Welcoming Fall

Even though it doesn’t feel like it, fall is upon us. Time to support and cleanse the organs involved with the Metal element (Lung and Large Intestine).

This means possibly processing grief, letting go emotionally and physically. Symptoms may be showing up in your skin, digestion, mood, energy levels and/or your immune system. 



Now is the perfect time for a seasonal tune up, and perhaps a detox to help with the letting go of what is not needed.Talk with Kim and Loren to find out more about what kind of fall detox program will best support you.

Great explanation for cupping, it's a podcast, enjoy!

This podcast is really good, explains what cupping is used for and how it works: http://www.everydayacupuncturepodcast.com/cupping/

Acupuncture and Moxa for Breech baby

Did you know that acupuncture and moxa can correct a breech position baby?
 This treatment is safe, and most effective in weeks 33-37 of pregnancy. Studies have shown success rates are best when mom includes gentle daily stretches and exercises specific for helping baby's position.

The acupuncture points used are located throughout the body, and moxa and acupuncture are applied specifically to UB 67, the little point on the end of the little toes (image shown below). Women are instructed on how to continue moxa daily on the UB 67 points.

Resources for our fertility clients

Over the years we have shared these great books and websites with our clients facing fertility challenges. Some of them are framed in the eastern medicine approach, and some address a blend of eastern and western medical approach. Because our approach includes diet and lifestyle, some of the books and dvd's pertain to that as well. 

The Infertility Cure by Randine Lewis

Making Babies by Sami S. David MD and Jill Blakeway, L.Ac.

The Way of the Fertile Soul by Randine Lewis

Cooking for Fertility by Katherine Simmons Flynn

Taking Charge of your Fertility by Toni Weschler

Restoring Fertility Yoga DVD by Dr.'s Brandon Horn and Wendy Yu, PhD.

Waiting for Daisy Peggy Orenstein

Inconceivable by Julia Indichova

The Fertile Female by Julia Indichova

Conquering Infertility by Dr. Alice Domar

Natural Solutions to Infertility by Marilyn Glenville, PhD.

Fertility Wisdom by Angela Wu, OMD

Your Fertility Program, the East/West Guide to Maximimum Fertility by Maureen Rozenn

Websites with Fertility-related mind-body audios:

Circlebloom.com

Anjionline.com

Acupuncture (and herbs) for your health maintenance

This post is written for any of you who are curious about what regular acupuncture might do for your health and wellbeing. 

Often, clients find us to address specific acute and chronic concerns, such as nagging headaches, or migraines that worsen during heightened stress or long work hours. Irregular and painful menstrual cycles that stops you every month and re-routes your plans for the day. Then there are the digestion complaints that come and go, and you aren't sure what foods or events might trigger it. Many of us have experienced times when the demands of work or family bring on stress that leads to tired eyes, headaches, tense muscles, restless sleep, and a feeling of irritation and low energy. Perhaps you notice a vague sense of pressure or tension which seems to continue building, and your regular workouts or the occasional glass of wine helps in the short term, but it's still there in the background. Injuries that haven't completely healed may effect your ankle or your shoulder, limiting your enjoyment of a kayak outing or a hike with family or friends.

Whatever the symptom or pattern, acupuncture is a gentle and effective way to reduce the discomforts many of us live with. It also helps to melt away the build up of many types of stressors. People call us every week asking if we treat this symptom or that diagnosis, and our typical answer is Yes, we can help, because we are addressing you!





We have lots of fancy explanations for how acupuncture works in our bodies, but if you want to find out how it can help YOU, give us a call, read through the reviews on our online schedule, or make your first appointment this week. 









650-948-9642. http://www.whitepeony.com/about_acupuncture.html.

We are two providers available six days a week by appointment. A link to our online schedule is below. We are out of network with insurance, but our fees are reasonable, and we are certain you will enjoy the benefits you feel from each session.

http://www.genbook.com/bookings/slot/reservation/30204558?bookingSourceId=1000

Two ways to approach natural labor preparation with acupuncture

Labor preparation

There are two ways to approach natural labor preparation with acupuncture. One approach is to start acupuncture once weekly from 37-40 weeks. These sessions help to gradually soften and ripen the cervix, as well as address stress, anxiety, and physical discomforts women typically have in the last month of pregnancy.

