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MTHFR & Acupuncture - Can Acupuncture Help?

9/28/2013

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Picture
When I first saw this acronym and heard about MTHFR from my dear friend Cathleen my first thought was, "you have the Motherf***er disease?"  I mean, if someone texted you the letters "MTHFR" you could think that was the word they were communicating, right?  Hm...

I was admittedly embarrassed that my first gut-shot interpretation of this acronym was such a dirty word and did not share that with her for a while, but as her symptoms progressed and she shared more of her story with me it actually seemed like a reasonable correlation so I did tell her eventually.  Luckily she found it pretty amusing so we are still friends and general health-focused mommy co-conspirators.

[Picture by chagniel [Public domain], via Wikimedia Commons]

The more I learn the clearer it becomes that MTHFR is a missing piece of a huge portion of the population's health puzzle - its estimated that 30% of people carry the gene mutation though not everyone expresses it (high stress events such as pregnancy, childbirth, trauma etc. can epigenetically trigger the change) - and the more motivated I feel to learn more and explore how Acupuncture and Chinese Medicine can help.

My goal with this post today is simply to raise awareness, communicate my (limited) experience in treating MTHFR with Acupuncture in the Portland area, and ask for any and all local resources and connections for people with MTHFR or suspect MTHFR.

What is MTHFR?  How does it affect me? The short answer.

If you don't know what MTHFR is, the short answer is that it is a gene mutation which results in a lack of the MTHFR (Methylenetetrahydrofolate Reductase) enzyme which deals with methylation in the body.  Methylation plays a role in how the body deals with environmental stressors, how it detoxifies, adapts and rebuilds.  MTHFR is therefore essential for processing a number of things in the body, primary among them B vitamins such a B12 and Folate.  There are many resources online that give you the long answer so I won't belabor that here.  If you want more details try one of these links below:

MTHFR.net
Loving Our Guts
Life With Spirit

A MTHFR genetic disorder can cause or contribute to a myriad of symptoms and disorders including:
  • Fatigue
  • MS-like neurological symptoms
  • Preeclampsia
  • Neural Tube Defects
  • Fertility Issues/Miscarriage
  • IBS
  • Elevated Homocystine Levels
  • Heart Disease
  • Autism
  • ADHD
  • Depression/Anxiety
  • Chronic Fatigue
  • Stroke
and quite a lot more.  A list of 57 known issues are listed HERE on the MTHFR.net site.  

If you want to know if this could be affecting you, the best way to find out if you have this genetic glitch is to get simple and inexpensive genetic testing done.  It costs $99+ if you do it independently of your regular physician depending on the vendor you go with.  Here are a couple resources for testing:

23 and Me $99
Lab Testing Direct $149
Holistic Health International $495 (much more comprehensive test)

If you have a combination of the disorders above, or especially if you are fatigued all the time, have tried taking B vitamins but find that they don't help or make you feel ill, you could very well have an MTHFR gene mutation and testing might help you get answers and guide you on a new path to wellness.  Oh yeah, getting tested can make you feel less like a crazy person too because you aren't insane or just overly stressed - you may have a genetic disorder that you can do something about.

Knowledge really is power and even though it can be scary to think that you might have a genetic disorder, it is better to get tested and find out sooner rather than later.  If it is MTHFR, lifestyle changes can make a big difference.  Testing can also help you avoid a misdiagnosis of something else from your western physician such as Fibromyalgia or Chronic Fatigue which might herald pharmaceutical interventions that may or may not be favorable to your constitution over time.

Current Treatment for MTHFR

Treatment for MTHFR is varied depending on the severity of any individual's symptoms, or so it seems from what I am learning slowly but surely.  It is clear, however, that there are a number of lifestyle changes that can help you manage the cascade of symptoms, heal, recover and find a new healthier more manageable baseline. 

There is an exhaustive list HERE on the MTHFR.net site.  It starts with a list of 30 dietary and lifestyle changes you can make to improve your health with relation to MTHFR and is based on Dr. Lynch's experience treating patients with this disorder and I trust his recommendations.

