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Hypothyroidism according to Traditional Chinese Medicine (TCM)

Hypothyroidism affects an increasing part of the population. It is 5 times more common in women than in men. This disease is caused by a deficiency of thyroid hormones and its diagnosis is inconclusive, due to the complex number of symptoms.

We are visited by patients with thyroid dysfunction, who most often complain about general weakness and fatigue, low mood and reluctance to act, which are often accompanied by severe and persistent feeling of cold, even on warm days. When it comes to the functioning of digestive system, patients report recurring constipation and liquid bowel movements. Many of them struggle with weight gain, leg swelling, water retention in the body, and dryness of skin, hair and nails that makes them brittle and weak.

Blood tests enable the diagnosis of hypothyroidism, whilst the determination of the concentration of TSH and fT4 hormones helps in determining the appropriate treatment and nutritional support.

TCM’s dietetics have shown us more than once that life doesn’t have to revolve around pills and supplements which only seem to cover up the problem. In TCM’s point of view, symptoms of hypothyroidism are associated with, among other things, the pathology of the functional circulation of the spleen, kidneys and liver.

One of our patients came to us with a diagnosed and hormonally treated thyroid insufficiency. Despite using the medication, majority of the symptoms interfered with normal functioning, and the results were not satisfactory.

The most severe ailments our patient struggled with were painful periods, hair loss, emotional disorders, weight gain despite the lack of appetite, weakness, and fatigue.

After a thorough interview, an introduction of nutritional changes, the use of appropriate culinary techniques and high systematicity – the patient’s well-being improved after a few weeks. The nutritional support received by the overwhelmed liver effectively influenced the course of menstruation, the patient no longer struggles with severe pains in the lower abdomen and loins, and for the first time in many years there are no clogs in menstrual blood. The condition of the skin and hair has improved significantly, hair fall out in a small, natural amount and new hair appear on the scalp.

All these improvements have a positive influence on our patient’s mood and motivation.

Nutritional therapy in the case of deficiencies that we are dealing with may last up to several months. Despite the positive effects that the patient has achieved with systematic work, we continue our work to be able to say goodbye not only to the symptoms but also their causes.

Frequently, physiotherapists hear from their patients that they suffer from meniscus damage and chondromalachia, and that they were told that there is no other way to treat it other than to undergo a surgery. In our previous article, we proved that degenerations not always manifest themselves in the symptoms. So, what is the truth about the necessity of  surgery?

The tendency has been visible for quite a long time, although the earliest experiment consisting of placebo orthopedic surgery that we found took place in 1996.

Despite it being a small study, it showed that something is going on. After familiarizing themselves with the possibilities, the nature of placebo surgery, and giving their consent for taking part in this experiment the participants were randomly assigned to three groups. First group consisted of 5 patients who were to undergo a placebo arthroscopy, the second group consisted of 3 patients who were to undergo arthroscopic lavage, and the last group consisted of 2 patients who were to undergo the standard arthroscopic cleanup. The doctors who carried out the postoperative assessment, and the patients were unaware to which group they were assigned. The patients who underwent the placebo surgery reported decreased frequency, intensity, and duration time of knee pain. Additionally, they deemed the procedure cost-effective and would recommend it to their family and friends.

Afterwards, in 2002, the experiment was repeated on a larger scale, proving the placebo phenomenon to exist in surgeries. Simultaneously, the study showed that knee pain is not necessarily an indicator of knee degeneration, and that the cause may lie elsewhere.

In total, 180 patients with degenerative knee joint disease were randomly assigned to an arthroscopic cleanup, arthroscopic lavage, and placebo surgery. The patients from placebo group received skin incisions and underwent simulated treatment without the insertion of arthroscope. The patients and their assessors were unaware as to which group they were assigned. The results were evaluated in many points during the next 24 months after the procedure through 5 self-describing questions. Three of those questions were based on a pain scale and two were based on a function scale. Besides the aforementioned questions the results were also based on one, objective test which involved climbing and going down the stairs. Research was completed by 165 patients, the results indicated that the effects of classic surgeries were not much different from the effects of placebo surgeries.

This long and precise research, showing that surgeries related to meniscus damaged in a degenerative process can prove to be unnecessary, was published in 2017.

We carried out a multicenter, randomized, controlled study where neither the patients nor the assessors knew to which group they were assigned to, with participants aged between 35 to 65. Every patient had symptoms in the knee area during the last 3 months before the study, which were consistent with degenerative medial meniscus fracture, nonreactive to conventional conservative treatment, and lack of clinical or radiographic knee osteoarthritis and knee joint inflammation.

