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Can Acupuncture Benefit Stroke Recovery

Reposted from scalpacupuncture.org

Can Acupuncture Really Benefit Stroke Recovery?

Ming Qing Zhu, L.Ac., OMD (China)

Moyee Siu, L.Ac., MTCM

Key words: Stroke rehabilitation, acupuncture, scalp acupuncture, functional recovery

Subject Code: [74] Other stroke treatment – medical

Word count: 2462

Published date: December 30, 2011

Abstract

A number of studies and meta-analyses indicate that there is no clear evidence that acupuncture has additional value to post-stroke rehabilitation. This article outlines key issues underlining the failure of the acupuncture treatments in previous studies: delay in intervention, incorrect procedures and inadequate treatments. The authors offer suggestions, based on years of relevant practice, on how acupuncture should be done to effectively foster stroke recovery.

Introduction

The World Health Organization estimates that 15 million individuals suffer from stroke annually worldwide, most of whom in developed countries where hypertension, hypercholesterolemia and cardiac diseases are prevalent. Stroke is the third leading cause of fatality and ranks highest as a cause of disability.¹

Western medicine has made some advances in the treatment of strokes, including the use of Tissue Plasminogen Activator (tPA) and intracranial angioplasty. However, these procedures are not indicated for or accessible to all stroke patients. Despite receiving tPA in the recommended window, 58% of the patients still die or end up with severe disabilities.²

Typical post-stroke care in the USA starts with seven days of hospital stay, then one to two weeks of physical therapy, occupational therapy and speech therapy in a rehabilitation facility. After three or more weeks of rehabilitation as an outpatient, the treatment comes to an end, but the patient’s recovery is far from complete. In one study³ on ischemic stroke survivors who were at least 65 years of age, the following disabilities were observed six months after stroke:

• 50% had some hemiparesis.
• 30% were unable to walk without some assistance.
• 26% were dependent in activities of daily living.
• 19% had aphasia.
• 26% were institutionalized in a nursing home.

Obviously, there is a lot of room for improvement in standard stroke protocol.

Can acupuncture really benefit stroke patients?

Many people have asked this question. Our answer is a definite “yes”. However, recent western research and meta-analyses make the claim that there is no clear evidence that acupuncture has additional value for post-stroke rehabilitation.^4,5 Why is there a discrepancy? Whose statement is true, ours or the researchers’ ? Both are valid. What is more accurate is: acupuncture can significantly benefit stroke patients if it is done right; otherwise it is of little value. Our own experience with stroke patients over the years demonstrates that when applied correctly, acupuncture can shorten recovery time to as little as two weeks and restore function to over 95% in some patients.

Case Reports

1. In December 2010, a man in his fifties suffered an ischemic stroke. Three days after the stroke onset, he presented himself at our clinic with slurred speech, right hemiparesis and wheelchair bound. After two hours of acupuncture treatment, he was able to move his right upper extremity. The next day, less than 24 hours later, he stood up and walked on his own. On his third day of treatment, he climbed the stairs. He recovered all motor functions within two weeks.⁶
2. One night in 1992, Mr. Shen, president of an acupuncturist association in California, suddenly dropped on the floor and became stuporous. A CT scan of his brain revealed a big lesion in the left cortex and basal ganglia, due to hemorrhage of the middle cerebral artery. Within seven hours, we started Zhu’s Scalp Acupuncture treatment on him, and continued for 20 consecutive days. Two weeks later, he started to talk. After three months, he was able to return full-time to his acupuncture practice and administrative work.
3. In 1998, a 55 year-old man discharged himself from the Taipei Veterans General Hospital of Taiwan despite his doctor’s advice. It was the 8th day after his stroke when he arrived at our clinic in a wheelchair. His ischemic stroke left him paralyzed on the right side. Twenty minutes after applying scalp acupuncture needles, he stood up. An hour later, he took a few steps. After two weeks of daily acupuncture, he started walking with a cane. He ultimately regained all his gross and fine movements. Today he is living his life as a fully-recovered stroke patient and still persists in his daily exercise routine to stay healthy .
4. In 2007, an MD referred his 58 year-old male patient to us. This patient had an ischemic stroke and was bed-ridden for 20 days. On the first visit, he came in a wheelchair but left our clinic walking down two flights of stairs without assistance. After 10 daily Zhu’s Scalp Acupuncture treatments of three hours each, he returned to work.

