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What is Sjögren’s syndrome and how can TCM help?

15 Feb 2024

By: Lee Hui Min

Blog, Acupuncture, Article, Autoimmune Disease, Fertility, Physician Lee 李医师, TCM Herbs

What is Sjögren's syndrome? Sjögren’s syndrome is a chronic autoimmune disorder characterized by inflammation that primarily affects the glands responsible for producing tears and saliva. This inflammation leads to the hallmark symptoms of the condition, which include dry eyes and dry mouth. However, Sjögren’s syndrome can also affect other parts of the body, leading to a variety of symptoms beyond dryness, such as joint pain, fatigue, and organ involvement.The exact cause of Sjögren’s syndrome is not fully understood, but it is believed to involve a combination of genetic, environmental, and hormonal factors. The immune system mistakenly attacks the body’s own moisture-producing glands, leading to their dysfunction and the resulting dryness. How is Sjögren’s syndrome diagnosed and treated? Diagnosis of Sjögren’s syndrome involves a combination of medical history, physical examination, and various tests, including blood tests, eye tests, and salivary gland tests. While there is no cure for Sjögren’s syndrome, treatment focuses on managing symptoms and preventing complications. This may involve the use of artificial tears and saliva substitutes to alleviate dryness, as well as medications to reduce inflammation and manage other symptoms. It’s important to note that diagnosis of Sjögren’s syndrome can be challenging due to its varied symptoms and overlap with other autoimmune conditions. A comprehensive evaluation by healthcare professionals familiar with the condition is essential for an accurate diagnosis. Treatment for Sjögren’s syndrome focuses on managing symptoms, preventing complications, and improving quality of life. Since Sjögren’s syndrome is a chronic autoimmune disorder, there is currently no cure, but various treatment options are available to alleviate symptoms. Treatment plans are often individualized based on the specific symptoms and needs of each patient. Some common approaches to managing Sjögren’s syndrome includes the use of Artificial Tears and Eye Lubricants, Saliva Substitutes and Prescription Medications It’s essential for individuals with Sjögren’s syndrome to work closely with healthcare providers, including rheumatologists, ophthalmologists, dentists, and other specialists, to develop a comprehensive treatment plan tailored to their needs. Additionally, lifestyle modifications such as staying hydrated, avoiding irritants, and protecting the eyes from dry environments can help manage symptoms and improve quality of life. How can TCM help with the management of Sjögren’s syndrome? Traditional Chinese Medicine (TCM) offers a unique perspective on health and illness, including autoimmune conditions like Sjögren’s syndrome. In TCM theory, Sjögren’s syndrome would likely be viewed as a manifestation of underlying imbalances in the body’s Qi (vital energy), Yin and Yang energies, and organ systems. Here’s a brief overview of how TCM might approach Sjögren’s syndrome:Imbalance of Yin and Yang: TCM considers health to be a state of balance between Yin and Yang energies. Sjögren’s syndrome, with its symptoms of dryness, might be seen as an excess of Yang energy leading to the depletion of Yin fluids in the body. Treatment would focus on nourishing Yin to restore balance.Deficiency of Body Fluids: Dryness is a key characteristic of Sjögren’s syndrome, indicating a deficiency of body fluids. TCM views body fluids as essential for maintaining health and lubricating the body’s tissues. Treatment would aim to tonify the body’s Yin and fluids through herbal medicine, acupuncture, and dietary modifications.Kidney and Liver Imbalances: In TCM, the Kidney and Liver organ systems are often implicated in conditions involving dryness and autoimmune disorders. Kidney Yin deficiency and Liver Qi stagnation are common patterns seen in Sjögren’s syndrome. Treatment would involve nourishing Kidney Yin and regulating Liver Qi circulation to address these imbalances.Heat and Inflammation: TCM recognizes the presence of heat and inflammation in autoimmune conditions. Sjögren’s syndrome may be associated with internal heat patterns, which can exacerbate dryness and inflammation. Herbal formulas and acupuncture points aimed at clearing heat and dampness may be used to alleviate symptoms.Acupuncture and Herbal Medicine: Acupuncture and herbal medicine are integral components of TCM treatment. Acupuncture can help regulate the flow of Qi and nourish Yin, while specific herbal formulas may be prescribed to address underlying imbalances and alleviate symptoms associated with Sjögren’s syndrome.Dietary Recommendations: TCM emphasizes the importance of diet in maintaining health and treating illness. Foods that nourish Yin and fluids, such as soups, stews, and hydrating fruits and vegetables, may be recommended. Avoiding spicy, heating foods and excessive caffeine intake, which can exacerbate dryness and inflammation, may also be advised.It’s important to note that TCM treatment is highly individualized, and practitioners would assess each patient’s unique pattern of disharmony before prescribing specific treatments. Additionally, TCM is often used as complementary therapy alongside conventional medical treatments for conditions like Sjögren’s syndrome. Patients interested in exploring TCM should consult with a qualified TCM practitioner for a personalized assessment and treatment plan.
What is an Auto Immune Thyroid Disease (AITD) and how can TCM help?

