eating raw vegetables and salads, and having sex as activities that will make us healthier and therefore should be done the more the better. TCM, however, is not so sure about it, and will actually recommend that less is better. Let’s try and pick them up one by one.

Salads, (I am referring to raw vegetable salads), according to modern medicine we should have as many as possible. The reason for this is that raw vegs contain vitamins and antioxidants and are very low in fats and calories. All is true and correct! Why then does TCM have a problem with raw veg and actually recommend to boil, steam or stirfry before eating? The reason is that Chinese medicine has a much better understanding of the digestive system function then WM. Raw Vegetables are much harder to digest than cooked ones. The body needs to invest a lot of energy in warming and breaking them down. People with robust digestive systems will have no problems with dealing with the regular intake of raw salads. However, people who constitutionally have weaker digestion will start to have problems at a certain stage-symptoms may include bloating, abdominal pain, loose bowels and fatigue.

The digestive system is of a major importance in Chinese Medicine. It is considered to be in the centre of our physical existence. Through the digestive process we create the building blocks for our body as well as the energy that makes everything work(the Qi). The blood and the energy for our immune system is also produced in the Gut. You can see, therefore, why it is so important. The idea therefore in Chinese medicine dietary advice is to make life as easy as possible for the digestion to prevent any problems developing. Following this logic the TCM recommendation is to boil, steam or cook. On the face of it, this makes perfect sense, however, there is another consideration here. The general diet in modern times is very different to hundreds of years ago when the TCM rules were made. The modern days’ diet is much richer, food is very available and people tend to eat more in general and more meaty and fatty food in particular. Because of this, raw veg has an additional importance in detoxifying and cooling the system as well as simply taking the place of more rich food and therefore balancing our diet. In the olden days people ate mainly vegetables anyway. Meat and other rich food  (fatty, oily, sugary and high protein) was much less available! Another concern regarding the TCM advice is the claim that a lot of the goodness (vitamins etc) in the vegetables is washed away when you boil it. I am not sure if this true or not but, in any case, we can steam, stirfry or have as a soup if you want to make sure. To sum up the raw veg question: In the contest of modern day diet, raw veg have a part to play -mainly as a balance for a high protein and rich food diet. However, we should not have too much on a regular basis since it can have a bad effect on our digestive system. Cooked veg can be consumed more freely. How much is too much? That very much depends on the individual constitution; knowing your own constitution is very important. Those of us blessed with a strong digestive system will be able to cope with larger amounts and a more frequent consumption of raw vegetables. 

Exercise. According to modern medicine we should all exercise at least 3 times a week, or more if possible. TCM not so sure. Originally the Chinese medicine advice was don’t waste your energy. An ancient Chinese saying declares: A farmer should live near his field. The idea here is energy conservation. If the farmer’s house is far away from his field he needs to wake earlier in the morning, then walk all the way to the field and then all the way back., after a full day of hard work, spending more energy than needed in the process! Why then does one need to voluntarily go to the Gym and spend precious energy? The answer is similar to the raw vegetable conundrum: times have changed. In the ancient days people were naturally very active-every job had to be done by hand and every journey by foot. People had to use quite a lot of energy just to get through the day. In addition to that, food was low on availability and on calories. Preserving energy was important and extra exercise was out of the question. As we all know, things have changed. Lack of activity is one of the main reasons for health problems in modern Western societies. Our bodies have been designed through thousands of years of evolution to be active. These days we sit in the office or in the car. We hardly ever make our bodies work. As a result many systems in our body become lazy and sluggish with many possible health consequences ranging from high blood pressure to diabetes to cancer. So surely exercise is a good thing-or is it? While generally speaking I agree with modern advice that exercises are recommended to keep us healthy, I don’t think we should completely ignore the traditional view regarding energy conservation.

As I mentioned (probably a hundred times) in the past: healthy living is all about balance. Over the years I saw many people who suffered from fatigue as a result of trying so hard to be healthy. Overdoing it is very common. People think that the energy available to their body is endless. They think they can do anything as long as they want it hard enough. This is a common mistake. It comes from the complete lack of understanding by modern science of the body energies. Our energy is definitely not limitless. Some of you, as we mentioned earlier, have been blessed with stronger constitutions and may get away with more extreme stuff without damaging your health. Most of us, however, need to be a bit careful. Exercise yes, but it has to be moderate and sensible.

Sex, we got there at last. This one is more controversial. According to Western medicine Sex is healthy for you. The more the better. Modern studies say that people having sex regularly are generally healthier than those who don’t. A possible explanation, according to Western

wisdom, is that it’s another form of exercise. Before I present the Chinese medicine view lets look at those claims. It seems to me like a classic abuse of statistics (very common these days). Is it possible that people who are healthier and feel better are having more regular sex rather than that people who are having regular sex are more healthy? Makes more sense to me. As to the possible explanation (form of exercise)-really?.

According to Chinese medicine, having a lot of sex is unhealthy. It’s rarely mentioned by local practitioners (don’t want to be unpopular no doubt) but has been talked about in every major TCM textbook. According to TCM we lose a small amount of our kidney energy (this is the part of our energy that we have been born with rather than the part we get from food and breathing). As a result, overdoing it on that front will eventually lead to weakness of the kidneys with possible symptoms of: low back pain, weakness in the legs, fatigue, sexual dysfunction, problems with bladder control, premature graying or loss of hair and premature death. Sounds quite ominous indeed. To support this claim we can look at the case of the Eunuchs. The Eunuchs were servants in the palaces of the ancient Royals. They had their sexual bits removed in order to guarantee no funny business with the Palace inhabitees. These humble servants used to live ten to fifteen years longer on average than the rest of the population. This is not exactly a complete proof to the TCM theory regarding sex but it surely makes you think. In any case, as you know, Chinese medicine theories are all based on hundreds of years of careful observation. We can never dismiss it lightly. It is therefore, unfortunately, probably true-too much sex is not good for your health! However, there are more aspects to this issue. How do you define Health? Whilst sex may not be contributing to your physical health, it is probably good for your mental and emotional health. These in turn will have a good effect on your physical health. Another issue is: how much is too much? Here, we have to take into account the individual constitution. Traditional sources recommend not to exceed once every two weeks (sorry). However, those whose constitutions have strong kidneys can get away with more than this. Age is also a factor. Our kidney energy gradually weakens as we grow older and therefore will be more negatively affected by sex. So, similar to the other issues we have discussed today, it is all about balance. Sex is good for you, too much sex isn’t!

To sum up: during the writing of this post I was quite surprised to see how often I was siding with the modern medicine views. Naturally I more often tend to side with the traditional medicine view. However, particularly in the cases of exercise and salads, it is clear that times have changed and with it our lifestyle. It has changed to such an extent that we also have to adjust our ideas regarding what is healthy and what is not. At the bottom line I find myself going back to two important factors a) balance and b) know and respect your own body constitution. So, salads are good for you but probably not too many, particularly if your digestion is not very strong. Exercise is good for you but don’t overdo it, particularly if your energy is naturally not very strong. And good old sex is ok, but less is probably more!

Great Health Everyone

Dr Ilan Shahor

Should Complementary Medicine be used on the NHS?