The second approach is to have acupuncture at or after your due date, at a frequency of one to three times per week.Both approaches are effective, and help facilitate a more efficient labor. 

We see clients in our office in Los Altos, and we are available Monday through Saturday by appointment. You will rest with needles in for 20-30 minutes, and the sessions are very comforting and relaxing!

Kim Silsby and Loren Romley, California Licensed Acupuncturists and Herbalists. 

Call us, we would love to talk with you. 650-948-9642

Online schedule http://www.genbook.com/bookings/slot/reservation/30204558?bookingSourceId=1000

11th Annual Blossom Birth & Family Fair

11th Annual Blossom Birth & Family Fair

Palo Alto’s most popular event for new and expectant families! 

Sunday, April 17, 2016​
9:00am- 2:00pm

 Mitchell Park Community Center, Palo Alto
3700 Middlefield Road, Palo Alto, CA 94303

Free Event

Join us for lots of kids entertainment and connect with the best local pregnancy, birth and parenting resources and services.

We will also have a baby and toddler play area, kids entertainment, food raffle prizes and much more.

Keynote Speaker

​

11:00am-12:30pm
“What makes Toddlers Tick? Tips and tricks to raise happy, respectful, well balanced tots!”  

by Dr. Harvey Karp
America’s most read pediatrician!

This is your chance to spend a morning with Harvey Karp, MD FAAP, pediatrician, author and child developmentalist. His landmark DVDs/Books The Happiest Baby on the Block, The Happiest Toddler on the Block and The Happiest Baby Guide to great Sleep: Birth to 5, are international best sellers. Dr. Karp will answer questions and be available for book signing. 

​Schedule of Activities

9-9:45 am	Event Kick-Off with Andy Z ( multiple award-winning children's performer, singer/songwriter)
10:30am	Award Ceremony for Mother's Day Achievement Award Presented to Nursing Mothers Counsel
11am-12:30pm	Keynote Speaker: Dr. Harvey Karp
12:30-1pm	Storytime with Palo Alto City Library
1-1:30pm	Baby/toddler Sign Language Fun with Bill White, Touch Blue Sky
ALL DAY	Connect with exhibitors and local resources
ALL DAY	Food available for purchase
ALL DAY	Raffle
ALL DAY	Multiple kids play stations

Nutrition suggestions from the American Pregnancy Association

Pregnancy Nutrition: Food Groups

It is helpful to pay attention to recommended daily servings from each food group. Most foods come with a nutrition label attached. This nutrition label will help you to know what amount constitutes one serving.

Protein

Experts recommend 75 to 100 grams of protein per day. Protein positively affects the growth of fetal tissue, including the brain. It also helps your breast and uterine tissue to grow during pregnancy, and it plays a role in your increasing blood supply.

Examples of daily sources of protein:

2-3 servings of meat (1 serving = approximately 3 ounces/size of a deck of cards)

• fully cooked fish or seafood
• liver
• chicken
• lean beef
• lamb
• pork
• nuts (1 serving = approximately ⅓ cup)
• tofu (1 serving = approximately ½ cup)

2-3 servings of legumes (1 serving = approximately ½ cup)

• split peas
• red and white kidney beans
• black beans
• navy beans
• black-eyed peas
• chick peas (garbanzo beans)

Calcium

The daily requirement of calcium is around 1000 milligrams during pregnancy. Calcium helps your body regulate fluids, and it helps build your baby’s bones and tooth buds.

Examples of daily sources of calcium:

3-4 servings of dairy

• milk (1 serving = 1 cup)
• eggs (1 serving = 1 large egg)
• yogurt (1 serving = 1 cup)
• pasteurized cheese (1 serving = approximately 1.5 ounces or 4 playing dice
stacked together)
• tofu (1 serving = ½ cup)
• white beans (1 serving = approximately ½ cup)
• almonds (1 serving = approximately ⅓ cup)
• salmon (1 serving = approximately 3 ounces)
• turnip greens (1 serving = approximately 1 cup)
• cabbage (1 serving = approximately 1 cup)

Iron

In combination with sodium, potassium, and water, iron helps increase your blood volume and prevents anemia. A daily intake of 27 milligrams is ideal during pregnancy.

