Why Chinese medicine and acupuncture is not always enough

May 7, 2007

Yehuda

I agree with everything you said and practice integrating all of these

approaches. That said i have plenty of pt that are simply not willing to do such

comprehensive approaches. Others simply think they have their nutrition under

control because they take what ever they do. Dealing with food allergies and

sensitivities is not always simple as from what i have seen only a good

elimination diet is accurate, although i do use some testing. Heavy metal detox

can take a long time and i have seen mix results in doing so as well as having

pt willing to complete programs. I am not sure why you emphasize zinc as all

minerals are extremely important especially with BP. As far as genetics i think

it depends on the genetic condition. Some diseases are so strongly genetically

determined that it is by far the dominating factors in others it is only a

factor among many other factors.

-

yehuda frischman

Monday, May 07, 2007 12:00 AM

Why Chinese medicine and acupuncture is not always enough

Dear Alon,

Please allow me to expand upon and clarify my previous post: Although it is

true that a good technician will have a relatively high degree of success, it is

my opinion based upon intuition and experience that for a higher degree of

success, other very important criteria need to enter into the treatment plan.

First of all is consider what the patient may be doing wrong to exascerbate

their condition. That could include allergies and food sensitivities (which

cannot be underestimated and certainly manifest a degree of an inflammatory

response), exposure to heavy metals or chemicals, poor diet, poor lifestyle

habits, and addictions (including food, sugar, caffeine, alcohol, drugs,

pornography, adreneline, etc), and parasites. Second, don't underestimate the

impact that traumas have on virtually everyone. Living in an unnaturally

stressful world forces every person I have ever met to adapt, in order to

survive. It is our ability to release and completely let go of

those traumas which are unbearable, that makes the difference between

surviving and flourishing. Also, just because someone is efficient, can

multi-task, thinks quickly, is charismatic and makes a powerful impression,

doesn't mean that they are succeeding and flourishing. There are lots of folks

out there who are wonderful performers, but who are miserable inside, and

candidates for autoimmune dis-ease, which, IMO, often results from sympathetic

hypertonicity (repeatedly not allowing oneself to rest after being in

fight-or-flight). Third, consider biochemical deficiencies. As far as

hypertension is concerned, two nutrients come to mind: Zinc and essential fatty

acids. I had a patient, an athlete, who, after receiving acupuncture,

craniosacral therapy and herbal formulae, was feeling great. He was highly

motivated and was doing everything right, but just one problem: His blood

pressure remained dangerously high, and he refused to use western drugs. . Then,

after treating him for 2 months, I asked him about his diet, and lo and

behold, it was completely lacking fat. I told him that I wanted him to eat

minimally 1 avocado a day, have at least one portion of fish daily, and take a

tablespoon of hemp seed oil twice daily. Miraculously, within a week, his BP

dropped from 160/110, to 125/ 80 and it has pretty much stayed there. I have

another patient who is in constant fight or flight. Really strung out. From what

I have read Zinc is depleted by stress, and Zinc deficiency causes the arteries

harden, become brittle and often inflamed instead of soft and flexible. This

loss of flexibility will raise BP, especially systolic pressure. It is very easy

to test for Zinc deficiency as well: Metagenics makes a wonderful product called

Zinc Tally. It is Zinc Sulfate in distilled water. To test for Zinc deficiency,

simply have the patient take a teaspoon of the Zinc Tally, hold it in the mouth

for 30 seconds and then swallow

it. If the patient is deficient, the liquid will taste like water, tasteless.

But is the patient has sufficient zinc, they will have a metalic, unpleasant

rusty taste in their mouth. Anyway, I tested this patient weekly, and only now,

after 2 months of supplementing with 20 mg of zinc twice daily is she just

starting to taste ever so slightly the zinc tally. Meanwhile, she is noticing

that her sense of smell has dramatically heightened, and though BP is not an

issue for her, it certainly should be considered when herbs and acupuncture

don't make an impact. In all cases, the key is integration. As I have said

frequency, we need to address the patient biochemically, biomechanically and

bioenergetically.

