February 11, 2024 A 36 year old female patient has complaints including Dysmenorrhea with heavy bleeding and thyroid nodules. She had been suffering from dysmenorrhea since teenage years and had history of ovarian cysts and fibroid in her teens and twenties. Her period has 20 to 35 day cycle and lasts 5 to 9 days. Spotting happens often before period. Bleeding is extremely heavy with blood clots and severe cramps at scale of 6 to 8 out of 10 for 2 days at day 2 and 3. The pain is burning in nature with strong contractions, which is not relieved by heat but managed by better sleep, exercise and relaxation. She has no pain with urination, bowel movement or sexual activity. She has neither fever or nor foul smelling discharge. In 2019 she was diagnosed with thyroid nodules due to high thyroglobulin level. The nodules were measured by MRI at R 6.3cm/2.0cm/2.0cm and L 4.4cm/1.1cm/1.6cm.
She also had high blood pressure and high cholesterol. She is overweight. She has family history of hypothyroidism, diabetes, stroke, high blood pressure and fatty liver. Her job is very stressful. She often works overnight or works till midnight and is lack of exercise due to deadlines. She drinks coffee every day. Diet is not healthy including refined sugar, oil and flour. She often takes ibuprofen and prescribed NSAID for pain relief during period. She also takes fish oil and multivitamin daily.
She often feels fatigued. Her feet are very cold to touch. She likes to sleep at 65 degree , which indicates that she tends to feel hot at night. She has lower back pain , knee pain, upper back and shoulder pain. Her tongue is dusky red with thin body, scanty coating and red dots on the tip. Her Pulse is deep and thin in general and especially on both chi region. Emotionally she is easily worried and anxious. According to above signs and symptoms her TCM differentiation would be essence (both kidney yin and yang) deficiency with liver Qi, blood and phlegm stagnation. Kidney essence deficiency would manifest as cold lower extremities, lower back and knee pain, and feeling hot and sweaty at night. Liver qi and blood stagnation would manifest as pain aggravated by stress. The deep weak rapid pulses at both Chi region also indicate kidney essence deficiency.
Her blood work in 2019 showed high thyroglobulin, ALT, CRP, CALC LDL, Ferritin, and iron serum. Her insulin level was 12 with glucose level of 97 in 2019. With acupuncture treatments her nodules didn’t grow much bigger. The lab result in March 2021 showed normal ALT, Ferritin level, and Iron serum level, but her insulin level increased from 12 to 13. Her menstruation is regulated to 5 days instead of 9 days with no spotting, but her menstrual pain would improve one cycle and get worse another cycle with stress.
It is suspected that the pain is associated with thyroid dysfunction and thyroid nodules. A cross sectional study in India concluded that thyroid dysfunction is closely related to menstrual disorders, therefore thyroid function should be checked for all the patients with menstrual issues (Ajmani, Sarbhai, Yadav, Paul, Ahmad &Ajmani,2014, P.115). Her blood work in March 2021 showed normal TSH, T3, T4, and antibodies but did not test thyroglobulin level. Her thyroglobulin level should be checked again. According to a systematic review by Panth, Guerin & DiMarco Iodine deficiency is re-emerging in vulnerable group such as women of reproductive age(2019, P208). Her iodine level should be checked to rule out iodine deficiency related to her thyroid nodules. Urine iodine concentration is a excellent marker for recent iodine intake.
Pelvic ultrasound should be done to rule out ovarian cyst ,fibroid, and PCOS if the pain does not improve with managing the thyroid issues. There is possibility of PCOS according to her irregularity of menstruation, obesity, increased insulin level, high LDL, and blood pressure. Ovulation status, androgen level should be checked according to Rotterdam Criteria in order to rule out PCOS. There is also a high chance of endometriosis due to high CRP but at the same time she does not have enough symptoms like sexual intercourse pain, bowel movement pain and urination pain to confirm that. CA125 and laparoscopic procedure should be the last resort to rule out endometriosis.
