by Dr. Joel Kahn 
When the student is ready, the teacher will appear. After a year of adjusting medications and supplements to control a heart rhythm condition in my patient, "Billie," she came in with a big smile and a bounce. In this case, she was the teacher.

We shared a holistic attitude to health but had been frustrated by the unpredictable heart racing, and on her own she had begun frequent sessions with an acupuncturist she was acquainted with. In just a short time she documented a reduction in the bothersome episodes, and after a few months she was enjoying over a 95% improvement.

Her experience led me to research the use of acupuncture more broadly for my patients and it is now part of my “tool box” for restoring health at a root cause level. Although more research is needed, there are five heart conditions that I have seen a response to with acupuncture therapy.

1. Angina pain

Angina is a choking, squeezing or pressure like feeling in the chest brought on by activity and quickly relieved by rest or a nitro tablet. It usually results from a large heart artery that's severely blocked, but many patients have apparently normal arteries on angiography, and disease of small arteries is also suspected.

The angina is the result of a lack of oxygen supply to active heart muscle cells. Perhaps by reducing the activity of the sympathetic nervous system to the heart muscle (the fight or flight system), selected patients with angina respond to acupuncture with less symptoms and better ability to walk long distances.

2. Congestive heart failure

This potentially serious condition can result from a heart weakened by a heart attack or viral damage, but is often seen with strong hearts that relax inadequately. Research studies have shown improvements in the ability to walk longer distances without shortness of breath after acupuncture therapy, and I have seen similar results. Again, reductions in sympathetic nerve activity is the supposed mechanism.

3. Arrhythmia

Just as my patient Billie taught me, the heart is an energy organ with every heart beat controlled by a wave of electricity and recovery. Furthermore, while the heart is richly supplied by nerve fibers originating in the brain, it also has many nerve communications from the heart back to the brain. With every breath in, the heart rate should speed up subtly; with every exhale, it should slow down, something that can be measured as the heart rate variability, or HRV. The better your HRV the healthier you are.

Acupuncture has been shown to improve the HRV in humans. Furthermore, studies of various heart rhythm problems show promise for reducing or eliminating the distress of palpitations such as atrial fibrillation.

4. Hypertension

Overdrive of sympathetic nervous system plays a role in the rise in blood pressure that can damage kidneys, arteries, eyes and the brain. I have seen individual patients benefit from a lowering in blood pressure with a consistent practice of acupuncture, and the American College of Cardiology considers it a promising alternative therapy. The scientific literature is still divided as to how predictably acupuncture results in normal blood pressure.

5. Smoking cessation

Fortunately rates of usage have dropped but smoking is still the number 1 root cause of deaths due to heart disease and cancer. Acupuncture is one of the modalities that may help the nicotine addicted patient to successfully quit this habit. Over 3,000 patients have been studied in randomized trials of the role of acupuncture to quit smoking and most favor a positive effect.

I'm experienced with the use of needles to perform cardiac catheterizations and stent procedures, but have had the good luck of being taught the potential of acupuncture from my patients. Traditional therapies do not work for all persons, and some just prefer a non-drug and holistic approach.

I'm grateful that Billie explored an alternative approach of her own to reduce her palpitations. I plan to continue to explore the use of acupuncture and other Eastern practices, such as tai chi and yoga, in my treatment plans for patients. Maybe they can help someone you know, too.

Dr. Kahn is a Clinical Professor of Medicine at Wayne State University School of Medicine and Director of Cardiac Wellness, Michigan Healthcare Professionals PC. He is a graduate Summa Cum Laude of the University of Michigan School of Medicine. He lectures widely on the cardiac benefits of vegan nutrition and mind body practices. He also writes for Readers Digest Magazine as the Holistic Heart Doc and his first book, The Whole Heart Solution, is available for sale now.

Acupuncture is safe and effective for the treatment of perimenopause. Researchers from Heilongjiang University of Chinese Medicine and Henan University of Chinese Medicine investigated the effects of acupuncture on perimenopausal syndrome as it relates to metabolism, reproductive endocrinology, and the immune system. Clinical and laboratory findings reveal important biochemical benefits induced by acupuncture and electroacupuncture.