These four case histories are a small representative sample of the large number of stroke cases we have treated. What is common in these patients is that all were treated very early and had nearly full functional recovery.

Discussion

How can we make acupuncture maximally beneficial for stroke patients? Below are recommendations based on Zhu’s 50 years of clinical experience.

There are a few important factors to consider.

I.    Time is crucial

There is a misconception that acupuncture is contraindicated in the acute stage of stroke. Quite the contrary, acupuncture should intervene promptly, as early as the first hour after onset. Every hour of delay can cause a difference in the outcome. The best treatment windows are, in decreasing order of therapeutic value: (1) the first three hours, (2) the first three days, (3) the first week, (4) the first month, (5) the first three months, and (6) the first six months. Both ischemic and hemorrhagic stroke can receive acupuncture treatment from the first day, but they differ in operation details.

Acupuncture has exceptional value in the first 3 to 72 hours. As evidenced by our own clinical cases, acupuncture seems to be able to salvage the penumbra surrounding the core of the stroke. Usually about 72 hours after a stroke, cerebral edema starts to form and it is very damaging. Although the mechanism is not well understood, acupuncture triggers some changes in the brain that result in the protection of brain cells from necrosis. Therefore it prevents or reduces edema and consequently promises a better prognosis. The often dramatic results in our stroke patients suggest that acupuncture could promote the reperfusion of the brain in a very short time, perhaps through the activation of the collaterals or the dissolution of fibrin around the clot. More research is needed to understand the mechanism.

Rehabilitation, like acupuncture, should also start as soon as vital signs are stable. This is particularly important for aphasia and dysphagia. Our experience shows that if speech therapy does not begin within the first month, speech recovery will be almost impossible or very limited. Again, ischemic and hemorrhagic strokes call for different types of rehabilitation exercises during the acute phase.

II.   The treatment method

(1)  Choose the right acupuncture style

Which acupuncture protocol is better for treating strokes? For many years Zhu had used conventional body acupuncture to treat strokes but was not satisfied with the results. So in the 1970’s he started to explore scalp acupuncture and developed Zhu’s Scalp Acupuncture. Often people are amazed at the outcome. For neurological conditions such as strokes, scalp acupuncture is by far the most effective.

(2)  Do the correct needle manipulation

Acupuncture is not just about inserting needles at certain points, it is about regulating the qi flow. Hence manipulation of the needles is necessary to affect the qi. The technique and amount of manipulation vary with the type of stroke, stage of the disease and the patient’s condition. For example:

• If the patient is hypertensive or nervous or still hemorrhaging, very light stimulation is desirable on the scalp treatment areas.
• It is not uncommon that the paralyzed side of the body feels colder to touch. When this happens, the classical technique “Setting Mountain on FIre” often brings miraculous change to the body temperature. “Unblocking the channels, warming the Yang and promoting Qi”, as these are called in Chinese medicine, certainly will benefit the patient’s recovery. It should be noted, however, that this warming effect is not achievable by using electrical stimulation.
• During recovery stage, one can use stronger stimulation both on the scalp and body.
• A comatose stroke patient whose vital signs are stable needs stronger stimulation.
• Strong stimulation is contraindicated for spasms.

           

(3)  Perform appropriate Daoyin

As mentioned before, acupuncture is not simply an act of inserting needles at certain points. Acupuncture is a complete therapy that involves, besides needling, psychological counseling, encouragement, building the patient’s confidence to heal, helping the patient to relax, teaching the patient how to talk and to move. All these things, which we call “Daoyin,”⁷ should be organically integrated into every acupuncture session.

Daoyin has a much broader implication than conventional physical, occupational or speech therapy. Since its content can vary so much, an experienced acupuncturist customizes specific daoyin activities to suit the needs of the patient at particular points in time. It requires that the acupuncturist is knowledgeable of the nervous system, the musculoskeletal system, sports medicine, rehabilitation science, and various traditional Chinese healing modalities such as martial arts and taiqi.

