Consider the article yesterday in the SF Chronicle "UCSF doctors see colic-migraine link."
And an elaborate study out of China looking at different acupuncture treatment approaches for migraine prophylaxis. Acupuncture for migraine prophylaxis: a randomized controlled trial (full text at link.)
What is of interest between the two? The UCSF study finds that mothers with migraines are more likely to have babies with colic. Of course, we still have no idea what causes colic, even though the name implies something to do with the GI system. But there is a link between migraines and abdominal pain in youths called "abdominal migraine." Some children suffer bouts of nausea or dizziness before developing more classic headache symptoms as adults. There clearly is some link between the gut and migraine.
Then consider the study out of China. It compares classic treatment for migraine using Shao Yang points (Gall Bladder, lateral points.) And Yang Ming or treatment using stomach points. Though Shao Yang had slightly better results, both showed a decrease in migraines compared to controls (sham acupuncture.)
So wouldn't it be fascinating, in light acupuncture's effect on the gut, to compare different electroacupuncture treatments using acupuncture points for the gut for migraine prophylaxis? (Too many studies to do, too little time.)
I would also like to mention a fascinating anecdote related to me by a patient. Her horse had a common type of colic in which they get distension, bloating and obstruction. An acupuncture veterinarian put some needles near the nostils of the horse (Large Intestine Meridian) and the horse was cured. Maybe a clue for migraine treatment??
(More on my practice here.)
Sunday, February 26, 2012
Friday, February 24, 2012
Ha ha. Drug Makers Required to Show Benefit
The highlighted sentence in the second paragraph of this article could have been taken from the Onion.
(This article reminds me of an old New Yorker cartoon that showed a doctor talking to a patient at his desk saying. "I'm going to give you a new medication that works almost as well as aspirin but costs a whole lot more.")
(There are then many paragraphs boo hooing about how hard this will be on the poor Big Pharma companies.)
(This article reminds me of an old New Yorker cartoon that showed a doctor talking to a patient at his desk saying. "I'm going to give you a new medication that works almost as well as aspirin but costs a whole lot more.")
Austerity in Europe Puts Pressure on Drug Prices
By STEPHANIE NOVAK
PARIS —Profits at pharmaceutical companies have been declining or showing little growth for the last year as austerity measures across Europe lead to cuts in health care spending. Some analysts say this trend could continue until at least 2014.
Budget cuts mean that many European governments are not willing to pay as much for pills. But new laws in some countries are also putting pressure on companies to prove their drugs are effective or risk having them dropped from the coverage list, or covered at a lower rate...
(There are then many paragraphs boo hooing about how hard this will be on the poor Big Pharma companies.)
“2011 is the first year recorded where R.& D. is down in the industry as a whole,” Mr. Bergström said...
Adding to the challenge for companies is the need to show newly cost-conscious governments that their drugs are cost effective.
Germany, Europe’s largest pharmaceutical market, has required drug companies since January 2011 to prove the added benefit of a new medication by producing documentation comparing it with other treatments on the market...
Partly as a result of these changes, the German government reported saving 1.9 billion euros on drugs in 2011, three times the savings in 2010, Business Monitor International said.
Drug companies worry that actions in Germany could hurt sales in other European markets.
My snark is borne of the great lengths that acupuncture research studies have had to go to to show benefit. An incredibly high bar that few other aspects of medicine have had to reach. Info on my practice here.
Neuromodulation in the Gut: Part II
Dr. Takahashi was kind enough to send me PDF of his paper discussed here.
It is a comprehensive look at the research, both animal and human, involved in acupuncture neuromodulation of the gastrointestional tract. There were many interesting tidbits, but I'll stick to the most usable ones, and the results pertaining to HRV (my area of interest.)
Electroacupuncture at Stomach 36 stimulates gastric motility. This is fascinating to me because when I was getting my acupuncture training, my teachers insisted that this point was contraindicated in someone dieting. The science confirms this teaching.
Acupuncture on the abdomen inhibits gastric motility. This is also of interest since the traditional treatment for profuse, watery diarrhea is moxa at the umbilicus. Takahashi reports that electroacupuncture at Stomach 25 inhibits gastric emptying.