Onset of perimenopause may occur years prior to menopause. It may occur in the 40s, 30s, or earlier and is related to a decrease in estrogen production by the ovaries. Perimenopause typically lasts approximately four years. Indications of perimenopause include hot flashes, fatigue, increased premenstrual syndrome (PMS), irregular menstrual cycles, insomnia, vaginal dryness, decreased libido, mood swings, anxiety, and breast tenderness. Conventional treatments include hormone replacement therapy, antidepressants, and vaginal lubricants.

The researchers note that a reduction of serum estradiol in perimenopausal women leads to changes in the hypothalamic-pituitary-ovarian (HPOA) axis thereby causing pathologies. Citing several investigations in their meta-analysis, the researchers note that acupuncture regulates the HPOA and levels of serum estradiol, follicle stimulating hormone (FSH), and luteinizing hormone (LH). Additionally, they document the clinical success of acupuncture for the treatment of hot flashes.

The meta-analysis covered a large body of research. Jin et al. compared acupuncture with Premarin oral intake. Premarin is a brand name for conjugated estrogens. The acupuncture group received the administration of Back-Shu acupoints. The acupuncture group demonstrated superior patient outcomes over the group taking oral conjugated estrogens.

Shang et al. document that Yuan-Primary and Back-Shu acupoints are effective for the regulation of estradiol, FSH and LH in perimenopausal women. Qin et al. conclude that electroacupuncture applied to acupoint SP6 (Sanyinjiao) effectively modulates reproductive endocrine system functions in perimenopausal women. Li et al. measured significant beneficial increases of estradiol levels in perimenopausal women after the application of either of two acupuncture point prescriptions. Prescription #1 was:

• Guanyuan (CV4)
• Sanyinjiao (SP 6)

Prescription # 2 was:

• Neiguan (PC6)
• Zusanli (ST36)

Human clinical trials are augmented by laboratory research. Chen et al. conducted an experiment entitled “Effects of electroacupuncture on the expression of estrogen receptor protein and mRNA in rat brain.” Electroacupuncture increased estradiol levels while downregulating other factors thereby normalizing “the function of hypothalamic-pituitary-ovarian axis.” The work of Yao et al. confirms that electroacupuncture can increase estradiol levels and expression of prolactin releasing peptide in the medulla oblongata. The researchers cited several other studies demonstrating that acupuncture increases estradiol levels by transforming androgen into estrogen and by “promoting aromatase activity and mRNA expression in adipose and liver tissues.” 

The above findings are but a few covered by the researchers. They examined the regulatory effects of acupuncture on the immune and neuroendocrine systems plus the regulatory effects of acupuncture on metabolism. This broad body of research confirms acupuncture’s ability to regulate bodily systems. 



The researchers conclude that acupuncture is effective in the treatment of perimenopause “by improving clinical symptoms such as menstrual disorders, hot flashes, sweating, insomnia, and mood disorders.” They add that acupuncture benefits perimenopausal women by:

• increasing estrogen levels
• decreasing levels of FSH and LH
• increasing estrogen receptor protein expression
• inhibiting GnRH
• transforming androgen into estrogen

Immunity system benefits of acupuncture include increasing E-selectin and L-selectin and also by regulating immune cell estrogen receptor expression. Neuroendocrine benefits of acupuncture include:

• increasing dopamine and GABA
• decreasing aspartate and glutamate
• free radical regulation via nitric oxide and superoxide dismutase
• blood lipid regulation
• oxidative stress suppression
• bone metabolism regulation of alkaline phosphatase and DPD

The researchers note that the goal of their study was to investigate and summarize the mechanisms by which acupuncture affects perimenopausal women. They document clinical benefits and important biological regulatory effects induced by acupuncture and electroacupuncture. Given the large body of supportive research, the investigators recommend a multicenter study to further evaluate the effects of acupuncture on perimenopause.