15 Feb 2024

By: Lee Hui Min

Blog, Acupuncture, Article, Autoimmune Disease, Fertility, Physician Lee 李医师, TCM Herbs

What is an Auto Immune Thyroid Disease (AITD)? Autoimmune thyroid disease, also known as autoimmune thyroiditis or autoimmune thyroid disorder, refers to a group of conditions in which the immune system mistakenly attacks the thyroid gland, leading to inflammation and potentially affecting its function. The two main types of autoimmune thyroid disease are:Hashimoto’s thyroiditis: This is the most common form of autoimmune thyroid disease. In Hashimoto’s thyroiditis, the immune system produces antibodies that attack the thyroid gland, leading to chronic inflammation and eventual destruction of thyroid tissue. As a result, the thyroid gland becomes unable to produce enough thyroid hormones, leading to hypothyroidism (underactive thyroid).Graves’ disease: In Graves’ disease, the immune system produces antibodies that stimulate the thyroid gland to produce excessive amounts of thyroid hormones. This leads to hyperthyroidism (overactive thyroid) and can cause symptoms such as weight loss, rapid heartbeat, tremors, and anxiety.Autoimmune thyroid disease can have various symptoms depending on whether it causes hypothyroidism or hyperthyroidism. Treatment typically involves managing the symptoms and may include medications to regulate thyroid hormone levels, such as thyroid hormone replacement therapy for hypothyroidism or medications to reduce thyroid hormone production for hyperthyroidism. In some cases, surgery or radioactive iodine therapy may be recommended to treat severe cases of hyperthyroidism. AITD and Fertility Autoimmune thyroid disease, particularly when it leads to thyroid dysfunction such as hypothyroidism or hyperthyroidism, can potentially affect fertility in both men and women. In women, hypothyroidism or hyperthyroidism can disrupt ovulation and menstrual cycles, leading to irregular or absent periods (amenorrhea) and thus affecting fertility. Thyroid hormones play a crucial role in regulating the menstrual cycle, and low levels or high levels of thyroid hormones can interfere with normal ovulation. In men, hypothyroidism and hyperthyroidism can affect sperm production and quality, leading to reduced fertility. Autoimmune thyroid disease itself, regardless of thyroid hormone levels, has been associated with an increased risk of fertility issues. Autoimmune disorders can cause inflammation and immune system dysfunction, which may affect reproductive organs and processes. How is AITD managed? Autoimmune thyroid disease, such as Hashimoto’s thyroiditis and Graves’ disease, is typically managed through a combination of western medication, lifestyle modifications, and, in some cases, surgical interventions or radioactive iodine therapy. Treatment aims to alleviate symptoms, regulate thyroid hormone levels, and minimize autoimmune-related inflammation. The specific approach to treatment depends on the type and severity of the autoimmune thyroid disease. A balanced diet rich in nutrients, including iodine and selenium, is important for thyroid health. Some individuals with autoimmune thyroid disease may benefit from dietary modifications, such as avoiding excessive iodine intake or following a gluten-free diet if they have coexisting autoimmune conditions like celiac disease. Regular exercise and stress management techniques can help support overall health and may positively impact thyroid function. Individuals with autoimmune thyroid disease require regular monitoring of thyroid hormone levels and thyroid antibodies to assess