Jun
15
2013

Electro-Acupuncture Is Twice As Effective As Conventional Acupuncture

I am discussing here that electro-acupuncture is twice as effective as conventional acupuncture. Imagine that you had lower back pain and your doctor said that physically everything was OK. Would you consider traditional Chinese acupuncture? According to Ref. 1 chances are that 70% of patients with back pain will get better with a few visits to an acupuncturist. In 1972 Dr. Ulett’s laboratory at the University of Missouri succeeded in getting the first NIH research grant for the study of acupuncture in the US. During these studies they found remarkable facts, the most important perhaps that electrical stimulation of acupuncture needles resulted in a doubling of the effectiveness of traditional Chinese acupuncture. After extensive research Dr. Ulett stated: ”The ancient practice of traditional Chinese acupuncture is now obsolete” (Ref.1). The much simpler, but more effective electro-acupuncture using electrical skin pads instead of needles replaced traditional Chinese acupuncture.

The science of electro-acupuncture

In 1958 news came from China that they were doing major surgeries with patients staying awake and pain free only with the use of electro-acupuncture. In other words no chemical anesthesia was necessary to make patients comfortable. Professor Ji-Sheng Han from the Beijing Medical University observed that only electrical stimulation was powerful enough to produce the pain relief that was necessary to allow general surgery. Dr. Han conducted systematic experiments to study the phenomenon of electro-acupuncture and published this in Ref. 2. One of the experiments consisted of two rabbits. Electro-acupuncture anesthetized the donor rabbit. The vet removed spinal fluid from the first rabbit and transferred it into the second rabbit (the recipient rabbit) that did not receive further treatments.

The second rabbit was pain free and the vet performed surgery 

The injection of spinal fluid made the second rabbit pain free to the point where the vet could performed surgery on it without pain. Other researchers such as Dr. Pomeranz found that the brain released endorphins in response to electro-acupuncture, powerful morphine-like substances. It was the endorphins that were responsible for making the recipient rabbit of Dr. Han’s experiment pain free. Other experiments of Dr. Pomeranz showed that naloxone, a morphine and endorphin blocker also blocked the analgesic effect previously found by transferring spinal fluid. These lines of experiments also explain why some patients did not respond to electro-acupuncture, as they have a deficiency in the pain control system of their brain lacking endorphin release. Dr. Han did 30 years of experimentation and also observed patients very closely.

Placebo effect investigated by Dr. Han

Dr. Han also investigated the placebo effect and found that this can explain about 30% of healing. However, the remainder of the 70 to 75% response to electro-acupuncture in his opinion was due to the procedure. He was able to explain that traditional Chinese acupuncture points were merely spots on the body where electric currents penetrate the skin easier. When internal nerves pick up the electrical signals the also transmit to the spinal cord and to the brain. The electrical impulses then switch over in the brain and spinal cord to nerves that go to other areas of the body. This explains how electrical impulses can travel from conducting polymer pads applied over acupuncture points, release neuropeptides in the brain and help the body to heal. Functional MRI studies confirmed that certain frequencies stimulate the brain through electro-acupuncture or traditional Chinese acupuncture to give pain relief.

Electro-Acupuncture Twice As Effective As Conventional Acupuncture

Electro-Acupuncture Twice As Effective As Conventional Acupuncture

Electro-acupuncture produces stronger signals in the brain

These types of studies have also shown that electro-acupuncture produces stronger signals in the brain than traditional Chinese acupuncture.

Beside pain relief many other applications exist for electro-acupuncture. Addiction medicine makes use of electro-acupuncture in weaning people from morphine or heroine etc. The health professional can use this method to treat psychiatric illness, particularly depression. It is useful in relieving nausea and vomiting due to chemotherapy with cancer treatments or associated with pregnancy without affecting the pregnancy. However, this may also be useful as an adjunct to treating high blood pressure and cardiovascular disease.

