Welcome to my blog

Acupuncture specialist for Fertility, Facial rejuvenation, Pain relief.
Based at Kensington Central London.Qualified as a medical doctor in Western medicine over 20 years ago in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences

Doctor who is passionate about acupuncture

I love what I do, I am good at it and I am always there for my patients. If you come and see me, you will know why I am standing out.
This blog is to introduce latest development and research of acupuncture and offer a chance of awareness of more treatment options for your condition. The blog is for information purpose only.

About Me

My photo

My specialised areas include fertility for women and men, facial rejuvenation, acne, various pain conditions, chronic fatigue and hormone regulation with acupuncture treatment.

Practice contact for appointments and addresses 

Kensington: for appointments (Mondays, Fridays, Saturdays, and Thursdays) at Anamaya center Kensington please call at 02030110355 or email at info@anamaya.co.uk
Address: 1 Adam and Eve Mews, Kensington, London W8 6UG
2 min walk from High Street Kensington underground station

Harley Street: (Wednesdays)
Address
Suite 3 Harmont House
20 Harley Street, London W1G 9PH
5 min walk from Oxford Circus underground station

My background: I became a qualified medical doctor in Western medicine 20 years ago in China and was well trained in Western medicine together with Chinese medicine in the best Medical University in Beijing, China. Also I was trained with Dr Zheren Xuan--famous orthopedics expert and founder of soft tissue surgery in China. I am dedicated to treat patients with acupuncture and am recognized as one of the world leading acupuncture specialists.

I obtained a PhD degree in the University of Leeds in the UK.

I had post doctoral training and worked as a senior researcher in St George's hospital, London, UK.

I had frequently presented my research findings in the top international conferences in the field.

I have many publications including ebooks and articles.

I have many year clinical experiences. Over the years of practicing, I have developed unique treatment approaches for infertility, skin aging, acne, vulvodynia, neck pain, headache, migraine, shoulder pain, back pain, fatigue and hot flushes etc to achieve best treatment results. My devotion and skills are highly praised by my patients. 


Tuesday, 31 March 2015

Acupuncture helps with chronic fatigue syndrome

I am very tired. It is not a rare complaint. Everyone must ever feel tired sometimes, but the tiredness would go away after rest or sleep. If it does not go away, it is a problem. Constant fatigue is the main symptom of chronic fatigue syndrome (CFS). CFS refers to severe exhaustion during and after daily activities or to a lack of energy which is prolonged for 6 or more months and resting and sleeping cannot make fatigue go. CFS affects about 1 in 300 people in the UK. It is about three times as common in women as in men. Most common age group developing CFS is 20-45 and it occurs more in women than in men. Apart from constant fatigue feeling, there are also other symptoms associated with severe fatigue, such as muscle and joint pain, headache, insomnia and poor short term memory etc.

The cause is not clear but there are a few theories including: a viral infection, immune system problems, neuroendocrine dysfunction causing hormones imbalance and psychiatric problems, such as stress and emotional trauma, various inflammatory conditions, central nervous system impairments, and stress. Recently a reduced blood flow in some brain region is found. Some biochemical changes were found in the brain. The purpose of the treatment is to improve the symptoms. Treatments include cognitive behavioural therapy, a structured exercise programme called graded exercise therapy, medication to control pain, nausea and sleeping problems. Acupuncture helps improves symptoms such as reducing pain, stress and improving sleep. This will help improve quality of life in patients with CFS.

Effectiveness of acupuncture on chronic fatigue syndrome

There is no known cure for this condition although treatment may help to ease symptoms. Recently much research has been done to show acupuncture is helpful for chronic fatigue syndrome. For example, one study compared the effects of acupuncture, warm needle and non acupoint groups. They have shown that in comparison with pre-treatment, the scores of Chalder Fatigue Scale including physical and mental fatigue and total score were significantly decreased in both acupuncture and warm-needling groups but not in the non-acupoint group. The physical, mental and total scores of the acupuncture and warm-needling groups were significantly lower than those of the non-acupoint group. Another study compared the effect of acupuncture and prednisone. They have shown that after one course of treatment, the BELL's scores of both groups were obviously improved, but there was no significant difference between groups; after two courses of treatment, the BELL's score in acupunctureand cupping group improved more obviously than that in Prednisone group, and the total effective rate of 91.9% (34/37) in acupuncture and cupping group was superior to that of 71.4% (25/35) in Prednisone group. There was a study compared the effect of acupuncture on chronic fatigue syndrome with herb injection. They found that acupuncture had better effect than herb injected on fatigue scores and symptoms improved.