The following are a few examples of Daoyin:

• A stroke patient with dysarthria or Broca’s aphasia is instructed to move his/her tongue and make sounds during acupuncture.
• A stroke patient with paralytic lower limb is instructed to stand and walk with support.
•  A stroke patient with paralytic upper limb is instructed to push and pull on his/her affected arm during needle manipulation.

Acupuncture with Daoyin is not a replacement but a great enhancement to conventional rehabilitation therapies. However, there are several areas where they differ.

1. Our approach is proactive. We help a patient sit before he can sit on his own. We make the first attempt to stand when the patient cannot even imagine or believe it is possible. We provide whatever support the patient needs to regain his lost function instead of waiting for the first sign of the function to come back spontaneously. A proactive approach not only speeds up recovery, it boosts the patient’s self-confidence.
2. When doing Daoyin, we give the patient only minimal assistance while taking adequate precaution and safety measures. The more active efforts from the patient, the better the treatment results. By the same token, we discourage the use of orthoses. Muscles, tendons and ligaments can be strengthened by proper exercises. We have corrected countless foot inversion without using ankle-foot orthoses (AFO) and not causing any harm to the patient. Orthoses rob the patient’s opportunity to exert effort on his/her own, resulting in muscle atrophy and permanent dependence on a brace.
3. Unlike conventional therapy, we find that supporting a patient on his paralyzed side instead of the good side brings better outcome in the end.

III. The right dose of treatment

Concentration and repetition are necessary to provoke and reinforce plastic changes in the brain. Hence, to achieve speedy functional recovery after a stroke, intensive treatments are paramount. The frequency and duration of acupuncture treatments (needling and Daoyin combined) must be adequate especially in the first three months. A daily three to six hours of focused and active Daoyin engagement is the most desirable. We recommend multiple short sessions to avoid fatigue. The average two to six hours a week that most stroke patients currently receive in out-patient rehabilitation facilities is dismally insufficient.

IV.Management and prevention of complications following a stroke

1. Seizures: Because anti-seizure medication is usually sedative, it hampers the rehabilitation process. Scalp acupuncture is an effective substitute without causing adverse side-effects.
2. Blood thinning: Avoid overuse of warfarin or coumadin to prevent secondary hemorrhage.
3. Body postures: Spasticity does not set in immediately after a stroke and it can be avoided if more attention is given to body postures in the first month. Always keep the patient’s head, body, and limbs in normal physiological positions, especially the joints - neck, elbow, wrist, fingers, ankle and feet.
4. Dementia and Parkinsonism: These are common after-effects that manifest after a long period of inactivity as the brain atrophies.^8,9 Because they are not always apparent immediately after a stroke, they are often neglected in the rehabilitation process. Acupuncture is an excellent preventative treatment.

Conclusion

Acupuncture can be a major benefit to stroke rehabilitation when administered correctly. Results are most remarkable in the acute stage. First, treatment must begin promptly. Earlier intervention promises fewer deficits. Second, an effective acupuncture system should be employed. Scalp acupuncture excels over body acupuncture in treating neurological conditions such as strokes. After insertion, needles should be manipulated to ensure qi flow. Third, appropriate Daoyin must be carried out simultaneously. Finally, treatments have to be repeated frequently for reinforcement. In this manner a stroke patient will achieve a faster and more complete recovery.

By sharing our experience, we hope that acupuncture treatments for stroke can be optimized and that future research on this topic can yield more meaningful results.

Author Disclosure Statement

No competing financial interests exist.