Concerning genetics, my experience is that predisposition does not necessarily

mean predestination. The greatness of the human species is our ability to

change, and just because parents and grandparents had a condition, though one

indeed has a predisposition for it, absolutely does not doom them to that fate.

There you have it. You may still disagree with me, but at least you know what

I would do. But I feel that even if you are doing everything right, you still

might be overlooking an important detail.

Respectfully and with friendship,

Yehuda

Alon Marcus <alonmarcus wrote:

Yehuda

i was not talking about acupuncture but CM. The pt i followed in china were

mainly treated with herbs although some also did acup and qi gong. Emotional

trauma was certainty not addressed, at least were i was and at the time i was

there 1985. My interest in medicine is interventions that work on the majority

of the population. I do not think many are interested or have the time to deal

with their emotional traumas to lower their blood pressure, unless they suffer

emotional pain. I am a good example, I have genetic metabolic syndrome with

hypertension. I am willing to change my diet to some extent which is difficult

because i eat out more than i do at home. I train in aikido 3-4 times a week so

i do get some physical activity. I am willing to take herbs although i would

probably not be willing to cook formulas for extended periods. My attitude is

even more cooperative than many of the pt i see. So when talking about any

treatment i think it must be realistic. I have been

trying to use alternative methods for about 4 months or so. So far my blood

pressure is reduced but not enough to be in the recommended levels which are now

at 120's/70's. I have been taking combinations of powders and pills (with

attention to multiple patterns) as well as some of the more popular nutritional

approaches. Obviously this was not done in a " vacuum " although it would be nice

to have the time to get regular acup which i do not. Looking at current

evidence, keeping blood pressure at the recommended levels makes a big

difference in prognosis so what is a person like me to do. I could give it more

time but i am probably damaging my heart and kidneys by having a higher blood

pressure.

Finally, as i said before i do not see many pt for blood pressure in my

practice so my US experience is limited to what i saw in school, following some

of the most well known practitioners in the US as well as my training in China.

From this experience when a pt asks me about treating hypertension at this point

i tell them that TCM does not predictably lowers blood pressure and i have seen

more failures than successes. I have seen many pt being able to reduce dosage of

their medicines. However the question is if they do not have much sideeffects

does that make much sense because it takes time and costs money.

-

yehuda frischman

Saturday, May 05, 2007 11:54 PM

Re: Acupuncture no better than sham in hypertension - SHARP

Trial

Dear Alon, Jason, Z'ev, Phil, Todd and all,

I feel very strongly that it is foolish and short-sighted to consider that

using simply a " tool " such as acupuncture alone is going to resolve a condition

such as hypertension. Hypertension as with virtually every other condition is a

manifestation of any number of patterns (eg. yin vacuity, liver fire, phlegm

fire, liver yang rising, etc) along with so many other factors such as genetic

predisposition, dietary indescretions, substance abuse, physical and emotional

traumas, etc. To successfully resolve it, we must take a comprehensive approach,

and any successful practitioner does just that. That means addressing the

patient's imbalances biochemically, biomechanically and bioenergetically, as

well as eliminating counterproductive behavior and lifestyle, sources of

toxicity,and addressing emotional traumas. High blood pressure does not occur in

a vacuum, and it is ridiculous to say that acupuncture is ineffective in

treating it, any more than it is ridiculous to say

that eating only organic produce will prevent liver disease or digestive

disorders.