The research took place in 5 different orthopaedic centres in Finland in the period from December 2007 to March 2014. All (146) patients had suspicion of meniscus fracture based on their symptoms and clinical tests. Those fractures were later verified on the basis of MRI and knee arthroscopy. The Patients with visible beginning of symptoms caused by an injury or with recent history of locked knee were excluded from the study. Entering the research the participants were informed about the possibility of undergoing another surgery, 6 months after or later, if they won’t get an appropriate improvement of symptoms.   

Evaluation was carried out after 2, 6, 12, and 24 months. During the 24-month-long observation all participants were also tested clinically by an independent orthopaedic surgeon, who was also unaware of the assignment of treatments. The standard medical examination contained clinical meniscus tests – McMurray test, pain caused by joint line palpitation, and pain caused by forced bending of the knee. Knee’s range of motion, knee joint sesamoids, bone augmentation, effusion, pain localisation in palpation test, and overall knee stability were also registered. During the procedure, the damaged and loose parts of meniscus were removed until the solid meniscus tissue was obtained, with the preservation of as much of the tissue as possible. As for the placebo surgery, the whole procedure was simulated to imitate the sensations and sounds of real operation. The participants were also kept in operating room for the duration time of the real procedure.

In the case of every group, postoperative care was provided in accordance with normalised protocol which specified that all participants will receive the same medical assistance.

Both groups showed noticeable improvement in all original results. Most participants were satisfied and reported improvement, there was no statistically relevant difference between two groups. The difference between the two groups concerning the fastness of recovery and returning to normal activity level or frequency of mechanical symptoms was not observed. There were no statistically relevant differences between the two groups regarding meniscus test during clinical examination.

Middle aged men and women with knee pain attributed to degenerative knee condition, in other words – meniscus damage with accompanied by various level of knee joint degenerative condition, were the largest group of patients reffered to orthopaedic surgeons. Knee pain felt by the patient is attributed to degenerative meniscus damage or cartilage damage. The symptoms associated with the degenerative meniscus damage are usually chronic and of fickle nature. Nevertheless, the last population-based study proved, a little bit paradoxically, that degenerative meniscus tear is most common between middle aged and elderly people , and that they seem to be symptomless in most cases. In the USA alone one million knee joint arthroscopies are done annually; in Poland between the 2017 and 2018 73.000 procedures had been done, the cost of knee operation oscillates around 7.000 zł.

Arthroscopic joint surgery is  definitely the most frequent orthopaedic procedure in treating the degenerative knee condition.

Many patients report an improvement  (knee pain relief, better function, and improvement of quality of life) after this kind of operation. Similar results were obtained also in conservative treatment in randomized placebo studies. Taking into consideration that the lack of procedure eliminates any complications, the placebo surgeries are favoured.

So far, there is a serious lack of high quality evidence (from the randomized control tests, RCT) about the efficiency of arthroscopic knee surgeries!

In orthopaedics, the reality is that a large number of methods of treatment is ‘known’, ‘accepted’ or ‘standardised’, but none has ‘proved’ efficiency in the true sense of the word.

We tend to forget that the joints are controlled by fasciae and their muscles. Humans possess over 400 muscles, if we put them together with circulatory and lymphatic systems we will end up with a puzzle of hundreds of thounsands kilometers long! In this puzzle, we must also include visceral fasciae, the reason being their function of connecting our internal organs with every joint and muscle in our body which effective cooperation depends on good condition of the fasciae. For this reason, if somewhere in this tangle fascia will lose its quality (‘become stiff’) the muscle and/or vessel, and consequently the whole systems, will experience problems. In other words, weakened muscle weights down the joint, stiffened fascia compresses other parts, and ischemic tissue, like her predecessors, in the face of these irregularities will cause pain.

Our patients are aware that the cause of joint pain very often lies outside the joint.

In conclusion, the basis is efficient holistic physiotherapy

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612785/#R93

https://www.nejm.org/doi/full/10.1056/NEJMoa1305189

https://www.ncbi.nlm.nih.gov/pubmed/8638750

https://www.ncbi.nlm.nih.gov/pubmed/12110735

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867417/

https://www.crazynauka.pl/jaka-dlugosc-maja-naczynia-krwionosne/

The article above has no intention of advising the patients against undergoing the surgeries they require.

Cluster headaches (those are the hardest to endure), migraines, and sporadic but regular headaches in general can all be treated with the holistic model.

