Tag Archives: Chinese medicine

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

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

About Chinese Medicine Part 2: So how does it all work?

Today I will set about the complicated task of trying to explain the logic behind Chinese Medicine, or How It All Works. I use the word complicated, not because the logic itself is complicated, in fact it is all based on very simple and practical principles. However, to explain it to someone with no formal knowledge of TCM can be tricky. I remember the first time I was battling with TCM theories. It was during my TCM course with the Beijing University. We were all medical doctors and we all struggled. It was very hard for us to comprehend what the lecturers were saying. It was completely different from everything that we knew (and remember most doctors think they know most things there are to know about human health). The main problem was that we heard about Qi and Yin and Yang, heat, cold, dampness and what happens when these are out of balance. It sounds initially like a dry list of statements that didn’t make much sense,it was like reading out of telephone directory. How do you know? Where is the proof? What makes you think that all of this is actually true? We all felt a bit uncomfortable, with some of us probably questioning the wisdom of paying out good money for attending the course.

This heart-sinking feeling started to gradually change when we began to see patients. All of these seemingly dry and abstract theories (for modern doctors) started to come to life. We could actually see then that the Yin deficient patients were getting hot and dry mouthed at night for example, and that the patients with excess dampness felt heavy, bloated and sluggish. The Qi deficient ones were tired and their speech sounded like they were straining to get the words out of their mouths. The blood deficient ones were pale and a bit dizzy; the liver stagnation patients were emotional and impatient and so on. It all started to make sense. We started to realise that all of these TCM theories are based on careful and patient observations, and are based in reality. The warming up of our attitude towards the TCM theories further strengthened when we noticed the night heat and dryness had improved when the patient was treated for the Yin deficiency; the mood swings and irritability had disappeared when the liver stagnation had been attended to, and so on. Brilliant, I thought; as I keep on telling my patients-the proof is in the pudding. I have never looked back since.

In the beginning, however, it was all a bit difficult to understand so I will do as I always do and try and simplify TCM for you. So, where shall we start? I think that the two most important principles in maintaining health according to Chinese medicine are flow and balance. Flow refers to the flow of Qi (body energy), blood and body fluids. Balance refers to the balance between Yin and Yang, heat and cold, dryness and dampness and excess and deficiency. As long as free flow and balance are maintained in our bodies then all is good; we feel well and are not suffering from any ailments or symptoms. However, if the flow is blocked or disturbed, or if the balance fails to be maintained, then problems will start. These problems can be on the physical, emotional or mental levels. I will explain in more detail, starting from the flow. The most important flow is the flow of the Qi. Blockage of this flow will result in pain that is usually dull or throbbing in nature. A common example of pain from the stagnation of Qi is the abdominal pain suffered by some of the IBS (irritable bowel syndrome) sufferers. On some occasions the flow of Qi is not blocked but just disturbed. A very common example of that is when the liver Qi flow is disturbed usually following stress or worry. The resulting symptoms will be mainly emotional such as mood swings and irritability. The Qi is needed for all the body functions and therefore a disturbance in its flow can be followed by symptoms in different systems of the body. It will usually start to cause a problem in the weakest area in each individual. Problems with the flow of blood will also primarily manifest as pain. Pain from blood stasis will typically be sharp and stabbing in nature. Blood is most important in women and most gynaecological problems are related with blood circulation problems. Examples are endometriosis, PCOD (polycystic ovary disease), infertility and painful periods.

The flow of blood is also essential in the healing process of wounds and traumatic injuries. It is quite astonishing to see how quickly traumatic injuries are healed when treated with Acupuncture and herbs to improve blood flow.Another example is non-healing ulcers. These are typically occurring in diabetics and old people and are the result of poor blood circulation that prevents healing.These patients will have to go to the GP clinic two or three times a week to change the dressing on the wound/ulcer but there is not a prospect of it healing. However, if it is treated with Chinese herbs that improve blood flow then the wound/ulcer will heal within a few weeks!