Sincerely,

Yehuda

Alon Marcus <alonmarcus wrote:

Jason

That would have been my next question, what was the BP to start with. I have

not treated to many BP pt but i have not seen much reduction in pt with

pressures about 150/100 i have seen changes in mild cases. In china i have

followed some 100 cases with high BP and i cant say i saw one pt that had such

BPs manage them with herbs alone

-

Saturday, May 05, 2007 7:12 AM

RE: Acupuncture no better than sham in hypertension - SHARP

Trial

Alon,

Not sure, quite a few. But I guess we must clarify things, many must continue

taking herbs / receive acupuncture. Most are on custom formulas, but I actually

have 2 patients that are completely managed with Tian Ma Gou Teng Yin (pre-made

granules). One of them needs only 6 capsules a day. (That is 3 grams or 3

scoops) in addition to her custom herb formula (osteoarthritis of the knee â? "

which is completely managed) (6 caps a day) - it took 1 week for it to start

working. Another I am thinking of was interesting because due to my poor intake

I had no idea they had HBP and just treated the CC (GI). They reported back a

couple months later and said that their BP had gone down dramatically (this was

a modified bulk san ren tang).

I myself had essential hypertension years ago, did raw herbs steady for 6

months and it has now been gone for years. I have a family history, so we will

see with timeâ?¦ It seems like in most people, with a little tweaking you can

get things under control. If the BP is too high already, you can get a reduction

of meds but these people usually have many other problems as well. What are

otherâ?Ts experiences?

-

_____

On Behalf Of Alon Marcus

Friday, May 04, 2007 10:09 PM

Re: Acupuncture no better than sham in hypertension - SHARP

Trial

Jason

Out of curiosity how many pt with essential hypertension have you treated

successfully?

-

@ <%40>

Friday, May 04, 2007 8:58 PM

RE: Acupuncture no better than sham in hypertension - SHARP

Trial

I agree with Zâ?Tev here 100%. There is no doubt CM has the ability to work

(for HBP and many other conditions). Just because a modern cookbook style TCM

approach may be found ineffective in some research, does not mean that CM cannot

treat that disease. Do you know how many approaches one could find for any given

complaint / condition. This is just with herbs. But in regard to acupuncture,

just putting a needle in IMO is far from â?orealâ? acupuncture, therefore any

standardized point (or herbal) prescription is a crap shoot either way (if it

will work or not). We love to jump up and down when it does work and laugh (or

cry) when it doesnâ?Tt. But clearly no one practices this way, or at least the

practitioners that I respect and the ones that I see get bomber results. So why

perform research in a way that the medicine is not practiced? IMO there is only

one way to research CM, the way it is practiced (with placebos and all) â? " Put

it as a whole, straight up against what

ever your testing.

IMO, â?oTrueâ? CM in practice literally relies on its ability to see the

individual and customize treatments. This is not some clichÃ© holistic mumbo

jumbo, but clearly demonstrated in the CM literature by anyone who has spent

time reading pre-modern or modern case studies. Clearly it is my experience, and

doctors that I have followed, that it can effectively treat the very difficult

diseases. Not just musculoskeletal. To judge CM with some base sample

prescription (with some mods) is just not how the great doctors (that I have

observed or read about) practice. It is comparing apples and oranges.

Over simplification? Just because the current trend in China is to modernize

and simplify the medicine with standardize protocols etc does not mean that

practicing in an (opposite) individualized fashion doesnâ?Tt work, X does not

negate Y. Quite frankly it is very hard to practice at the level that really

makes use of all information (past and present) and writes individualized

formulas, essentially practicing CM the way it is designed to. So why is China

doing what they are doing? This is a complicated question and answer. But China

is currently teaching to the masses, never before done like this. One school I

recently visited (ZheJiang) had over 10,000 students enrolled. (BTW- only around

33% of them end up practicing, most looked like they for 18-20 years old, oh,

they were).

This western modernization has little to do with effectiveness, there are many

factors, including economics (as always). Why are McDonalds popping up all over

China? Training in China has many problems like we do.

To put thing in perspective, one has to look where much of the research, that

for example Bob has extensively published, comes from. For example, for a PHD

thesis many students decide to do some easy research project, taking some base

prescription with mods etc and putting it to the test for a given disease. Just

like what we commonly read in the journals. When I was talking with the students

they said, yes it is easy, you can be done in a few months. This is great for

the many who just want there PHD and be out. The alternative is doing some

classical literature research (or whatever) which can take years. Granted this

(former) type of research can result in the newest and greatest patent for

disease X, which does happen, but come on, this is not the in the trenches

medicine. Granted there are all levels of doctors, there are those that just

give xiao yao san over and over, but again let the results speak for themselves.