Hello everyone! After trying to deal with the heavy comprehensive and emotionally charged issue of the NHS existential pathology in my last post, this time we are going to focus on one aspect: should Complementary medicines like Acupuncture, Osteopathy, Homeopathy etc be used on our NHS? It’s a question I am often asked by my patients. It is usually more like: why can’t complementary medicine be used on the NHS? For people who benefit from Acupuncture or Chinese herbs or both it is a bit of a mystery. They are usually delighted with the treatment but also annoyed by the fact that they have to pay in order to sort out their health problems. After all, they paid their taxes all their lives so why then can’t they get this only treatment that helps them, through the NHS? Why indeed? The subject is also appearing on the fringe of the news from time to time-most commonly in the shape of the Establishment being astonished that Homeopathy is still available on the NHS. Well, that is not widely available. A few brave GPs who also practice Homeopathy managed to secure the agreement of prescribing Homeopathy on the NHS. Personally, I take my hat off to them. I haven’t got a clue how they manage to do it. The rest of the Medicine establishment however is outraged. Homeopathy is the enemy number one of modern medicine science. From all the complementary medicines it is the most hated. As far as modern science is concerned, when you take Homeopathic medicine you are basically taking nothing, zero, no active materials whatsoever, and so how can it possibly work? So instead of looking at the phenomenon in amazement and thinking “here is something that we don’t yet understand”, it is much easier to just denounce the whole thing as a con. So the poor few GPs who dare to use something else to conventional medicine on the NHS always get bad Press. I have probably heard about 6 times now, over the years, that their budget is going to be stopped and yet they are somehow carrying on! It’s admirable.
Apart from the Homeopathic GPs, my experience of the NHS trying to implement complementary medicine is as follows: there is some sort of cyclic process that repeated itself a few times over the last 20 years. It starts when the NHS, as a response to the rising popularity and demand for CM, decides to run a pilot scheme- that means that in one area of the UK (usually one Health Authority) there will be some limited and controlled availability of CM on the NHS. This pilot will run for a year or two and then it’s effectiveness will be analysed. I remember being present when one of these pilot schemes was presented, it was a good twenty years back. It ran somewhere in Scotland ( forgive me for the vagueness-it was a long time ago) and whilst I have forgotten some of the details I can remember clearly the important ones. The young lady who analysed the data from that pilot showed clearly it was a win win win situation. The therapies that were offered were Acupuncture, Osteopathy, Chiropractic and Homeopathy. Overall the data showed that the scheme benefited the patients as well as the GPs as well as the NHS. The patients benefited from improvements in their health. The GPs benefited by an ability to offer more options to the patients, as well as by reducing their inhuman workload and offloading some particularly difficult cases. The NHS benefited by saving money! Although CM cost money to the NHS, over the length of the scheme it saved money overall by having to pay less for prescriptions and for GP visits! These benefits and cost savings do not include the most important one which is the reduction in serious long term complications from taking long term medication. To our slight surprise, and no doubt the horror of the medical establishment, the most popular therapy in that pilot was Homeopathy.
Following the success of these pilots the NHS decides to try and implement them. The CM treatments then become available on the NHS in a slightly bigger area (a few more Health Authorities). All good so far. The problem is that without fail, due to the NHS’ very tight budget, these authorities will get into financial difficulties. Some expenses will have to be cut. Not surprisingly the CM budget is the first in line for the axe. I have seen it happen time and time again. This is, of course, short sightedness as the pilot shows that using the CM therapies is clearly saving the NHS money. However, they need to cut somewhere and this particular budget is politically the easiest to cut out.
A few years later there was another brave attempt to incorporate CM into the NHS. This time it took the form of an NHS CM Practitioners directory. The idea was that CM practitioners would be registered in an NHS directory which meant that they would be allowed to supply services to the NHS. Unfortunately this scheme has been proven to be just another waste of public money. The problem being that, at the moment, if any GP wants to give a patient medicine or send him for any treatment it has to be first approved by a body called the PCT (Primary Care Trust). Despite an intensive effort from myself and some GPs and Clinic Managers the PCT stood stern, no money for Acupuncture treatment! They just won’t budge!
There was however a short period in the past when I was able to treat people on the NHS. This was about 23 years ago. At that time some of the GP clinics were given the status of Fund holders. That meant that they were in charge of their own expenses and choices. It used to work beautifully. People who weren’t normally able to afford having Acupuncture treatment privately, were benefiting from the treatment paid by the NHS. As we mentioned before, everyone was happy: the patients, the GPs and myself. In 1997 a new Government came to power and some bright spark decided to change the system and created the aforementioned PCTs. Basically another expensive layer of Bureaucracy that has taken away the GPs’ ability to independently choose which treatment they would like to use. That was the end of that nice cooperation between the NHS and Complementary Medicine. Strangely enough, until recently the current Government tried to bring back the Fund holding system for GPs clinics. However, this plan was shelved after fierce reaction to it. It kind of demonstrates the point I made in my last post regarding overreaction to any attempts made to make any changes to the NHS.
The case then for using CM on the NHS is very clear, but what about the other side of the argument? Surprisingly I can see some arguments for why not to use these therapies on our National Health Service. I think the first problem is that, in comparison to modern Western medicine, the world of CM is in a bit of a mess. There are probably hundreds of different types of therapies that can be practiced in thousands of different ways and are probably loosely regulated by hundreds of different organisations. It is understandable then why people who have been asked to look at it as a possible treatment option on the NHS felt a bit dizzy and weren’t sure where even to start. We must narrow the field then and talk about only more established therapies like Acupuncture, Chiropractic, Osteopathy, Homeopathy and Herbal Medicine. Some Practitioners of other methods will justifiably feel upset by that. However, we have got to start with something.
Even after narrowing the field, many people will claim that there is not enough evidence to support the effectiveness of these therapies and therefore the NHS should not waste money on them. I can see where this claim is coming from (although not agreeing with it). The modern medicine Science is obsessed by a type of studies they call double blind placebo control studies. In those studies the patient and his Doctor don’t know if the medicine used is a real one or just a placebo. The idea here is to eliminate the placebo effect (where the patient feels better because he thinks the medicine he is taking is working, rather than the medicine itself is working). Of course, when it comes to Acupuncture or manual therapies this type of study is impossible to do. On top of this, in order to produce results which are statistically reliable, we need hundreds, or preferably thousands, of people to take part in the study. This, again, is a limiting factor since we, in the world of Complementary medicine, are all working in small private clinics. The cost is another factor as this type of Research is extremely expensive and unfortunately, the only ones who can produce it are the Pharmaceutical companies. That is the reason why they have almost a complete monopoly on modern Clinical research. Due to all these things CM is often referred to by modern medical speakers as unproven. Well, there is my point: unproven may sound bad but what does it actually mean? It definitely doesn’t mean it doesn’t work. It only means it hasn’t been shown to work through that particular process. My former patient, an eminent intensive care Consultant, told me once as a response to this: 75% of the meds we use are also unproven. There is plenty of research that demonstrates the effectiveness of therapies like Acupuncture, Chiropractic and Homeopathy. All you need is the will to look.
The last reason for resistance for the use of CM on the NHS, I think, is an emotional one. It is very hard for Doctors to recommend a therapy they don’t understand. To be fair, as a former Doctor, I can kind of understand it. However, I think they need to find a way to focus their minds on what is good for the patient.
There is a paradox here, the medical community claiming that Complementary Medicine is “not scientific”, while at the same time most of their arguments against including CM on the NHS are more emotional than scientific. To demonstrate this point of how emotionally charged is this topic we are conveniently having the Election campaign at the moment. The main subject is the NHS (more than Brexit believe it or not) and the Parties are falling over themselves to pledge more money for the NHS. Now, try and imagine in your mind what will happen to a Party who allows CM on the NHS. They’ll immediately be crucified by the Media and the Scientific community. It will be presented as a reckless waste of public money. This brave little imaginary Party is guaranteed to lose the Election!
But how come? At the beginning of this post I mentioned a series of pilots issued by the NHS which showed clearly that using established complementary therapies (Acupuncture, Chiropractic, Homeopathy and Herbal Medicine) on the NHS is not just a win win win situation ( for patients, practitioners and GPs) but also is saving money in the medium and long terms! The answer to this question is that in politics (make no mistake it is about politics) things are not simple or straightforward, let alone logical. Emotions often take over logic and short termism is king. For these reasons I think it will never happen, in a meaningful way anyway, However, our original question wasn’t” would” CM be used on the NHS, the question was “should” it be used.
So, let’s try and sum up: Should CM Therapies be used on the NHS?
The short answer is Yes. The established CM therapies (in my book-Acupuncture, Chiropractic, Osteopathy, Homeopathy and Herbal Medicine) are extremely effective and safe. Using them on the NHS will benefit the patients, the GPs and the NHS budget. In order to address the worries of the Medical Establishment start with a list of only the established therapies and use only qualified and experienced Practitioners. GPs judgement should be trusted to make the decision regarding referrals to CM medicine.

Best Health everyone,

 

Dr Ilan Shahor!

 

So, What Is Wrong With The NHS?

 

Brexit aside, the NHS is probably the subject most likely to divide opinions in Britain these days. You can hear it referred to as “the best healthcare system in the world” and also as “outdated, inefficient and not fit for purpose”. You can hear stories about inadequate service, neglect, huge waiting lists, waste and chaos alongside stories of great care and professionalism. There is no doubt the NHS is a very integral part of the British existence, so much so that I think it also became part of the British identity. It has definitely got a special status. No politician in his/her right mind would touch it with a barge pole. Any policy makers daring to suggest that maybe the traditional way the NHS runs needs a change is seriously risking a fierce backlash that may put their future careers at risk. It all becomes very emotional. I, however, am not a politician or a policy maker so I am completely relaxed about saying what I think on the matter. I have also seen how Health Service can be delivered, in a different way to the NHS, in other countries.

Before I start it is important to make 2 points very clear!

Firstly, is the fact that I have no personal interest or bias regarding the matter. If anything, my own business is benefitting greatly from the failings of the NHS. My only interest is my despair at watching this great institution crumbling under its own enormous weight, unable to supply the high level Health Service the citizens of this great country deserve!

Secondly, none of the criticism in this post is directed towards the NHS staff. The great majority of the NHS staff, particularly the Doctors and Nurses, are very professional and hard-working people. The failings of the NHS are not their fault. If anything, they are another victim of the problems. Having to work in an under-staffed, under-financed and often chaotic organization can’t be fun. They deserve more just as the patients do.

 Those “Drs and Nurses” are often used by people who are resisting change in the NHS: “How dare you criticize our wonderful Doctors and Nurses who work so hard to save people’s lives.” Well, I don’t. Actually, I never heard anyone do so. This hysterical tone is very common everytime the issue comes up for discussion. Another common, and no less hysterical argument, is that any suggested change is somehow an attempt to privatise the NHS by the back door. An interesting thing happened last night. As if to help me demonstrate my point I got an email from Mr Stephen Fry urging me to sign a petition calling for the Government not to allow any American companies to apply for any contract relating to the NHS. I am a big fan of Stephen Fry (anyone who watches The Black Adder Goes Forth or listens to the Harry Potter audio knows the man’s a genius!). I know he had some problems with his health, I assume he has been treated by the NHS and now wants to do something to help. That is great but is it helpful? For a start, why single out the US? What difference does it make from which country is the company? It sounds to me very much like discrimination. Secondly, who is to say that UK companies will necessarily do a better job than a company from abroad? You may not be aware of it but in today’s Global way of doing things, foreign companies are running a few of our operations in the UK, just as UK companies do in other places around the world. So long as those companies comply with UK rules and regulations and supply a service at the level required by the UK Government then it doesn’t really matter where they originate from! In any case, my point is that this is nothing to do with privatizing the NHS. Indeed, many private companies are already taking part in running different parts of the NHS at this present time. I think the greatest fear that people have is that treatment may not be available (free) when they need it.