The flow of body fluids is also very important-we are 70% water. Still, normally, we don’t feel that damp. However, if the normal flow of fluids around the body is disturbed then problems will start to manifest. These types of problems can manifest in different systems of the body. A few common examples are: digestion problems such as bloating and diarrhoea, oedema, skin conditions like eczema and psoriasis, joint problems like arthritis, thrush and others. So, maintaining the free flow of Qi, blood and body fluids is very important. As long as they flow then all is in working order.

Now, what about balance? We mentioned Yin and Yang, heat and cold, dryness and dampness and excess and deficiency.First Yin and Yang, this blog is too short, of course, to explain the Yin and Yang concept properly. It’s a bit tricky to understand and I have met a few practitioners who still struggle with it but I’ll try to explain. Yin and Yang are the two opposite aspects of any energy. They contrast but co-exist and are co-dependant. Everything in nature has a Yin and Yang aspect to it. The famous Yin and Yang symbol (see picture) symbolises this co-existence. It shows two separate powers creating the whole. The little dot represents the small amount of Yin within the Yang and vice versa. They are co-dependant and nourish each other. Yang is hot and fiery and rising upward and Yin is cool and watery and going downwards and so on. So what does it all mean to human health? In the human body the Yin and Yang have to be operating in perfect balance. Any change from this balance will start to manifest as physical symptoms e.g. if the Yin energy is weak then the person may feel hot, particularly at nights-night sweats are possible, dry mouth, or general dryness and sleeping difficulties. It’s like our coolant and moisturising fluids are missing. The Yin deficiency symptoms tend to be more prominent at night as night is normally the time when the Yin is predominant whilst the Yang is predominant during the daytime. The most common example of Yin deficiency is the menopausal age. At this age the woman experiencing a sudden drop in the Yin energy results in symptoms of night sweats, dryness and so on. These women, by the way, will respond wonderfully well to a course of treatment to strengthen their Yin energy. When the Yang energy is low, the patient will feel cold and tired. Low libido, sexual function and difficulties, and water retention are common as well. The deficiency of Yin or Yang can be general in the body but can also be limited to a specific organ e.g. asthma arising from lung Yin deficiency will typically manifest as wheezing with a dry cough and a dry throat whilst asthma arising from a lung Yang deficiency will more often manifest with wheezing with a cough with a large amount of phlegm obstructing the airways. The picture can be a bit more complicated when there is a mix of Yin and Yang deficiency but an experienced TCM practitioner should be able to make the right diagnosis and apply the right treatment!

The second type of balance that needs to be maintained in order to promote health is dampness and dryness. Our body needs to be in a perfect level of humidity throughout all the different tissues and organs. We are made of 70% water and yet we normally don’t feel watery. That is due to this perfect working balance of the fluids within us. What happens if this balance is disturbed? We start to struggle. This can happen in certain areas of the body (e.g. digestive system) or within certain systems (e.g. joints) or it can be general in our body. An added complication to these conditions is that when fluids start to accumulate in the body they often turn from clear healthy fluids to more thick heavy and sticky fluids, termed by TCM as damp. Damp is a major pathogen in TCM. It commonly arises as a side product of ineffective digestion and is found to gradually accumulate and spread in the body. It’s common in modern day due to rich and often unhealthy diet and eating habits, often combined with being under pressure and with a weakened digestive system. When it accumulates it can cause problems in different systems of the body e.g. abdominal pain, bloating and diarrhoea, arthritis and asthma. Heaviness and stiffness are common.
The opposite of dampness is dryness. In these situations the organs and tissues are suffering from a lack of moisture. This situation can arise from the presence of heat which dries the tissues, from problems in the body water distribution system or pathway or from lack of Yin ( remember, the energy that keeps us cool and moist). A common manifesto can be constipation with dry stools, dry skin conditions like eczema, and lung conditions like asthma.