Judging the medicine on its lowest common

denominator makes little sense to me.

Not to toally bash the Chinese, because they have 1 distinct advantage. The

student who does want to break out of the box has almost unlimited resources

compared to us. There are old doctors to study with, TCM libraries that I

estimate are over 1000x bigger than the average school US TCM library to access

material. There are young doctors that are totally rebelling against this modern

trend and are very vocal about it!

Addressing Toddâ?Ts 15 year observations: Do you think it is fair to gauge how

well the medicine performs by years of watching students in a western school

clinic? I have much respect for Todd and his herbal abilities, but in the three

school clinics I have been in, I can only laugh at the level of medicine. I am

not saying I am any better and I was at one time one of those fumbling students.

But putting a 75 year old Chinese doctor to the test makes much more sense then

concluding that CM doesnâ?Tt work from meager observations, especially with the

relatively poor level of practice that goes on in the states (at least herbal

medicine). Even supervisors prescriptions in the school clinic are not a fair

judge, they rarely spend much time with patients and rely many times of the

students observations and perspectives.

There are many levels and CM has a black hole of knowledge if one desires to

access it. It is not easy, but testing simflied approaches (the way that is

happening) is just Western medicine testing CMâ?Ts tools, not CMâ?Ts thinking!

Finally, because of all of this, I think standardization is a double edged

sword, and the many Chinese I have spoke with agree. It is a complex arena and

many differing opinions. There are many ideas and articles on the subject.

-

_____

@ <%40>

[@

<%40> ] On Behalf Of Z'ev

Rosenberg

Friday, May 04, 2007 5:31 PM

@ <%40>

Re: Acupuncture no better than sham in hypertension - SHARP

Trial

Ah, that's too bad, I guess I'll have to tell my patients I've helped

with hypertension over the years that it didn't really work. Also,

I'll have to tell all the patients I've treated over twenty-five

years with menstrual disorders, insomnia, digestive problems, and

other conditions that acupuncture only treats musculoskeletal disorders.

On May 4, 2007, at 2:28 PM, (AT) comcast (DOT) <%40comcast.net> net

wrote:

> shocking. in 13 years of practice, I never saw any sustained

> decrease in BP from the typical regimen of any form of acupuncture

> plus patent meds that could not be explained by other concurrent

> changes such as diet and exercise. Not just talking about myself,

> but also the patients seen by dozens of others supposedly skilled

> px in school clinics. Even high does herbs are not very effective

> and I was always dismayed to learn how many senior herbalists from

> China took BP meds as they aged as a result. sadly, I predict

> controlled evidence will ultimately show that acupuncture is good

> for some musculoskeletal problems and herbs for a wide range of

> minor complaints. But this medicine is not going to turn out to be

> the salvation of the world. If you really could cure things like

> hepatitis or lupus with TCM, the chinese would be making hay out of

> it instead of racing headlong into their embrace of modern science

> and cutting edge therapies like stem cells. Chinese med is a nice

> safe alternat

> ive to the drugstore for many of the minor things that ail people.

> no miracle cures hiding anywhere.

>

> -------------- Original message ----------------------

> " " < (AT) tinet (DOT) <%40tinet.ie> ie>

>> Hi All,

>>

>> Bad news: the SHARP trial reported no benefit from AP over sham AP in

>> treating hypertension (BP: systolic 140-179mm Hg; diastolic

>> 90-109mm Hg).

>>

>> I have not been able to access the full text but the abstract is

>> below:

>>

>> Hypertension. 2006;48:838.) ï¿½ 2006 American Heart Association, Inc.