In related research, Tan et al. concluded that acupuncture combined with Chinese herbal medicine is effective in the relief of insomnia due to perimenopause. The researchers combined administration of the herbal formula Zi Shen Tiao Gan Tang with acupuncture. The total effective rate of the combined therapy increased significantly over using acupuncture as a standalone therapy. Acupuncture achieved a total effective rate of 74.60% but the combined therapy achieved a 96.83% total effective rate.

Online Courses
At the Healthcare Medicine Institute (HealthCMi), we offer many acupuncture continuing education courses for the treatment of gynecological related conditions. The course entitled The Menstrual Cycle covers the treatment of menorrhagia, PCOS, painful menstruation and many other important health concerns. The course entitled Free the Qi and Blood covers treatments for ovarian cysts, leukorrhea, uterine bleeding, PMS, breast nodules, and more. There are many other online courses at HealthCMi including Herbal Insights: Tonify Blood, which covers the treatment of menopause, dysmenorrhea, PMS, and late menstruation. This course is presented by Prof. Richard Liao, L.Ac. and is available 24/7 for acupuncture CEUs and  NCCAOM PDAs through the HealthCMi online learning system.


References:
Li, Rui-li, Jin-ying Fu, Ying-ying Deng, Wen-juan Shen, Hong-li Ma, Wei Li, and Xiao-ke Wu. "Review of acupuncture treatment for perimenopausal syndrome." Journal of Acupuncture and Tuina Science 2, no. 13 (2015): 129-133.

Chen BY. Acupuncture normalizes dysfunction of hypothalamic-pituitary-ovarian axis. Acupunct Electrother Res, 1997, 22(2): 97-108.

Zhao H, Tian ZZ, Chen BY. Electroacupuncture stimulates hypothalamic aromatization. Brain Res, 2005, 1037(1-2): 164-170.

Cheng K, Tian SL. Effects of preventive- electroacupuncture of “Guanyuan” (CV 4) and “Sanyinjiao” (SP 6) on hypothalamus-pituitary-ovary axis in ovariectomized rats. Zhen Ci Yan Jiu, 2012, 37(1): 15-19.

Hu L, Wang HL, Gao XZ, Shen XM, Jin R, Zhu QC, He ZB. Comparison of regulative effects of electro- acupuncture at “Guanyuan” (CV 4) and “Sanyinjiao” (SP 6) on sex hormones and hypothalamic β-endorphin in perimenopausal model rats. Zhongguo Zhen Jiu, 2004.

Jin H, Liu TT, Wang R. Clinical observation on acupuncture at the five-zangshu for treatment of perimenopausal syndrome. Zhongguo Zhen Jiu, 2007, 27(8): 572-574.

Shang YJ, Bhang Y, Kong LL, Wang YY, Wang DS, Li J. Clinical observation on combination of source point and Back-Shu point for treatment of perimenopausal syndrome. Zhongguo Zhen Jiu, 2009, 29(6): 444-448.

Qin ZY, Ling H, Xia XH, Meng L, Wu ZJ. Effects of electroacupuncture of Sanyinjiao (SP 6) on genito- endocrine in patients with perimenopausal syndrome. Zhen Ci Yan Jiu, 2007, 32(4): 255-259.

Li Y, Xia Y, Liu SM, Ju ZY, Shi XL, Chen MG, Cheng L, He JS. Effect of electroacupuncture on serum sex hormones in patients with perimenopausal syndrome. Shanghai Zhenjiu Zazhi, 2010, 29(4): 199-201.

Chen BY, Cheng LH, Gao H, Ji SZ. Effects of electroacupuncture on the expression of estrogen receptor protein and mRNA in rat brain. Shengli Xuebao, 1998, 50(5): 495-500.

Yao X, Wang XQ, Ma SL, Chen BY. Electroacupuncture stimulates the expression of prolactin-releasing peptide (PrRP) in the medulla oblongata of ovariectomized rats. Neurosci Lett, 2006, 411(3): 243-248.

Tan KP, Yao X, Li XW. Observation on clinical effect of acupuncture plus Zi Shen Tiao Gan Decoction for perimenopausal insomnia. J Acupunct Tuina Sci, 2015, 13 (1): 49-53.


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