Besides finding the underlying reasons for the pain, it is very important to manage the pain through exercise, diet, acupressure and acupuncture with heat. According to a 2000 study by Barnard, Scialli, Hurlock & Bertron there is significant reduction of dysmenorrhea and premenstrual symptoms related to higher level sex hormone binding globulin by following a low fat vegetarian diet. Exercise, heat and acupressure showed high to moderate effect in reducing menstrual pain. They can be potentially used as alternative to pain killers(Armour, Smith, Steel&Macmillan, 2019). According to Woo, Ji, Pak, Lee, Heo, Lee &Park Acupuncture might be more effective for reducing menstrual pain than NSAIDS(2018). Ear acupuncture is 91.9% effective compared to 60% with Chinese medicine treating dysmenorrhea related to endometriosis(Xiang, Situ, Liang, Cheng & Zhang, 2
December 12, 2022 by Trisha HanEmotional Freedom Technique tapping for Stress and Anxiety related to Infertility
- Combine tapping on energetic acupoints and cognitive behavioral therapy.
- Start with SI3(hou xie) followed by BL2(zan zhu), Gb2(tong zi Liao), St2(si bai), Du26(Shui Gou, Renzhong ). Ren24(cheng jiang), Ki27(shu fu), Sp21(Da Bao), Du20(bai hui) in sequence.
- Start tapping Si3 with positive affirmation three times.
- “Although I feel emotional such as anxious, worried , unsettled, scared, angry, sad et al, I completely deeply accept myself and how I feel”.
- Acknowledge our feelings while tapping along
- At the last point tell ourselves to let go of the feelings and worries.
- Tap several rounds until relaxed
- https://m.youtube.com/watch?v=7X4FIDPXOVM
- https://www.youtube-nocookie.com/watch?v=Sqe3h3l8a7w
How to Maximize the effect of Tapping
- Drink water to keep hydrated
- Put favorite music on or follow the tapping meditation
- Measure stress anxiety or pain level at scale of 1 to 10 before starting
- Take deep breath and close eye to internalize energy
- Do minimum three rounds up to 15 minutes for each session and two sessions per day
- Be persistent for six days to see significant result
- Enjoy as a bed time routine or whenever stressed
Research Evidence on EFT
- Four to six one hour sessions are required to help PTSD patients to reduce PTSD measurement score to non clinical level(Church&Feistein, 2017).
- Only 14% of 49 veteran exceed PTSD measurement score after 6 one hour sessions of EFT and the effects lasted at six month follow up beyond post treatment(Church &Feinstein, 2017).
- A system Review concluded that acupressure point tapping part play a very important and active role and contribute to the efficacy of EFT protocol and the effect of EFT tapping lasted at six month follow up assessment (Church, Stapleton, Yang &Gallo, 2018).
September 10, 2022 Foods to eat( omega 3 fatty acid, protein and iron rich food)
- Red raspberry leaf tea
- Warm water with lemon and honey
- Trail mix with Walnuts, cashew, Goji berries and longan fruit
- Cardamom, Nutmeg, Ginger(for cold damp patterns with white thick tongue coating and teeth mark)
- Yams
- Sweet Potato
- Squash
- Pumpkin
- Avocado and egg( one per day)
- Raspberry and other berries
- Broccoli and dark leafy green vegetables ( eat with vitamin C rich fruit to increase non heme iron absorption)
Foods or Drink to avoid : (Acid inducing and cold natured foods)
- Ice cubes, Ice cream
- Refined sugar
- Soda(have refined sugars, which create unstable blood sugar levels)
- Coffee(choose Wulong, green, or black tea instead, coffee is acid inducing)
- Alcohol(acid inducing beverage)
- High fructose corn syrup
- Hydrogenated oil(cause inflammation)
Life style suggestions:
- Please do not use tampons during menstruation, use pad instead (tampons can block the blood flow, which increase the risk of endometriosis)
- Please schedule a week off during and after IVF transfer to reduce stress in order to increase the chance of pregnancy.
- Please do belly breathing exercise with meditation and yoga to increase energy flow to the uterus(check yoga with bird on YouTube).
- Restful sleep is the best way to help regulate hormone. Staying away from electronics and relaxing with mindful breathing help with deep restful sleep.
- Staying away from sexual activity during the first three months of pregnancy if there is tendency to miscarriage
- Please keep hydrated during the day especially from 3:00pm to 5:00pm to help your body detox.
- Please take Vitamin B12 supplement and eat adequate food rich in zinc and selenium if you are vegetarian.