One area where clinical hypnosis and electro-acupuncture have a closely relationship is called “conditioned healing” (Ref.1). For instance, with posttraumatic stress disorder (PTSD) in soldiers who returned from battle or in rape victims researchers showed that hypnotherapy treatment while using electro-acupuncture for 30 minutes at the same time can be useful in alleviating the symptoms these patients experience.

A few case studies using electro-acupuncture

Here are a few case studies that illustrate the use of electro-acupuncture with regard to patients (modified Ref.1). A treatment consists of a 30-minute session where the patient is either sitting or resting comfortably on an examining table. Treatments initially are often given twice per week until the pain is only about 50% of the original pain (severity of pain is scored on a 0 to 10 scale in the beginning). From that point on the visits are reduced to weekly sessions. Most clinical problems require three to 12 sessions. If the pain goes away, but returns after a few weeks, repeat sessions can be scheduled, which often lead to pain relief in a shorter time interval than was the case with the original problem. Chronic problems can be treated on an ongoing basis once per month, if there was a clinical response, but the pain reoccurs.

A 53-year-old painter with left shoulder pain

A 53-year-old painter with left shoulder pain, which radiated into the left chest, had problems with painting above his head. His physician did heart studies, but everything was OK. He was told that this was due to a muscle spasm in the shoulder muscles. One electrode was placed over the hoku point (also called LI-4  acupuncture point), which is located over the first interosseous muscle between the thumb and index finger, the other electrode over the area of pain in the left shoulder. Only seven treatments, twice per week for 2 weeks were given, then treatments with weekly intervals were administered. This approach cured his shoulder problems, and he could return to paining.

A 39-year-old woman with lower back pain

A 39-year-old woman came to the office complaining of lower back pain, which radiated into her right leg to the knee area. After tests she was told that she had spinal stenosis with sciatica (irritation of the sciatic nerve). No surgery could be done for this. She was given twelve electro-acupuncture treatments with one electrode placed below her right knee (ST-36 acupuncture point) and another electrode placed over her right lower back over one of the BL acupuncture points. She was almost pain free for about two weeks, but the pain came back after the last treatment. Since then she has been getting ongoing monthly electro-acupuncture visits with about 80% pain relief. Keep in mind that spinal stenosis is a condition for which regular medicine has nothing to offer other than symptomatic pain medication, which she did not want.

A 30-year-old schoolteacher with anxiety attacks 

A 30-year-old schoolteacher suffered from anxiety attacks and agoraphobia (fear of open spaces) for several years. The therapist used conditioning with electro acupuncture to treat this woman. She received a series of treatments with electro-acupuncture over both interosseous muscles (hoku acupuncture point or LI-4) for 30 minutes during which time she was also listening to a relaxation tape with music in the background and suggestions for self-hypnosis. The physician taught her how to do self-imagery at home. Subsequently she did this for 10 minutes two or three times per day. Several weeks later she was able to control her anxiety attacks and overcome her fear of open spaces. In the beginning she rated her symptoms as 8 to 10 in severity on a scale from 0 to 10. At the end of the sessions, she only had occasional symptoms with a 1 to 2 rating on this scale.

A 50-year-old man with cluster headaches 

A 50-year-old man with cluster headaches who had been investigated extensively by a neurologist without any other underlying cause was treated with electro-acupuncture. The electrodes were placed on acupuncture points of the head. Within only 4 sessions most of the headaches were gone. After 8 sessions he had no more headaches. However, a few weeks later his cluster headaches returned, but with ongoing monthly treatments he is able to prevent them from recurring. He did not like the side effects of all the pain medications, so he rather goes for his monthly booster electro-acupuncture treatments.

Take-home message regarding electro-acupuncture

Many people never considered traditional Chinese acupuncture for fear of needles. However, extensive research by Dr. Han and Dr. Ulett showed that electro-acupuncture with electrically conducting polymer pads or with EKG pads will replace the acupuncture needles. Not only is this method needle free, but also the weak electrical impulses that are used with electro-acupuncture treatment double the effectiveness of the older acupuncture method.