References

1.  Véronique R, Go A, Lloyd-Jones D, Adams R, Berry J, Brown T, et al. Heart Disease and Stroke Statistics – 2011 Update: A Report from the American Heart Association. Circulation Journal of the Americn Heart Association. http://circ.ahajournals.org/content/123/4/e18.full.pdf. Accessed August 11, 2011.
2.  The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. E Engl J Med. 1995;333:1581-1587.
3.  Kelly-Hayes M, Beiser A, Kase CS, Scaramucci A, D’Agostino RB, Wolf PA. The influence of gender and age on disability following ischemic stroke: the Framingham study. J Stroke Cerebrovasc Dis. 2003;12:119 –126.
4.  Sze FK, Wong E, Or K, Lau J, Woo J. Does acupuncture improve motor recovery after stroke?: A meta-analysis of randomized controlled trials. Stroke 2002; 33:2604-2619.
5.  Sze FK, Wong E, Yi X, Woo J. Does acupuncture have additional value to standard poststroke motor rehabilitation? Stroke. 2002;33:186-194.
6.  Siu M. A Speedy Stroke Recovery using Zhu’s Scalp Acupuncture. Available at: http://www.youtube.com/watch?v=fuQ7hiYaj9s. Last accessed August 11, 2011.
7.  The concept and practice of Daoyin were depicted in the Emperor’s Classic and archaeological painting from the Han dynasty 200 BC.

8.  Handley A, Medcalf P, Hellier K, Dutta D. Movement Disorders after Stroke. Age and Ageing. 2009;38(3):260-266. 

9.  Tatemichi TK, Desmond DW, Mayeux R, Paik M, Stern Y, Sano M, et al. Dementia After Stroke. Neurology. 1992 Jun;42(6):1185-1193.

Acupuncture and Cardiovascular Health

Reposted from Acufinder.com

Give Your Cardiovascular Health a Boost with Acupuncture
By: Diane Joswick, L.Ac., MSOM
 
The cardiovascular system consists of the heart and blood vessels and is responsible for carrying nutrients and oxygen to the tissues and removing carbon dioxide and other waste from them.  Heart disease includes conditions affecting the heart, such as hypertension, coronary heart disease, heart attacks, congestive heart failure, and congenital heart disease.
Despite dramatic medical advances over the past fifty years, heart disease remains a leading cause of death globally and the number one cause of death in the United States.
By integrating acupuncture and Oriental medicine into your heart healthy lifestyle, you can reduce your risk of cardiovascular disease by as much as 80%.  Steps to prevention include managing high blood pressure and cholesterol, quitting smoking, eating healthy, maintaining a healthy weight, physical activity, reducing stress and improved sleep - all of which can be helped with acupuncture and Oriental medicine.   

1. Manage High Blood Pressure

High blood pressure makes the heart work harder, increasing its oxygen demands and contributing to angina. This excessive pressure can lead to an enlarged heart (cardiomegaly), as well as damage to blood vessels in the kidneys and brain. It increases the risk of heart attacks, stroke and kidney disease.

Acupuncture has been found to be particularly helpful in lowering blood pressure. By applying acupuncture needles at specific sites along the wrist, inside the forearm or in the leg, researchers at the Susan Samueli Center for Integrative Medicine at the University of California, Irvine, were able to stimulate the release of opioids, which decreases the heart’s activity and thus its need for oxygen. This, in turn, lowers blood pressure.

2. Quit Smoking
Most people associate cigarette smoking with breathing problems and lung cancer. But did you know that smoking is also a major cause of coronary artery disease? In fact, about twenty percent of all deaths from heart disease are directly related to cigarette smoking.

Acupuncture has shown to be an effective treatment for smoking. Acupuncture treatments for smoking cessation focus on jitters, cravings, irritability, and restlessness; symptoms that people commonly complain about when they quit. It also aids in relaxation and detoxification.

3. Maintain a Healthy Weight

Obesity is associated with diabetes, high blood pressure and coronary artery disease, all of which increase the risk of developing heart disease, but studies have shown that excess body weight itself (and not just the associated medical conditions) can also lead to heart failure. Even if you are entirely healthy otherwise, being overweight still places you at a greater risk of developing heart failure.

Acupuncture and Oriental Medicine are an excellent adjunctive tool when it comes to losing weight. They can help to energize the body, maximize the absorption of nutrients, regulate elimination, control overeating, suppress the appetite, and reduce anxiety.

4. Reduce Stress
Stress is a normal part of life. But if left unmanaged, stress can lead to emotional, psychological, and even physical problems, including heart disease, high blood pressure, chest pains, or irregular heart beats. Medical researchers aren't sure exactly how stress increases the risk of heart disease. Stress itself might be a risk factor, or it could be that high levels of stress make other risk factors worse. For example, if you are under stress, your blood pressure goes up, you may overeat, you may exercise less, and you may be more likely to smoke.