September 10, 2022 November 1, 2021Trisha Han Acupuncture, Self-Help Topics, Wellness & Prevention
Did you know Autumn is the time of year when the lungs are the most active, when they are in the most optimal condition. We can take advantage of this time to nurture our lungs, to give them any necessary attention and care. According to Chinese medicine, the lungs have two primary functions: one is to “release”, the other is to “reduce”, or to pass through. The releasing function is expressed in ways such as sweating, coughing, and sneezing. The reducing function is expressed in two ways: one is opening the water passage within the body through the Bladder Meridian; the other is opening up the digestive organs and allowing waste to pass through. However, the reducing function can only be seen and analyzed during sickness; in other words, when the lungs’ reducing function is normal and healthy, its effects can’t easily be observed—only when it is abnormal can you see any symptoms.
Sometimes, the cause of constipation isn’t the hard, dry nature of the stool; rather, it is often because the stool is unable to make its way out. Many people also find that they do not urinate as often as they should. These conditions are both caused by and directly related to an abnormal reducing function.
So where exactly does the energy of the reducing and releasing functions come from? This energy originates in the spleens and lungs, and is the central source of energy in our body. This is why many Chinese medicines focus on replenishing this source of energy. One example is the Shen Ling Bai Zhu teapills—this herbal medicine not only reinforces the spleen but also replenishes the lungs and restores balance in the body, so it is the perfect remedy for a weak central energy source. Another example is the Bu Zhong Yi Qi teapills. Its name means “Restore and Increase the Vital Central Energy”, and the medicine does exactly that. However, the Bu Zhong Yi Qi teapills work by using the energy of the liver and kidney organs in order to restore the energy of the central source (the spleen and lungs), so this medicine is not suitable for those with a weak liver and kidney function.
On the Lung Meridian, there is a point called Zhong Fu, meaning “central residence” because this is where the central energy of the body comes together and resides. Therefore, it is one of the key points in treating and restoring the body’s central energy. Another key point is the Tai Yuan point; it is the point where the Lung Meridian originates, so it has enormous effects in restoring the body’s central energy. Either using moxa or massaging out these two points will prove extremely beneficial in restoring the body’s energy balance, and meanwhile, taking care of the lungs.
Many people don’t want to eat medicine or drink porridge for medicinal purposes, either because they dislike the practice or have difficulties preparing it. So they wonder if there are any other good methods to maintain and replenish the lungs. In actuality, if the lungs do not receive harm from the exterior, no sickness will arise—so how would we go about maintaining them? The main source of exterior harm that our lungs receive is the cold; if the body is exposed to the cold for an extended period of time, it will come into the body through the pores and do damage to our lungs. Therefore, preventing the cold from entering our bodies is the key to keeping our lungs healthy.
The lungs do have one threat that comes from the body’s interior—it is the excessive heat of the liver, or liver inflammation. In Chinese Medicine, we call this “Liver Fire”. Although this excessive heat given off by the liver is very intense, it shouldn’t do too much damage to the lungs, as long as it is controlled in time. The Yu Ji point is a point on the Lung Meridian that, when massaged, can heal coughs and lung inflammation caused by “Liver Fire”.
Some people do not have enough Chi in their lungs, therefore their bodies do not retain heat well, and easily feel cold. People with this condition often find that they have difficulty breathing, or don’t always take in enough oxygen; this is because the spleen does not absorb energy well. Because the spleen is one of the centers of our body’s energy, we must treat this condition starting with the spleen. To strengthen the spleen, you can use moxa on the Ming Men point, the Shen Que point located near the waist, the Guan Yuan point located beneath the belly button, and the Tai Xi point located on the Kidney Meridian. By using moxa on this acupuncture points, you will give warmth to the meridians they are positioned on and open up the stagnant pathways. If you persist in this method, you will find that it is the best way to treat a weak spleen and lungs during the fall season.
Another common condition occurs in people who have excess liver fire, but their lungs are not weak either; these people easily get upset, but they stifle it instead of expressing their emotion. Because of this, they often feel like there is a huge weight inside their chest, preventing them from breathing with ease. If you have this condition, you can massage the Lung Meridian’s Chi Ze point. Massaging this point daily can also relieve symptoms of conditions such as high blood pressure, asthma, and enuresis (bed-wetting syndrome).
The methods above can be used according to individual body types, conditions, and needs. However, one method that can be applied to all conditions relating to the lungs’ releasing and reducing functions is the “Making-Yourself-Sneeze” method. This method was introduced in a previous blog entry, and can relieve such conditions as allergies, cold, stagnant or obstructed energy in the body, various skin diseases, and etc.
April 9, 2022 by Trisha Han- Starting your favorite music, standing tall like a tree and breathing like a tree.