Many acupuncturists use both methods of acupuncture, but Dr. Ulett who used traditional acupuncture in the past has completely abandoned it and uses electro-acupuncture with the HANS machine instead. It is a complementary medical treatment, which has been authorized by the FDA.

More on pain conditions: http://nethealthbook.com/neurology-neurological-disease/pain/

References

1: George A. Ulett, M.D., Ph.D. and SongPing Han, B.M., Ph.D.: “The Biology of Acupuncture”, copyright 2002, Warren H. Green Inc., Saint Louis, Missouri, 63132 USA

2. J.S. Han: “The Neurochemical Basis of Pain Relief by Acupuncture”. Vol. 2. Hu Bei Science and Technology Press, Beijing, 1998 (784 pages).

Apr
14
2013

Allergies Not Only In Spring

This article is about “allergies not only in spring”. Springtime is the time of spring allergies: those affected develop a runny nose, itchy eyes and in more severe cases they may experience a flare-up of asthma. Allergies can be triggered by the increase of pollen counts in the air that occurs every spring. In those who are sensitive, this leads to antibody formation in the blood. But often people have not only sensitivities to the pollens of spring bloomers; they may also be allergic to spores from molds, to dust mites and may have underlying allergies to foods.

Memory cells of the immune system

The immune system has memory cells that memorize that a person has had an allergic encounter to one of these items in the past, and allergic reactions can become more significant with a future encounter. Allergies often get worse when a person has food sensitivities and there are cross reactions between pollens of trees or grasses that share surface protein regions with similar protein regions in foods.

Cross allergies

It is known that cross allergies are possible between birch pollen and apple, carrots or hazelnut. In its extreme form allergies due to antibodies, called IgE antibodies, can cause anaphylaxis. A person presensitized by inhaling birch pollen, after eating an apple, hazelnuts or a carrot can develop itching of the throat, swelling of the lips and very quickly deteriorate getting into an anaphylactic shock.

Other cross allergies exist between ragweed pollen, which is a powerful inhalant allergen and melons or bananas. Again there are specific IgE antibodies that are responsible for this immune reaction. In this case the ragweed allergy primes the immune system to produce IgE antibodies, which are experience potentiation by certain foods that share similar protein components as the ragweed pollen.

In the following I will deal with inhalant allergies separately from food allergies.

Inhalant allergies

Inhalant allergies are easier to diagnose and to treat than food allergies. Your doctor will likely refer you to an allergist when you have allergies that do not respond to treatment with intermittent over the counter antihistamines. Your symptoms may come on in the spring with itchy eyes and a runny nose. From year to year you find that you become more and more dependent on antihistamines and nose drops to unplug your nose. The allergist likely will do sensitivity tests, which consist of skin prick or scratch tests on the back or the forearms.

Allergy shots to stabilize allergies

In more serious allergies, where the patient has coughing and wheezing attacks following allergic reactions, the allergist may suggest to start intermittent allergy injections alongside the standard inhalation therapy for asthma. The allergist prescribes an allergy serum where the lab mixes ingredients based on all of the positive tests that led to a strongly positive skin reactions through allergy testing.

Allergy injections

Typically, the family doctor or his nurse will start the allergy injections initially in weekly intervals.  After reaching the  maintenance dose, there may be a modification to injections every 10 to 14 days.

The allergy injections stimulate the immune system to produce harmless competing antibodies, which counteract the disease producing allergic antibodies. In the process of desensitization shots the immune system will normalize, which means that the inflammatory response of the immune system settles down to normal.

This is not the end of the story with inhalant allergies. The allergist needs to retest the patient on a yearly basis. The immune system changes all the time as new allergies can develop and old ones may go away.

Retesting allergies and sublingual immunotherapy

Retesting is necessary to keep track of what is going on and to change the composition of the allergy serum. Those patients who are working together with the allergist can do very well, and often they gradually outgrow their allergies. Others may not be so lucky. They may have reactions to the allergy injections. In these cases avoidance of what causes the allergy may be the only solution to treat the allergies.