At the moment, anyone in the UK can be treated for free on the NHS regardless of their age or their medical condition. This principle should be preserved. People are looking at private insurance companies, like BUPA, PPP etc, and worry that the future of the NHS will look like them. The panic is understandable. These companies are a rip-off. They charge high fees that will be unaffordable for most people and, worse, these fees grow exponentially if your health deteriorates. It is understandable why people panic when they hear the words private and medicine used in the same sentence. The good news is there is a third way. Great Health service is possible without the need for poor and poorly people having to pay a lot of money for it. I will explain how this third way works later but first, what is actually wrong with the NHS at the moment?

Where do we start? Well, to simplify I’ll focus on two points: availability and organization.

The problem with availability, or the lack of it, is probably emanating from the lack of resources, there are simply not enough doctors, nurses and medical facilities for the size of the population it serves. As a result we often need to wait two to three weeks before being seen by our own family doctors, or many months before seeing a specialist. I have to let you in on something, citizens of this Great country: this situation would be completely unacceptable in any other country. I was about to write “in any other developed country” but thinking about it-no, any other country. More than that, it would sound ridiculous to them. If someone is suffering why do they need to wait for weeks or months to get help? Yet somehow it has become acceptable in this country.

As to organization, the NHS is massive, one of the biggest organisations in the world. I keep on hearing stories regarding the insufficiencies of its practices. Nothing demonstrates this point better than the failure to implement a computer programme for the NHS. Amazing as it sounds, NHS hospitals and other institutions don’t have an electronic way of communication between them eg patients, patients’ notes, tests and so on. More than that, even within many hospitals there is no one computer system to connect all the different wards and departments. This is causing an enormous waste of time and money, not to mention problems with a good level of medical service. For example, imagine a consultant facing a patient who has been in different wards in the hospital before. He needs to have all the information about him, there and then, on his computer screen. Because of this problem that is often impossible. The lack of a single unifying NHS computer system is just one example of inefficiency. Unfortunately, I have to say indifference towards inefficiency is a typical phenomenon in the public services.

People are probable expecting me to talk about the ongoing refusal of the NHS to use any complementary medicine. Whilst I am sure that incorporating therapies like Chiropractor, Acupuncture or Herbal medicine in the NHS will help a lot in both improving the service and saving money, I also think this problem is dwarfed by the problems of lack of availability and organization. Actually, it has just given me an idea for my next blog: should the NHS use Complementary Medicine? But now back to our issue: what is the problem with the NHS? I was talking about lack of availability which is mainly resulting from a chronic lack of adequate funding plus organisational problems and inefficiencies which contribute to the lack of funding problem as well as reducing the level of service.

So, what is the solution? Well, the tragedy is that the solution is very simple. There is no need to reinvent the wheel or come with some super- sophisticated plan. All you need is the political will to change and then just look across the Channel to Europe. Many countries in Europe have health services that are operated and funded in a different way to the NHS. The levels of service are enviable and it doesn’t cost much. My own experience is with the system operating in Israel. I know many countries in Europe have the same, or very similar, systems.

So, how it works? A number of private companies are the Health providers. A person can choose which one he goes with. This creates healthy competition between them regarding both the level of services and the prices. The prices are means-tested and also supervised and limited by the State. The monthly contribution only depends on your level of income (like a kind of Health income tax) and you will never be asked to pay more just because you use the service more (which is the case with private health insurance companies). So this Health Service is always available for everybody at anytime as long as they pay their fees. These fees, by the way, needn’t be high and are worth every penny. The Health Service you’ll get will be superb, a world apart from the current deficiencies of the NHS. An added bonus is much more money for social services, education and other public services. Some people may object to paying for Health Service. Well my answer is: we really don’t have much choice. The system of funding the Health Service from general taxation is clearly not fit for purpose and is having a disastrous effect on other services. Most people said in a survey they’ll be happy to pay if they know they’ll get a better service. It doesn’t have to be expensive: if everyone pays (it has to be compulsory) then the individual fee is quite small. And the bottom line is: we can see it is working beautifully in other countries so why not in the UK?

Best Health for all,

Dr Ilan Shahor

  

 

 

The Great British Med Off V.

Stress, anxiety, mood disorders and sleep.

Hi everyone! Today I am going to discuss a group of conditions that is close to my heart. Generally, we can refer to them as conditions of the mind. They include stress, anxiety, mood disorders (depression, irritability, bipolar disease etc) and insomnia (sleep problems). So why are these close to my heart? I think for two main reasons. Firstly is the lack of understanding of these conditions by modern medicine. The brain is by far the most complex organ in our body. Our understanding of its working is extremely limited. This fact hasn’t stopped modern medicine from producing a long line of medicine aimed at affecting our brain. Secondly, people who suffer from these conditions often feel ashamed of their situation. They have no physical ailment as such to show for their difficulties and yet the suffering inflicted by conditions of the mind can often be worse and more debilitating than the physical ailments.

Before I start talking about the specific conditions, there is one general principle that is of major importance. In my opinion there is always a reason, a cause, for these symptoms. If someone is suffering from depression or anger or mood swings or any other mental/emotional condition it is always a result of something that happened, or is happening, in the patient’s life. This may not be obvious, sometimes it is hidden or repressed or happened a very long time ago, but there is always something. This may sound obvious, however, I am afraid to say that there is very little consideration for it when it comes to treatments available in both Chinese and Western medicine.  Both disciplines look at the current symptoms and ask how can we help with these? There is not much consideration for what brought them on, for the underlying cause. In my opinion, until the underlying cause has been addressed the treatment won’t be complete. It may give some help with the symptoms but in most cases it will be only temporary relief. How can we address the cause? I will explain later but for now let’s start the comparison.

As usual I will try and simplify things. For that I’ll divide the subject into two: mood and anxiety disorders, and  sleeping problems (insomnia). The Western medicine (WM) treatment for anxiety is with antidepressants. If this doesn’t work then they may be supplemented with a tranquiliser or antipsychotic or both. These medicines have some success in reducing anxiety-however, the tranquilisers are highly addictive and the antipsychotics tend to have side effects. The antidepressants are usually safe but their effect on anxiety is limited. Chinese medicine treatment with Acupuncture and Chinese herbs will aim at the underlying condition. From a Chinese medicine point of view anxiety is often the result of physical, mental and emotional factors. A careful diagnosis has to take place for effective treatment. For example, a common cause of anxiety is when too much stress and pent up emotions affect the liver. The liver regulates the emotions and therefore, when under pressure, our ability to cope with stress reduces dramatically. Chinese medicine treatment of anxiety is not as powerful as the western medicine tranquilisers, but in mild to moderate cases tends to be a more effective, safer and longer lasting solution. 

In the case of other mood disorders, I think, both WM and CM have more effective treatments than in the case of anxiety (although the general principles for how treatment is carried out is similar). Antidepressants are usually effective in treating the symptoms of mood disorders. If one suffers from low mood, depression, anger or mood swings then antidepressants will often be effective in moderating those emotions and are therefore considered to be an effective treatment.

 Indeed, if these symptoms are stopping you from being able to function normally and the drugs make you functional again then that must be considered a success. However, there are a few problems here: firstly, most users of antidepressants report a general damping down of their emotions. They will often say they don’t feel depressed any more but neither do they feel real happiness or real excitement so although they feel better than they were they want to be able to feel emotions again! ; secondly, the usual problem with WM drugs: they don’t treat the cause, the reason for the mood problems. The symptoms are therefore likely to come back when the medicine has been discontinued. This point, which is true for many WM medications, is particularly important in the case of anxiety and mood disorders. One in every 5 people in the UK has been prescribed antidepressants over the last year! Over 4 million people are long term users. In the US one in 6 people are long term users of antidepressants. These figures are shocking. The fact that so many people need mood modifying drugs to stay functional primarily raises questions regarding the way we live our lives in these modern times-but this is a subject for another post. In the context of this post, these figures clearly indicate that modern medicine is failing in curing these conditions and is instead producing a generation of people who are dependent on these drugs. A great situation for the pharmaceutical industry but not particularly good for the sufferers.