- Lifting hand up to the air , holding together, and swaying side to side to work on GB and Liver M for 2 minutes; opening hands , fingers splitting and stretching hand and swaying from side to side for 2 minutes( to wake up Jing Well and Shu wood points).
- Circling the wrist in both ways, clockwise and counterclockwise to simulate all the yuan earth points on yin Meridian and Jing Metal River points on Yang meridian ( wrist reflect neck, pelvic )Can swaying from side to side. (2 minutes)
- Twisting your arm and wrist inward and outward to move elbow, upper arm and shoulder.
- Be a tree full of life and hope.
April 9, 2022 by Trisha Han80% of gynecological illnesses are caused by irregular menstrual cycles. If the menstrual cycle can be regulated, then many of these gynecological illnesses would disappear by themselves. Ignoring menstrual irregularities is not smart, as they may cause many unforeseen problems later on in life. Some common menstrual problems include menstrual cramps, bloating, headaches, spotting, back pain, and irregular cycles, etc. If these problems are recognized early on and are treated without delay, they are not difficult issues to deal with.
In treating menstrual problems there are three organs that must be focused on: the liver, spleen and kidney. There are two important acupuncture points that, if applied pressure to daily for a couple of minutes, may be extremely beneficial in regulating menstrual cycles and getting rid of the painful symptoms.
1. The “San Yin Jiao”
San Yin Jiao is, from a gynecological standpoint, a panacea. It’s a remedy for just about any female-related illness, so it’s one whose abilities and importance we must value. The point has a two-way effectiveness; in other words, it can act as both a channel and an absorber, and can either evoke circulation of the blood or slow it, depending on an individual’s physique. It is very easy to find on the body, located around 7 centimeters above the inner ankle. To find the exact point, feel around the area for a spot of sensitivity.
2. The “Ci Liao” Point
This point is located at the base of the spine, and it is also a very important point when it comes to treating gynecological illnesses. As long as there’s a problem with the female reproductive system—no matter if it’s located in the uterus, ovaries, etc.—this spot will be sensitive when applied pressure to. If this point is massaged frequently, the pain around the point will gradually lessen and disappear, and the corresponding illness will also go away.
The points above are very effective external methods in curing gynecological illness; if the body’s internal cycles are regulated as well, the results will be even better. How to regulate these internal cycles then? You can take herbal medicines such as Free and Easy Wanderer, or Free and Easy Wanderer Plus (ask a local practitioner about these medicines). These two medicines are extremely helpful in getting rid of menstrual problems or illnesses causes by menstrual irregularities. It is effective in treating 70% or more of gynecological illnesses.
Free and Easy Wanderer Pills, just as the name suggests, promotes energy and raises spirit, eliminating depression. Many gynecological illnesses and reproductive problems are directly related to emotional stress and spiritual well-being.
What’s the difference between Free and Easy Wanderer Teapills and Free and Easy Wanderer Plus? The answer lies in the “Plus”. Free and Easy Wanderer Plus was created on the basis of Free and Easy Wanderer, with an addition of several herbs to reduce internal heat and relieve inflammation.
If you find that you are easily agitated or upset, often are thirsty and like to drink cold beverages, you should take Free and Easy Wanderer Plus. If you don’t like to drink water and are not often thirsty, it’s better to take Free and Easy Wanderer.
In general, you should begin taking the herbs 3 or 4 days before menstruation, and stop taking the herbs temporarily once menstruation begins. If you feel comfortable with the herbs, it’s okay to take them for an extra two days. By taking these herbs, you will feel that your menstruation period passes smoothly and without incident.
There are several other medicinal regulating methods that also give pretty good results:
Because menstruation uses up a lot of the body’s energy, after menstruation many people will feel light-headed and weak, having symptoms such as a sore back or leg pain. This problem is easily solved. When menstruation is just about to end, take Liu Wei Di Huang teapills. People who easily get cold can take Shi Quan Da Bu teapills as an alternative, because this can prevent a weak body and energy deficiency.
If spotting occurs, it’s often because the spleen is weak or has weak circulation. This problem can be solved by taking Bu Zhong Yi Qi teapills and eating Chinese red dates/jujubes. During menstruation, you can also take San Qi in powder form and Ba Zhen. People who get cold easily can also add some brown sugar while taking the herbs.
If you are not familiar with Chinese Medicine, please ask a local practitioner/acupuncturist about the herbs. As long as you follow the above methods, I’m sure your gynecological illnesses will be solved.