There is an alternative to allergy injections, which physicians in Europe use, namely a sublingual immunotherapy. Recently there has been a review of the literature for FDA approval that is needed for oral desensitization for ragweed, dust mites, grass pollen and cat dander. It will take some time before the FDA approval process will become a reality for sublingual desensitization in the US.

Allergies to pets

A special form of inhalant allergies are allergies to pets (mainly dogs and cats, but also allergies to petting zoo animals). The dander that the human comes in contact with is a protein from the animal hair. It causes hives when it touches the skin. This occurs as the dander penetrates through the skin and meets the local mast cells that release histamine. This in turn is responsible for the hive formation. Sneezing and even asthma can develop from inhaled protein particles that reach the lungs. Allergy injections for the treatment of animal dander allergies often do not help or make the allergies worse. The allergist usually recommends avoidance of animal contact as the solution, a recommendation, which the affected animal lover often does not appreciate.

Allergies Not Only In Spring

Allergies Not Only In Spring

Food allergies

Often we eat  some foods more frequently, because they are our favorites. This means that our gut lymphocytes that get in contact with these foods can start to react to one or more of the foods we ingest. At this time we may experience abdominal cramps, diarrhea, vomiting and a host of other possible symptoms.

The physician will tell the patient that testing for food allergies is a problem. Most of the usual skin tests employed for inhalant allergies do not reliably work in determining food allergies. The doctor will ask the patient or the mother of the child with food allergies to keep a food diary and keep track of the allergic symptoms in the diary as well. An elimination diet will have to be devised based on the information gathered in the diary as it becomes clear from that record which foods cause which symptoms. The foods causing allergic symptoms are subsequently eliminated. This is a cumbersome process, but it is the most reliable method of testing and treating food allergies.

RAST test

In the past there was a blood tests, called RAST test, which tested for common food allergies that can cause severe allergic reactions like egg, milk, peanut, tree nuts, wheat, crustacean shellfish and soy. Since about 2010 this has been replaced by the more sensitive ImmunoCAP Specific IgE test.

Children often develop food allergies to egg, milk, wheat, nuts, peanuts and soy, which are food allergies with positive IgE tests. When they age, their immune system develops tolerance to many of these foods and they often outgrow these allergies.

Antibody tests for food allergies

Only a blood drop is necessary to test a panel of foods with IgG, IgM and IgE antibodies. A number of suppliers offer these tests.  However, the specificity, sensitivity and reliability can pose problems with regard to the interpretation of the results. Allergists often point out that a test may be a false positive when a person likes certain foods. IgG antibodies against this food show up despite the patient having no symptoms. Another specialist may interpret this to indicate that the body shows early sensitization to a certain food.  However, clinically it is not yet obvious. In other words, the sensitivity of the test is so high that it undermines the validity of the test. Recently a panel of international scientists reviewed the validity of these IgG based food intolerance tests and they found the tests not reliable.

Testing for food allergies

The immune responses to food allergies are complex as there are immediate type immune reactions and delayed type immune reactions. The physician investigates the immediate immune responses with the above mentioned ImmunoCAP Specific IgE test. The delayed immune responses can be measured using the ELISA test.

Other considerations about allergies

You see from this discussion that a patient with allergies needs a properly trained allergist who will do a comprehensive analysis involving a thorough history, examination, blood tests and immune tests.  The specialist interprets the test results, which requires his/her experience and clinical judgment.

Clearfield wheat

Since the 1970’s when Clearfield wheat was introduced around the world on a large scale, which has a much higher gliadin (gluten) content than the old wheat varieties. As a result of exposure to this new type of wheat gluten intolerance and leaky gut syndrome have increased. Scientists registered a substantial increase in wheat gluten intolerance in the world population. Genetically modified foods like soy, corn, sugar beets, canola and more are a challenge for the immune system. This is particularly so  in sensitive humans. Physicians do not fully understand why this is so. We do know that some people can develop autoimmune diseases. This may be the reason that a host of diseases are much more common now than in the past. Common autoimmune diseases are MS, rheumatoid arthritis, Hashimoto’s thyroiditis, ankylosing spondylitis and others.