>> Original Articles Stop Hypertension With the Acupuncture Research

>> Program (SHARP) Results of a Randomized, Controlled Clinical Trial

>> Eric A.

>> Macklin; Peter M. Wayne; Leslie A. Kalish; Peter Valaskatgis; James

>> Thompson; May C.M. Pian-Smith; Qunhao Zhang; Stephanie Stevens;

>> Christine Goertz; Ronald J. Prineas; Beverly Buczynski; Randall M.

>> Zusman

>> From the New England Research Institutes (E.A.M., L.A.K., S.S.),

>> Watertown, Mass; New England School of Acupuncture (P.M.W., P.V.),

>> Watertown, Mass; Childrenï¿½s Hospital Boston (L.A.K.), Boston, Mass;

>> Massachusetts General Hospital (J.T., M.C.M.P.-S., Q.Z., B.B.,

>> R.M.Z.),

>> Harvard Medical School, Boston, Mass; Samueli Institute (C.G.),

>> Alexandria,

>> Va; and the School of Medicine (R.J.P.), Wake Forest University,

>> Winston-

>> Salem, NC. Correspondence to Eric A. Macklin, New England Research

>> Institutes, Inc, 9 Galen St, Watertown, MA 02472. E-mail

>> EMacklin@NERIScienc <EMacklin%40NERIScience.com> e.com Case studies

and small trials suggest that

>> acupuncture may effectively treat hypertension, but no large

>> randomized

>> trials have been reported. The Stop Hypertension with the Acupuncture

>> Research Program pilot trial enrolled 192 participants with

>> untreated blood

>> pressure (BP) in the range of 140/90 to 179/109 mm Hg. The design

>> of the

>> trial combined rigorous methodology and adherence to principles of

>> traditional Chinese medicine. Participants were weaned off

>> antihypertensives before enrollment and were then randomly

>> assigned to 3

>> treatments: individualized traditional Chinese acupuncture,

>> standardized

>> acupuncture at preselected points, or invasive sham acupuncture.

>> Participants received 12 acupuncture treatments over 6 to 8 weeks.

>> During

>> the first 10 weeks after random assignment, BP was monitored every 14

>> days, and antihypertensives were prescribed if BP exceeded 180/110 mm

>> Hg. The mean BP decrease from baseline to 10 weeks, the primary end

>> point, did not differ significantly between participants randomly

>> assigned to

>> active (individualized and standardized) versus sham acupuncture

>> (systolic

>> BP: -3.56 versus -3.84 mm Hg, respectively; 95% CI for the

>> difference: -4.0

>> to 4.6 mm Hg; P=0.90; diastolic BP: -4.32 versus -2.81 mm Hg, 95%

>> CI for

>> the difference: -3.6 to 0.6 mm Hg; P=0.16). Categorizing

>> participants by

>> age, race, gender, baseline BP, history of antihypertensive use,

>> obesity, or

>> primary traditional Chinese medicine diagnosis did not reveal any

>> subgroups

>> for which the benefits of active acupuncture differed

>> significantly from sham

>> acupuncture. Active acupuncture provided no greater benefit than

>> invasive

>> sham acupuncture in reducing systolic or diastolic BP. Key Words:

>> acupuncture o blood pressure o hypertension o randomized clinical

>> trial o

>> traditional Chinese medicine

>>

>> Best regards,

>>

May 7, 2007

Alon,

You hit the nail on the head: What percentage of patients are willing to

comply and make significant changes to their lifestyles. I would venture to say

a minority. Usually it takes a crisis such as a life threatening illness to

wake them up. Otherwise, people prefer a bandaid and keep on going, not

listening to the warnings their bodies give until more serious illness presents

itself. About genetics--DNA can be changed and I stand by what I said,

predisposition is not predestination. I believe that this is one very exciting

area where science and research can be married to the holistic medicine and can

potentiate healing, using a combination of stem cell research together wilth

lifestyle changes. I specifically mention zinc of all the minerals, because it

is specifically depleted by stress, and is so easy to test for.

All the best,