Study Shows Acupuncture Normalizes Hormones, Ups Pregnancy Rates

by William Alexander | Aug 30, 2016 | Acupuncture Nashville TN

Researchers document that acupuncture produces higher pregnancy rates than fertility medications for women with hyperprolactinemia (HPL).

Acupuncture produces a higher rate of pregnancies than fertility medications with significantly less adverse effects. In a controlled clinical trial, researchers document that acupuncture outperforms bromocriptine and bromocriptine plus clomiphene for the treatment of infertility for women with hyperprolactinemia (HPL). Acupuncture produced a 43.3% pregnancy rate whereas fertility medications produced 20% pregnancy rate.

One important mechanism responsible for the fertility treatment success with acupuncture is hormonal regulation. Acupuncture more rapidly normalized levels of prolactin than fertility medications. In hyperprolactinemia, elevated levels of prolactin (PRL) hormone causes infertility by inhibiting gonadotropin-releasing hormone (GnRH) production. GnRH is responsible for stimulating gonadotropins (Gn), luteinising hormone (LH), and follicle-stimulating hormone (FSH) production. As a result, hyperprolactinemia affects the overall function of the ovaries, ovulation, and corpus luteum formation because Gn, LH, and FSH play an important biological role in reproductive health.

The study (Hu et al.) confirms that acupuncture normalizes prolactin levels more rapidly than receiving bromocriptine or bromocriptine plus clomiphene. Patients receiving acupuncture averaged a normalization of prolactin levels within two weeks. Patients receiving bromocriptine or bromocriptine plus clomiphene experienced normalization of prolactin levels within four weeks. The research indicates that acupuncture produces a faster homeostatic response for prolactin production in women with hyperprolactinemia.

One significant advantage to acupuncture treatment for the treatment of fertility emerged; acupuncture did not produce a high adverse effect rate. Conversely, fertility medications produced a high adverse effect rate. Patients receiving bromocriptine or bromocriptine plus clomiphene had a 63.33% adverse effect rate.

Hu et al. (Mawangdui Hospital of Hunan Province) determined that acupuncture is a preferential fertility treatment option for women with hyperprolactinemia. Production of greater positive patient outcomes combined with a significantly lower adverse affect rate was the basis for the conclusion. Let’s take a look at the treatment protocols for both the Traditional Chinese Medicine (TCM) approach and the pharmacological approach.

The investigation included 60 female patients with infertility due to hyperprolactinemia. They were randomly divided into two equal sized groups. Patients ranged from age 26 to 33. The duration of illness ranged from 2 to 8 years. Acupuncture group patients received only acupuncture. Medication group patients received bromocriptine or bromocriptine plus clomiphene. The clomiphene was added for patients with thermoregulation irregularities. The primary acupoints selected for acupuncture therapy were the following:

Qihai (CV6)
Guanyuan (CV4)
Zusanli (ST36)
Sanyinjiao (SP6)
Taichong (LV3)
Taixi (KD3)
Ligou (LV5)
Therapy commenced on the 8th day of menstruation. A 0.30 mm x 40 mm disposable needle was used to administer acupuncture on all acupoints. For Qihai and Guanyuan, the needle was inserted in a slanted orientation and an upwards direction, thereafter manipulated with the Bu (tonify) technique. Zusanli was pierced perpendicularly for a depth of 1.5 inches, and the needle was manipulated with the Bu technique. Taichong and Ligou were both pierced for a depth of 0.5 inches, perpendicularly and horizontally respectively, then treated with the Xie (reducing) needle manipulation technique. For Taixi, the needle was inserted perpendicularly 0.5 inches deep and manipulated with the Bu technique. A needle retention time of 30 minutes was observed. During each menstrual cycle, one daily acupuncture session was conducted for a total of 10 days. The above treatment was administered for a period of 1 year.

For the fertility medication control group, an initial dosage of 1.25 mg of bromocriptine was administered twice per day after meals for 7 consecutive days. After that, the dosage was increased to 2.5 mg. Patients remained on the medication for a period of 1 year. In cases where the patient did not experience changes in dual-directional thermoregulation after 3 months of bromocriptine treatment, clomiphene was administered to facilitate ovulation. Bromocriptine is a synthetic drug and is an analogue of ergot alkaloids. It stimulates cortical dopaminergic receptors thereby inhibiting prolactin release. Clomiphene is a fertility drug that stimulates ovulation.