treatment response and adjust medication dosages as needed. Follow-up appointments with healthcare providers, including endocrinologists, are essential for ongoing management and optimization of treatment strategies. What is TCM perspective on AITD? Traditional Chinese Medicine (TCM) offers a unique perspective on autoimmune thyroid disease, viewing it as a manifestation of imbalances within the body’s energy systems rather than solely as a malfunction of the thyroid gland itself. In TCM theory, autoimmune thyroid disease is often associated with patterns of disharmony involving multiple organ systems and energetic imbalances. Here are some key aspects of the TCM perspective on autoimmune thyroid disease:Energetic Imbalances: TCM views autoimmune thyroid disease as a result of disruptions in the flow of Qi (vital energy) and Blood, as well as imbalances between Yin and Yang energies within the body. These imbalances can affect the proper functioning of the thyroid gland and contribute to the development of autoimmune conditions.Organ Systems Involved: According to TCM, the health of the thyroid gland is closely connected to the functioning of other organ systems, including the Spleen, Kidney, Liver, and Heart. Imbalances in these organ systems can contribute to the development or exacerbation of autoimmune thyroid disease.Patterns of Disharmony: TCM practitioners diagnose autoimmune thyroid disease based on patterns of disharmony, which may include:Spleen Qi Deficiency: Weakness or dysfunction of the Spleen, which may lead to poor digestion, fatigue, and accumulation of Dampness in the body.Kidney Yin Deficiency: Insufficiency of Kidney Yin, which may manifest as heat symptoms, night sweats, and dryness in the body.Liver Qi Stagnation: Impaired flow of Liver Qi, which can result in emotional imbalances, stress, and stagnant energy in the body.Heart and Kidney Yang Deficiency: Weakness or depletion of Heart and Kidney Yang energies, leading to cold intolerance, fatigue, and fluid retention. How can TCM help manage AITD? The management of autoimmune thyroid disease through TCM aims to rebalance the body’s energies and address the underlying patterns of disharmony. Treatment modalities may include:Acupuncture: Acupuncture points are selected to stimulate Qi flow and promote balance within the body’s energy systems.Herbal Medicine: Chinese herbal formulas are prescribed to tonify deficient energies, clear heat, resolve stagnation, and harmonize Yin and Yang.Dietary Therapy: Recommendations for dietary modifications may be provided to support digestion, nourish Yin, and avoid foods that exacerbate Dampness or heat.Lifestyle Recommendations: TCM often emphasizes lifestyle factors such as stress management, adequate rest, and regular exercise to support overall health and balance.Individualized Treatment: TCM treatment is highly individualized, with practitioners tailoring therapy to address each patient’s unique pattern of disharmony and constitution. Conclusion It’s important to note that while TCM can offer complementary approaches to managing autoimmune thyroid disease, it should not replace conventional medical care. Individuals with autoimmune thyroid disease should work with qualified healthcare providers, including TCM practitioners and conventional medical doctors, to develop comprehensive treatment plans that address their specific needs.
Balancing Act: TCM Approaches to Easing Rheumatoid Arthritis Discomfort

02 Feb 2024

By: Kang Ting Tan

Blog, Acupuncture, Article, Autoimmune Disease, General Health, Pain management, Physician KT 陈医师