April 9, 2022 by Trisha Han Self-Help Topics, Wellness & Prevention
In the ancient times, women’s health was often a thorny issue in Chinese medicine, much like in Western Medicine not too long ago. Women were often reluctant to discuss their problems and lifestyles openly with male doctors, and because of this, could not get the most accurate diagnosis of their conditions. Although modern women are more open with their doctors, and there are many female doctors as well, there has also been a significant increase in illness in female patients compared to a few thousand years ago–several conditions in particular. It includes coldness, blood stagnation, Qi stagnation. Today we only talk about the first issue – coldness.
The first is excess cold, or conditions derived from being exposed to the cold for too long. Through the tens of thousands of years that humans have existed, we have developed an aptitude for adapting to all sorts of temperatures, and our bodies have become used to the temperature cycles in spring, summer, fall and winter. But technology brought something so different from what we had adapted to in nature–air conditioning. With A.C., we can go from the sweltering heat to the freezing cold in less than a minute, just by stepping into a room. Only a hundred years ago, it took the course of many months from summer to winter to accomplish that same temperature change.
These days, every single building has air conditioning installed–whether it’s the supermarket, your house, your workplace, or the gym. And our bodies have not been able to adapt to such sudden temperature changes yet. One piece of evidence is the rise of skin diseases such as ezcema and acne. Part of it, I believe, comes from the food we eat, but another large factor is the fluctuating temperature environments caused by air conditioning.
For example, if you’re walking outside during the summer and sweat is pouring down your face, then you suddenly walk into an air-conditioned room, what’s going to happen to all the sweat that was supposed to continue pouring down your face? Your sweat pores close unexpectedly because of the temperature change, and all the sweat collects underneath the skin and traps debris and oil that can’t be transported out. If this scenario continues for many days, months and years, it will eventually lead to various types of skin conditions, infections and rashes.
Being exposed to rapid temperature changes can also cause digestive problems. In the summertime, we usually wear less clothes because the temperatures are high outside–chances are, our limbs are usually exposed. When we walk into a cold building, the cold easily enters through our hands and feet and go into our visceral organs, including our digestive organs. Many people have sensitive stomachs during the summertime, and will have indigestion or an upset stomach due to one small thing–it is all because there is excess cold in the organs because of the A.C.
But the people most easily affected by the cold are women, because women usually wear less clothing during the summer, at times even exposing the stomach–upon walking into a cold room, the cold will immediately seep into her body through the exposed areas.
According to Chinese Medicine, women’s bodies cannot afford to have stagnant blood and Qi, because a woman’s reproductive organs all depend on the circulation and warmth of blood. Stagnant blood and Qi could cause irregular or absent menstrual cycles, which leads to infertility and other gynecological conditions. This is why I always tell my infertility patients not to drink ice water and drink warm water instead.
When I first became acquainted with gynecology, I was confused: why do women who are not experiencing heat deficiency often have to take warm-natured herbs to regulate their conditions? Finally I realized that a woman’s uterus thrives in warmth–even if there is malignant and excessive heat present, caution must be taken so that the warmth is not countered completely by cold-natured herbs; that is why women must take warm-natured herbs, even in regulating a heat-related illness.
Another cause of malignant cold is drinking ice water. While air conditioning is considered “inner heat, outer cold”, drinking ice water is just the opposite–“outer heat, inner cold”. You could be outside in 100 degrees, and then drink some cold water in hopes to relieve the heat, but all it does is make your stomach very confused. Drinking ice water is another habit that our ancestors couldn’t have even imagined–but now, especially here in America, it has become ingrained into our daily lifestyles, and our bodies simply have not adjusted.
Drinking ice water also has a large impact on women’s health, because the coldness that we ingest causes harm to our organs almost immediately. The coldness will cause blood and Qi stagnation in the uterus, and obstruct menses flow. If the stagnation is ignored, it will accumulate, causes various types of gynecological illnesses.
So, in general, we must all be careful of our daily habits, because they can gradually build and affect us for a lifetime. But women, especially, must take care to avoid excess cold from entering their bodies. Instead of drinking ice water, try drinking room temperature or warm water instead. Always keep a light jacket or sweater on hand, for the times you have to enter an air-conditioned building after being outside in the sun. And eat some ginger snaps as a snack, or some ginger chew candies (ginger is warm-natured), just to be safe.