Segment from patient record:

Chronic headaches for about 10 years, with cluster headache pain accompanied by auras, nausea, and vasomotor/sudomotor reactions. Pain medication does not work.

Pain is practically constant on daily basis on a low/medium level with regular sudden sharp pains which make normal functioning impossible.

Pain is more intense on the right side, triggered by significant changes in external and emotional stimuli. The patient is sensitive to temperature changes, especially increasing heat; heat reactions to emotions (reddening of the body).

Our diagnostics indicated couple of elements responsible for this symptom, from which one was pivotal.

TOS (Thoracic Outlet Syndrome) restricted vertebral and carotid artery, simultaneously increasing the tension of scalene muscles. The increased density of suboccipital muscles area caused the increase in tension of tissues there, and influenced vertebral artery capacity, which in itself is a frequent cause of pain.

High tension of the masseter muscle caused by its considerable fibrosis (the patient had undergone dry-needling as seen on the attached video). Fibrosis was so „relentless” that only after 20 minutes of needling it was possible to overcome this structure, which turned out to be the main cause of the problem.

Afterwards, considering TCM (Traditional Chinese Medicine), we tried Chinese cupping massage to remove the extra heat from the body, i.e. reddening (vasomotor/sudomotor reaction)

Currently, practically no daily headaches nor sudden pains occur. “Practically”, since appearing headaches does not lead to a state where normal functioning is challenging, and, what’s more, they became receptive to pharmacological treatment; simultaneously, reaction to heat has receded.

„Neither the spur shape nor size significantly correlated with symptoms.”

Our previous posts proved that, against the common belief in the medicine market, the research indicate that it is not degenerative changes which are responsible for pain conditions.

Discopathy, chondromalacia of the kneecap, general degenerations, damaged meniscus -not including direct injuries – are the effects of disbalance in the musculo-fascio-visceral system. They are only the symptoms, not the cause, of the conditions. Inspired by the news from our patients, gathered from all over the world, we would like to add that it is also the case for the so-called Calcaneal (heel) spur.

Calcaneal spur can exist for decades and still go undetected, simultaneously, the patient without calcaneal spur can feel immense foot pain.

Why, then, when the foot is hurting it is always the spur which is being blamed for the pain?

Sadly, the answer is simple – it is the lack of holistic perspective on the matter.

Of course, heel pain can be caused by local problems. Soft tissues surrounding calcaneus (heel bone) after years or decades of uneven weight distribution become calloused. But, since the weight was unevenly distributed we have to consider what failed in the human organism and led to this situation?

To answer this this question, and determine the cause and treatment, we must analyse patient’s past and properly examine all tissues and muscles to draw conclusions – in short, dedicate our time to it!

If you’re suffering from those problems, we invite you to visit our clinic.

Together, we will find the solution.

https://journals.sagepub.com/d…/abs/10.1177/1071100716649925

In the public consciousness there is still a mistaken belief, certainty even, that discopathy results in pain – we must live with it, without any prospect on improving, it won’t disappear on its own, it’s best to do absolutely nothing. After diagnostics, an operation is still sometimes presented as the only cure, even if clinical state of the patient is described as “good”. Unfortunately, there is a long way ahead to ensure that the situation will change; the Internet is full of health websites filled with old-fashioned, unverified convictions, and not facts. Similarly, a part of specialists still lives with their mind in the previous century. That’s why we are quick to help and explain everything. 

The set of research presented below proves that degenerations and discopathy are natural processes. They are not the main cause of the pain – discopathy heals on its own, so miracles do happen. It is not required to lie down for a long period of time when sharp pain occurs, quite the opposite. Interestingly, the tests conducted on rats showed that it is not the pressure that generates the sensation of pain; the pain is caused mainly by chemical irritation, meaning it is present during the continuing inflammation or new sequester (active environmental acidity of the stem nuclei). It would explain the lack of symptoms accompanying the extrusion state, sequestration, and pressure on the root; it would also explain lack of efficacy of the anti-inflammatory medication and blockage treatment. Conversely, inflammation accompanying discopathy is a good sign – it is a regenerative component ensuring self-healing, therefore, decreasing the inflammation should be conducted with great care.

