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By David Hoh
Acupuncture is an ancient Chinese medical
art, practiced for thousands of years. CFIDS is an illness that has only been
identified and studied in the United States for about 15 years. How can
the two possibly come together?
The use of acupuncture is becoming
increasingly accepted in Western medicine as a valid treatment for a variety of
illnesses, most commonly those involving pain. In 1997, a National Institutes of
Health panel said acupuncture was "an acceptable alternative, or part of a
comprehensive treatment program" for certain conditions, particularly nausea and
pain following surgery or chemotherapy but also for a variety of
Acupuncture makes sense to many CFIDS specialists
and their patients because it treats the patient as a whole, without trying to
identify a particular physiological cause, which Western medicine has not been
able to do in CFIDS. Acupuncture also has far fewer side effects than do most
drugs, to which many CFIDS patients are sensitive.
Charlotte, N.C., acupuncturist, describes the theory behind acupuncture this
way: "We're talking about an energy that flows through the body, a life force
that the Chinese call qi (pronounced chee). This energy needs to get to every
cell in the body, just like blood needs to get to every cell. Just like there
are pathways (arteries and capillaries) to get the blood to every cell, there
are pathways to get the qi to every cell, and these pathways are called
meridians. There are 12 major meridians, and each one feeds a different
internal organ. In Chinese medicine we believe that if the qi, the life force,
is balanced and flowing unobstructed throughout the body, then there is health.
So when a person is sick, we describe that as an out-of-balance or a blockage in
the qi. We want to find out which meridians don't have enough energy and put
more energy in them."
An acupuncturist's primary diagnostic tool is his
or her fingers, placed on the meridians to feel the flow of qi. "A trained
acupuncturist can tell if there is too much or not enough life force in there
and if it's irritated in some way," Hipple explained. An acupuncturist also
typically will take a detailed family history of health and illness and ask
questions about past minor ailments, personal traits, preferences and habits.
The patient's normal temperature and the appearance of his skin and tongue
may also be significant.
How it works
Acupuncture works by
stimulating specific points along the meridians, using the needles to redirect
the flow of qi or to open up a blockage, in much the way that poking a stick
into an earthen dam allows water to break through and wash away the
obstruction. Western studies suggest that the insertion of needles at
acupuncture points helps release chemicals such as endorphins in the body that
affect nerve impulses and help reduce pain and inflammation.
used in acupuncture are not like needles used for injections. These needles are
solid, usually stainless steel, very fine and flexible. Mary Jo Fishburn, MD, a
professor at Johns Hopkins University and a practicing acupuncturist, says most
patients experience an electrical quality or an aching sensation at the point of
insertion. Sometimes the sensation travels along the meridian channel. The
needle may be inserted a few millimeters and possibly even a few centimeters
into the skin, but any pain sensation is usually brief and not
Fishburn describes the risks as minimal, as needles are either
disposable or sterilized using standard procedures. "Very rarely," she writes in
the Johns Hopkins Insider, "a misplaced needle can puncture a lung,
resulting in air entering the chest cavity; this requires immediate medical
Treating the whole patient
acupuncturist also will use herbs, particularly to help build up energy in the
body and support the immune system or to address specific problems such as
Candida overgrowth or a retrovirus (called latent heat in Chinese medicine)
which may be robbing the body of energy. Herbs are much less potent than
pharmaceutical drugs and work over a longer period of time but with fewer side
effects, Hipple explained.
Another potential energy drain is
lifestyle, possibly stress from a job or a difficult family situation, and that
has to be addressed, too, if it's present. "With CFIDS," Hipple said, "you're
trying to put energy back into a person, and it's like trying to fill a barrel
with water when it's got all these holes in it. You're never going to get if
filled until you plug up the holes, so you have to find out what's draining the
energy and address those things first.
Eighty to 90 percent of things
people go to doctors about are lifestyle induced-diet, stress, activity. If we
don't figure out the source of the problem, then we may be able to cure the
symptom, but six months later they'll be back. Unfortunately, a lot of doctors
don't look at that. If you go in for headaches, he's not going to ask you what
your life is like. He's going to give you a drug."
What to expect
immediate with acupuncture treatments. Fishburn advises her patients to expect
to undergo at least four or five sessions before feeling some benefit. If there
is no change during that series of treatments, then acupuncture may not be
working for that patient.
Hipple explains that, while the symptoms of
CFIDS may be triggered by a sudden injury, infection, environmental toxin or
stressful event, the imbalances in the body develop over time and are complex.
"CFIDS is not something you get overnight. Most people who have CFIDS
have gone through a very, very stressful time of overworking, using up too
much energy for a very long period of time. Maybe they've worked and taken care
of the kids for 10 years, and then it finally happens. They don't notice it as
long as their will can push them to get up and do what they need to do.
Americans tend to be very out of touch with their bodies. Most are
sleep-deprived. They push themselves, or use outside stimulants like caffeine,
constantly drinking coffee or cola. Then one day they're going to crash.
One day they can't ignore it. But by then they're already in big trouble.
"One of the reasons Western medicine is having so much trouble with this
is that they're always trying to find one cause for things, but there's not one
cause, so there's not one cure. With CFIDS, there are too many things out of
balance. What happens is one thing gets out of balance, it doesn't get
corrected, and then it leads to another imbalance and another, and by the time
you get CFIDS, you have 15 or 20 out-of-balances in the body. These have got to
be addressed. You have to find out which ones are the major ones, which one
needs to be put back in balance first. It's different in each person. No two
people that have CFIDS have the same imbalances, and that's the beauty of
Chinese medicine. We look at the person, we don't say 'OK, CFIDS, do this and
this.' We don't even care about giving the illness a name."