Recently Zhang W et al studied the effect of acupuncture of Back-shu acupoints in patients with CFS. This was a randomised controlled trial involved in 120 patients with CFS. These patients were equally divided into two groups: acupuncture group and control group. General health was measured and fatigue was measured using Chalder fatigue scale. At the end of the treatment and follow up survey at 4 weeks and 3 months after the treatment, mental and physical function, pain sensation as well as Chalder fatigue scale was improved significantly in acupuncture group compared with those control group. They concluded that acupuncture is effective on chronic fatigue syndrome both on immediate and mid- term basis.

Ng SM &Yiu YM studied the effect of acupuncture on chronic fatigue syndrome (CFS). The participants were 99 patients with chronic fatigue syndrome. This study was well designed with randomized, controlled and single blinded methods. These participants were divided into two groups: acupuncture group and control group with sham acupuncture. The interventions were given twice a week for 4 weeks. They found that physical and mental fatigue was significantly decreased after the treatments. Health related quality of life was improved significantly. Surprisingly there was therapeutic effect with sham acupuncture which was considered due to pressure on the acupuncture points from the sham needles in addition to normal placebo effects. However acupuncture has significantly greater effects than that for sham acupuncture.

When is the best time for acupuncture treatment for chronic fatigue syndrome?

Acupuncture is use to treat chronic fatigue syndrome effectively. In modern era, people are busy at work and they usually go to acupuncture treatment in the evening after finish a day’s work. For chronic fatigue syndrome treatment with acupuncture, is there different effect when acupuncture is received during different time of the day? Ling JY et al investigated this aspect using acupuncture in selective time 9:00 am to 11:00 am in the morning and compared the effect with acupuncture at any time apart from the selective time. 80 patients with chronic syndrome are participated the study. The results have shown that the improvements in the scores of the selective-time-acupuncture group were superior to the anytime acupuncture group. More specifically in the anytime acupuncture group, the total score of fatigue and the score of physical fatigue were reduced after treatment as compared with those before treatment. In the selective-time -acupuncture group, the total score of fatigue, the score of physical fatigue and the score of mental fatigue after treatment were reduced obviously as compared with those before treatment. The ratio of CD3+ and CD8+ T cells was increased obviously after treatment in both groups and the ratio of CD4+ and CD8+ T cells was reduced obviously in the selective-time-acupuncture group, which was better than that in the anytime acupuncture group. The total effective rate was 95.0% (38/40) in the selective-time-acupuncture group, which was better than 80.0% (32/40) in the anytime acupuncture group. They concluded that the acupuncture therapy at selective time is effective in the treatment of chronic fatigue syndrome, which is especially better at relieving mental fatigue. The effect of this therapy is achieved probably by improving the immune function via the regulation of the ratios among CD3+, CD4+ and CD8+ T cells.

Recently a clinical trial studied the effect of acupuncture on CFS. The Fatigue Severity Scale (FSS) score, the Stress Response Inventory (SRI), the Beck Depression Inventory (BDI) and the Numeric Rating Scale (NRS) were used to assess the effect. After 5 weeks of acupuncture treatment, FSS score, SRI and NRS were significantly lower in the treatment group compared to the control group. After 13 weeks of treatment BDI score was significantly lower in acupuncture group. Body acupuncture in addition to usual care may help improve fatigue in CFS patients.

References
Ling JY et al Zhongguo Zhen Jiu (2013) 33:1061-4
Zhang W et al Zhen Ci Yan Jiu (2011) 36:437-41
Ng SM & Yiu YM Altern Ter Health Med 2013 19:21-6
Couilliot MF et al J Integr Med (2013) 11:26-31
Lu C et al Zhen Ci Yan Jiu (2014) 39:313-317
Kim JE et al Trials (2015)16:314

Monday, 30 March 2015

Acupuncture needles for low back pain

Acupuncture needles for low back pain

Back pain is a common condition which affects more than 1 million people in the UK. Back pain can be caused by many factors. But some of the causes cannot be found.

95% of back pain occurs in the lower back. It is defined as non-specific low back pain. Non specific low back pain is tension, soreness and stiffness in the lower back region and the specific cause of the pain cannot be identified. The pain is normally as lasted for more than 6 weeks, but less than 12 months. The pain is persistent or recurrent. Joints, discs and connective tissues in the back may contribute to symptoms. Low back pain affects more than 79% of the population in developed countries. It accounts for 13% absences due to illness in the UK. 35-55 year old are affected most. 90% of the episodes of acute low back pain settle within six weeks, up to 7% of patients develop chronic pain. A study from a study with 5000 adults by the British Acupuncture Council to mark 'Acupuncture Awareness Week' (3rd-10th March 2014) show that almost 80 per cent of people suffer with back pain admit to behaviours that put their backs under unnecessary strain. This study found that almost half of the adults admit to eating on their lap, 40 per cent complain they sit at a desk all day and over a third admit to watching TV or films in bed. When asked about their posture, almost a third also admitted they slouch most of the time.