Rheumatoid Arthritis (RA)  is a chronic inflammatory disorder that causes joint inflammation and pain. RA commonly affects the hands, knees, ankles and usually the same joint on both sides of the body. In some people, RA can affect other parts of the body as well such as skin, eyes, lungs, heart and circulatory system.  Unlike the wear-and-tear damage (degeneration) of osteoarthritis, RA is an autoimmune disease. The immune system mistakenly attacks the synovium, the lining of the membranes that surround the joints. The immune system considers the body’s own cells, particularly those in the synovium, as foreign invaders, leading to chronic inflammation. Synovium is the tissue lining around a joint that produces fluid to help the joint move smoothly. The chronic inflammation results in  red, warm, tender and painful swollen joints that can eventually cause bone erosion and joint deformity. In addition to the joints, RA can affect other organs in the body.  Rheumatoid factor (RF) is an antibody that is often present in the blood of individuals with rheumatoid arthritis. Its presence is one of the diagnostic markers for RA, but not everyone with RA has detectable levels of RF, and some people without RA may have elevated RF levels. The exact cause of RA remains unclear, but researchers believe that a combination of genetic and environmental factors plays a role in its development. It is thought that individuals with specific genetic predispositions may be more susceptible to RA, and certain environmental triggers can activate these genes. These triggers may include viral or bacterial infections, physical or emotional stress, or other external factors (for e.g. being constantly in a cold or humid environment). The reasons behind a higher prevalence of RA in women compared to men remain unclear, and the condition typically manifests during middle age (25-50 years old). The likelihood of developing RA is higher for individuals with a family history of the condition. Early stage of RA Often affect smaller joints (wrists , certain joints (particularly the 2nd and 4th finger) in the hand and feet ) first  Muscle aches or joint pain worsens during humid or rainy days Disease progression Affect other bigger joints like wrist, elbows, shoulders, hips, ankle and knee Joint pain and deformity affecting daily activities  Anemic  About 40% of people also experience symptoms that do not involve the joints.  The inflammation associated with RA can damage other parts of the body as well such as:  Eyes: Dry eyes, redness or sensitivity to light  Mouth: Dryness and chronic gum inflammation  Skin: Rheumatoid nodules near joints (formed due to the accumulation of inflammatory cells and fibrous tissue) Lungs: Chronic inflammation and scarring can lead to progressive shortness of breath How TCM views Rheumatoid arthritis  RA belongs to the category of “ 痹症,Bi Zheng” in Traditional Chinese medicine (TCM). 《素问·痹论》说:“风寒湿三气杂至,合而为痹也。” TCM believes that the pathogenesis of RA is related to external causes and internal causes. External cause: Wind, cold, heat and dampness pathogen Internal cause: Deficiency of qi, blood, spleen, liver and kidney RA etiology in TCM perspective  其人平素体虚或劳倦内伤过甚,腠理空疏,元气不足,导致风寒湿邪(或郁而化热,或风湿热邪)流注于关节。 Experiencing chronic over-exhaustion or having a weaker body constitution may make one more susceptible to the invasion of wind, cold, or dampness pathogens targeting the joints. Extended inflammation leads to the buildup of heat and dampness within the joints. 若反复发炎则诸邪内损,可损及肝脾肾,亦能深伏于骨关节,筋脉,而血停为瘀,湿凝成痰,然后痰热互结,最总导致关节中肿胀,僵硬变形,而关节周围发生结节,皮肤色素沉着。 In the TCM  framework, chronic inflammation has the potential to harm the liver, spleen, and kidneys over time. This persistent inflammatory state can lead to either blood stasis or heat dampness, eventually giving rise to symptoms like swollen and deformed joints, the formation of rheumatoid nodules, or discoloration of skin. TCM approach to treating RA TCM employs a holistic approach to health and often utilizes a combination of therapies to treat RA. RA are generally categorized into three stages based on factors such as the duration of the condition, the type of pathogen involved, and the individual’s body constitution. Herbal medication, acupuncture and dietary restrictions are common methods to treat and manage RA. 1.Initial stage (早期:Wind and cold dampness Type  风寒湿型)   Symptoms:  Shorter duration 病程短 Generally weaker body constitution 多体虚 Morning stiffness and joint pain , especially during cold, humid or rainy environment or emotional triggers 晨僵,痛处受寒或气候潮湿或情绪波动时加重 No redness or warm joints 患处不发热发红 Aversion to cold or heat 恶寒发热 Floating and tight pulse 脉浮紧或沉弦带紧 Herbal prescription commonly used: 麻黄加白术汤加减 (麻黄, 桂枝,炒白芍,炙甘草,炒白术,姜黄,鸡血藤,忍冬藤等。)  