Some of the items on this list are understandably specific to MTHFR, such as supplementing specific forms of B12 and Folate and limiting your protein intake to 0.7 grams per kilogram of weight per day, but many others are good recommendations for basic health and for decreasing general inflammation in the body such as:
  • Eliminate Gluten (wheat especially) and Dairy from your diet
  • Eat a diet rich in multi-colored fruits vegetables daily, i.e. "Eat the Rainbow"
  • Limit intake of processed foods
  • Avoid heating or cooking foods in plastic (known to leech estrogen mimicking compounds which your body has to detoxify)
  • Choose hormone free and antibiotic free meat sources
  • Filter Chlorine out of your water
  • Increase intake of whole foods and home prepared meals
  • Drink at least two liters of filtered water mixed with Vitamin C and Electrolytes per day (in specific proportion, click link to get the formula)
  • Sweat or Sauna (infrared sauna if possible) regularly to support the body's natural detoxification pathway
But two things strike me as most important of all:
1. Find a physician - MD, ND - who is experienced in treating this disorder
2. Make managing Stress and decreasing Inflammation a primary focus in treatment and recovery
Your symptoms and journey, or that of someone you know or love, with MTHFR is going to be unique. You need a guide to recovery and care who is going to listen to you and recommend reasonable interventions based on your symptoms and your lifestyle.

MTHFR & Acupuncture Treatment

At this point there is no research or evidence supporting acupuncture treatment for MTHFR specifically.  I have literally found one article which mentions an increase in MTHFR mutation found in patients who have migraine with aura, which mentions acupuncture as a known favorable treatment for migraines - but does not specifically link acupuncture with MTHFR.  

I have one confirmed MTHFR patient right now, one who has been told by her ND that MTHFR is highly suspect but isn't recommending testing and a dozen more that I suspect based on their symptom pictures.  I don't consider myself an expert, but I'm setting out to become one so I want to share what I see and how I think acupuncture can help.  I hope to have the opportunity to treat more confirmed MTHFR cases in the coming years so I can compile further data and case studies.

As a 3,000+ year old traditional medicine, Acupuncture and Chinese Medicine has a lot going for it.  While no single mechanism of action has been identified by western science for its efficacy, there have now been over 10,000 scientific acupuncture studies.  It is increasingly accepted that acupuncture is worthwhile in the treatment of pain, in down-regulating the sympathetic nervous system or "fight or flight" reaction, in treating migraine, PTSD, fertility, gut issues from inflammation to constipation, diarrhea and gut motility disorders and more.

Even this short list shows a correlation between these accepted issues for acupuncture treatment and the list of disorders that MTHFR can produce.  This, combined with the hallmark of Chinese Medicine as a tradition which treats every individual uniquely based on energetic diagnosis, makes it a natural fit for the MTHFR road to recovery.

Thus far I feel that my clinic experience shows the same.  My confirmed MTHFR patient often comes in with insomnia, back pain, anxiety and nervous energy, high stress, headache and fatigue.  I generally see her walk out of treatment with a different gait and posture and she reports feeling better than when she walked in.  There have been a couple instances of a detox-type reaction to treatment where she will feel worse for a day but when it happens it does pass and there has always been a net positive response over the course of the week in-between treatments.  I see her sleeping better, feeling less anxious and experiencing fewer headaches in particular.

My highly probable yet unconfirmed MTHFR patient right now saw a marked difference after just one treatment.  Her symptoms are highly stress related/stress activated - high stress type A personality and high pressure job, neck and shoulder pain, insomnia, anxiety, gut issues clearly increased with stress - and she walked out of treatment feeling relaxed which she found very surprising with a marked decrease in her pain.

Stress is one of my primary specialties, both from a lifestyle perspective and a nervous system perspective.  I work hard with my patients to help them identify stressors in their life and make a plan to deal with them while using acupuncture and Chinese Medicine including herbs, dietary and lifestyle changes and general supplementation to create change physically, energetically and emotionally.  