In the case of treatments for back pain, 74 per cent say they repeatedly use painkillers to deal with their discomfort, which would numb the end symptom and mask the problem but do not address many of the combined underlying causes of back pain rather than addressing the root cause of the problem. Statistics show that 41 per cent of people would only consider acupuncture as a last resort and 88 per cent didn't know the National Institute of Clinical Excellence (NICE) recommends acupuncture therapy for persistent, non-specific lower back pain.

Some patients do turn to complementary and alternative medicine for back pain treatments. What do these patients expect from CAM treatments?

There was a study with semi-structured interviews with 64 individuals receiving massage, chiropractic, acupuncture or yoga for chronic low back pain. The findings included that participants' expectations of treatment outcomes were in four key aspects: pain relief, improved function (including an increase in ability to engage in meaningful activities), improved physical fitness, and improved overall well-being (including mental well-being). Typically, patients had modest expectations for outcomes from treatment.

With 2.3 million acupuncture treatments carried out each year, traditional acupuncture is one of the most popular complementary therapies practised in the UK today. By stimulating different points of the body, traditional acupuncture can be extremely beneficial for back pain, providing long term pain relief and reducing inflammation.

Low back pain with acupuncture treatment

Acupuncture is well known for its effectiveness for back pain. Many research data have provided solid evidence that acupuncture is effective for lower back pain.

NHS recommended acupuncture combined with self-care for persistent low back pain.

Acupuncture alone is effective to relieve back pain. Also acupuncture can be one of the combined treatments offered to patients which reduce the use of medications and improve the outcome. Self care and acupuncture can help release low back pain. This is recommended by NICE guidance as treatment options for persistent low back pain. Cheshire A et al reported their survey based in a primary and community care setting, delivering acupuncture, self management and information to patients with chronic low back pain. They evaluated patient outcomes and experiences of the Beating Back Pain Service (BBPS). The questionnaire is at three time points: pre-BBPS, immediately post-BBPS and three months post-BBPS. There were 80 participants with mean age 47 years. 65% of them were female. Their results showed that pain scores were improved between baseline and post treatment, these improvements were maintained at 3 months follow-up. Patients receiving a combination of acupuncture and self-management sessions produced the most positive results. Patients satisfaction with the BBPS was high. They concluded that combining self-management with acupuncture was most effective, though further consideration is needed to engage patients in self-management. Acupuncture has no severe side effects which can be applied over a longer period of time. The National Institute for Heath and Clinical Excellence guidelines on best practice now recommend offering a course of 10 sessions of acupuncture as a first line treatment for persistent, non specific low back pain.

Effectiveness and acceptance of acupuncture for low back pain

There was a study involved 18000 patients with chronic pain including low back pain. This study showed that the effect of acupuncture was more than placebo. There was a further evidence provided by research from Germany showing that acupuncture is effective for chronic low back pain and acupuncture was highly accepted and had positive effects in patients with chronic low back pain. This was a randomized controlled trial. There were 143 participants with chronic low back pain. 74 patients were offered acupuncture twice a week, while other 69 patients were not given acupuncture as a control. Acceptance of acupuncture, health-related quality of life and pain/symptoms were assessed. The result of the study showed that acceptance of acupuncture was excellent. 89% of the patients would like to have TCM integrated treatment and 83% would have paid for TCM if necessary. Physical functioning, general health, vitality and emotional role were all better in patients with acupuncture treatment compared with control group. Pain relief in acupuncture group was superior to the control group. For instance, pain with sitting/standing, pain upon carrying loads of 10 kg or more and pricking in hands and feet were significantly reduced. Author’s conclusion was that acupuncture was highly accepted and had positive effects in patients with chronic low back pain. Acupuncture can be an effective, well tolerated therapy with no major side events.

Why acupuncture is effective for low back pain?