Numerous studies have demonstrated the substantial benefits of acupuncture in the treatment of stress, anxiety and mental health. In addition to acupuncture, Oriental medicine offers a whole gamut of tools and techniques that can be integrated into your life to keep stress in check. These tools include Tui Na, Qi Gong exercises, herbal medicine, dietary therapy, meditations and acupressure that you can administer at home.

5. Improve Sleep
Poor sleep has been linked with high blood pressure, atherosclerosis, heart failure, heart attacks, stroke, diabetes, and obesity. Researchers have shown that getting at least eight hours of sleep is needed for good heart health and getting less than eight hours of sleep can put you at a greater risk for developing heart disease.

Acupuncture has shown great success treating a wide array of sleep problems without any of the side effects of prescription or over-the-counter sleep aids. The acupuncture treatments for problems sleeping focus on the root disharmony within the body that is causing the insomnia. Therefore, those who use acupuncture for insomnia achieve not only better sleep, but also an overall improvement of physical and mental health.

Osteoarthritis and Omega-3

Reposted from http://articles.mercola.com/

The Worst Possible Thing to Ignore if You Have Arthritis

Posted By Dr. Mercola | December 29 2011

Story at-a-glance

• A diet enriched with omega-3 fats may help prevent osteoarthritis as well as slow its progression; benefit was seen in both cartilage and bone beneath cartilage
• Omega-3 fats produce compounds called resolvins and protectins, which help quell inflammation before it can do too much damage to your tissues.
• Numerous studies have been published on the remarkable effectiveness of the animal-based omega-3 fat krill oil in combating inflammation-related disorders such as arthritis

By Dr. Mercola

About one in five adults, or nearly 50 million Americans, have been diagnosed with arthritis, the most common form of which is osteoarthritis.
If you have osteoarthritis, the cartilage within your joints is progressively being damaged, and the synovial fluid that keeps your joints lubricated and cushioned is typically reduced as well.
The pain and joint stiffness that you feel is a result of your bones starting to come into contact with each other as cartilage and synovial fluid is reduced, and if you don't take action it can become progressively worse until you are unable to carry out your normal daily activities.
More than 21 million Americans have trouble climbing stairs, getting dressed and staying active due to arthritis, a number that has jumped from 19 million just a few years back.
If you are one of the millions struggling with osteoarthritis, or want to avoid becoming one of them, one of the simplest and most powerful steps you can take is adding animal-based omega-3 fats to your diet. The research continues to pour in that these healthy fats have exciting potential to prevent and treat arthritis.

Omega-3 Fats Incredibly Important to Treat Osteoarthritis

According to the latest animal study, a diet enriched with omega-3 fats reduced the majority of disease indicators among guinea pigs prone to developing osteoarthritis. This included both cartilage and subchondral bone changes, and the lead researcher noted that the evidence was strong that omega-3 fats may help prevent the disease and also slow its progression in those already diagnosed.
Omega-3's impact on joint health, arthritis, and inflammation is an active area of research, as they're known to produce compounds called resolvins and protectins, which help quell inflammation before it can do too much damage to your tissues. Several studies have been published on the remarkable effectiveness of the animal-based omega-3 fat krill oil in combating inflammation-related disorders, including arthritis. Three notable examples are:

• A 2007 study in the Journal of the American College of Nutrition investigated krill oil's ability to reduce inflammation. Researchers found that 300 mg krill oil per day significantly reduced inflammation, pain, stiffness and functional impairment after just 7 days, and even more profoundly after 14 days.
• A study published in the American Journal of Gastroenterology in 2005 showed similar findings with respect to reducing inflammation and arthritis symptoms, for both rheumatoid arthritis and osteoarthritis sufferers.
• A study in Advances in Therapy found participants with moderate-to-severe hip or knee osteoarthritis who received 1,500 mg of glucosamine sulfate along with 200 mg of omega-3 had greater pain reduction and fewer osteoarthritis symptoms (morning stiffness, pain in hips and knees) than those who took glucosamine by itself.