In the case of MTHFR, I feel like the MTHFR itself is such a huge stressor - having it, dealing with the lifestyle changes that accompany it and the healthcare journey associated with it - that one of the best things I can provide is a safe space to be heard, to be present, and to receive treatment that doesn't require you to actively *do* anything in the moment.  

Part of acupuncture is just resting on the table and letting the needles do their work to rebalance the body energetically - i.e. stopping for a moment and just allowing yourself to *be*.  When you are pursuing a health journey like MTHFR which has a steep learning curve, you can feel like you are spending all your time running from one test and doctor and obligation to next with your already limited reserves dwindling as you try to put the puzzle of your health and your needs together.  The experience of acupuncture is one of relaxation and restoration - hard to come by in the heat of the healing journey, but so necessary.  

As I continue to see and treat more MTHFR patients I will write more about the specific types of energetic diagnoses I see and treatments that are successful, but at this point I don't have enough cases to draw any correlations or conclusions.  Suffice to say that at this stage, I feel that the theory and practice of Chinese Medicine can be a strong addition to managing MTHFR on many levels - from the mental emotional piece to the physical symptoms themselves - and I am clearly seeing results in my practice from the limited cases I can draw on.

Share Your Resources - Come In For Treatment!

Do you have MTHFR or know someone who does?  Can you share specific resources or health care professionals you feel know their stuff in the comments section?  I am looking to build a good referral network for MTHFR patients and cases and I would love to know who you feel is really listening to and working for you in the local area.

I am also interested in treating more MTHFR cases so I can compile data and information to share about Acupuncture and Chinese Medicine in the management of this disorder.  I feel very strongly that Chinese Medicine is a great fit, but I need more experience and data.  I would also love to be a partner in your care or that of a loved one with this disorder.  I bill lots of insurance!
Book Now - free 15 minute consultations always available
I have not been tested myself and I know I handle B vitamins well so I believe I am low on the possible MTHFR mutation spectrum, but I do have IBS gut issues, gluten intolerance and a strong history of Heart Disease in my family.  Its possible that I have poor methylation ability myself so I am going to pursue testing as well.  We'll see what I find out.

If you have resources or a story to share please post it in the comments section or email me directly - I'd love to hear from you - and stay tuned!  As I learn more I will continue to post on my blog about MTHFR.

Thank you for listening,
~Rebecca
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Acupuncture for Motor Vehicle Accident Recovery

9/21/2013

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For those in the know, Acupuncture is often a first stop for any new injury or pain, but for the Acupuncture Newbie, a Motor Vehicle Accident often heralds their first experience with Acupuncture treatment.

If you've ever been in a car accident, or MVA, you know how even a minor accident can have lasting effects on the body.  The whiplash, neck pain, headaches, low back pain - its far from an excess of wonderfulness.  My personal and clinical experience shows that the worst of the pain can take 10 days to 2 weeks to fully manifest and this fact often lulls people into a false sense of security about the relatively minor nature of any new accident.  

Ironically, it is during these first two weeks that you can create the most change through Acupuncture, massage and physical therapy thereby heading off the worst effects of a new accident!  So the message of the motor vehicle accident day is this:  
Get Treatment Immediately

Car Accident Recovery - Treat Early, Recover Quickly

If you or someone you know is in an auto accident, even a relatively minor one, its imperative to be mindful of the way you use your body over the next few weeks and to seek treatment immediately.  The more you pay attention to the use and treatment of your body in those early days, the better you will feel and the faster you will recover.

I say this both from professional clinical experience AND from personal experience.  In May 2010 at 4 months pregnant my husband and a friend and I were driving home from dinner and got rear-ended due to a reckless driver who cut us off.  It didn't feel like a whole lot at the time,  but our car got lifted and the back bumper was completely crumpled (mind you we'd only had this new car 10 days!  Oy vey...).  Being pregnant I was very nervous, of course, so we went to urgent care and predictably I checked out just fine.  