The third balance is the one between heat and cold. The temperature has to be right all over the body to sustain good function. As is the case with other elements, heat and cold can affect one area of the body or be generalised all over the body. Some of us are naturally colder and will be more susceptible to cold related problems, and vice versa with the naturally hotter people. In some cases we can have a mixed picture where in certain parts of the body there is too much heat and in others too much cold. This can make treatment a bit tricky and an accurate diagnosis is essential here. The most common symptom from excess cold is pain. It is commonly in joints (the ones that get worse on a cold day), in the digestive system or in the gynaecological system. Heat problems are very common these days. Generally speaking, a rich diet and stress are to blame for that as both tend to generate excess heat in the body. Excess heat is a common cause of most skin conditions, inflamed joint conditions like gout, most types of migraines and many others.

The balance between excess and deficiency is very important but is also a bit hard to explain. Generally speaking the practitioner has to decide, in any one case, are the symptoms a result of the patient lacking in something or having too much of something. In other words, what is causing the imbalance-too much (excess) or too little (deficiency)? For example, the patient is feeling too hot-is that a result of too much heat in the body or is it a result of a deficiency in the Yin energy which is the energy that keeps the body cool? The patient feels a lack of energy – is it a deficiency in his Qi energy or is it a result of dampness clogging his body and making him feel heavy and sluggish? Correct diagnosis is absolutely essential and getting it right is more than halfway towards successful treatment.

Alongside free flow and balance, there is one more critical aspect of Chinese Medicine, which I have not yet discussed with you: the function of the body organs.

One of the most amazing insights of TCM into the human body is the understanding of the subtle function of the organs. Try and tell a doctor that the heart is responsible for our sleep and our mental ability and he will think that you are tripping on something! The heart is just a muscly pump which pumps the blood around the body, he will say. A similar bemused reaction will follow the claim that the liver is in charge of our emotional functions and is of crucial importance in conditions like depression and anxiety. Modern medical science knows only about the physical and chemical functions of our organs but unfortunately has no idea about their subtle functions! Understanding the function of the different organs, particularly of the heart, kidneys, lungs, liver and spleen ( in TCM the concept of spleen includes the pancreas, the duodenum and the small intestine) is essential for successful diagnosis and treatment.

In reality, of course, humans are not simple and often symptoms will arise of a combination of two or more of these imbalances. For example, stress can disturb the flow of the liver Qi which will often affect the spleen; a weak spleen will cause inefficient digestion which will result in an accumulation of dampness. The dampness can clog the flow of Qi and so on. In my clinics I often see cases which are very complicated, many systems are involved and imbalances are intertwined.
The longer you leave the problem without treating it the more complex things tend to get. The reason for this is simple: when one area or system starts to malfunction it inevitably puts pressure on other areas or systems of the body; after all, they are all connected and intertwined in the great living work which is our human body. It is very important therefore for the TCM practitioner to have a deep understanding of the subtle workings of the body and of the different pathologies that may affect it. An accurate diagnosis is key to a successful treatment.

I hope this post makes TCM a bit more understandable. It is about a fully established and very effective form of medicine and it’s important to me that people understand more about it.

In my next post (or maybe few posts since it’s a big subject) I am going to compare Western and Eastern medicine in their philosophy, understanding and methods. That is, I am going to try and look at how they compare in treating different conditions.

Good health to all of you,

Dr Ilan Shahor

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

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

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

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

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

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

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

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

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

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

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

Have a good week,

How much does Medical Science actually know?

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

Best of health everyone,

The Pain

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

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

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

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

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

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

Hormone Replacement Therapy – The consequences and the alternatives.


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

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

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

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

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

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

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

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

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

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


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

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

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

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

1) Yin deficiency and heat

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

2) Yang deficiency and cold

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

3) Kidney Qi deficiency

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

4) General Qi deficiency

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

5) Blood stasis

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

6) Qi stagnation

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

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

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

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

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


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


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


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


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

1) Anovulation

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


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




2) PCOD (Polycystic ovary disease).

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

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




3) Blocked Fallopian Tubes

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




4) Auto Immune Conditions

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

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



5) Male Factors

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




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