Epi-Pen, chronic inflammatory diseases

After food elimination for 2 to 12 months depending on the severity of the food allergy, your body may have eliminated the allergy to the food you have avoided, in other words your body built up tolerance. Before you expose yourself to any food that you used to be allergic to and that you want to re-test, it is best to have an EpiPen ready in case your allergy has not resolved. Caution is necessary with regard to foods that cause more severe allergies, e.g. shellfish or peanuts. These type of allergies may last life long. It is safer to avoid these foods that cause more severe allergies altogether.

Chronic inflammatory diseases

Allergic reactions of the immune system belong into the category of chronic inflammatory diseases. These are known to be the root of chronic diseases like asthma, arthritis, heart disease, high blood pressure and cancer. Be vigilant about allergies and get proper assessment and treatment by an allergist. You will prevent serious health problems including the above mentioned chronic diseases.

More on asthma, which is a chronic inflammatory lung condition, often associated with multiple environmental allergies:

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Apr
01
2008

H. Pylori Can Be The Culprit For Indigestion

Indigestion, heart burn, bloating and stomach discomfort are common problems. Often the reason is simple. Too much food and drink at a party, a plateful of deep fried Buffalo wings or a midnight order of double-pepperoni pizza will contribute to stomach upset and a bad night’s sleep. A few over the counter antacids will come to the rescue. If indigestion is a faithful but miserable daily companion, the excuse of “just having a sensitive stomach” becomes a form of denial and a dangerous form of self diagnosis. Something is wrong, and it is time to seek medical attention instead of over the counter meds. The first line of defense will be prescription drugs called “proton pump inhibitors” (PPI). They are designed to eradicate excessive acid production in the stomach. If symptoms are more severe, e.g. weight loss, a gastroscopy will be necessary. Even though the prevalence of a stomach infection with Helicobacter pylori (H.pylori) is declining, about 30% of patients with chronic stomach upsets test positive for an infection with these bacteria. This can cause recurrent stomach pains. In this case it becomes necessary to treat this with a combination of PPI’s and antibiotic medication. Eradication of H.pylori can mean a cure from a stomach ulcer. It also reduces the risk of developing gastric adenocarcinoma, a form of stomach cancer that could have developed out of an untreated gastric ulcer. Just because a person has heartburn does not mean that the condition is due to gastro-esophageal reflux of stomach acid. If after treatment with a PPI the problems of indigestion, heartburn, bloating or stomach aches reoccur, lab tests can give more information. According to a prospective trial conducted by Dr. Delaney and others the H.pylori serology (a blood test) is unreliable, but other H.pylori tests like urea breath test or stool antigen are reliable tests to establish whether a stomach infection with H.pylori is present or not.

H. Pylori Can Be The Culprit For Indigestion

H. Pylori Can Be The Culprit For Indigestion

If the bacterium is present, its eradication with antibiotic therapy will stop the stomach problems in a high percentage of cases with one treatment protocol. What was surprising was that after one year the treatment result of the treatment group with PPI/antibiotic combination was as successful as the control group that was treated with PPI’s alone. It was concluded that in the more severe cases with weight loss, vomiting, or overt bleeding an upper gastrointestinal endoscopy should be performed where a direct H.pylori test from samples is also done. However, in the vast majority of cases with minor symptoms can be treated safely by the general practitioner with PPI’s and follow-up examinations in subsequent visits. Treatment failures can then be referred to a gastroenterologist, if necessary.