Omega-3 is actually anti-inflammatory in a very general way, which seems to be good for most people in general, even if you're interested in preventing a variety of diseases. For more information about the various health benefits of omega-3 fat, please review the following links:

Healthier, stronger bones	Improved mood regulation	Reduced risk of Parkinson's disease
Protecting your tissues and organs from inflammation	Brain and eye development in babies	Reduced risk of death from ALL causes

Are You Deficient in Omega-3 Fats?

Ideally, everyone really needs to aim for a lifetime of high omega-3 levels to reap all the health benefits that it has to offer, including protection from arthritis. However, the average American diet is seriously deficient in the animal-based omega-3 fats, DHA and EPA, as except for certain types of fish, which I don't recommend eating because of pollution concerns, there are very few sources of these crucial fats.
As a result, many are deficient and omega-3 deficiency has actually been called the sixth biggest killer of Americans,
You can now measure the omega-3 level in your blood, thanks to the research of Dr. William Harris, a research professor at the Sanford School of Medicine in South Dakota, and an established authority on omega-3 fats. Dr. Harris' research led to the development of an assay that measures your omega-3 level, which is referred to as the "omega-3 index."

Make Sure You Include a High Quality Animal-Based Source of Omega-3

Most people today are deficient in omega-3 fats and consume far too many damaged omega-6 fats, which are found in vegetable oils and processed foods. The ideal ratio is probably close to 1:1, but the average American's ratio is more like 20:1, or even 50:1 in favor of omega-6. Because of this severe imbalance, I recommend you supplement your diet with a source of high-quality omega-3 fats, while simultaneously reducing your omega-6 intake to bring this ratio into balance.
There are both plant and animal sources for omega-3 fats, and there are differences between them. All have different ratios of three important omega-3 fatty acids—ALA, EPA and DHA. DHA is the most important for your brain. EPA is also required by your brain, but in smaller amounts.
Plant-based omega-3 sources like flax, hemp and chia seeds are high in ALA, but low in EPA and DHA. Although ALA is an essential nutrient, the key point to remember is that the conversion of ALA to the far more essential EPA and DHA is typically inhibited by impaired delta 6 desaturase, an enzyme necessary for you to convert the ALA into the longer chain EPA and DHA. Elevated insulin levels impair this enzyme, and more than 80 percent of the U.S. population has elevated insulin levels. So from that perspective alone, it is important to include animal-based sources of omega-3 fats in your diet.

The Three Types of Animal-Based Omega-3 Fat

When it comes to choosing between the animal-based omega-3 options, the primary sources are fish, fish oil, or krill oil. As I'll explain, I believe krill oil is the far superior choice on this list.

• Fish: In a perfect world, you would be able to get all the omega-3s you need by eating fish. Unfortunately, the vast majority of our fish supply is now so heavily contaminated with industrial pollutants and toxins like mercury, PCBs, heavy metals and radioactive poisons that I just can't recommend most fish any longer. However, there are suppliers, like Vital Choice, that do harvest the fish from less polluted areas of the world and they clearly are less contaminated.
• Fish oil: I used to recommend that you take fish oil to enhance your intake of omega-3 fats, and high-quality fish oils are certainly great products with many important health benefits. However, fish oil is weak in antioxidant content.
  
  This is a major drawback for fish oil, because as you increase your intake of omega-3 fats by consuming fish oil, you actually increase your need for even more antioxidant protection.
  This happens because fish oil is quite perishable, and oxidation leads to the formation of unhealthy free radicals. Therefore, antioxidants are required to ensure that the fish oil doesn't oxidize and become rancid inside your body. So, you need to consume additional antioxidants both for your health in general, AND for your increased need for antioxidants when using fish oil.
  
• Krill oil: Last but certainly not least is my preferred choice for animal-based omega-3 fats. I believe krill oil is superior to fish oil because it contains phospholipids that dramatically improve DHA and EPA absorption. It also has a very powerful antioxidant called astaxanthin, and omega-3s bonded together in a way that keeps them protected from oxidation. Many popular fish oil brands are already oxidized before you open the bottle. Krill oil is also 48 times more potent than fish oil and contains vitamin E, vitamin A, and vitamin D.
  