The order in
which problems are addressed in acupuncture depends on the individual, Hipple
said. If the initial out-of-balance could be identified and repaired, in theory
the others will eventually repair themselves, but that could take years. Often
the patient has to work for a living or care for a family, so Hipple works on
the three most important problems at the same time.
"These people are
delicately out of balance, and the imbalances are woven together," Hipple
explained. "You've got to unweave them in much the same way they were woven
together. You've got to work a little on the liver meridian, a little on
the heart meridian, a little on the spleen. You can't just focus on one at a
time, otherwise you'll have a crash. A common saying for CFIDS patients is that
if you go to bed tired, you've done too much. You've got to replenish, rebuild
the reserve. It's very important to be paced, both in your daily activity and in
According to the Johns Hopkins Insider, there are
approximately 10,000 licensed acupuncturists in the United States. About 3,000
of them are either conventionally trained medical doctors (MD) or doctors of
osteopathy (DO). Many of these are members of the American Academy of Medical
Acupuncture (800/521-2262) and will have undergone at least an intensive
300-credit training course beyond their medical training. Non-physician
acupuncturists have their own schools and should be certified by the National
Certification Commission of Acupuncture and Oriental Medicine
A number of web sites may also be useful in providing
more information to persons considering acupuncture. American Whole Health, a
chain of integrated medicine clinics, gives a good overview of acupuncture by
one of its doctors, Richard Feely, DO, at
Acupuncture.Com, Misha Ruth Cohen explains what to expect when you visit
a Chinese Medicine practitioner. That page is at
David Hoh is a former editor of
Acupuncture---ancient Chinese practice of
puncturing skin with hair-thin needles at particular locations called
acupuncture points on the patientís body. Believed to cure inbalances in yin and
variation of traditional acupuncture that involved electrical stimulation at
flowing through body.
pathways that bring qi to cells.
to provide local heat over acupuncture points.
positive energy and forces in universe and body; counterpart to
negative energy and forces in universe and body; counterpart to yang.
SAMe marketing takes
A dietary supplement that
has been around for more than 25 years is now being marketed aggressively in the
United States, and CFIDS patients are among the targets. According to a report
in the July 5, 1999, issue of Newsweek, SAMe, or
S-adenosylmethionone, is one of the hottest supplements on the market, available
at grocery, drug and health food stores.
The supplement has been widely
studied, especially in Italy and Germany, for treatment of arthritis and
depression, although the studies are not as large as those the U.S. Food and
Drug Administration would require for the product to be
approved as a drug. In European trials involving thousands of patients, SAMe has
been found to be as effective as pharmaceutical treatments for arthritis and
major depression. Research also suggests it contributes to the repair of damaged
cartilage in joints and that it can improve chronic liver
SAMe is a molecule produced constantly by all living cells.
It is an essential part of a cyclical process that occurs a billion times a
second throughout our bodies. Methionone, an essential amino acid found in
protein-rich foods, combines with a substance called ATP to form SAMe. SAMe then
releases a group of four atoms called a methyl group to neighboring molecules
and becomes SAH, or S-adenosythomocysteine, which rapidly breaks down to
form homocysteine. If homocysteine builds up, it causes many health problems, so
the body converts homocysteine back into methiononine (a process that requires
Vitamin B-12 and folic acid, a B vitamin found in fruits and vegetables)
or into the antioxidant glutathione (in a process requiring Vitamin B-6).
The typical American diet is often deficient in B vitamins. Also, as we age,
SAMe levels tend to decline and homocysteine levels rise.
(Supplementation with two other components of this methylation
cycle, ATP and glutathione, have also been recommended by some CFIDS
Researchers believe SAMe may treat depression by
giving a boost to the mood-enhancing brain messengers such as serotonin and
dopamine. In arthritis, the process of converting homocysteine into glutathione
releases molecules called sulfate groups that ultimately helps protect and
repair cartilage, thus easing joint pain. It also appears to normalize liver
function in patients with cirrhosis, hepatitis and blocked bile ducts, and it
has been found to prevent or reverse liver damage caused by certain drugs.
Drugs typically prescribed for depression and arthritis pain have
potentially serious side effects, but studies have found the most serious side
effect from SAMe is a mild stomach upset. The Arthritis Foundation has said its
medical experts agree that SAMe provides pain relief but that there is not
enough evidence that it repairs damaged joints.
Unfortunately, SAMe is
expensive, typically between $2 and $4 for a daily dose (studies have suggested
that 400 mg is an effective dose for arthritis and a reasonable starting dose
for depression, although some trials have used much higher doses). Experts
advise taking it twice a day on an empty stomach, although different people
may benefit from different amounts.
As with any unregulated
product, consumers canít tell from the label whether they are getting
full-strength SAMe. According to Newsweek, pharmaceutical grade SAMe
comes in two forms: tosylate and a newer, more stable form called
botanedisulfonate. Nature Made and GNC sell the butanedisulfonate, but several
U.S. manufacturers import reliable tosylate products. Look for a product that is
enteric coated, so that it causes less stomach upset.