So, what are the CM solutions for these mood related conditions? On the one hand CM has a much deeper understanding of these conditions. The treatment therefore is working on a deeper level and results, when positive, tend to be long term. On the other hand, in my experience CM, whilst often very effective in treating mild to moderate conditions, often tends to struggle with severe forms of depression and anxiety. It is not completely failing with severe cases and can sometimes still work, but much less than is the case with mild to moderate manifestations. Another problem with CM treatment of these conditions is that, like WM, it doesn’t deal enough with the emotional circumstances of the patients: are they in a stressful situation? Are thinking patterns and conditioning affecting how they feel? Is there an emotional trauma or traumas in their past?. With a lot of sufferers until we have cleared these conditions then we won’t be able to truly help them since the emotional problem which is emanating as a result of these conditions will keep on coming back. In these conditions, in my opinion, the patient will greatly benefit from counselling. I am referring here to patient and proper counselling, one that persistently explores the deep seated reason for the mood disorder or the anxiety. It can be hard for the patient and it may take time but in the hands of  good counsellor or psychologist the results will be very good and long-standing. The counselling technique that is used in the NHS called CBT (cognitive behavioural therapy) can be helpful but is limited. It gives you tools to help you deal with your symptoms but, just like antidepressants, it’s not (in most cases) treating the root of the problem.

 So, to sum up: for mood disorders and anxiety, WM medications should be preferably avoided unless the symptoms are severe and no other solution is working. In cases where you feel you need these medications, it is recommended to use them as a temporary solution until deeper and more permanent change can be achieved.

 CM offers more gentle, deeper and non-addictive treatment and therefore will be preferable as a first choice. However, in some more severe cases it may not be effective and WM medicines will be needed. Both forms of treatment are recommended to be supplemented by counselling.

Sleep problems or insomnia is a lot easier to compare. The verdict here is, I think, fairly straightforward. WM has a few different drugs that will make you sleep. The majority of them are tranquilisers but there are a few exceptions. Some will work well but often the patient will still feel sleepy it is time to wake up in the morning and start the day. Another problem with those meds is the usual one: not treating the cause will lead to dependency. Often, as well, one tends to get used to the pills and will need something stronger..and so on.

The CM approach to insomnia is very different. In CM we don’t look to tranquilise the patient or to knock him out. Instead we are looking for the reason, the cause of the insomnia, and will aim to mend it to allow our sleep mechanism to work properly again. There are clearly different patterns of sleep difficulties. Some can’t go off to sleep easily, some will wake up very early in the morning, some will have a very light sleep and will keep on waking up. Other factors are vivid dreams, night heat or night sweats, palpitations etc. Different sleep patterns arise from different reasons and therefore will be treated differently. Different Acupuncture points and/or different herbs will be used to treat different causes of insomnia. With this individual approach of looking at the root of the problem, the treatment of insomnia with Chinese medicines and Acupuncture is very successful. Most importantly there is no dependency-when the patient sleeps well he’ll be able to keep on doing so without the treatment.

So, to sum up. Insomnia: CM has the clear edge. WM should be used only in the most resistant cases.

That’s it for this post. Next time I am going to take a break from The Great comparison series of blogs and turn my attention to sorting out the NHS. 

Good health everyone.

Dr Ilan Shahor

THE GREAT BRITISH MED OFF: IV

Lungs and Airways Conditions, Allergies and Hayfever

Hello everybody. It’s nice to be back again writing about Health issues rather than Politics – although I have to admit it was fun to write my last one! Fun may be an exaggeration. Let’s say it sometimes feels good to get things off your chest!

Today we are going to discuss lungs and airways conditions, allergies and hayfever. These are not accidentally put together. In Chinese Medicine terms these are very much related. Hayfever is a type of allergic reaction and most allergies, in Chinese medicine, are a result of the lungs Immune system dysfunction.

We’ll start from the most common airways conditions: colds, flus and chest infections. I put these together as they are all Acute infection type conditions. Colds and flus are caused by a virus whilst chest infections can be caused by a virus or bacteria. The Western medicine approach to these upper respiratory tract infections (URTI) is mainly to help with the symptoms until the infection will clear by itself. The reason for this approach is that we still haven’t got an effective medicine for viruses. The medicines that are available to reduce the symptoms are varied but, generally speaking, are based on chemicals which aim to reduce the body’s natural immune reaction to the virus e.g. paracetamol or aspirin. This may sound counter intuitive but the principle here is that a lot of the symptoms we feel, such as a high temperature for example, are as a result of our immune system trying to fight the invader. Stop this reaction and you stop the symptoms! These medications tend to be quite effective in reducing the symptoms and help us to continue to function but is this necessarily a good thing for our long term health? The answer, in my opinion, is most probably not! I can’t see how stopping our immune system from doing its job is a healthy approach. I understand that sometimes in life we need a fast relief but I will recommend to use it as sparingly as possible. I feel there will be long term consequences to our immune system’s ability to deal with invaders if we use it on a regular basis. This advice is particularly important for parents who tend to feed Calpol (Children’s paracetamol) to their kids on a very regular basis. In the case of chest infection, as a result of a bacteria rather than a virus, the Western medicine treatment with antibiotics will be often very effective. However, in my opinion antibiotics for chest infections should be used only in the difficult and stubborn cases since it is clear that regular use of antibiotics has a weakening effect on our digestive and immune systems.

The approach of Chinese medicine to URTI is very different We are not looking at the type of bug which has invaded the body, instead we are looking at the reaction of the body to this invasion and then treat it accordingly. An experienced TCM Practitioner will be able to identify one of many patterns of Acute URTI and will then be able to choose the right combination of Herbs and /or Acupuncture points to remedy this pattern and restore normality. In some cases (particularly with children and the elderly) herbs to support and strengthen the immune system will be added. The treatment of URTI with TCM is, in most cases, highly effective. The old belief that a cold will clear within a week without treatment and within seven days with treatment is not applicable in the case of Chinese medicine. In most cases we can shorten the duration and help with the symptoms without damaging the immune system in the process. So, in the case of Acute URTI (colds, flus and chest infections) there is a clear advantage to Chinese medicine with one exception being the most severe and stubborn bacterial chest infection that may end up needing antibiotics!

The second most common lung condition is Asthma. Asthma is a condition characterized by shortness of breath, wheezing and coughing caused by the narrowing of the airways. This narrowing is a result of a contraction of the airways or a secretion of phlegm in the airways or both. The reason for the contraction and the phlegm is largely unknown. In some cases there is a clear link to Allergic reaction but in the majority of cases the cause remains a mystery (at least according to modern medicine knowledge). Asthma is very common and, alarmingly, is getting more and more common over the last 30 years. The reason for this increase is again mainly unknown although air pollution, stress and bad nutrition are the usual suspects. Asthma can affect all ages and in severe cases can be lethal.

The treatment of asthma from a Western medicine point of view is aimed initially at reducing the symptoms by reversing the contraction of the airways and the main medicine used for this is the famous Ventolin inhaler. Ventolin is very popular due to its fast effect: short of breath? take a puff and feel better almost immediately. However, medical studies have shown that long term use of Ventolin increases morbidity and mortality (the severity of the condition and the death rate!). The other type of inhaler is more for prevention of attacks and contains steroids. Steroids are a very effective anti inflammatory and asthma is no exception. Steroid based inhalers are fairly effective in prevention of asthma attacks. The problem is, as usual in the case of steroid use, the side effects. Since the use here is targeted and local (not passing through the digestive system) it was hoped therefore that it wouldn’t spread through the body. However, studies into the effects of a long-term use of steroid based inhalers showed risks that are very similar to those caused by the use of oral steroids e.g. diabetes, high blood pressure and osteoporosis.

The Chinese medicine view of asthma is a bit different to the Western medicine one. Most importantly we don’t see it as one condition. I often use asthma as an example when I try to explain the difference between TCM and WM thinking. If you take a step back and look at it carefully you can see clearly that asthma can manifest in a different way in different people. The main symptom can be shortness of breath in some cases or cough in others. The cough can be phlegmy in some and completely dry in others. The phlegm can be thick or loose or watery, white or yellow or green. Triggers differ largely-some are triggered by stress, some by exercise, some by the weather (humidity or dryness), some react to allergent, and so on. In Chinese medicine each one of these will be considered to be a different condition and will therefore be treated differently. For example, a dry type asthma will be treated with herbs and acupuncture points that aim to help the airways and lungs produce the moisture needed for normal function. The phlegmy and wet asthma, however, will be treated with herbs and acupuncture points that will do just the opposite this time, helping the airways and lungs to dry up and get rid of the phlegm. There are of course a few other considerations when choosing the treatment in each case, most importantly-as ever in TCM-treating the underlying cause as well as the symptoms. The point is the treatment is tailored for each individual case! This approach combined with a deep understanding of the asthma symptoms and causes leads to a very high success rate in the treatment of Chronic Asthma with TCM.

So, to sum up asthma. In the case of acute attacks WM has the upper hand in its ability to bring fast relief. In the case of the treatment of Chronic Asthma TCM is much more effective.

The next lung condition is COPD (chronic obstructive pulmonary disease). COPD is very common and it actually includes a few conditions, most commonly emphysema and chronic bronchitis. Here the comparison is easy since WM doesn’t offer any effective treatment for these conditions, except oxygen support in the very late stages. Chinese medicine however has more to offer. These conditions are chronic in nature and often cannot be reversed, but with a good course of Acupuncture and Chinese herbs the symptoms can be reduced and the deterioration in the lung function slowed down.