Examples of daily sources of iron:

2-3 servings of green leafy vegetables (1 serving = approximately 1 cup)

• collard
• turnip
• spinach
• lettuce
• cabbage

3 servings of whole grains (1 serving = approximately ½ cup or one slice)

• bread
• cornmeal
• cereal
• oatmeal

2-3 servings of lean protein (1 serving = approximately 3 ounces/size of a deck of cards)

• beef
• seafood
• poultry

Folate/Folic Acid

Folic acid plays a key role in reducing the risk of neural tube defects, including spina bifida. Experts recommend 600 to 800 micrograms (.6 to .8 milligrams) daily.

Examples of daily sources of folate:

2 servings of dark green leafy vegetables (1 serving = approximately 1 cup)

• collard
• turnip
• spinach
• lettuce
• cabbage

2-3 servings of fruit (1 serving = approximately ½ cup)

• orange
• strawberry
• lemon
• mango
• tomato
• grapefruit
• kiwi
• melon

3 serving of whole grain (1 serving = approximately ½ cup or 1 slice)

• bread
• cornmeal
• cereal
• oatmeal

2 servings of legumes (1 serving = approximately ½ cup)

• split peas
• red and white kidney beans
• black beans
• navy beans
• black-eyed peas
• chick peas (garbanzo beans)

Vitamin C

Fruits and vegetables rich in Vitamin C will promote wound healing, tooth and bone development, and metabolic processes. Experts recommend at least 85 milligrams per day.

Examples of daily sources of Vitamin C:

3 servings of fruit or vegetables (1 serving = approximately ½ cup)

• orange
• strawberry
• lemon
• mango
• tomato
• grapefruit
• kiwi
• melon
• potato
• peppers

Other Nutritional Concerns

During pregnancy, some foods can cause harm to a developing baby. Be sure that all meats are thoroughly cooked to avoid exposure to toxoplasmosis, salmonella, and other harmful bacteria. Eliminate tobacco smoke, drug use, and alcohol consumption from your diet. Reduce or eliminate caffeinated beverages (soda, coffee) from your daily intake, and maintain a reasonable exercise program throughout your pregnancy. Walking andswimming are considered healthy activities during pregnancy, but always consult with your health care provider before starting a new exercise program.

Can Moxibustion Help Turn Breech Babies?

By Rebecca Dekker, PhD, RN, APRN

Occasional Science & Sensibility contributor Rebecca Dekker of www.EvidenceBasedBirth.com examines the practice of Moxibustion to help turn breech babies head down.  Rebecca looks at what the current research shows on this ancient treatment for turning babies and shares the results with Science & Sensibility readers in an article that can be easily shared with students, clients and patients. – Sharon Muza, Science & Sensibility Community Manager.

About 3-4% of pregnant women end up with a baby who is in breech (bottom first) position at term. The vast majority of these babies (90%) are born by planned cesarean section. In order to avoid a cesarean section, many women try various ways to turn their babies into a head-down position. I have written in the past about using external cephalic version (ECV), also called the hands-to-belly procedure, for turning breech babies. However, although ECV is safe and frequently effective, it can be uncomfortable and women may want to try different options for turning a breech baby. One potential option is moxibustion.

What is moxibustion?

Moxibustion is a type of Chinese medicine where you burn an herb (Artemesia vulgaria) close to the skin of the fifth toes of both feet. The fifth toe is a traditional acupuncture point called Bladder 67.

How do you use moxibustion?

There is no one recommended way to use moxibustion, but many women burn the moxa sticks close to their toes for about 15-20 minutes, from anywhere to 1-10 times per day, for up to two weeks. This treatment is usually started between 28 and 37 weeks of pregnancy.

How could moxibustion work?

The burning of the moxa stick stimulates heat receptors on the skin of the toe. It is thought that the heat encourages the release of two pregnancy hormones—placental estrogen and prostaglandins—which lead to uterine contractions. These contractions can then stimulate the baby to move (Cardini & Weixin, 1998).

So, does moxibustion work?

