I wanted to take an opportunity to share my opinion on some hot button topics that are brought up a lot during treatment sessions or from inquiring patients. These frequently asked questions may get different responses from different acupuncturists or other types of practitioners, so you should know that the answers in this blog all represent my own opinion. Also, I tried as best as I could to resist the urge to answer all questions with, "Just take herbs."
-Colby
What are your thoughts on probiotics?
Generally, probiotics are used to improve digestive function by introducing healthy microorganisms into the gut, but this is something that should be achieved by adjusting the diet. Why is digestion a problem in the first place? Usually cleaning up digestion starts with cleaning up the diet. If there's a more significant pathology at work, then I'd rather turn to an herbal formula tailored to the specific diagnosis rather than a general probiotic treatment. Probiotics can be useful after taking antibiotics, but I still feel it's best to reintroduce flora to the gut through the diet.
What about vitamin supplements?
It's the same with vitamins. If you're eating right, there isn't a need to super-dose vitamins. You should be getting all of the proper nutrients from your diet. The argument I run up against is that the typical American diet does not provide enough of the nutrients we need. That's an excuse as much of a reason. Vitamins may not be the same as pharmaceutical medications, but in many cases they still represent looking for answers in a pill rather than in lifestyle adjustments. Vitamins are best absorbed in their natural forms, hence why so much is wasted and excreted from the body in the form of neon green urine when taking supplements.
How do you feel about coffee?
I hate coffee. I think it's gross. 99% of people I know have a love affair with coffee that I will never understand. Medically speaking, I kind of feel that same way. Sure, every now and then you see some study that says coffee prevents or treats such and such disease. Ok, fine; but that's extracts from the coffee plant, not anything mixed up at Starbucks, mind you! My thoughts on coffee, from a TCM point of view (and I will say that there are acupuncturists who will disagree with me here), is that it taxes the Kidneys. I really believe that the energy and buzz that comes with drinking coffee is, in fact, Qi activated and released from the Kidneys. Coffee acts as the catalyst for burning your own fuel rather than being the source of that quit boost. Essentially, you're robbing Peter to pay Paul, and eventually you get caught - that's why there's the crash a few hours later, and that's why over time people tend to feel greater levels of fatigue. You're slowing spending Kidney Qi that normally would be stored and preserved for more fun things, like baby-makin'.
What are your thoughts on cannabis?
Overall, I'm not a fan. Cannabis has a similar effect on the Kidneys as coffee does. Cannabis also has an effect on the aspect of the spirit controlled by the Kidney, the Zhi ("will" or "willpower"). This is why frequent users tend to lack motivation... Also, I think it's fairly obvious that smoking is bad. Cannabis may not have every chemical that cigarettes do, but inhaling smoke adds pathological heat to the Lungs and weakens the Lung Qi. I do have cancer patients who believe it's an important part of the puzzle for managing some of their symptoms, and I generally don't argue with them. If you're looking to use it to manage pain, however, I'll probably steer you towards a more effective and specific herbal treatment.
What about St. John's Wort / Echinacea / Milk Thistle / Rhodiola / etc.?
Most of the herbs that are popularly known or you read about on the internet come out of a western/European herbal tradition and are generally different from the Chinese herbs we use (though there are some that overlap). Typically, these herbs are misused, according to their Chinese medicinal properties, which is understandable because most (western) "herbalists" are not really trained, and fewer will have any formal education in the subject. That's why you don't see many apothecaries around, and most of these people work at Whole Foods, etc. The approach to western herbology tends to be symptom management with blanket treatments, i.e. "this is good for headaches" and "this is good for sleep." That's crap. Diagnosis is so, so important! Long story short, we generally use other herbs that achieve the same goals but are much more effective because they correspond to a diagnosis that encompasses all symptoms stemming from a root cause. Oh, I do like echinacea, though! And rhodiola is actually a Chinese herb - you just gotta use it right!
Juice cleanses?
No. Just, no.
Which is best for me: yoga, tai ji, qi gong, or the gym?
Yoga is great for most people - it's just important to choose the right kind for your body type and constitution. I admittedly don't know much about the different types of yoga, but based on my clinical experience, I recommend that patients with Blood and Yin Fluid deficiencies avoid "hot yoga," as the loss of body fluid worsens those conditions. It's also important to be supervised; I see a lot of people who injure themselves trying to do yoga from a video. Tai Ji and Qi Gong I think are universally beneficial. They are considered yang sheng - nourishing life practices that when mastered lead to immortality. It's a great meditative practice, actually, because it engages mind and body, just as yoga does. Again, better to be instructed and supervised. The gym is great, so long as you're not overdoing it. It's important to do rigorous exercise as part of your routine. Getting the heart pumping and the sweat flowing is a good thing. Again, supervised and not to the point of damaging body fluids, which can in turn lead to musculoskeletal injury. I use an herbal formula for anyone starting a new workout regiment or who is routinely sore after working out. You can read about it here: Supporting Athletes and Performers
How do you feel about cholesterol and blood pressure numbers and cut off values?