Next is Bronchiectasis. This condition is characterized by a formation of air pockets in the lungs. These pockets tend to fill up with phlegm resulting in chronic cough and deterioration in the normal lung function. The WM treatment is limited to breathing physiotherapy. It is important since it is helping the patient to release some of the phlegm which is stuck in the lung. However, the effect on the patient’s symptoms is fairly limited. From my experience the effect of Chinese medicine on this condition is much more substantial. Treatment with herbs and acupuncture points which clear phlegm and strengthen the lungs result in significant and long-lasting improvement in most cases! CM will have a similar effect in most cases of chronic cough.

Next for Allergies. To simplify and shorten things I’ll try and consider all types of Allergies in one section. This will include skin allergies, airways related allergies and Hayfever. Generally speaking, allergic reactions occur when our Immune systems hyperreact to a stimulant. In other words, instead of having the normal measured and effective Immune response as a normal response to what the body identifies as an unwanted invader, the Immune system will overreact and will activate mechanisms in the body which are inappropriate for this situation and will therefore cause problems (symptoms).We are all familiar with hayfever, allergies to cats or other animals, dust mite allergies etc. These are all different materials or organisms which will commonly trigger an inadequate Immune reaction in susceptible individuals.

The Western medicine treatment for allergies is mainly with Antihistamines. Antihistamines are, generally speaking, quite effective in reducing the symptoms of allergic reaction. The problem here is that they don’t treat the root of the problems but are purely for the symptoms. They are fairly safe medications but can cause drowsiness. The Chinese medicine approach to allergies is a) treat the symptoms and b) calm and regulate the Immune system (stop it from over-reacting). As a result of this approach the improvement is long lasting and often even permanent.

 To sum up, lungs, airways conditions and allergies are a good demonstration of the difference between WM and CM approaches. If you need a quick relief of your symptoms then WM is probably more effective. However, if you are a bit more patient,  care about your health and are interested in long term relief or a cure then CM is your preferred option.

Best of health everyone,

Dr Ilan Shahor.

Traditional Chinese Herbal Medicine and Brexit

As promised, we are taking a break from the Great Med Off series. I’ll be back covering Western and Chinese medicines next time, but today I am going to discuss the issue which is on almost everyone’s mind-Brexit. For the love of God, WHY??? Nobody wants to hear yet another opinion! Also, of course, I can get myself into trouble with some of my patients. Emotions are very high, yet the sequence of events which helped me make up my mind regarding the Brexit question is interesting and is TCM related and that is why I am going to share it with you.
In the early days after David Cameron announced that there was going to be a referendum. I thought that I would vote for remain. To be perfectly honest, like most people, I knew very little about the EU. It was more of an intuition. It has always made sense for me that people should cooperate, share and help each other so why not be in a union with our friends in Europe? Indeed, why not? Well, something has happened during the run up to the referendum which has started me thinking properly. Before I tell you about it I have to give you a bit of background. The struggle of Herbalists against the mainstream medical institution’s attempt at stopping them from practising is hundreds of years old.  Mainstream medicine always viewed the Herbalist community (out of ignorance of course) as a bunch of charlatans. In the old days Herbalists were considered as witches and often ended up in jail or even burned on the stake. Luckily the methods of persecution have changed but not the principle. Mainstream medical science (these days strongly supported by the pharmaceutical industry) relentlessly tries to stop Herbal medicine practice.

Since I started practicing Chinese medicine 24 years ago there have been 3 orchestrated attempts by the Authorities to pass laws regarding the manufacturing, the prescribing, and the use of Herbal medicine. These laws, often camouflaged as public safety concerns, were very clearly designed to devastate the herbal medicine industry and the Herbal medicine practice. The first of those came in the late 90’s-a set of new rules and regulations regarding the manufacturing, the selling and the prescribing of herbal medicines brought in front of Parliament by the Medical Control Agency (MCA). The centre point of this new legislation was that herbal products would no longer be regarded as food supplements.  Instead they would be treated as medicines! The implications of that were huge! It meant that each herbal medicine would have to go through the same testing that new medicines do in order to be approved for use!  This would have completely destroyed the Herbal practice since no herbs would ever be available again. The herbal medicines companies are all very small with a large amount of products (hundreds). Unlike the pharmaceutical companies which are very big companies with a very small amount of products. To test a new product takes years and costs many millions, but it is still worth it for the pharmaceutical companies. They will get their money back on the investment. For the Herbal companies it is of course a complete impossibility! So, faced with the prospect of annihilation, the Herbalist community fought back. Herbalists and their patients wrote to their local MPs, signed petitions, and even went on a demonstration in front of the Houses of Parliament. To everyone’s surprise the Campaign worked. The MPs had a good look at the Bill, realized the problems, and rejected it. The MCA was told to go back to the drawing board and to come back with a more balanced and sensible Bill. This was Democracy in motion!
About 3 years later the MCA came back to Parliament with a new Bill. There were few little changes from the original one. Firstly, the MCA changed its name to the MHRA (Medicines and Healthcare Products Regulatory Agency). Secondly, they kept it secret and the Herbalists heard of it only about 2 weeks before the vote in Parliament so we had very little time to campaign. Other than these there were very little changes of substance, just cosmetic ones. Again we fought a fast and successful campaign. Common sense and Democracy prevailed again!
The third time the Herbalist community had to face this sort of threat was around 2008. This time we had a real problem. This time the herbs directive came from the EU. There was simply nothing we could do about it. The EU Herbal medicine directive, although not as devastating as the original MCA one, is still a very bad piece of work. It is supposed to offer public protection from rogue medicines and yet it is doing just the opposite. For example: those “take-away” style  Chinese herbal places which sprout up around the town centres are having no problems practicing with the new regulation-and that is despite the many court cases brought against them for using banned Herbs and Pharmaceuticals. At the same time, genuine Herbalists run into trouble and have to seriously find a way to bend the rules just to be able to keep on practicing. Many useful, effective, much loved and 100% safe products had to be stopped. They just disappeared never to come back. A few Herbal companies had to close down. But probably worst of all, courses for Herbalists are now impossible to find. Chinese medicine courses are simply not on offer anymore. It is simply too hard and complicated to practice TCM in the UK in light of the EU Herbs directive. It came into full effect in 2014.
I think what happened is that I heard about yet another of my Herbs suppliers closing down in the run up to the Referendum and that made me start thinking.  The main problem is not with the directive itself (although bad enough) it is with the process. Some bright spark in an office in Brussels set out a directive. There was no consultation, there was not understanding of the situation, problems or needs of the Herbal medicine reality in the UK. We had no chance to have any influence on the process and could not even protest after. I didn’t vote him in and I can’t vote him out. No accountability whatsoever, no consultation, no democracy.
 It’s not just the Herbs directive, this flawed process happens in many other areas of our lives controlled by the EU. If you value democracy then this is very very wrong!  This lightbulb moment made me look a bit more closely at the effects of the EU projects on our lives.
Not far from my Leicester Clinic a big construction project was unfolding. Humberstone Road was having a very welcome facelift. At the end of the street a sign declared: this project is supported by money from the European Union! The initial response to this information is ”Great! We are getting money from the EU to make Leicester look better!” Then I thought again. What is actually happening here? We pay our hard earned tax money to the UK Government. They then pass it to the EU. The EU use it to pay for fancy offices and generous salaries for its workers and then, whatever is left, they send back to the UK for Projects. Which Projects get the left-over money? That is decided by EU Bureaucrats who probably don’t know much about the UK, about its culture, its ways, and its needs. Sorry my dear Remainer friend but this just makes absolutely no sense to me.
The more I looked at it the more convinced I became. The way the EU operates at the moment and, maybe more importantly, the direction it is moving toward is simply not good and is going to end up in tears. I am aware of course that there are some good sides to the Project. As I mentioned earlier I am always for cooperation and support but there is absolutely no need for the obsessive control over Member countries’ rules and internal affairs which is coming from Brussels!!! As demonstrated by the case of the Herbal medicine directive: it doesn’t work and it will gradually cause more unrest in other EU countries!
Please understand that my support for leaving the EU is nothing to do with a hope of getting my herbs back. I know unfortunately this is not going to happen, not in my working lifetime anyway. It is purely about bringing back sovereignty and democracy.
And, one last thing I would like to say to my “Remain” friends: many people born in the UK  who have probably never experienced life anywhere else often don’t appreciate how great this country is. Of course it is not perfect and it has problems the same as everywhere but, nevertheless, it is a great place with great strength, great tradition and great people! It will have no problems with coping, flourishing and fulfilling its potential outside the EU.
And on this positive note we’ll end today’s post. I hope I haven’t upset anyone. Next time, hopefully we’ll be back to proper TCM and Human Health matters!

Dr Ilan Shahor

Acupuncture Leicester Blog Post

The Great British Med Off!