In hyperprolactinemia, women have unusually high levels of peripheral prolactin (PRL) and experience hypothalamic pituitary gonadal axis dysfunction. This often causes menstrual disorders, galactorrhea, reproductive dysfunction, and infertility. The rate of occurrence of hyperprolactinemia is 0.4% among healthy women and 7% – 9% for infertile women (Zhang, 2012). The authors focused on the benefits of acupuncture for promoting fertility. However, the normalization of prolactin levels may have additional benefits for the patients. Further studies to examine the more global effects of acupuncture on PRL normalization and bodily health are required to quantify and confirm these additional benefits.

In Traditional Chinese Medicine, hyperprolactinemia results from a Chong and Ren meridian imbalance. The acupuncture point prescription chosen for the treatment protocol reflects this principle. The signature Zusanli acupoint is effective in promoting overall qi circulation. Together with Qihai and Guanyuan, these three acupoints consolidate yuan qi, revitalize the body, nourish body cells, and strengthen the reproductive system. Taichong and Ligou are acupoints located along the liver meridian, making them significant acupoints for promoting liver health. Taixi, being a kidney meridian acupoint, is ideal for promoting kidney health. Sanyinjiao is a powerful acupoint that maintains general bodily health and has proven efficacy in treating gynecological disorders. Acupuncture administered to Taichong, Ligou, Taixi, and Sanyinjiao has an overall effect of promoting qi circulation along the liver, spleen, and kidney meridians. Acupuncture on all of the aforementioned acupoints collectively promotes liver and kidney health, dredges liver qi, and benefits the Chong and Ren meridians.

As part of continuing education in the field of acupuncture and clinical research, additional studies using this acupuncture point prescription protocol with larger sample sizes will help to confirm the findings of Hu et al. It will also be interesting to see a third study group added to future investigations comparing acupuncture combined with medications to groups receiving medications or acupuncture only.

Rubin et al. conducted an investigation of acupuncture combined with medications. The research team consisted of investigators from the University of Washington, Oregon College of Oriental Medicine, and Northwest Center for Reproductive Sciences. Their meta-analysis confirms that live birth rates increase when acupuncture is added to standard care protocols for women receiving donor egg IVF (in vitro fertilization).

Xu et al. conclude that acupuncture benefits fertility rates for women with anovulatory infertility. The Ruikang Hospital researchers had a sample size of 40 patients. The effective rate was 85% based on the pregnancy rates measured in follow-up examinations. Acupuncture normalized FSH, LH, and E2 levels. Additionally, the thickness of the endometrium and the follicle diameter increased. Zigong, CV4, and CV3 were the primary acupoints used in the treatment protocol supplemented by additional Ling Gui Ba Fa acupoints. Ling Gui Ba Fa (eightfold sacred tortoise method) employs the addition of acupoints from a selection from the eight confluent points based on the time of day.

Overall, there is wealth of information indicating that acupuncture is successful in promoting reproductive health. Pregnancy rates increase accompanied by measurable improvements in hormonal regulation. Additional research is warranted based on the evidence.

References:
Hu J, Yan XL & Wang ZX. (2014). Acupuncture and Bromocriptine in the Treatment of Special HPL in Infertile Women. Journal of Clinical Acupuncture and Moxibustion. 30(7).

Zhang P. (2012). Bromocriptine in treating hyperprolactinemia. Journal of Jingchu University of Technology. 24(7): 50-52.

Hullender Rubin, Lee E., Michael S. Opsahl, Lisa Taylor-Swanson, and Deborah L. Ackerman. “Acupuncture and In Vitro Fertilization: A Retrospective Chart Review.” The Journal of Alternative and Complementary Medicine (2013).

Zhongguo Zhen Jiu. 2012 Feb;32(2):113-6. Effects of electroacupuncture on embryo implanted potential for patients with infertility of different symptom complex]. Kong FY, Zhang QY, Guan Q, Jian FQ, Sun W, Wang Y. Department of Reproduction, The Second Affiliated Hospital of Shandong University of TCM, Jinan, China.