Electroacupuncture at St36 and PC6 accelerates gastic emptying and increases the regularity of gastice slow waves in the stomach.
Electroacupuncture at St36 decreases the LF/HF HRV ratio in rats, suggesting that the gastric responses are mediated via the vagus nerves.
Electroacupuncture at St25 increases the LF/HF ratio in rats.
So what does this all mean? LF/HF ratio is a proxy for the subjects' stress repsonse. When LF/HF decreases, that means stress response is lowered. So it would make sense that if you're encouraging gastric emptying, you're encouraging the restorative arm of the autonomic nervous system, not the excitatory or "flight or fight" arm. Indeed, alert readers will recognize that the point combination of St36 and PC6 is the combination recommended to treat hypertension by Longhurst et al. (Personally, I can't imagine doing electroacupuncture at PC6, ouch!)
One other anecdote to share. In my poster for the ISAMS I charted one particular case where I was treating a patient for PCOS (Polycystic Ovary Syndrome.) The Stener-Vitorin protocol calls for strong electroacupuncture (2 HZ) on the abdomen at CV3 and CV4 and St25. My HRV monitoring showed an increase in LFR/HFR (increase stress response) with each treatment. When I stopped the electroacupuncture in an attempt to improve the stress response, the LFR/HFR decreased. Okay. Interesting and this is in line with the studies outlined here.
But even MORE interesting is that I've been treating a patient for intractable insomnia (many years duration.) She also has PCOS. She had been getting some benefit from the acupuncture treatments, but then I added in the electroacupuncture for the PCOS and she lost any of the calming benefit of the acupuncture. She figured this out and when she mentioned it to me, I remembered the previous case that I had presented at the ISAMS. We stopped doing the electroacupuncture and hopefully she'll get the improved response.
More information on my practice here.
It is a comprehensive look at the research, both animal and human, involved in acupuncture neuromodulation of the gastrointestional tract. There were many interesting tidbits, but I'll stick to the most usable ones, and the results pertaining to HRV (my area of interest.)
Electroacupuncture at Stomach 36 stimulates gastric motility. This is fascinating to me because when I was getting my acupuncture training, my teachers insisted that this point was contraindicated in someone dieting. The science confirms this teaching.
Acupuncture on the abdomen inhibits gastric motility. This is also of interest since the traditional treatment for profuse, watery diarrhea is moxa at the umbilicus. Takahashi reports that electroacupuncture at Stomach 25 inhibits gastric emptying.
Electroacupuncture at St36 and PC6 accelerates gastic emptying and increases the regularity of gastice slow waves in the stomach.
Electroacupuncture at St36 decreases the LF/HF HRV ratio in rats, suggesting that the gastric responses are mediated via the vagus nerves.
Electroacupuncture at St25 increases the LF/HF ratio in rats.
So what does this all mean? LF/HF ratio is a proxy for the subjects' stress repsonse. When LF/HF decreases, that means stress response is lowered. So it would make sense that if you're encouraging gastric emptying, you're encouraging the restorative arm of the autonomic nervous system, not the excitatory or "flight or fight" arm. Indeed, alert readers will recognize that the point combination of St36 and PC6 is the combination recommended to treat hypertension by Longhurst et al. (Personally, I can't imagine doing electroacupuncture at PC6, ouch!)
One other anecdote to share. In my poster for the ISAMS I charted one particular case where I was treating a patient for PCOS (Polycystic Ovary Syndrome.) The Stener-Vitorin protocol calls for strong electroacupuncture (2 HZ) on the abdomen at CV3 and CV4 and St25. My HRV monitoring showed an increase in LFR/HFR (increase stress response) with each treatment. When I stopped the electroacupuncture in an attempt to improve the stress response, the LFR/HFR decreased. Okay. Interesting and this is in line with the studies outlined here.