Digestive System Disorder 2

In today’s post I am going to conclude the discussion we started in the last one: the treatment of digestive system conditions using Western Medicine (WM) versus Chinese Medicine (CM). Meds and operations versus Acupuncture and Chinese herbs, which one is more effective? I hope you’re not starting to get a bit bored with the matter. The reality is that different conditions will react differently to WM and CM and therefore need to be discussed separately. I think this comparison is important, although I’ll consider having a little break from it in the next post, and find something maybe more exciting to talk about before coming back to complete the mission!
So, back to our subject. We are going to carry on down the GI tract with Diverticulitis, Anal conditions and IBS. Diverticulosis is a very common diagnosis given to people with GI symptoms. The pathology here is the formation of pockets in the wall of the large colon. The problem I have with this diagnosis is that studies have shown that 70% of the over sixties will have diverticulosis in their large colon. Of course, most of these won’t have any GI symptoms. I have seen many patients over the years who had general GI symptoms like abdominal pain, bloating, diarrhea, constipation etc. These were diagnosed as diverticulosis just because that’s what came up in the scan. In most of these cases, in my opinion, the diverticulosis was obviously present but wasn’t the reason for the symptoms. In these cases the condition should have been diagnosed as IBS! They were treated as IBS and they got better. However, in some cases, the symptoms are as a result of the diverticulosis and in these cases the typical symptoms are localised abdominal pain or discomfort, usually after food and often in one specific location (where the pocket is). These cases are a bit more difficult to treat as there is a structural change in the colon which disturbs the normal function. The WM approach is to improve the smooth movement of digested material by creating a better bulk. This is done with bulking agents which are basically fibre rich powder like Fybogel. The idea is that better formed stools will be less likely to get stuck in the pockets. It tends to work reasonably well. The CM approach is to improve the general function of the large colon and to clean away any toxic stuff which is actually stuck in the pockets. This approach is often successful in alleviating the symptoms.
To sum up: the majority of the diverticulosis sufferers will be treated better with Acupuncture and Chinese herbs due to the fact that most of their symptoms are caused by IBS and not diverticulosis. For the few experiencing diverticulosis symptoms the CM and WM treatments are of about equal effectiveness. In some rare cases the diverticulosis pocket will get infected and this condition (called diverticulitis) is considered to be a medical emergency requiring hospitalisation and, often, an operation.
Next, Anal conditions, namely piles and anal fissures. These two are fairly common. The treatment with WM is initially with creams to soothe the symptoms in conjunction with meds to maintain bowel movement, but, if the condition persists then the next step is an operation to remove the fissure or a procedure to remove the piles. The Chinese medicine understanding of these conditions is that they are caused by blood stagnation and heat in the lower end of the digestive tract. The treatment aims at remedying that in conjunction with keeping the bowel movement regular and soft. The results are usually good and long-lasting. Piles and anal fissures, then, are treated more efficiently with Acupuncture and Chinese herbs than with the WM cream. However, in difficult cases we may have to resort to an operation or a procedure.

I’ve left the best to last. The most common of digestive system conditions is IBS (Irritable Bowel Syndrome). IBS refers to a situation where the patient experiences a symptom, or a mix of symptoms, like abdominal pain, swelling of the stomach, diarrhoea, constipation or both without having any pathological findings in medical tests.
From the definition you can understand why WM is struggling to get its head around this condition. If there are not pathological findings then what the hell is wrong here? What causes these symptoms? I was present once in a lecture given at a TCM convention regarding IBS. The lecturer was a Doctor from a world-leading centre for the study of IBS. The subject was “IBS , the WM view”. It went more or less like this: fifteen years ago we thought that IBS was caused by this, then we discovered we were wrong and it is actually caused by that, but then we found out that we were wrong again and ,actually, it was caused by that and so it went until now we are almost sure it is caused by this and that. Forgive me for not boring you with the details of this and that theories. I am not sure I can remember them anyway. I am not being disrespectful to the Lecturer. He was obviously a very intelligent man who was trying his best and besides, he did agree to come and give a presentation to a TCM convention- a thing that most WM doctors probably decline to do. It wasn’t his fault. It is the wrong assumption that IBS is one condition with one cause. It’s the WM model that a disease has a cause, certain pathological changes and a pattern of symptoms and this simply doesn’t work in the case of IBS. It follows that the treatment on offer is poor; doctors will try different medicines like Omeprazole or Mebeverine with very limited success in relieving the symptoms. Chinese medicine, however, understands IBS very well, a lack of pathological findings makes no difference to a good TCM practitioner. IBS is a functional condition. A lack of function of the digestive system is bread and butter in TCM. No two IBS sufferers will be the same. Each individual case should be initially assessed to understand the causes of the condition and the symptom patterns as well as the patient constitution. When this has been achieved the treatment will be very effective. Generally speaking, the common patterns that cause disruption of the digestive system functions are as follows:
• Weakness of the digestive system
• Too much fluid in the gut
• Problems with the movements and the energy flow in the digest tract
These can be combined and intertwined. They can be caused by stress and worry or by eating the wrong food or by overworking etc. This is a significant simplification. I don’t want to bore you with all the details. I just hope it will help you to understand that Chinese medicine has a very thorough understanding of IBS and therefore the treatment with Acupuncture and Chinese herbal medicine is very often successful.

To sum up our comparison, in this post we looked at Digestive tract conditions and which sort of treatment would be most effective: Diverticulosis -TCM, Anal fissures and Piles-TCM but some difficult cases will need WM, IBS -Acupuncture and Chinese herbs any day.

Good Health,
Dr Ilan Shahor

Acupuncture Leicester - Digestive System

Digestive System Conditions (Part One)

 

In today’s post we are going to have a close look at the treatment of digestive system conditions from the point of view of Western Medicine (WM) and Chinese Medicine (CM- and including Acupuncture and Chinese herbal medicine). This particular area may demonstrate more vividly the difference between the two approaches. Whilst WM tends to concentrate on the biological and chemical changes occurring in the disease process, CM is more concerned with the functional changes and what has led to them. The same applies to the approach regarding the treatment: WM focusing on trying to reverse, stop, or at least slow down these chemical and biological pathological changes, whilst CM focuses more on restoring the impaired functions of the organs by treating the underlying cause as well as the symptoms themselves. I will try and demonstrate that with an example: the different approach is particularly apparent with the most common G.I. condition i.e. Irritable Bowel Syndrome (IBS). It has no known chemical or biological changes associated with it. It is purely a functional problem and therefore a complete mystery to WM. For CM, however, it is the complete opposite. Since the symptoms are abundant we have a lot to work with to analyse, understand and treat the condition. On the other hand, in the case of IBD (Inflammatory Bowel Disease) like Crohn’s Disease the Doctors can see clear inflammatory changes and Autoimmune involvement and they therefore have more to offer in the way of treatment than in the case of IBS.

I am going to discuss in a bit more detail the most common of GI conditions: IBS, IBD, chronic constipation, diarrhoea, diverticulitis and stomach related conditions.

Let’s start from the beginning. The GI tract starts with the mouth. The most common mouth complaints are mouth ulcers/sores and inflamed gums. In both these conditions the treatment with WM is limited to soothing and pain reduction. CM, however, understands that both are a result of excess heat mainly in the stomach. The treatment, therefore, with Acupuncture and Chinese herbs, is aimed at reducing the stomach heat. The results are excellent and, since we treated the source, also longstanding.

Next is the Oesophagus. Primary oesophagus problems are fairly rare. Oesophagus problems are more commonly a result of stomach acid damaging the oesophageal lining, producing pain known as heartburn. We’ll discuss it with stomach acid problems.

Let us continue our journey down the digestive system. After the oesophagus is the stomach. The stomach function is to receive the food we eat, start the digestive process and gradually move it downwards to the duodenum. Stomach problems can generally be divided into acid related problems and stomach dysfunction problems. Acid problems are usually due to the stomach fluid being too acidic or due to the protective layer of the stomach walls being very weak or damaged. Another common problem occurs when the sphincter between the stomach and the oesophagus is malfunctioning allowing stomach acid to travel upwards causing heartburn. The symptoms of hyperacidity problems are usually a burning type of pain around the stomach area, sometimes radiating to the back; sometimes after

food but can also come before food (hunger pain). The symptoms of a malfunctioning stomach are more common after food and include bloating, fullness, extending or swollen stomach and pain. Other possible symptoms are low appetite, nausea and sickness. These two types of stomach problems can sometimes be combined. The WM treatment for stomach acid related problems is with antacid medications. There are different levels of those: from alkaline buffers like Gaviscon or Rennies which simply reduce the level of acidity of the stomach fluids, to drugs like Omeprazole which completely stop the production of acid. From the point of view of fast symptom relief these medicines are, in most cases, remarkably effective. When Omeprazole came on the scene about 25 years ago (I was a young doctor then, working in a hospital) doctors were reluctant to prescribe it. The worry was about the impact of no acid production on the stomach. The rationale was that the acid production must be there for a reason and that if it was eliminated it may cause some long term problems. At the time, Omeprazole was prescribed for the most severe acid related problems which had not responded to other treatment. However, over the years, the doctors became more and more relaxed about prescribing it. It is now one of the most commonly used medicines and these days it is used for almost any stomach niggle.  Recent studies into the long term effects of taking Omeprazole have found out, not surprisingly I have to say, that depriving the stomach of its natural way of working in an acidic environment has its price: from a problem in vitamin absorption which can lead to Osteoporosis and other problems and to increase cases of Oesophageal cancer. Yet again’ we find out that attempts to interfere with the natural working of the body have a long term negative consequence. So, treatment of acid problems with WM: good on the symptoms but worries about the long term use of the drugs. It is probably worth mentioning that WM almost eliminated the problems of stomach and duodenal ulcers. This very painful condition which used to be fairly common when I was a young doctor has almost disappeared now since the discovery that it is caused by a bacteria. Adding a course of antibiotics to the antacids made the treatment of these conditions very effective.