Common acupuncture points used 五虎穴  复原穴  三间穴 阴陵泉穴    2. Middle stage (中期: 久病化热伤阴型)   Symptoms: Pain in the hand and feet joints 四肢关节肿痛,僵硬 Morning stiffness worsens with inactivity 晨僵,屈伸不利 Other accompanying symptoms: Dry throat, heart palpitations, dizziness 咽干,心悸,眩晕 Tight, thin and fast pulse 脉弦细数 Herbal prescription commonly used: 桂枝芍药知母汤加减 (桂枝,白芍,炙甘草,知母,生石膏,白术,防风,生地,炮附子,石斛,姜黄,秦艽等。) Common acupuncture points used 五虎穴  复原穴  三叉三穴 四肢穴   3. Late stage (晚期: 肝肾气血亏虚,痰瘀痹阻型)   Symptoms: Chronic pain: persistent and intense joint pain 慢性疼痛,关节刺痛或僵直 Limited mobility 关节活动不利 Joint deformities: swelling, stiffness and changes in joint structure maybe more pronounced 关节变形 Rheumatoid nodules can be seen 可见类风湿结节 Decreased quality of life. Daily activities, social interactions, and mental well-being may be compromised. 生活素质变差。 Herbal prescription commonly used: 独活寄生汤合虎潜丸加减 (独活 桑寄生 秦艽 防风 黄芪 当归 生地黄 熟地黄 黄柏 知母 白薇 炒白芍 石斛 姜黄 淫羊藿 桂枝等。) Common acupuncture points used 五虎穴  复原穴  足三里穴 丰隆穴 太溪穴 Acupuncture is a traditional Chinese medicine practice that involves inserting thin needles into specific points on the body to stimulate energy flow and promote healing. Here are some potential ways acupuncture might help individuals with RA: Pain Relief: Acupuncture may help alleviate pain associated with rheumatoid arthritis. The insertion of needles at specific acupuncture points is thought to stimulate the release of endorphins, the body’s natural painkillers, which may contribute to pain relief. Inflammation Reduction: Some studies suggest that acupuncture may have anti-inflammatory effects. By modulating the immune system and reducing inflammation, acupuncture might contribute to the management of RA symptoms. Improved Joint Function: Acupuncture may help improve joint function and mobility in individuals with RA. By promoting better circulation and reducing muscle tension, acupuncture might have positive effects on the range of motion in affected joints. Dietary restrictions Reduce consumption of  Sugary Foods, Cold Drinks, and Beer Excessive sugar consumption is associated with inflammation, and some people may experience allergic reactions or increased joint pain as a result. Raw and Cold Foods  In TCM, foods that are considered “cold” and “damp” are thought to obstruct the flow of yang energy, potentially leading to discomfort or achy joints. Peanuts, chocolate, millet, yogurt, glutinous or dairy products These certain foods possible due to their amino acid content  (tyrosine, phenylalanine or tryptophan), may contribute to production of inflammatory factors such as prostaglandins, leukotrienoic acid or IgE antibodies, potentially worsening joint inflammation or causing pain relapse  Too much sour food such as  sour plum, vinegar or lemon.  Sour foods are generally considered to have a contracting and cooling nature and may worsen joint pain. One is encouraged to consume more Chinese barley (reduce dampness), black beans, green beans, yellow beans, soy products, chestnut or sesame, Chinese yam, carrot, blueberry or turmeric powders (antioxidant properties). Early diagnosis and treatment in the earlier stages of RA can help prevent or slow down the progression to late-stage complications. Regular medical monitoring and adjustments to treatment plans are crucial in managing the disease effectively. Individuals with late-stage RA may benefit from working closely with a rheumatologist, TCM physicians and other healthcare professionals to optimize their care and improve their quality of life. Note: Information provided is not a substitute for a physician or any form of medical care. Individual symptoms differ due to different body constitutions and diagnosis. One should consult a licensed TCM practitioner for accurate diagnosis and treatment. Prices exclude GST. ^Treatments are done by certain physicians only