Having a PT for a husband, I started physical therapy at home immediately, got weekly massage, acupuncture and osteopathic care.  With all the extra laxity in my joints from the pregnancy, my back did not feel good to begin with - the accident therefore did not do me any favors.  But with such frequent and regular treatment, I recovered easily and well. I kept up that frequency of treatment for a little over a month, and then saw each of my providers once a month through the rest of my pregnancy just to be safe rather than sorry.

Get Treatment - Its Covered

While it can be hard to keep up with seeing multiple providers on a regular basis, if you can work out the time constraints it is completely worth it - approaching the body from multiple avenues ensures that the body heals on multiple levels concurrently leading to a speedier recovery.  And there's no financial reason not to, because its covered!  

In Oregon, massage, acupuncture, physical therapy and all medical treatment related to your accident are all covered 100% by your PIP or personal injury protection coverage up to a max of $15,000 for all medical treatment.  In a severe accident if you seek a lot of western medical care or need surgery, this can disappear very quickly, but if pursuing primarily alternative treatments it should be sufficient to get you through your injury.

Course of Treatment

I see the average MVA patient for an average of 12 treatments over the course of 3-4 months.  This allows for twice weekly treatment if necessary for the first 2-3 weeks, and once a week treatment thereafter for 4-6 additional weeks plus a follow up one month hence.  Starting with a 90 minute combined Acupuncture and Massage session is my general recommendation to begin. 

Accounting for both 60 minute sessions and 90 minute combined Acupuncture and Massage/Cupping sessions over the course of treatment including a heat lamp if indicated, this ends up costing your insurance somewhere between $1,500-$2,000.  Considering that one trip to the ER can cost the same, I'd say acupuncture treatment is quite a bargain and not expensive enough to make a major dent in your PIP amount available.

My ideal combination of modalities for auto accident patients is to see them combine acupuncture, massage and physical therapy.  My 90 minute combined acupuncture + massage treatments generally provide enough massage for the average MVA patient, and your physical therapist will likely do some manual therapy (read "therapeutic deep tissue massage or myofascial release" here if you're unfamiliar with that term) and meet your body's massage needs as well.  Physical therapy can be essential to ensure that your range of motion and function are not impaired by the effects of the accident.  Combined with the pain relieving and muscle relaxing aspect of acupuncture, it is a winning combination for quick and efficient recovery.

So if you know someone who has been in an accident and needs help getting better fast, please think about sending them my way.  My personal and professional experience with motor vehicle accidents makes me well familiar with treatment and recovery, and insurance billing is a specialty of mine to make treatment and recovery as simple as booking online!

Until next time,
~Rebecca
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How Important is Breakfast Really?

9/14/2013

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As I mentioned a few weeks ago, a recent OPB special sparked my interest in Intermittent Fasting for health and I've been experimenting with it and learning more about it.  In the special, Michael Mosely ended up fasting 2x/week, and by fasting I mean eating only one meal a day, and derived and maintained some amazing health benefits.  I'm still in the trial phase myself and once I get a little further along with my journey, I'll report in about it - I promise.

My continued research brought me to some great articles by Dr. Mercola - hence the YouTube video presentation above.  Dr. Mercola has done a great job gathering recent research on Intermittent Fasting and putting it together in an easy to understand collection in the article linked to this presentation.

Intermittent Fasting - a great tool for overall health

Intermittent Fasting involves not eating on a regular or alternating basis for anywhere from 6-36 hours at a stretch.  Different types of intermittent fasting are better for different people and different lifestyles.  The Michael Mosely OPB special examined two different types of intermittent fasting - prolonged fasting for 3-4 days on a monthly basis and alternate day fasting where you eat one meal a day every other day, or 1-2x/week.  Dr. Mercola's site gives research based evidence for 4 different types of fasting as listed here:
Variations of Fasting
In his blog on marksdailyapple.com, Mark Sisson delves into four different variations of fasting, and how to implement them. The variations he includes are:

  1. LeanGains (a fasting protocol by Martin Berkhan vii )—A daily 14-16 hour fast, during which time you consume nothing, with the exception of non-caloric fluids. Sleeping time is included in this time-frame, leaving an 8-10 hour window during the day when you're allowed to eat.
  2. This protocol is designed with regular exercise in mind, with specific nutrient ratios for workout days and rest days, and is geared for those who want to shed excess fat and gain muscle mass. Hence, it's best suited for those who are actually exercising and lifting weights each week and can tolerate working out in a fasted state.