In 2012, researchers combined results from eight studies where 1,346 women with breech babies were randomly assigned to moxibustion, no treatment, or an alternative treatment (like acupuncture). The women in these studies lived in Italy, China, and Switzerland (Coyle et al., 2012).

For the women who were assigned to receive moxibustion, some used moxibustion alone, some had moxibustion plus acupuncture, and some used moxibustion plus posture techniques.

When moxibustion alone was compared to no treatment (3 studies, 594 women) there was:

• No difference in the percentage of babies who were breech at birth

• No difference in the need for external cephalic version

• No difference in cesarean section rates

• No difference in the risk of water breaking before labor began

• No difference in Apgar scores at birth

• A 72% decrease in the risk of using oxytocin for women in the moxibustion group who ended up with a vaginal birth

Side effects of the moxibustion included smelling an unpleasant odor, nausea, and abdominal pain from contractions.

When moxibustion alone was compared to acupuncture alone, fewer women in the moxibustion group had breech babies at birth compared to the acupuncture group. However, there were only 25 women in the single study that compared moxibustion alone to acupuncture alone, so this doesn’t really tell us that much.

When moxibustion plus acupuncture was compared to no treatment (1 study, 226 women), women who had moxibustion plus acupuncture had a:

• 27% decrease in the risk of having a breech baby at birth

• 21% decrease in the risk of having a cesarean section

When moxibustion plus acupuncture was compared to acupuncture alone, one study with only 24 women found no difference in the number of women who had breech babies at birth. Because this study was so small, it doesn’t really give us much meaningful information.

When moxibustion plus postural techniques was compared to postural techniques alone (3 studies, 470 women), women in the moxibustion plus postural group had:

• a 74% decrease in the risk of having a breech baby at birth

Are there any limitations to this evidence?

Overall, the studies that were used in this review were good quality. However, some of the studies were very small, and sometimes researchers did not measure things that we would be interested in—for example, when moxibustion plus postural techniques was compared to postural techniques alone, we have no idea if it made a difference in cesarean section rates or any other health results. Also, all of the researchers used different methods of moxibustion. Some women may have had more frequent or longer sessions, and some women may have been more compliant with the therapy than others.

Is there any other good evidence on moxibustion?

After the review above was published, evidence from a new randomized controlled trial that took place in Spain came out in 2013. In this new study, 406 low-risk pregnant women who had a baby in breech position at 33-35 weeks were randomly assigned to true moxibustion, “fake” moxibustion, or regular care.

What kind of treatments did the women receive?

In the true moxibustion group, the women laid face up, and the hot moxa stick was held near the outside of the little toenail 20 minutes per day for two weeks, changing from one foot to the other when the heat became uncomfortable. The women did the moxibustion at home with the help of a family member. In the fake moxibustion group, the same treatment was carried out, except that the moxa stick was applied to the big toe, which is not a true acupuncture point. Women in all of the groups were educated on how to use a knee-chest posture to try and turn the baby.

Did the moxibustion work?

Women who did moxibustion plus postural techniques were 1.3 times more likely to have a baby in head-down position at birth when compared to both the fake moxibustion and the usual care groups. If you look at the exact numbers, 58% of the women who used moxibustion had a baby who was head-down at birth, compared to 43% of the fake moxibustion group and 45% of the usual care group. The number of women who would need to use moxibustion in order to successfully turn one baby is, on average, eight women.

There was no statistical difference in cesarean section rates among the three groups, but it looked like the numbers were trending in favor of true moxibustion: 51% of the women in the true moxibustion group had cesarean sections, compared to 62% of the fake moxibustion group and 59% of the usual care group.

Were there any safety concerns?

Overall, evidence showed that moxibustion treatment was safe. About 1 out of 3 women reported having contractions during the treatment, but there was no increase in the risk of preterm birth. Some women (14%) said they felt heart palpitations. One woman experienced a burn from the moxibustion. Other complaints from women in all three groups included heartburn, nausea and vomiting (2%), dizziness (1.7%), mild high blood pressure problems (1.7%), stomach pain (1.5%), and baby hiccups (1.2%). However, there were no differences among the three groups in the number of women who had these complaints. There were also no differences in newborn health issues or labor problems among the three groups. All of the babies had good Apgar scores five minutes after birth.