More information about gastritis and H. pylori: http://nethealthbook.com/digestive-system-and-gastrointestinal-disorders/gastritis/

Reference: British Medical Journal 336:623-624 (March 22, 2008)

Last edited November 3, 2014

Dec
01
2003

Help For Patients With Iron Overload

Patients who are born with an inborn enzyme defect that leads to iron overload (hemochromatosis) and others with secondary hemochromatosis due to sickle cell anemia will benefit from new research by Dr. Gavin Oudit, Dr. Peter Backx, Dr. Peter Liu and others. The researchers at the University of Toronto and Toronto General Hospital have published their findings in the Sept. 15 issue of Nature Medicine.

In animal experiments they found that the same calcium channels that transport calcium to vital organs are also the channels through which poisonous levels of iron are introduced with iron overload disease. In both animal experiments and in the clinical situation, human iron overload affects mainly the pancreas, the heart muscle and the pituitary gland. The authors of this study found that in hemochromatosis patients the calcium channel blockers, such as amlodipine (Norvasc), verapamil or diltiazem will stop the accumulation of toxic levels of iron in these organs.

Dr. Peter Backx, professor of physiology and medicine at U of T in the Heart & Stroke/Richard Lewar Centre of Excellence and senior author of the paper, explained that more detailed research determined that the L-type calcium channels that play a role in the normal calcium transport across the cell membrane are the same channels that allow the iron molecules into the heart muscle cells and into the cells of the other organs that get damaged with hemochromatosis. By using calcium channel blockers, heart drugs that are already on the market, it is possible to prevent accumulation of iron to the point of toxic levels. Up to now the only approach to therapy was to remove excessive iron from the body by expensive iron chelation medication that had to be given intravenously.

Help For Patients With Iron Overload

Further clinical trials on a larger patient population are necessary to determine who will benefit most from this approach of treating iron overload conditions with calcium channel blockers and what dosage to take. Dr. Peter Liu is another senior author regarding this study and is a cardiologist at the Toronto General Hospital and director of the Heart & Stroke/Richard Lewar Centre of Excellence and professor of medicine and physiology at U of T. He stated that this alternative therapy for heart failure from iron overload cardiomyopathy will likely open the doors for those patients worldwide who could not afford to have expensive chelation done, which is presently the only treatment method to remove the excessive iron. People of North American, European, Mediterranean or Asian descent are more prone to genetic hemochromatosis, thalassemia and sickle cell anemia that can all lead to iron overload requiring this type of therapy.

Last edited December 9, 2012

Oct
01
2002

Endometriosis Is A Cause Of Infertility, Even Without Scarring

When the lining of the womb grows into the Fallopian tubes, this can be a cause of scarring of the tubes and lead to infertility of the woman.

Up to this point in time medical science had no explanation for cases where the surgeon found only a few spots of endometriosis on the surface of the womb inside the abdominal cavity without any disease in the fallopian tubes. Dr.Ovrang Djahanbakhch and his coworkers from the The Royal London Hospital in London found that there is a factor contained in the abdominal fluid of women who have endometriosis (article published in the Lancet 2002;360:p.1221-1222). These investigators looked at fallopian tubes of hysterectomy samples (=wombs that were surgically removed) and studied the movement of the cells lining them under a special microscope.

Hair cells can be seen that are lining the Fallopian tubes and are normally responsible for the transport of the released egg at the time of ovulation. They found that when they added abdominal fluids from women who have endometriosis, the wave like pattern of these hair cells (=known as “ciliary movement”) came to almost a standstill. Abdominal fluids of women with no sign of endometriosis did not cause such a slowdown. This finding sheds important new information on our understanding of the nature of endometriosis and may some day lead to the development of new fertility drugs.

Endometriosis Is A Cause Of Infertility, Even Without Scarring

Endometriosis Is A Cause Of Infertility, Even Without Scarring

At this point the chemical factor from patients with endometriosis that is responsible for the slow-down of the normal ciliary movement has not yet been isolated. The authors will pursue this line of research further. Here are some links that are related to this topic:

Endometriosis: http://www.nethealthbook.com/articles/painfulperiods.php

Infertility: http://www.nethealthbook.com/articles/infertility.php

Last edited December 10, 2012