But even MORE interesting is that I've been treating a patient for intractable insomnia (many years duration.) She also has PCOS. She had been getting some benefit from the acupuncture treatments, but then I added in the electroacupuncture for the PCOS and she lost any of the calming benefit of the acupuncture. She figured this out and when she mentioned it to me, I remembered the previous case that I had presented at the ISAMS. We stopped doing the electroacupuncture and hopefully she'll get the improved response.
More information on my practice here.
Tuesday, February 21, 2012
Common Denominator Between Yoga and Acupuncture
I'm sure there is more than one common denominator, but in this Jane Brody blog post about yoga in the NY Times, she says,
That is exactly the gist and purpose of my studies on the autonomic nervous system and acupuncture. She said it so succinctly and well. My studies suggest that in those people who benefit from acupuncture with a decrease in symptoms, you see their vagal activity increase, which is the restorative arm of the autonomic nervous system. This corresponds to decrease stress and an increase in health and slowing of the aging process.
More on my practice here.
"Possibly through its stimulation of the vagus nerve, yoga appears to counter inflammation throughout the body, and may reduce the effects of diseases like lupus and rheumatoid arthritis. And by relieving physical and mental stress, which can erode the tips of DNA, which are called telomeres and program cell death, yoga may slow biological aging and prolong life."
That is exactly the gist and purpose of my studies on the autonomic nervous system and acupuncture. She said it so succinctly and well. My studies suggest that in those people who benefit from acupuncture with a decrease in symptoms, you see their vagal activity increase, which is the restorative arm of the autonomic nervous system. This corresponds to decrease stress and an increase in health and slowing of the aging process.
More on my practice here.
Monday, February 20, 2012
The Puzzling Rise in Type I Diabetes
From Scientific American February 2012
"A Diabetes Cliff Hanger" Researchers are balled by the worldwide increase in type 1 diabetes, the less common form of the disease.
From the article, it says 90% of the 350 million people around the world who have diabetes mellitus have type 2 diabetes, or non-insulin dependent diabetes, as we used to call it. Type 1 diabetes requires insulin shots and often starts in childhood. This second type of diabetes has been rising by 3 to 5% per year. Type I diabetes has not classically been associated with obesity, so the reason for the rise in rates has scientists puzzled. Since the rise in Type 1 diabetes is world wide, the cause must be world wide also. Here are some of the hypotheses.
1. Gluten. Type 1 diabetics are more likely to have celiac disease which is caused by gluten intolerance. There has been a world wide increase in the amount of gluten most people consume over the decades.
2. Hygiene hypothesis. This is the hypothesis that links clean modern lifestyles and allergies. Since living hygienically deprives developing immune systems from early exposure to infections and soil organisms, it not only overreacts to allergens, but to the bodies own tissues, including insulin producing cells in the pancreas.
3. Fat. Perhaps there is a link between being overweight and developing Type I diabetes afterall. It may be possible to "burn out" your insulin producing cells by overtaxing them with too much food or the wrong kinds of food.
"A Diabetes Cliff Hanger" Researchers are balled by the worldwide increase in type 1 diabetes, the less common form of the disease.
From the article, it says 90% of the 350 million people around the world who have diabetes mellitus have type 2 diabetes, or non-insulin dependent diabetes, as we used to call it. Type 1 diabetes requires insulin shots and often starts in childhood. This second type of diabetes has been rising by 3 to 5% per year. Type I diabetes has not classically been associated with obesity, so the reason for the rise in rates has scientists puzzled. Since the rise in Type 1 diabetes is world wide, the cause must be world wide also. Here are some of the hypotheses.
1. Gluten. Type 1 diabetics are more likely to have celiac disease which is caused by gluten intolerance. There has been a world wide increase in the amount of gluten most people consume over the decades.
2. Hygiene hypothesis. This is the hypothesis that links clean modern lifestyles and allergies. Since living hygienically deprives developing immune systems from early exposure to infections and soil organisms, it not only overreacts to allergens, but to the bodies own tissues, including insulin producing cells in the pancreas.
3. Fat. Perhaps there is a link between being overweight and developing Type I diabetes afterall. It may be possible to "burn out" your insulin producing cells by overtaxing them with too much food or the wrong kinds of food.
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