So what’s the bottom line?

• Evidence suggests that moxibustion—when combined with either acupuncture or postural techniques—is safe and increases your chances of turning a breech baby

• We still don’t know for sure which kind of moxibustion method (timing during pregnancy, number of sessions, length of sessions, etc.) works best for turning breech babies. However it appears that using moxibustion twice per day for two weeks (during 33-35 weeks of pregnancy) will work for 1 out of every 8 women.

• If women are interested in using Chinese medicine (moxibustion and acupuncture) to help turn a breech baby, they may want to consult a licensed acupuncturist who specializes in treatment of pregnant women.

As a childbirth educator or other birth professional, do you share information on moxibustion as a method that mothers might use to turn a breech baby?  How do you present this information?  How do the families you work with feel after learning about this option? If you did not cover this before, do you feel like you might start to include this information in your classes after reading Rebecca’s information here and on her blog? Are you aware of physicians who also encourage patients to try this treatment?  Please share your experiences in our comments section. I welcome your discussions. – SM

Pre-Birth Acupuncture Starting week 37

We provide pre-birth acupuncture sessions weekly, beginning at 37 weeks pregnancy. These sessions allow for a more efficient labor and can help women avoid induction, or if induction is required, acupuncture can shorten the duration of induction time and medicine needed. The first study on how acupuncture can affect labor onset and duration was performed in 1974 by Kubista and Kucera. (Kubista E Kucera H. Geburtshilfe Perinatol. 1974; 178 224-9)

Debra Betts is our mentor for Pre-birth Acupuncture. She has a background in nursing and graduated from the London College of Acupuncture in 1989. Returning to New Zealand she established a private practice specialising in pregnancy and women’s health care. She began specifically developing and teaching acupuncture courses to midwives in 1997. This led to the publication of articles on the use of acupuncture and acupressure in obstetric practice in 1999 and her book “The Essential Guide to Acupuncture in Pregnancy & Childbirth” in 2006, with subsequent translations into German and French. Debra completed her PhD on the use of acupuncture in threatened miscarriage in 2014 through the University of Western Sydney and is currently the Director of Postgraduate Programmes for an online Masters course through New Zealand School Acupuncture and Traditional Chinese Medicine. She is also a clinical supervisor at a hospital antenatal acupuncture clinic Wellington New Zealand, and lectures internationally on the use of acupuncture in obstetric care.

Debra Betts free acupressure booklet is available here: http://acupuncture.rhizome.net.nz/download-booklet/

Addressing Estrogen Dominance in Perimenopausal Women Using TCM

By Jill Blakeway, MS, LAc

“I have more perimenopausal patients with estrogen dominance than I used to and they worry me. How can Chinese medicine help with that?”

This question came from a colleague of mine who is a gynecologist, oncologist and a surgeon. Her focus is preventing and treating cancers of the female reproductive organs and her question was part of a broader conversation about how we can use our different skill sets to collaborate to keep our patients healthy and thriving after menopause.

Women who have excess levels of estrogen in the run up to menopause can have an increased risk of breast, uterine, and ovarian cancers, as well as of cervical dysplasia. They are also more likely to have intense and unpleasant menopausal symptoms. That’s why my colleague was keen to find solutions for her patients. My answer to her question was that Chinese medicine is really helpful when it comes to addressing this kind of hormone imbalance, because identifying patterns of disharmony and creating balance between different systems is one the medicine’s strengths.

The symptoms of estrogen dominance include (but are not limited to):

• Breast swelling and tenderness
• Anxiety and mood swings
• “Fuzzy thinking”
• Irritability
• Fatigue
• Loss of ambition
• Slow metabolism
• Water retention
• Loss of libido
• PMS
• Weight gain
• Insomnia
• Thickening of endometrial lining, clotted menses
• Increased risk of uterine fibroids
• Increased incidence of ovarian cysts.

From a Chinese medicine perspective many of these symptoms are related to stagnation of qi, blood and damp against a background of qi or yang deficiency.