There are several mechanisms that explained the effectiveness of acupuncture on pain relief. Acupuncture stimulates nerve endings located in muscles and other tissues leading to production of endorphins and other neurohormonal factors. Acupuncture reduces inflammation by releasing vascular and immunomodulatory factors. Acupuncture increases local blood circulation and improves muscle stiffness, joint mobility and swelling. Also how brain and spinal cord processing pain has been altered. In neuroscience, the default mode network (DMN) is a functional network of brain regions that show increased activation during wakeful rest. In patients with low back pain, this DMNconectivity has changed. Acupuncture has been widely accepted for effective low back pain treatment. How acupuncture affect DMN is not clear. Tang et al studied this subject. They used RsfMRI technique to analyse the connectivity of DMN and recruited 20 patients with low back pain and 10 health subjects for controls. They found that there was less connectivity within the DMN in patients with low back pain than healthy subjects, mainly in the dorsolateral, prefrontal cortex, medial prefrontal cortex, anterior cingulated gyrus and precuneus. After 4 weeks acupuncture treatment, patients brain connectivitys were restored almost to the levels seen in healthy controls. Reductions in clinical pain were correlated with increases in DMN connectivity. It can be seen from this data, modulation of the DMN by acupuncture is related to its therapeutic effects.

Standardization of acupuncture points for low back pain

TCM diagnoses and treatment recommendations for specific patients with chronic low back pain vary widely across practitioners. If you go and see a few different acupuncturists, you would get acupuncture at different points. There are no standardized acupuncture points for any conditions. A study has shown that twenty diagnoses and 65 acupoints were used at least once; and only one point UB23 was used for every patient by most acupuncturists. In China standardization of acupuncture points was encouraged to achieve best outcome of the treatment. There was a study compared the efficacy of standardized acupuncture and individualised acupuncture points. In this study up to 15 sessions of acupuncture treatments were offered. The standardized acupuncture was based on the acupuncture intervention from a large multicenter trial previously performed. 78 patients were in the standard acupuncture group and 72 patients were in the individual acupuncture group. Both acupuncture interventions were applied by the same medical doctor specialized in western general medicine (25 years of clinical practice) and trained in Chinese medicine with 20 years' experience in treating low back pain with acupuncture. The result has shown that the average pain severity after 8 weeks and 26 weeks did not differ significantly between both groups. This study has shown the possibility of standardization of acupuncture treatment for chronic back pain patients.

Which acupuncture points are frequently used in lower back pain?

There are over 400 acupuncture points in human body according to Chinese medicine theory. The selection of appropriate acupuncture points is the first step to obtain therapeutic effects. How acupuncturists select acupuncture points? There are three basic principles to select acupuncture points: the first is local acupoints near the area where symptoms occur; the second is distant acupoints along the meridian and the third is distant acupoints based on symptom differentiation. Lee SH et al analysed acupuncture points from 53 studies using modern techniques to extract most commonly used acupuncture points. There were 33 most frequently used acupoints for lower back pain (LBP). The most frequently used acupoints in the treatment of low-back pain were BL23 (51%), BL25 (43%), BL24 (32%), BL40 (32%), BL60 (32%), GB30 (32%), BL26 (28%), BL32 (28%), and GB34 (21%). All local acupoints for LBP are on the Bladder and the Governing vessel especially at the low back position of these meridians. Most of the distant acupoints are on the Bladder and Gallbladder meridians. The acupoints include seven acupoints (BL23, BL24, BL25, BL26, and BL32 as local points and BL40 and BL60 as distal points) on the bladder meridian and two acupoints (GB30 as a local point and GB34 as a distal point) on the gallbladder meridian.

Mechanisms of acupuncture for low back pain

Acupuncture needles are used to treat low back pain. The mechanism of this treatment is still not clear. Why some people respond well while others do not. A study examined changes in lumbar multifidus (LM) muscle function and nociceptive sensitivity after dry needling in patients with LBP and to determine if such changes differ in patients that exhibit improved disability (responders) and those that do not (non-responders). Sixty-six volunteers with mechanical LBP completed the study. Ultrasound measurements and pain algometry of the LM were taken at baseline and repeated immediately following dry needling treatment to the LM muscles and after one week. The percent change in muscle thickness from rest to contraction was calculated for each time point to represent muscle function. Pressure pain threshold (PPT) was used to measure nociceptive sensitivity. Participants were divided into responders and non-responders based on whether or not they experienced clinical improvement using the modified Oswestry Disability Index after one week. Patient responders showed larger improvements in LM muscle contraction and nociceptive sensitivity 1 week, but not immediately, after the treatment than non-responders. The results suggest that there may be lasting and clinically relevant sensorimotor changes that occur in LBP patients that improve with acupuncture needle treatment

References

Pach D et al (2013) Evid Based Complement Alternat Med 2013:125937

Hogeboom CJ et al (2001) Complement Ther Med 9:154-66

Tang WJ et al Acupunct Med 2013 Nove 26. Doi:10.1136/acupmed-2013-010423

Cheshire A et al BMC Complement Altern Med (2013)13:300

http://publications.nice.org.uk/low-back-pain-cg88/key-priorities-for-implementation