  3. Eat Stop Eat (created by Brad Pilon viii)—In this protocol, you fast for a full 24 hours once or twice a week. Your fast should be broken with a regular-sized meal (i.e. avoid gorging when coming off your fast), and you can maintain a regular exercise program without any special diet recommendations for workout days.
  4. Fasting for 24 hours can be tough for some people, but I would agree with Mark's advice that eating a high-fat, low-carb diet can make 24-hour fasting easier, as a higher fat diet will tend to normalize your hunger hormones and provide improved satiety for longer periods of time.

  5. The Warrior Diet (by Ori Hofmekler)—This is another protocol designed to improve your fitness by exercising in a fasted state. I've interviewed Ori and posted detailed articles on this in the past. His plan calls for 20 hours of fasting, and four hours of "feasting." You exercise during the day in a fasted state. Raw vegetables are allowed during your fast, but no protein, which is reserved for "feasting" or post-exercise recovery meals.
  6. To learn more about the Warrior Diet, please see this previous interview with Ori.

  7. Alternate Day Fasting—This fasting protocol is exactly as it sounds: one day off, one day on. When you include sleeping time, the fast can end up being as long as 32-36 hours.
  8. As Mark notes, this may be the most difficult of all types of fasting, as it will require you to go to bed with an empty stomach a few times a week. It's definitely not for everyone.

The above information is quoted directly from Dr. Mercola's website HERE.

The simplest method I think most people could incorporate into their lives with ease is probably the LeanGains method which basically involves (on the eating side alone, not the exercise piece of course) skipping breakfast.  Stop eating at 8pm and don't eat again until noon or later and voila - you've participated in intermittent fasting.

Recent research on intermittent fasting is extremely compelling.  Take for example the study by Dr. Mark Mattson, Senior Investigator for the National Institute on Aging published in the International Journal of Obesity in 2011 which found that intermittent fasting was just as effective as regular caloric restriction for weight loss and slightly better than regular caloric restriction for reducing insulin resistance (i.e. reducing likelihood of developing Diabetes).

In summary, the participants in this study showed improvements in
  • Normalizing insulin sensitivity, which is key for optimal health as insulin resistance (which is what you get when your insulin sensitivity plummets) is a primary contributing factor to nearly all chronic disease, from diabetes to heart disease and even cancer
  • Normalizing ghrelin levels, also known as "the hunger hormone"
  • Promoting human growth hormone (HGH) production, which plays an important part in health, fitness and slowing the aging process
  • Lowering triglyceride levels
  • Reducing inflammation and lessening free radical damage

All of these are pretty compelling reasons to skip breakfast, but skipping breakfast goes against all previous medical and nutritional guidelines.  I mean who hasn't heard that "breakfast is the most important meal of the day" before?

Well, according to this research, that may not be the case.  In fact, skipping breakfast could be one of the simplest things you can do to improve your overall health and longevity.  Who knew?

Of course you don't have to skip breakfast to participate in intermittent fasting - as listed above there are many different ways to do it, and even the "skipping breakfast" LeanGains method essentially involves only eating for an 8 hour stretch, and it can be any 8 hour stretch including or not including breakfast.  

If you're curious about trying it I recommend you review the information on Dr. Mercola's site as well as Mark Sisson's website which probably has the most detailed information about how to actually go about it.  If you have Diabetes, Hypo or Hyperglycemia or are nursing or Pregnant, it may not be the time to investigate this type of lifestyle choice, but it never hurts to read up and learn more or consult a health professional if you are interested.

I'll be reporting in about my personal experiment in a few more weeks here, so stay tuned for more information on an Acupuncturists Journey into Intermittent Fasting for Health and Longevity coming soon!

Until next time,
~Rebecca
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September is National America On the Move Month!

9/6/2013

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September is National America On the Move Month, hooray!  So its time to get off your duff and get moving while the Fall weather still provides some fair weather days to do so.  America On the Move, a nonprofit organization dedicated to helping Americans lead healthier lifestyles, is the unofficial sponsor of this event and while their website isn't perfectly user friendly, it does allow you to track your activity, set goals, participate in social media community and browse a list of articles to help you learn more about eating well, staying active and making positive lasting lifestyle change.

They have a great list of 100 ways to add 2000 steps to your day HERE and its surprising how little it can take.  Did you realize that an extra 2000 steps will burn at least 100 additional calories?  That might not sound like much when your average restaurant meal in the US is 1,000 calories, but hey - that's half a nonfat latte and every little bit really does count.

An extra trip encircling the grocery store as you shop for dinner, using the bathroom on the far side of the building at your office (if there's more than one) taking the stairs - everything adds steps, burns calories and keeps you moving leading to healthier you.

Lifestyle Change - its a journey

I personally find that lifestyle change towards lasting wellness is a journey.  Sometimes you are motivated to change your diet, your exercise habits, the way you mentally process stressful situations, and sometimes you feel like you are struggling and slogging along.  As someone who has battled an eating disorder and weight issues, I know it isn't easy and depending on the month and the day, I still struggle myself.

I remember my mom always used to get mad at me as a kid (or teen...) if I used the word "just."  She could never agree with the Nike slogan, because to her saying "just do X" or "lets just have..." was grossly inadequate for all the steps and stages of any given activity.  As a kid, this lead to many mother daughter arguments, but as an adult I see her perspective.  Even fixing a simple one pot dinner involves shopping, cutting, chopping, measuring - with two kids hanging on my coat tails, my mom to care for and my solopreneur Acupuncture practice - I often agree with my mom that there is no "just" anymore.

At the same time I recognize that the Nike-ism "Just Do It" is a state of mind as much as a call to action.  When stress and overwhelm get the best of me I feel like everything - even taking a 10 minute walk - is impossible, but when I can take a deep breath and *be* in the moment, I see that everything that needs doing is just another step, and I can only physically do one thing at time anyway.  Every step brings me one step closer to whatever my goal is - be it dinner or exercise or bill paying or anything else - and that is all I need; to keep making measured progress and to recognize it as such.

I think the hardest part of any lifestyle change journey is managing those times when you find yourself in the valley, when stress and overwhelm make it feel impossible to "just do" anything.  Those are the most important times to have your best wellness tools handy - to keep that (acupuncture!) appointment for self care, to decide the dishes can wait in favor of a walk or some meditation or a few yoga sun salutations.

Make Your Self Care Tools More Readily Available

If you have a hard time accessing your tools - the self care interventions you know you should do and could do easily if you *just* stopped and did them - make them a little more readily available.  You can do this by programming a daily reminder in your phone during the most stressful time of day that tells you to BREATHE or reminds you to schedule self care time.  You can keep a white board or bulletin board in a prominent place in your house where you post cards or pictures of 10-15 minute self care activities to remind you of things that are easy to do, or find an app for that!

My favorite app is GPS For the Soul by the Heart Math Institute.  It uses the camera to track heart rate and gives you a check in with your stress level, and then you can chose any number of short guided meditations and timed breathing exercises to help you calm down and refocus in the moment.  Its a simple thing, but sometimes simple works best.

In fact, I am going to make sure to use that app myself today just to check in because you can never do too much to keep yourself on track with decreasing stress and maintaining wellness.

Until next time,
~Rebecca
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    Rebecca M H Kitzerow is a Licensed Acupuncturist practicing in La Center, Washington. With over a decade of experience she has won 10 Nattie consumer choice awards from Natural Awakenings Magazine since 2014.

    Rebecca practices a variety of Acupuncture and Traditional Chinese Medicine techniques including Tan Acupuncture, Kiiko style Japanese Acupuncture, Traditional Chinese Herbal Remedies, Cosmetic Acupuncture, Foot Reflexology, Cupping and Gua Sha. Rebecca strives to help people Be Well and Stay Well in every way.

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