Xu, Yin, and Miao Zhang. Efficacy observation on 40 cases of anovulatory infertility treated by acupuncture and moxibustion. World Journal of Acupuncture-Moxibustion 23, no. 1 (2013): 40-43.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1668-acupuncture-normalizes-hormones-ups-pregnancy-rates

Acupuncture Can Improve Exercise Tolerance for Those with Heart Conditions

by William Alexander | May 2, 2016 | Acupuncture Nashville TN

Acupuncture can improve exercise tolerance in patients suffering from chronic heart failure, according to new research from Germany.

The finding comes from a clinical pilot study by the team headed by Dr. Johannes Backs, physician and study director at the Department of Internal Medicine III (Cardiology, Angiology, and Pneumology — Medical Director: Professor Dr. Hugo Katus) of Heidelberg University Hospital. The needles do not increase the heart’s pump function, but they seem to have an influence on skeletal muscle strength and thus can increase the walk distance that heart patients can cover. The results of the clinical study, which was conducted with a comparison group treated with placebo acupuncture using dull needles, have been published in the medical journal Heart.

Acupuncture influences the autonomic nervous system

Chronic weakness of the heart muscle is one of the most frequent diseases and causes of death in Europe. Patients with this disease suffer in particular from a reduction in work capacity. Shortness of breath and fatigue brought on by physical exercise are signs of the disease.

The disease is much more complex than previously assumed. It is not only the weakening pump function of the heart muscle that is responsible for the symptoms. What is known as the autonomic or vegetative nervous system and various nerve transmitter substances become imbalanced, which further worsens the course of the disease. This is precisely where acupuncture may intervene, by bringing these processes back into balance — it influences the autonomic sympathetic nervous system (excitation), boosts the parasympathetic nervous system (relaxation), and also has an anti-inflammatory affect. Thus far there have been hardly any studies of whether acupuncture can thus influence such life-threatening diseases such as heart failure.

Needles fight exhaustion

The scientists examined patients with heart failure who were treated with the conventional medications and were in stable condition. In addition, patients in the acupuncture group were given ten sessions of acupuncture focusing on the acupuncture points which boost general strength according to Traditional Chinese Medicine and are also known to influence the sympathetic and parasympathetic nervous systems and inflammation markers. The control group was treated with special placebo needles that simulate a needle prick but do not break the skin. After this therapy, the acupuncture patients could cover a greater walk distance in the time allowed than the placebo patients. They recovered more quickly and tended to feel subjectively less exhausted. However, the measurable work capacity of the heart was unchanged.

Inflammation messengers cause muscle fatigue

We already know from other studies that heart patient’s ability to tolerate exercise is independent of the pump function of the heart. It appears rather that easily becoming fatigued stems primarily from the muscles. Inflammation messengers in the blood are increased in chronic heart failure and make the muscles tired. They activate what are known as ergoreceptors in the muscle that signalize to the body that the muscle cannot sustain the workload. “The blood level of a certain messenger, tumor necrosis factor alpha (TNF alpha) actually drops after the real acupuncture treatment. Since TNF alpha leads to a reduction of muscle mass and muscle strength among other things, this would explain the positive effect on skeletal muscle function,” explains Dr. Arnt Kristen, one of the authors of the study.

Better long-term prognoses through acupuncture?

“Most studies on the effectiveness of acupuncture have methodological weaknesses, as there are no placebo controls and the study participants are not ‘blinded’. This means that the patients know which treatment they are given and may therefore have certain expectations,” according to Backs. “In our studies, all patients thought they had received ‘real’ acupuncture.” A fascinating question for the future will be whether relatively low-cost acupuncture can improve the prognosis for cardiac patients over the long term.

Story Source:

The above post is reprinted from materials provided by University Hospital Heidelberg. Note: Materials may be edited for content and length.

Journal Reference:

A. V. Kristen, B. Schuhmacher, K. Strych, D. Lossnitzer, H.-C. Friederich, T. Hilbel, M. Haass, H. A. Katus, A. Schneider, K. M. Streitberger, J. Backs. Acupuncture improves exercise tolerance of patients with heart failure: a placebo-controlled pilot study. Heart, 2010; DOI: 10.1136/hrt.2009.187930