These are generally used to decide "objectively" whether or not someone needs to be medicated. Again, medication tends to subvert the willingness to make lifestyle adjustments. As far as the numbers themselves, so long as someone is not at high risk for heart failure or stroke in the immediate future, I'm not too concerned with them as long as they're actively engaged with lifestyle adjustments. That can includes diet and exercise, as well as acupuncture and herbs, at least for my patients. There really is a lot to say about the numbers, particularly in that they don't accurately represent the needs of every person's body, but I will say this: they are useful in that they are an objective way to show an MD that Chinese medicine is benefiting the body.
What's the difference between an acupuncturist and doctors and chiropractors who claim to do acupuncture?
Training. MDs, chiropractors, and physical therapists do not have the 4-year education in acupuncture technique, which includes safe needling angle and depth for several hundred acupuncture points, nor do they have but perhaps the most rudimentary understanding of Chinese medicine diagnostics. MDs can legally needle someone with their license and can get acupuncture certificates through weekend workshops for MDs. How can you choose an acupuncture point without knowing the cause of the disease? They do many things well. I don't want an acupuncturist to remove my appendix, but I certainly wouldn't seek a physician to give me acupuncture to help me recover from surgery, either.
How do you know if an acupuncturist is legit?
Acupuncturists must be licensed, though in the state of Kentucky we are called "Certified Acupuncturist" though the state's medical licensure. In order to become licensed, we have to complete a 4-year Master's degree program at an accredited school. Definitely look for these credentials. Beware of so-called "medical acupuncturists," MDs advertising acupuncture, for the reasons stated above. Also watch out for acupuncturists claiming to be doctors of Chinese medicine. Some states call their acupuncturists doctors in their licensure - New Mexico comes to mind - but their training is only at the Masters level. There does exists a doctorate degree in Chinese medicine called a DAOM (Doctor of Acupuncture and Oriental Medicine), which requires advanced training and clinical work, as well as completing and defending a research dissertation. There are only around 50 DAOMs in the country currently, but I am happy to say I will be one of them in the next couple of months!
What about acupuncturists who don't use herbs?
I think there are some situations which require herbs, plain and simple. I can appreciate that there are some practitioners who specialize in sports medicine and think they don't need to use herbs for that (I guess...), and I can appreciate that herbal pharmacies aren't feasible for everyone's private practice. On the other hand, I had classmates who would often say they wouldn't use herbs in private practice because developing that expertise is too difficult. Being an herbalist improves your diagnostic abilities and your acupuncture skills, in my opinion.
What do you think of community acupuncture?
Really, it's a case of you get what you pay for. It's discount acupuncture at a discount rate. Sure the treatment may only cost $20, but you're only getting $20 worth of acupuncture, and when you don't see results, you've wasted that $20. Community acupuncture is usually done in an open setting with patients sitting together in chairs. Treatment times are short, so there's not enough time for a thorough intake and diagnosis, and because it's done in a much more public setting, there are privacy issues. Also, since there are other people around, and the treatments are done in a sitting position, not all points of the indicated points can be used. There are no herbs. Really, this model is for students to maximize patient exposure, essentially to practice and experiment on patients before going into private practice or working at hospitals. You wouldn't want to see a fledgling doctor or dentist who's bouncing around from person to person in an open room trying to figure out how to be a good practitioner. The advantage of seeing an acupuncturist is that one-on-one time followed by time to lie in peace and relax. I did work in a community clinic at a homeless shelter the semester before I became in intern while at school, and it is definitely a great way to bring the medicine to underserved populations, but that was certainly the most hectic place I've ever seen to treat patients.
What are some books you'd recommend to new patients?
For generally TCM info, I like Between Heaven and Earth: A Guide to Chinese Medicine. It has a lot of good info that's easy to understand. It's what I read before starting acupuncture school. There's a section in there about figuring out what element you are, if that's your thing. The Web That Has No Weaver: Understanding Chinese Medicine is good, too, but it's a little dry. For dietary information, I'd go with The Tao of Nutrition, Healing with Whole Foods, and Ancient Wisdom, Modern Kitchen. The last one was written by two of our amazing teachers who teacher the eastern nutrition classes and advanced herbology classes.
Who do you like in the game tomorrow?
CARDS