We know that women produce far less estrogen after menopause, so it would be logical to assume that estrogen steadily declines until women reach menopause. In fact, for many years, that was exactly what doctors did assume, and it was only in the last 25 years that research showed this wasn’t the case. Likewise, if you read Chinese medical textbooks you can be left with the impression that yin becomes increasingly vacuous until a woman stops having regular periods. In clinical practice, however, we often see a different picture. During the years before menopause, it is often levels of progesterone that decline, while estrogen levels remain stable or even increase. This leads to a situation where estrogen is relatively high in relation to progesterone, which is referred to as estrogen dominance. This is a term that was originally coined by Dr. John Lee, who was one of the first people to advocate natural progesterone supplementation.

Put another way, kidney yang becomes vacuous, often as a result of diminishing spleen qi. Because we need kidney yang to create movement and spleen qi to transform fluids, the result is often stagnation of qi, blood, and damp.

Estrogen is produced mainly in the ovaries and progesterone is produced predominantly by the corpus luteum, which is the outside lining of a mature egg after ovulation. As egg quality declines in perimenopause, so does the quality of the corpus luteum, leading to lower progesterone levels and relative estrogen dominance. Likewise, many perimenopausal women are periodically anovulatory, which means that estrogen goes unopposed during those cycles.

It’s noticeable that both biomedicine and Chinese medicine are identifying the same phenomena. The weak kidney yang correlates to low progesterone and the resulting estrogen dominance correlates to a stagnation of yin (blood and damp). The weak yang often has its root in declining spleen qi and this combination can lead to metabolic sluggishness. Many of my perimenopausal patients tell me how difficult it is for them to lose weight. Unfortunately, excess body fat causes the body to retain estrogen. This may be why overweight women have a lower incidence of osteoporosis, but have a higher breast and uterine cancer risk.

It becomes clear that supporting kidney yang and spleen qi is vital in this population, if we are to reduce their risk of reproductive cancers. Likewise for centuries Chinese doctors have identified the liver as playing a pivotal role in hormone balance alongside the kidney. Liver qi stagnation can be the result of kidney yang vacuity or it can be caused by stress, repressed emotions or a diet that puts a strain on the liver itself.

One of the liver’s functions is to filter excess estrogen. Anything that impairs the liver’s function can therefore result in estrogen not being broken down adequately. This is true for both men and women. Alcoholic men, for example, can develop a condition called gynomastia, where excess estrogen can lead to enlarged breasts and loss of pubic hair. In women, alcohol, environmental toxins, stress, and unresolved emotional issues can limit the liver’s ability to cleanse the blood of estrogen resulting in all the symptoms of estrogen dominance I listed above. The connection between stress and liver function has been recognized for thousands of years in Chinese medicine, but from a biomedical point of view stress can cause people to produce excess cortisol, insulin, and norepinephrine, which can play a role in the kind of hormonal imbalance we see in our patients with compromised livers, known in Chinese medicine as liver qi stagnation.

This stagnation leads to heat and inflammation, and one method that has been traditionally used in Chinese medicine to clear heat is to open the fu. In the case of heat from stagnation, this means making sure the intestines are functioning optimally. Physiologically, this makes sense, because excess estrogen is excreted through the bowel. When a patient is constipated and the stool remains in the intestines for a longer time, estrogen is reabsorbed. Correspondingly, studies have shown that women with a high fiber diet have lower levels of circulating estrogen than women with a low fiber diet.

My MD colleague believes she is seeing more estrogen dominance in women over 40 than she used to and I agree. Why is that? Our lives are speeding up. The internet has made communication very instant and the demands on us are now incessant. Many of us are constantly on the go and eating on the run. From a Chinese medical perspective an irregular diet and lifestyle taxes spleen qi, which leads to damp stagnation. Overscheduling depletes kidney yang and the stress of this disrupts the smooth flow of liver qi and blood.

Plus, there’s one more piece of the puzzle that’s become much more prevalent over the last two decades: the amount of xenoestrogens we are exposed to. These are chemicals that mimic estrogen and act on estrogen hormone receptor sites. They’re found in everything from sunscreen to plastic water bottles. Even our water supply now contains synthetic estrogen because of the widespread use of birth control pills. Cooking with non-stick coated cookware releases xenoestrogens into our food, as does microwaving food in plastic containers. Hormone disrupting chemicals are in our meat supply because of the way hormones are used to plump up cattle and they’re on our vegetables because of the widespread use of pesticides.