  Additionally, as Dr. Harris confirms, krill oil is also more potent gram for gram, as its absorption rate is much higher than fish oil. According to his research, you get somewhere between 25 to 50 percent more omega-3 per milligram when you take krill oil compared to fish oil.
  

  "You actually get more omega-3 from eating krill," he says.
  

  Krill is also a completely sustainable and environmentally friendly source of omega-3. Not only is krill the largest biomass in the world, but krill harvesting is one of the best regulated on the planet, using strict international precautionary catch limit regulations that are reviewed regularly to assure sustainability.
  

If You Have Arthritis, You Need to Know About Astaxanthin

It is likely that astaxanthin may be even more powerful in helping people with arthritis symptoms than omega-3 fats, as this antioxidant is leaps and bounds more powerful than beta-carotene, alpha-tocopherol, lycopene and lutein, other members of its chemical family. It exhibits VERY STRONG free radical scavenging activity and helps protect your cells, organs and body tissues from oxidative damage and inflammation.
Specifically, astaxanthin is a carotenoid antioxidant produced only by the microalgae Haematoccous pluvialis when its water supply dries up, forcing it to protect itself from ultraviolet radiation. It's the algae's survival mechanism -- astaxanthin serves as a "force field" to protect the algae from lack of nutrition and/or intense sunlight.
There are only two known sources of astaxanthin -- the microalgae that produce it, and the sea creatures that consume the algae (such as salmon, shellfish, and krill). One of the reasons why I recommend krill oil is because it naturally contains astaxanthin to protect it from oxidation. Adding the antioxidant astaxanthin to fish oil reduces its susceptibility to oxidation while making its immunomodulatory properties more potent, which is the beauty of krill oil, which has this natural protection built in.

But although I don't recommend many supplements, I believe many could enjoy even MORE benefits by further increasing your astaxanthin, even if you are already taking a krill oil supplement. If you decide to give astaxanthin a try on its own, I recommend a dose of 8-10 mg per day. If you are on a krill oil supplement, take that into consideration, as different krill products have different concentrations of astaxanthin, so check your label.

Arthritis Doesn't Have to be a Debilitating Disease

Osteoarthritis can be extremely painful and debilitating disease. By losing weight, exercising, making changes to your diet and lifestyle, and using natural anti-inflammatory relief measures you can potentially overcome this disease, or at least significantly decrease pain associated with it.

• Healthy Diet: Arthritis rates are more than twice as high in obese people as those who are normal weight, because the extra weight puts more pressure on your joints. This can not only lead to osteoarthritis, it can also make the condition exponentially worse.
  
  So if you are suffering from arthritis and are overweight or obese, losing weight is an essential form of treatment. You will want to jumpstart your weight loss by eating a healthier diet.
  
• Exercise: Most people have little appreciation for how powerful exercise can be in preserving bone density and joint function, which can help prevent and alleviate osteoarthritis as you age.
  
  The notion that exercise is detrimental to your joints is a misconception; there is no evidence to support this belief. Instead, the evidence points to exercise having a positive impact on joint tissues -- if you exercise sufficiently to lose weight, or maintain an ideal weight, you can in fact reduce your risk of developing osteoarthritis.
  People with arthritis must be careful to avoid activities that aggravate joint pain. You should avoid any exercise that strains a significantly unstable joint.
  
• Vitamin D: Low levels of vitamin D are associated with cartilage loss in your knees, and this is one of the hallmarks of osteoarthritis. The remedy, to make sure your vitamin D levels are optimized, is simple. It involves getting your blood levels tested, then optimizing them using safe sun exposure or indoor tanning on a safe tanning bed (safe tanning beds have electronic ballasts and produce less UVA than sunshine). LINE BREAK As a last resort, you can supplement with vitamin D3; recent research suggests the average adult needs to take 8,000 IU's of vitamin D per day in order to elevate their levels above 40 ng/ml, which is the bare minimum for disease prevention.
  