The Chinese medicine treatment of stomach over-acidity is aimed at reducing the hyper acidity state and at improving the stomach function. This treatment is often successful. It has no side effects and tends to last for the long term. However, in the case where Heartburn symptoms are a result of a Hiatus Hernia then CM can be less effective since we are talking about a structural problem. I still recommend to try and treat any stomach acid problems with Chinese herbs and Acupuncture first, but in some cases we’ll have to resort to acid blockers or, in some bad cases, to an operation to repair the Hiatus Hernia. 

The other type of stomach problems can generally be described as indigestion. It often includes symptoms like bloating, swelling of the stomach and epigastric pain. In some cases low appetite and/or sickness are present as well. WM will place these symptoms under the IBS diagnosis. The only WM treatment available for this condition is Mebeverine. It works on the nerve system. Although its mechanism of work is unknown it is thought to relax the digestive system muscles. Its effectiveness is controversial as a few studies failed to show anything above a placebo effect.

Chinese medicine treatment for these types of stomach complaints is highly effective. According to Chinese medicine these symptoms can arise due to one of three reasons:

 a) a weakness of the stomach 

b) accumulation of thick fluids in the digestive system (called dampness in CM)

c) stress, distorting the normal workings of the stomach

Combinations of two or three of those is not uncommon. The treatment of these with Acupuncture and Chinese herbs is very efficient. The aim is to restore the function of the stomach and therefore, when it’s done, we can stop the treatment without the risk of the symptoms returning.

I am going to skip Pancreal and Duodenum conditions which are fairly uncommon. We’ll briefly go through Gallbladder as I have a few more important conditions to cover in today’s post. So, the main problems with the Gallbladder are Gallbladder stones and Gallbladder infection (Cholecystitis). Cholecystitis is treated with antibiotics which are fairly effective for the Acute phase. The problem is, however, that the infection can turn into chronic inflammation of the Gallbladder wall. The treatment offered here is usually an operation to remove the Gallbladder. CM can treat Chronic Cholecystitis effectively without the need for an operation. Gallbladder stones are a much more common condition. They are more common in woman, over forty years old and overweight. CM is very effective in clearing gallbladder stones as long as they are 1cm or less in size. Bigger than this and we will struggle to dissolve them.

Next we are going to examine the treatment of IBD (Inflammatory Bowel Diseases). There are two conditions included in this category: Ulcerative Colitis (UC) and Crohn’s Disease (CD). Both are chronic inflammation in the digestive system but are different in some aspects, most importantly in their location. Whilst U.C. is limited to the large intestine, CD can accrue in any part of the GI tract. This difference has an implication re the treatment. Both conditions are probably Autoimmune in nature. 

The Western medicine treatment of both is generally with Immunosuppressant drugs. These medications suppress the activity of the Immune system and , by doing that, stop the Immune system from attacking the GI tract. Immunosuppressant drugs can be successful in reducing the inflammation and therefore the symptoms, and yet these are strong medications which are likely to have long term serious side effects like an increase in the likelihood of cancer (through repressing the normal work of our immune system). Another problem is that these meds are for life’ as often the case, they do not treat the root of the problem and therefore have to be taken continuously. In cases where the meds are not working, or have stopped working, the Doctors will resort to an operation to remove the affected segment of the GI. In the case of UC this will be a cure. Removal of the large colon means that the disease can’t come back. It will however leave the patient with chronic diarrhoea in a good case, or a colostomy bag in a bad one. When it comes to CD the situation is more complicated. Removal of the diseased area will only provide a temporary relief from the symptoms. The disease will flare up again in a different part of the Digestive tract. One of the things that shocks me most, is the willingness of the Doctors in this country to operate on a CD patient to remove the inflamed section. It is a temporary solution and will almost certainly eventually bring them to an early grave since there is only so much of the Digestive tract you can take out before it becomes incompatible with life. Sometimes there is no choice and an operation is needed but it should only be done as a last choice!

Chinese medicine treatment of IBD is quite effective although in some cases it needs to be given together with WM treatment, at least at the beginning of the treatment and until clear improvement has been achieved. These conditions are chronic and severe and therefore the treatment may take time. Acupuncture and Chinese herbs are needed and it is strongly recommended to go to an experienced Practitioner. If you can find the Practitioner and commit to possibly long term treatment then it is worth going for CM treatment for Crohn’s and/or UC. It will make you healthier and it may save your life. The few difficult cases that don’t react to CM treatment can be then treated with WM.

We are going to go down in the severity of the conditions and talk about chronic diarrhoea and chronic constipation . These can be very upsetting but, unlike IBD, there is no inflammation involved and they are extremely unlikely to kill you. I thought it important to discuss these fairly common conditions because, as amazing as it sounds, WM does not have the first idea as to what causes these two conditions and therefore the treatment offered is very poor! In CM however these conditions are the bread and butter of Digestive System malfunction. CM recognises a few clear patterns of diarrhoea and constipation. For example, constipation can be caused by dryness in the gut: the stools will be very dry and hard to pass. It can also be caused by Qi deficiency (lack of energy in the gut to move the stool forward). The stools in this case will be very thin. Constipation can also be caused by GI stagnation (problems with the smooth flow of energy in the colon); in this case the stools will be like small pebbles (rabbit droppings). Understanding the different patterns and the underlying causes allows Acupuncture and Chinese herbs to provide effective and longstanding treatment.

We are left with Diverticulitis, anal conditions and IBS and this post is already too long so I will discuss these in the next one! 

To summarise the Great WM /CM GI comparison so far: which is more effective?

Mouth conditions-CM all day

Stomach and Oesophageal related problems-WM for symptoms, CM for long-term help

Indigestion and other stomach malfunctions-definitely CM

Gallbladder conditions-Cholecystitis: WM for acute, CM for chronic

Gallbladder stones-CM for stones 1cm and smaller, WM for larger stones

IBD (Crohn’s Disease and Ulcerative Colitis)- CM except the difficult ones; often a combination of CM and WM will yield the best results

Next time IBS, Diverticulitis and anal conditions.

Looking forward for that!

Contact us today for any further information

Ilan Shahor Acupuncture

Dr Ilan Shahor

 

The Great Med Off 2: Musculoskeletal related pain conditions

In today’s post we are carrying on where we left off last time: trying to compare Chinese Medicine (CM) and Western Medicine (WM), from the point of view of effectiveness of treatment. In this post I am going to discuss a very common group of ailments- musculoskeletal related pain. Musculoskeletal conditions are probably the type of conditions most frequently seen in my Clinic. They are generally very common and are often poorly understood and treated by GPs. Musculoskeletal conditions include any pain that originates from the bones, muscles, ligaments, tendons and joints. Common manifestations are lower/middle/upper back pain, sciatica, neck pain, hip, knee, shoulder and other joints pain. Although there are a lot of different conditions in this category, the general treatment principles for the various Musculoskeletal conditions are pretty much the same (in both Western and in Chinese medicine). We’ll start with Western Medicine.

Generally speaking musculoskeletal related pain is, in my opinion, very poorly understood and treated by WM Doctors. However, in some situations, WM is superior to CM. I’ll try and explain. The WM treatment offered to people in these conditions is the usual sliding scale approach. Let’s take lower back pain as our example. A patient who presents at the GP with this complaint will usually be prescribed a course of painkillers or the so-called anti inflammatory drugs, which are painkillers with a different name. If these don’t achieve the desired results then the next step will be a course of Physiotherapy. Next will be the steroid injection and, if this fails, an operation will usually be offered. This is generally the flowchart with some small variations according to the individual circumstances. Let’s look at it stage by stage.

Stage one: painkillers/anti-inflammatory drugs. The case here is similar to the criminal overuse of antidepressants by GPs. The problem is the same: these medicines do not treat the problems that cause the pain, they only treat the pain itself. The problem here is that since the original condition hasn’t been resolved then the patient will become dependant on their painkillers. The longer the drugs are used the higher the risk of side effects. Possible side effects from the use of anti-inflammatory drugs and painkillers vary from digestive problems to stomach bleeds and kidney failure. Another problem is that after a while the body develops tolerance towards the medicine and its effect lessens. The patient will then need a bigger dose or even another type of medicine (often stronger). It is not unusual for people who struggle with chronic pain to be on two, three, or even four types of medicine to deal with the pain. Of course, the more medicines you take the greater the risk of side effects. I have to clarify here-I am not completely opposed to the use of pain medication. Just as in the case with antidepressants it has its place and should be used in some cases-mainly for short term help and when all else has failed. In any other cases we should surely try and treat the condition with safer and healthier methods and should always aspire to a long term relief whenever possible.

Stage two: If painkillers are found to not be enough then we move to a course of Physiotherapy. Physiotherapy, when it is being done properly, is an important part of effective treatment for musculoskeletal conditions. In the U.K. at the moment, unfortunately, the Physiotherapy available on the NHS is very limited.

Stage three: Steroid injections. A mix of steroids, painkillers and local anaesthetics is injected directly into the painful area. The results are mixed. While in some cases quite a quick reduction in pain can be achieved this tends to be only temporary. Within a few weeks to a few months the pain is often back. The injection can only be repeated two or three times as more than this can start to cause damage to the structure that has been injected.