So to answer my MD colleague’s question, there is much that Chinese medicine can do to help these patients. In my own practice I combine diet and lifestyle advice with acupuncture, herbs and supplements to help women achieve an appropriate balance between progesterone and estrogen as they head towards menopause.

I tend to use acupuncture to move the stagnations, in conjunction with herbs to address the deficiencies. And when it comes to herbs, I’ve found myself being inspired by the Pi Wei Lun (Treatise on the Spleen & Stomach), which was written by Li Dong-Yuan in 1249. I find it satisfying that a text from the 13^th century should have so much to say about a very modern phenomenon.

Li Dong-Yuan thought that the key to the diseases he was treating was in the digestive system. He observed that a combination of poor diet, irregular lifestyle and emotional strain damages the function of the spleen and stomach, which in turn damages yang qi. Weak kidney yang and spleen qi fail to raise the clear yang and descend the turbid yin, which leads to a buildup of damp in the lower jiao. The clear yang, instead of rising, sinks and stagnates, transforming into heat, which in turn can become damp-heat. Depressive heat and emotional agitation stir up the ming men, which counter-flows upwards causing heat in the upper jiao. He called this pattern Yin Fire.

If we look at the typical symptoms of estrogen dominance, we can see that Li Dong-Yuan’s theory of Yin Fire fits this pattern well.

Fatigue, loss of ambition, weight gain, water retention, slow metabolism, and loss of sex drive can all be attributed to a combination of spleen qi vacuity with damp and kidney yang vacuity.

Irregular periods, breast tenderness, PMS, mood swings and irritability are all related to stagnation of liver qi.

Heavy periods with clotted menstrual blood, fibroids, and ovarian cysts can all be explained by stagnation of blood and damp in the lower jiao leading in some cases to damp-heat.

Insomnia and anxiety can be caused by the heat rising up and harassing the heart, leading to heat yin vacuity.

I like this formula from the Pi Wei Lun for addressing this kind of hormonal complexity, even though it was originally intended to treat summer-heat.

Qing Shu Yi Qi Tang
(Clear Summerheat & Boost the Qi Decoction)

Huang Qi Radix Astragali Membranacei
Ren Shen Radix Panacis Ginseng
Cang Zhu Rhizoma Atractylodis
Bai Zhu Rhizoma Atractylodis Macrocephalae
Gan Cao mix-fried Radix Glycyrrhizae
Mai Men Dong Tuber Ophiopogonis Japonici
Ge Gen Radix Puerariae
Wu Wei Zi Fructus Schisandrae Chinensis
Dang Gui Radix Angelicae Sinensis
Chen Pi Pericarpium Citri Reticulatae
Qing Pi Pericarpium Citri Reticulatae Viride
Sheng Ma Rhizoma Cimicifugae
Huang Bai Cortex Phellodendri
Ze Xie Rhizoma Alismatis
Shen Qu Massa Medica Fermentata

And here’s the advice I give my patients when they ask me what they can do to help themselves:

• Take care of your liver. It is your best defense against estrogen dominance because it’s job is to eliminate excess estrogen. Minimize your alcohol intake and, to stimulate your liver, drink water with lemon juice first thing every morning. You can also promote healthy liver function by adding bitter greens such as dandelion greens, endive and radicchio to your food.

• Follow a hormone balancing diet by eating plenty of vegetables, adequate protein and some healthy fats.

• Make sure you eat enough fiber so that your bowels are able to eliminate excess estrogen.

• Eat cruciferous vegetables, such as broccoli, cabbage, cauliflower, kale and Brussels sprouts. These contain a phytonutrient called diindolylmethane (DIM), which supports the activity of enzymes that improve estrogen metabolism.

• Research endocrine-disrupting chemicals in cosmetics, processed foods, cookware, and cleaning materials and cut your exposure to xenoestrogens as much as you can.

• Talk to your doctor about progesterone supplementation. She may want to give you a transdermal 2% bioidentical progesterone cream to offset the effect of excess estrogen.

• Lose any excess weight and get regular exercise. Research shows that physical activity curtails the overproduction of estrogen.