  

If you need pain relief, which is typically an important component of osteoarthritis treatment, think long and hard before choosing anti-inflammatory drugs like non-steroidal anti-inflammatories (NSAIDs) and analgesics, like Tylenol. NSAIDs kill some 30,000 people every year due to bleeding ulcers, and the oral drugs have been linked to a host of problems including heart failure -- Vioxx and Celebrex are prime examples of these very real dangers.
There are safer, natural anti-inflammatory alternatives available, including:

• Boswellia: Also known as boswellin or "Indian frankincense," this Indian herb is one treatment I've found to be particularly useful against arthritic inflammation and associated pain.
• Hyaluronic acid (HA): Hyaluronic acid is a key component of your cartilage, responsible for moving nutrients into your cells and moving waste out.
• Astaxanthin: As mentioned above, astaxanthin is one of the most powerful lipophilic antioxidants yet discovered and is the most abundant carotenoid pigment found in crabs, salmon, trout, shrimp, and krill. Studies have found that it can help support joint health and mobility.
• Eggshell membrane: Elastin, collagen and glycosaminoglycans are three nutrients found in eggshell membranes, which can help support the stability and flexibility of your joints by providing your joints with the building blocks needed to build cartilage.
• Ginger: This herb is anti-inflammatory and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice.
• Bromelain: This enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form, but eating fresh pineapple may also be helpful.
• Cetyl myristoleate (CMO): This oil, found in fish and dairy butter, acts as a "joint lubricant" and an anti-inflammatory.
• Evening primrose, black currant and borage oils: These contain the essential fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain. It is reasonable for many to take these as a supplement, particularly if you struggle with dry skin in the winter, as this is a strong indicator that you are deficient in these fats. I prefer the use of GLA supplements from evening primrose oil but borage oil contains a higher concentration of GLA, which means you need fewer capsules, and it tends to be less expensive.
• Cayenne Cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting the body's supply of substance P, a chemical component of nerve cells that transmits pain signals to your brain.

Importance of the Tongue in Acupuncture and Traditional Chinese Medicine

The tongue, to the Chinese Medicine practitioner, acupuncturist revels what is going on internally with the organ systems and body fluids such as blood.

The tongue is highly vascular and is richly supplied by both the nervous system and the circulatory system.  It is also constantly nourished by or "bathed in" saliva.  Saliva is secreted by salivary glands which are controlled by our autonomic system.  Saliva contains water, electrolytes, mucus, and enzymes.  Saliva can change the appearance of the tongue.  Therefore, the tongue is an highly sensitive organ and its appearance can change mirroring the many physiological changes occurring inside the body.  

By observing the tongue we can observe the functioning of the body as a whole and determine imbalances within different organ systems in the body.  When an acupuncturist asks you to stick out your tongue we are observing the tongue in three distinct areas.

The first area is the area of the tongue proper

We evaluate the size of tongue compared to the opening of the mouth.  If teeth marks are present along the sides of the tongue this may indicate edema or swelling in your body, a water metabolism issue.  We search for any ulcerations or lacerations of the tongue, this indicates that the body is prone to or currently having some form of inflammation.  The colour of the tongue indicates the strength of one's health.  A normal tongue presents as pinkish red with a certain shine.  When the tongue is pale it indicates deficiency or weakened body.  When it is red, it means the body is in an excess state within in one or multiple organ systems.  When the colour is purple, this is an indication of pain or congestion or blockages within the body.

In general, the tongue size, shape and colours provides an indication of the strength of your body's immunity and functioning.

The second area is the tongue coating.

The tongue coating gives an indication of the Stomach function of the body.  A normal tongue coat is one that is very thin and clear.  This type of coating indicates proper enzymatic content and salivary secretions.  A thick coat is a sign of imbalance in the digestive system.  A thick and cruddy coat is a sign of decreased immune system with Candida presentation.   A 'peeled' coat indicates a sign of damage or weakening of certain systems within the body.  A yellow coat is a sign of infection or inflammation in the body.

The third area is regional analysis.

Different areas of the tongue are represented by the functioning state of different organ systems of the body.

 

And based on the colour, shape and size of these areas indicates the health of that particular organ systems within the body and the overall health of the individual.

So which Tongue are you, below is a small sample of the many possible tongue combinations observed in Traditional Chinese Medicine: