Background:
It is estimated that COVID-19 could be up to ten times more deadly than the flu. This could be due to the intense inflammatory response it triggers in the body. Covid-19 seems to have an effect on the production of proteins called “cytokines” which are known to be involved in systemic inflammation. These Cytokines are found to be overproduced in those suffering from severe COVID-19. 

A Cytokine Storm is "a severe immune reaction in which the body releases too many cytokines into the blood too quickly. A cytokine storm can occur as a result of an infection, autoimmune condition, or other diseases. It may also occur after treatment with some types of immunotherapy." A cytokine storm is the rapid release of pro-inflammatory proteins and is a classic sign to physicians as a symptom of sepsis; an often fatal response to infection.  Symptoms of a Cytokine Storm fall in line with what we have been told to look for as common symptoms of covid-19 such as fever, swelling, severe fatigue, and nausea.

Research:
A study originally published in early August of 2020 (linked here) demonstrated the anti-inflammatory effects of acupuncture.  This certainly is not the first study to provide evidence that acupuncture can be incredibly effective in supporting the body’s immune function, however considering the current pandemic, it seemed to catch the eye of many concerned readers. 

The study was able to conclude that though anti-inflammatory drugs are also effective, they come with undesirable side effects, including organ damage. Whereas acupuncture offered a safe, natural, and effective way of helping the body navigate the complexity of this disease with no lingering side-effects and many added therapeutic benefits. 

Similar findings were reported in a study originally posted in September of 2020 (linked here). While investigating the effects of acupuncture on those suffering from asthma, they were able to conclude that acupuncture does in fact have an effect on the immune response. 

Hang on, this gets a little science-heavy here, but this is an important statement from the above study as to why acupuncture is able to act as an anti-inflammatory treatment. “T-helper cell type 1 (Th1) plays an important role in cell-mediated immunity, whereas T-helper cell type 2 (Th2) is responsible for humoral immune responses, such as regulating immunoglobulin G (IgG) and IgE secretion. Acupuncture has been shown to restore the equilibrium between Th1 and Th2 activity by reducing the production of Th2-specific cytokines”. 

Though Acupuncture and Traditional Chinese Medicine (or TCM) have been around for over 3,000 years, the efficacy of TCM has been questioned in Western medicine since its arrival on our shores back in the 1970s. A fundamental difference between the two is that Western medicine often seeks to block neural pathways in order to relieve symptoms (such as pain) as the first course of action. TCM uses a more holistic approach to wellness. An acupuncturist is trained to identify areas of disharmony (such as pain or heat) within the body and with this knowledge treat the diagnosed condition (or conditions), not simply mask the symptoms. A benefit to this type of medicine is that TCM looks much more thoroughly into the health and condition of organs and their contribution, or lack thereof, to the system as a whole. Though much work needs to be done in order to fully understand the relationship between cytokines, Covid-19, and TCM, this continuing research represents an important step. Ongoing efforts will continue in order to understand the neuroanatomy of acupuncture, and how it could, and quite frankly should be used safely and effectively alongside just about any other treatment modality. 

What does all this mean?
Because of the disease’s potentially fatal production of these pro-inflammatory proteins, COVID-19 and Cytokine Storms have a lot in common. The good news is that acupuncture may be able to help! 

If you are looking to simply boost your immune system, or require some input on what to do next, please reach out. We are here for you. Feel free to call or schedule your appointment today.

Wellness doesn't always mean perfect health. Nor does a diagnosis mean you are doomed to a life of poor health. In fact, there are many things you can do to support wellness, even when facing chronic pain. Take action for your health now with these strategies from Always Well. 

​Start with a Healthy Environment
While a healthier home environment won't eliminate a diagnosis, it can help alleviate stress and some symptoms. Try these tips for making your home comfortable and less flare-up-inducing.

• Clear out household clutter for peace of mind (and fewer trip hazards).
• Reduce your exposure to toxins around your home by changing products and routines.
• Talk to your local HVAC specialist about repairing system issues and achieving cleaner air.

Change the Habits You Can Control
Chronic pain can make many things difficult, but healthier habits are always beneficial, and some may even help alleviate pain.

• Increase hydration to help your body discard waste and protect delicate tissues.
• Boost your system's defenses with antioxidant-rich foods.
• Choose anti-inflammatory foods to support healing.
• Try exercises to manage your symptoms while strengthening your body.

Address Pain from Multiple Angles
Living with chronic pain isn't easy, and there's no magic solution. But there are many ways to live with and minimize pain, no matter the cause.

• Consider acupuncture for relief; studies suggest it can have a clinically relevant effect on pain.
• Aim to relieve stress and tension; reducing anxiety may help minimize flare-ups.
• Advocate for yourself regarding conventional pain management, as needed.

There is no magic solution to eliminating pain due to a chronic condition. But these strategies can help minimize pain and enhance your quality of life while you find ways to live with your diagnosis.

Did you know that acupuncture can be a powerful ally for people who have various types of Diabetes? 

It’s true...let me explain how an acupuncturist views the common condition.

 Although Western and Traditional Chinese Medicine use different methods to treat common diseases, both approaches also agree on many things. Western medicine considers diabetes melletis as a disease of blood sugar metabolism. 

Diabetes is caused by either or a failure of the cell’s ability to accept insulin and dump toxins into the blood or the pancreas is not able to produce adequate insulin to lower blood glucose.

According to TCM, Xiao Ke or “wasting and thirsting disease” is divided by the patient’s symptoms into upper jiao, middle jiao and lower jiao. We’ll discuss more about this further in the article.

Diabetes, according to Western Medicine  is divided into three general categories (ADA, 2018): 

1)    Type 1—pancreatic beta cell autoimmune destruction is usually diagnosed in children.  

2)    Type 2, adult onset functioning, yet progressive beta cell destruction autoimmune markers along with insulin resistance. 

3)    Gestational diabetes is hyperglycemia during pregnancy.  Gestational diabetes usually resolves itself following delivery of the baby.

According to TCM, Xiao Ke or “wasting and thirsting disease” is divided by the patient’s symptoms and also divided into 3 general categories:

1)    Upper Jiao - The upper jiao is when the lung isn’t able to descend moisture to the rest of the body.  
2)    Middle Jiao - The middle jiao is “spleen not able to transform and transport” to the rest of the body.  
3)     Lower Jiao - Stomach may also have excess fire or deficiency thus unable to digest food.  Liver yin deficiency, creating fire may also  be a culprit.  Lower jiao involves kidney yin. Yin is the body’s ability to cool, ground, it’s substance and associated with water.  When yin is deficient, it creates heat in the body, and consumes the body’s fluids.  Diabetes Meletus is excessive glucose, heat, inability to ground in TCM.  

TCM physicians use the patient’s case history, looking at the patient’s tongue and feeling the patient’s “pulses”. “Reading” the pulse, isn’t counting beats. The pulse shows nine organ and channel conditions-- the “climate” of the body.  The practitioner can feel such as heat, cold, damp, excess, deficiency and phlegm which indicate how to best treat the patient. TCM therapy has seven aspects. Treatment is specifically individualized to harmonize climate and imbalance.” 

Similarities: Both Western and Eastern focus on diet, weight loss, and exercise to treat diabetes.  Both use medications, nutritional supplements or herbs to reduce blood sugar and improve cellular respiration.

Differences:
Western medicine uses a “one size fits all” approach. Everyone with a diagnosis of adult onset diabetes type 2 starts off with metformin. The A1C is measured after three months, then the medication is adjusted, or other medications are added.  If the A1C isn’t within normal limits, insulin may be added. According to Western medicine, the pancreas is diseased.

TCM uses differential diagnosis developed over 3,000 years. Urinating sugar illness is called Tang Niao Bin.  Diabetes is also called “Wasting and Thirsting” disease, “Xiao Ke”. Diabetes Mellitus is caused by heat, dampness and phlegm.  An acupuncturist will ask to see your tongue, feel the pulses in three positions and three levels. The TCM physician considers a detailed patient history, including past illness, emotional trauma and injuries important to determine the best treatment.  Treatment is specific to each person.  Diabetes Mellitus can be caused by disharmony in the upper body, middle or lower body.  Diabetes isn’t a “one size fits all”, but a symptom of a deeper problem (Guo, 2014).  

Though there are many TCM patterns for this condition , which pattern below best describes your symptoms?

Upper Body: 
1.    Lung Heat Injuring Fluids. This can be caused by childhood exposure to secondhand smoke, recurrent lung infections caused by viral or bacterial pathogens, often the pathogen has not been completely eliminated. Cigarette smoking dries the lung mucosa, destroying delicate cilia, depositing carbon into lung tissue. 

The patient experiences asthma, excessive thirst, dry mouth and tongue, hacking dry cough, sometimes producing a sticky phlegm.  Treatment: cool lung, descend lung qi. One formula is Bai Hu Ren Shen Tang (White tiger decoction). Diet would include pears, rice, mei men dong, sha shen tea, asparagus, mulberry leaf,  marshmallow root tea. Formulas may include Mai Wei Di Huang Wan and Sha Shen Mai Men Dong Tang.

Middle Body:
2.    Excess Stomach Heat.  Changes in diet and lifestyle usually clear this up.  Excessive consumption of alcohol, too much hot and spicy food, over-eating, too much red meat, too much highly processed food, dairy, and food allergens.   The person feels famished, heartburn after eating or at night, experiences constipation and dry stools, and elevated blood sugar. Pumpkin has been shown to lower blood glucose, avocados, one half gallon of water per day, sha shen tea, and lots of green vegetables. Beef is neutral in temperature and consumed in moderation, thus reducing heat and nourishes yin. Formulas prescribed may include Bai Hu Jia Ren Shen Tang, Shen Ling Bai Zhu San, Zeng Ye Tang.

3.    Liver qi deficiency (Hazlehurst, 2016) :  Blood sugar usually is higher with stress.  Some of the other symptoms include flank and chest discomfort, hypertension, red eyes, visual disturbances, short temper, irritability, depression, migraines, heartburn.  When liver qi is not flowing, the liver qi energy tends to rise. Exclude fried, dairy, alcohol, sodas. Diet includes  green leafy vegetables, olive oil and lemon juice, lemon water, dandelion, chlorella, and beets.  Formulas used to treat this pattern include Xiao Yao San, Yi Guan Jian and Chai Hu Shu Gan Tang (Guo, 2014).

Lower Body
4.    Kidney Yin Deficiency (Zheng, 2011): Yin is the body’s ability to “cool” itself, it is substance, anchoring and grounding.  Kidney energy is called Dan Tian “life force energy”.  If the “Dan Tian fire” is too high, fluids are evaporated, blood thickens, and energy raises. The patient experienced low back achy pain, knee pain, unmeasurable low grade feverish feeling in the afternoon.  Often patients complain of night time urinary frequency, elevated blood pressure, hearing difficulty, and elevated glucose.  

Treatment: Diet with fish, sea vegetables, dark green vegetables, pork, dark beans, bone broth, miso soup, vitamins and minerals, and one half gallon of water per day is commonly prescribed.  Herbal treatment includes Liu Di Huang Wan,  Da Bu Yin Wan, and Zuo Gui Wan.

TCM offers many treatment options to control diabetes. This article details a few suggestions. Please contact your primary care physician and your acupuncturist to find what is best for you.

Resources: 
1.    American Diabetes Association. (2018). Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2018. Diabetes care, 41(Suppl 1), S13–S27. https://doi.org/10.2337/dc18-S002
2.    Gökhan, S. Hotamışlıgil et al. (April 24, 2019).  “The short-chain fatty acid propionate increases glucagon and FABP4 production, impairing insulin action in mice and humans,” Science Translational Medicine, April 24, 2019, DOI: 10.1126/scitranslmed.aav012
3.    Hazlehurst, J. M., Woods, C., Marjot, T., Cobbold, J. F., & Tomlinson, J. W. (2016). Non-alcoholic fatty liver disease and diabetes. Metabolism: clinical and experimental, 65(8), 1096–1108. https://doi.org/10.1016/j.metabol.2016.01.001
4.    Guo, J., Chen, H., Song, J., Wang, J., Zhao, L., and Tong X. (July 14, 2014).  Syndrome Differentiation of Diabetes by the Traditional Chinese Medicine according to Evidence-Based Medicine and Expert Consensus Opinion. Article ID 492193.  https://doi.org/10.1155/2014/492193
5.    Zheng, A.S.D. (2011). Essentials of Chinese Medicine. Internal Medicine 2nd Edition. Pgs 281-289. Bridge Publishing Group. ISBN:  978-0-9728439-8-0.