Jill Blakeway is the founder of the YinOva Center in New York City, where she continues to treat patients. She is the host of CBS Radio’s Grow Cook Heal and the author of two books on women’s health. Jill teaches OB/GYN in the doctoral program at PCOM.

Acupuncture Relieves Shoulder Pain, Ups Range of Motion

Acupuncture relieves shoulder pain, inflammation, and range of motion impingement. Researchers from the Yuxi Hospital of TCM (Traditional Chinese Medicine) investigated the efficacy of acupuncture for the treatment of acute shoulder periarthritis. Commonly known as frozen shoulder or adhesive capsulitis, this condition is an inflammatory disorder of the rotator cuff and surrounding tissues that leads to pain and immobility of the shoulder. The investigation reveals that acupuncture has a total effective rate exceeding 90%. 

One hundred shoulder periarthritis patients were randomly divided into two equal acupuncture groups. One group received a style of acupuncture known as the Hui approach. The second group received conventional acupuncture treatments. The Hui acupuncture group had a 96% total effective rate and the standard acupuncture group had a 94% total effective rate. The scores indicate that acupuncture effectively reduces shoulder pain and improves range of motion. Moreover, the Hui acupuncture approach to care shortened the total treatment time needed to resolve the condition over standard acupuncture therapy.

A key component of the Hui acupuncture style is the elicitation of deqi at the acupuncture points. Traditional functions of this style include relieving spasms, dredging the meridians, and expelling stasis. The Hui acupuncture style for periarthritis involved the application of GB34 (Yanglingquan, Yang Mound Spring) and Ashi acupoints. The treatment protocol begins with the patient in a seated or supine position and GB34 is needled with a rapid insertion technique on the affected side. 

Perpendicular insertion with 0.3 x 40 mm acupuncture needles was used. Rotating and pulling manual acupuncture techniques were applied. During rotation of the needles, patients were advised to maximize shoulder movements including stretching, raising of the arms, reaching behind the back, and other movements on the affected side. Additional movements of the needle in the range of fifteen to forty-five degrees in all four directions to a depth up to one inch were made. The additional procedure repeated the process of rotating and pulling the needle during maximization of shoulder movements on the affected side. 

The Ashi part of the Hui technique involved palpation to find sensitive areas at the rotator cuff region. Needles were inserted into the areas of sensitivity with a rapid technique using 0.3 x 40 mm acupuncture needles at a perpendicular angle. Rotating and pulling were applied during the initial insertion process. Next, the needles were pulled to a level just below the surface of the skin and patients were advised to slightly stretch the shoulder joint outwards, upwards, posteriorly, and medially.

The needles were then inserted at an angle of fifteen to forty-five degrees to a depth up to one inch in all four directions during pulling and rotating manual techniques. The procedure was repeated in all four directions. Total needle retention time was twenty minutes. Acupuncture was conducted once per day for seven days.

The conventional acupuncture group received acupuncture needles at the following acupoints on the affected side with mild reinforcing and reducing techniques:

• Jianliao, SJ14 (Shoulder Crevice)
• Jianqian, MUE48 (Front of Shoulder)
• Naoyu, SI10 (Upper Arm Shu)
• Waiguan, SJ5 (Outer Pass)
• Hegu, LI4 (Joining Valley)

Total needle time was twenty minutes per acupuncture session. Acupuncture was applied once per day for seven days.

The total effective rate for both groups included everything from significant relief of pain and improvement of rotator cuff movements to complete resolution of the condition. The Hui group had greater positive patient outcomes but the conventional acupuncture group demonstrated a very high total effective rate. Coming in at 96% and 94% respectively, the Hui acupuncture and conventional acupuncture groups demonstrated significant total effective rates.

References:
 

Wang XY, Zhang YM, Jia YT, Wang H, Yue Q, Wu JK & Chen S. (2015). Treatment of 50 Patients with Acute Shoulder Periarthritis by Hui Acupuncture. Journal of Clinical Acupuncture and Moxibustion. 31(4).

Ma Y. (2009). Yun Ling Shu · Analysis of Guan Acupuncture and Zui Technique. Journal of Shandong University of Traditional Chinese Medicine. 33(5): 404-407.