Lee SH et al Evid Based Complement Alternat Med (2013) 2013:402180

Weiss J et al J Altern Complement Med (2013) 19:935-41

http://www.acupuncture.org.uk/public-content/public-pr-press-releases/3733-couch-potato-culture-causes-a-generation-in-pain.html

Hsu C et al BMC Complement Altern Med (2014) 14:276

Koppenhaver SL et al Man Ther (2015) Mar 13. pii: S1356-689X(15)00051-X. doi: 10.1016/j.math.2015.03.003. [Epub ahead of print]

Monday, 23 March 2015

What do you know about body fat?

What do you know about body fat?

When we say fat, one might instantly think of obesity. What is fat? Fat is one of the basic components that make up the structure of the body. It is necessary for normal, healthy body functioning. Body fat can be divided into two types: essential fat and storage fat. Essential fat is necessary for normal, healthy functioning. In men, essential fat is approximately 3% of body weight, while in women it is about 12%. This also depends on age. With increased age, the essential body fat increased. Storage fat is the fat increased when you gain weight and this is the fat that you want to lose when you lose weight. Most of people know that too much fat is not healthy. Too much fat increases your risk for developing heart disease, high blood pressure, gallstones, type 2 diabetes, osteoarthritis, certain cancers and for an early death increases.

Do you know too little fat is not healthy either. If a man’s body fat is too low, his health may be compromised and he may become more vulnerable to illness or experience chronic fatigue. If a woman's body fat is too low, her periods may stop and she may experience infertility. Or the other way around if a woman’s periods stops she may have low body fat. Also if a woman’s body fat is too low, the health of her bones, normal hormonal function may be compromised and she may have osteoporosis.

Amenorrhoea is the absence of menstrual periods. Women who are athletes or who exercise excessively on a regular basis are at risk of developing athletic amenorrhoea.

Low levels of body fat and exercise-related hormones, such as beta endorphins and catecholamines, are thought to interfere with the functioning of the sex hormones oestrogen and progesterone. If left untreated, long-term complications include increased risk of broken bones and premature ageing.

For a doctor to diagnose athletic amenorrhoea, all other possible causes, such as certain reproductive disorders, must first be eliminated. Treatment options include exercising less or, in some cases, starting hormone replacement therapy (HRT).

The long-term complications of untreated athletic amenorrhoea include:

Infertility – a woman can’t conceive when she is amenorrhoeic, but athletic amenorrhoea has no effect on long-term fertility once menstruation returns.

High levels of blood cholesterol – are caused by an oestrogen-related fall in the ratio of good cholesterol (high-density lipoprotein or HDL) to bad cholesterol (low-density lipoprotein or LDL).

Osteoporosis – is a disease characterised by brittle bones that break easily.

Premature ageing – the skin loses its elasticity due to low levels of oestrogen.

Unwanted gaining weight, which hormones to check?

If you gain weight unexpectedly and have trouble to lose the weight, you need to get your hormones checked. Imbalanced hormones can make you put on weight. Which hormones do you need to check?

First , thyroid hormones. If your thyroid function is low and you don’t produce enough thyroid hormones, you can put on weight. Thyroid hormone regulates the rate of the metabolism in your body. If it does not work well, you will likely become fat and have low energy. You may have other symptoms of low thyroid including weakness, cold hands or feet, constipation, low immunity and brittle hair.

Second, insulin. Insulin is produced in pancreas and it is a fat-storing hormone released in response to excess blood sugar. If you have insulin resistance, which means that insulin isn't working very well in your body, this leads to weight gain. Apart from weight gain, other symptoms of insulin resistance include excess thirst and urination, hunger and sugar craving, fatigue and poor circulation, cold hands and feet, poor immunity, poor thyroid function, PCOS, heart and liver problem etc. Improving
your insulin response is a great way to reduce body fat, improve energy and overall health.

Third, Cortisol. Cortisol, called stress hormone is produced in adrenal gland. High or low level of cortisol can cause weight gain. High cortisol levels will lead to fat gain around the belly. Low cortisol levels caused by adrenal fatigue will cause weight gain as well. Other symptoms of adrenal fatigue include bloating, fatigue, sleep disturbances, salt cravings.

Finally, Estrogen and others. Estrogen is stored in fat. Excess estrogen stresses the adrenal glands and binds up thyroid hormone, making weight loss very difficult, especially in the hips and thighs.