Stage four: Operation. I am often amazed how quickly patients with musculoskeletal problems are offered an operation to solve the problem. Of course, in some cases an operation is needed. If the cartilage is torn or the joint is completely worn out then no amount of Acupuncture or Osteopathy can help. However, in many cases, operating on a musculoskeletal problem is like using a sledgehammer to kill a fly. Usually there is no need to apply an expensive and possibly dangerous procedure, with questionable success rate, when you can almost always cure the problem with a simple and safe method like Acupuncture.

I am aware that I am generalizing here…there are a lot of different causes of musculoskeletal pain…but the general principle still applies: why use heavy handed methods (painkillers, steroid injections, operation) with possible dangerous side effects when you can sort out the problem with Acupuncture. Acupuncture is extremely safe and very effective in treating most musculoskeletal pain conditions, particularly when the pain is arising from ligaments or tendons, strains or inflammation, arthritic joints and muscle problems. Another major advantage of Acupuncture is that in many cases we can achieve a long term relief and even a cure. Unlike the opinion prevalent among Doctors and Physiotherapists, Acupuncture is definitely not just pain relief. In most cases it can create a better condition for healing by improving blood circulation, relaxing the muscles and reducing inflammation.

So, when it comes to musculoskeletal pain conditions, who is the winner? Western Medicine has the stronger ability to reduce pain with powerful pain killers. It can also replace the whole joint when the old one is beyond repair. However, in the great majority of musculoskeletal pain conditions Acupuncture will be more effective, much safer, and will achieve long standing results without developing a dependency on the treatment. It’s also important to say that in some situations a combination of Western and Chinese medicine will achieve the best results.

In the next post I’ll be concentrating on Gastrointestinal conditions. I will discuss Inflammatory Bowel Diseases such as Crohn’s Disease and Ulcerative Colitis as well as IBS (Irritable Bowel Syndrome) and others. I am looking forward to this one as it is going to be a particularly interesting one. Now I just have to find the time to write it!

Best of health to everyone.

Dr Ilan Shahor

The Great British Med Off

In today’s post I will try and embark on the very complicated task of comparing Chinese medicine and Western medicine. Having qualified and practised in both disciplines I think I am in a good position to do so. The subject is vast, it’s multifaceted with different layers to it. It can easily fill a book or two. As usual, I am going to try and simplify matters. I will try and focus on the practical aspects: which discipline is likely to be more beneficial in which condition; what are the pros and cons etc. The next few posts will be dedicated to this comparison with a different group of conditions in each post.

However, before starting with all of this I would like to stress a very important point. In many cases it is not necessarily one type of therapy or the other which will reap the most benefit but a combination of both. In China, Chinese and Western medicine are working effortlessly in harmony side by side. Chinese medicine practitioners are also trained in Western medicine and vice versa. There is an understanding of the pros and cons, the strengths and weaknesses and, most importantly, the limitations of each discipline. A Western medicine practitioner, in China, won’t hesitate to refer a patient for a course of Chinese medicine treatment on occasions where they feel it will be beneficial. A TCM (traditional Chinese medicine) practitioner, on the other hand, will be able to identify the cases which require Western medical intervention.

Let me give you an example of how it works in practice. A stroke is a very common condition. It can have a devastating effect on the patient. In the West, from the people who survive a stroke, 33.3% will recover completely, 33.3% will partially recover, that means they will have some residual paralysis, and 33.3% will stay fully paralysed. Western medicine has no means to affect or improve this outcome. In China, however, the treatment for a stroke is a beautiful demonstration of the possible cooperation between TCM and Western medicine. A patient with a stroke will be rushed firstly into a Western medicine ward and will normally stay there for a few days only. After being assessed by the doctors as being in a stable condition, the patient will be transferred into a rehabilitation unit. On that unit most of the methods used for rehabilitation are TCM methods, namely: Acupuncture, Chinese herbal medicine and tuina (physiotherapy of Chinese medicine). The full recovery rates on these units is around 80%!! This demonstrates how Western and Chinese medicines can (and should) work beautifully together. Soon after the stroke, at the early stage, Western medicine is essential. In a small portion of patients emergency surgery will be needed. Chinese medicine can’t help those patients at that stage. In the later stage, however, the rehabilitation is the important factor and that is where Western medicine can’t help much but Chinese medicine can!

The question that naturally arises is why can’t it work like that in our health system? After all we all want as successful an outcome as possible for the patient. The answer is that, unfortunately, when it comes to openness towards and awareness of other treatment options we are miles behind the Chinese. Whilst TCM practitioners qualified in this country have a good knowledge and understanding of Western medicine basics and in particular of “red flag symptoms” (symptoms that may indicate a serious medical condition and therefore require a referral to a doctor), Western medicine practitioners haven’t got a clue about TCM and what it can do. There is still a complete ignorance regarding the issue and that is a great shame!

However, we can’t keep digressing from our main issue: the Great Med Off! I would like to start with the treatment of cancer. It is by far the most asked about condition in my Clinic. Can Chinese medicine cure cancer? The answer to this question is, unfortunately, in most cases, no. Chinese medicine is extremely good in fixing body systems that are malfunctioning but if there is a lump of cancerous growth in the body then it is just not strong enough. I have heard about cancer cases which have been cured or at least been improved with TCM treatment but these were all in China, in a very specialist clinic using very strong herbs (mainly animal products) which are not available to us in the UK. The bottom line is that, despite the obvious shortcomings of the Western medicine treatment for cancer (severe side effects), I still usually recommend to those who ask me to keep on with the Western medicine treatment, particularly in cases where there is a chance of a cure.

Chinese medicine, however, still has an important part to play in the treatment of cancer. On my last trip to China I saw a presentation of a big study of the treatment of cancer by a combination of TCM and Western medicine. In that study breast cancer patients were divided into two groups. One group had received the traditional Western medicine treatment of an operation and chemotherapy or radiotherapy. The other group received the same treatment and in addition they received TCM treatment that included acupuncture, Chinese herbal medicine and a form of exercise (QiGong or TaiChi). The results were: a) a dramatic reduction in the side effects from the Western medicine treatment and a significant increase in the quality of life in the combined Western and Chinese medicine therapy and, more surprisingly, b) a 30% increase in the survival rate in the combined treatment group! So again I would say combine if you can. The problem is that it is becoming harder and harder to combine Chinese medicine in the treatment of cancer in this country. In the past I used to treat people who were going through chemotherapy and radiotherapy with acupuncture and herbal medicines. Those treatments were very successful. The patients used to suffer much less from side effects and felt generally better. They used to go through the treatment with much less problems including less bone marrow suppression (which causes a fall in white blood cell count and often forces the doctor to stop or to reduce the chemotherapy!). It was common for my patients to report that the doctors asked them how they were staying so well. Recently, unfortunately, more and more treatment centres tell their patients not to take any other treatment during the chemotherapy. The reason given is that they don’t want anything to interfere with their treatment. This policy comes out of the ignorance of Western Medicine Doctors regarding Chinese medicine. The doctors are probably too busy to check out the available research. Again I think that it’s a great shame. So when it comes to cancer I will say definitely combine if you can but if I had to choose a winner then it is Western medicine due to its better ability to deal with tumours and an overall bigger chance of a cure.

Next in our Great Med Off are skin conditions. I chose it to follow the cancer section probably due to my need to balance things up. After giving the advantage to Western medicine regarding cancer treatment, when it comes to skin conditions then Chinese medicine is a clear winner. Skin conditions like eczema, psoriasis and acne are common, usually chronic, and very poorly treated by Western medicine in my opinion. The Western medicine approach to treating these conditions is suffering from the usual problem: it only treats the symptoms. The first line of treatment is usually with creams, mainly creams containing steroids. On the one hand these are quite effective and will clear most types of skin lesions. The problems start when we stop using them. The condition is likely to come back. A long term use of steroid cream will damage the skin and is therefore not recommended. The use of steroid creams can therefore only be recommended in light and self limiting conditions and is usually not effective in the chronic condition. The second line of treatment is with steroid or other Immunosuppressant drugs. The dynamic there is similar to the use of cream. These medicines will often be very effective in clearing the skin condition. However, the condition will be almost certain to come back, at least as bad as it was before the treatment, when we stop the medicine. A long term use of these medicines will cause serious side effects such as kidney or liver failure, diabetes, atherosclerosis and others.
The only cases where I support the use of steroids or Immunosuppressant drugs in skin conditions are those where the condition is extremely severe and other treatments have failed.

The Chinese medicine approach for skin conditions is different. It has a good understanding of the reasons and causes of these diseases. Treatment with Acupuncture and Chinese herbs is directed towards the cause of the symptoms as well as the symptoms themselves. With chronic conditions the patient will have to be a little patient as the treatment may take a few months but the results are usually excellent and long-lasting. (For a more detailed explanation as to how Chinese medicine can understand and treat skin conditions please go to the conditions section in my website.)

In my next post I am going to discuss musculoskeletal conditions, digestive system problems and psychiatric conditions with the pros and cons of Western medicine and Chinese medicine regarding the treatment of these areas. Which one will come out on top? The answers are all in my next post.

Good health for everyone.

Dr Ilan Shahor