This research suggests that the mechanical stimulation of the lumbar discs does not always cause pain. The disc becomes sensitive to mechanical stimulus because of inflammation, which results in nociceptive (pain) information being transferred as a discogenic pain to the spinal cord by lumbar sympathetic system. This can partially explain variability of human symptoms of degenerative discs.

www.ncbi.nlm.nih.gov/pubmed/25009200

Another research aim was to verify the probability of a spontaneous regression (self-healing) of the herniated lumbar disc by using a systematic review. It was concluded that spontaneous regression amounts to 96% in the case of sequestration of the disc, 70% in the case of extrusion, 41% for protrusion, and 13% for disc bulging. The indicator of complete disc regression was 43% for sequestrated discs, and 15% for extruded discs.

Yet another research examines the inflammatory response in the regression of lumbar disc herniation.

Lumbar disc herniation (LDH) is closely connected with inflammation in the context of lower back pain. Currently, inflammation is connected to adverse symptoms linked to the stimulation of nerve fibers which can result in pain. However, inflammation was chosen as the main compound responsible for LDH regression. This apparent controversy presents inflammation as a good prognostic indicator of spontaneous regression of LDH. This overview/examination concerns  molecular and cellular mechanisms engaged in LDH regression, including matrix remodeling and neovascularization, within the range of clinical decision concerning conservative and surgical intervention. Basing on the proof, a special emphasis is put on inflammatory response in the context of LDH, especially as a monocytes/macrophages. The phenomenon of spontaneous regression of LDH, described at length in literature, is consequently analysed with regard to modulatory role of the inflammation. 

This research above concerns cervical spine disc degeneration on MRI in patients with Lumbar disc herniation and compares symptomatic and asymptomatic volunteers.

It was concluded, that there is a connection between the cervical spine disc degeneration progress and LDH. However, so far it has not been properly examined. Changes in intervertebral discs connected to age were examined with the help of MRI pictures of patients with LDH and, comparatively, with the MRI results of the healthy volunteers who did not feel any pain. The aim of this test was to answer the question if the frequency of symptom-less cervical spine disc degeneration is higher in patients with LDH than in healthy patients? The study was conducted on 51 patients diagnosed with LDH who had undergone MRI scan of the cervical spine. Patients consisted of 34 men and 17 women aged between 21 and 83 (of average age 46,9, give or take 14,5 years) at the time of the examination. Control group consisted of 113 healthy volunteers (70 men and 43 women) aged 24-77 (of average age 48,9, give or take 14,7 years) with no neck or back pain. The percentage of people with degeneration of the cervical spine discs was 98% in the LDH group, and 88,5% in the control group (p = 0,034). The presence of degeneration was connected to decrease in the intensity of intervertebral disc signal, and posterior disc protrusion in the cervical spine disc area. None of the MRI scans were significantly connected to the gender, smoking, sporting activity, or BMI.

In comparison to the healthy volunteers, patients with degeneration showed highest frequency of decreased intensity of the intervertebral disc signal and posterior disc protrusion on MRI scans of the cervical spine area.

The results of this research suggest that degeneration of the disc seems to be a systemic occurrence.

In the randomized research we compared the consequences of prescribing 2 days of bed rest (group 1) with the consequences of prescribing 7 days of bed rest (group 2). The research included around 203 patients with lower back pain: 78% with acute pain (decreasing or constant for 30 days) none of which whom showed the signs of explicit neurologic deficits. Control data was collected after 3 weeks (93%), and 3 months (88%). The patients from group 1 missed 45% less of work days than patients from group 2 (3,1 days vs 5,6 days, p = 0,01), no changes in physiological functions were observed. In the case of many patients without neuromotor deficits, clinicians can prescribe rather 2 days of rest than longer periods of time without the visible difference in clinical results.

Systematic overview of Polish literature illustrating characteristics of spinal degeneration in symptom-less populations.

Degeneration changes commonly occur in the spine imaging, but they are especially often encountered in patients who do not feel any pain, and also in patients who complain about pain. We tried to estimate the frequency of degenerative spinal conditions in relation to age by conducting a systematic review investigating the presence of degeneration on imaging in patients without symptoms.

Materials and methods:

We performed a systematic overview of the articles describing the prevalence of imaging results (CT or MR) in patients without any symptoms from the publications of English literature until April, 2014. Two reviewers rated every manuscript. We chose the age group according to decades (20, 30, 40, 50, 60, 70, 80 years old) specifying unique for the age estimations of spreading. For every found image we matched a generalized linear model of mixed effects for the age-specific clustering of prevalence estimate in our research, adjusting for the midpoint of reported age range.

Results:

Thirty three articles describing the results of imaging studies in 3310 symptom-less patients met our criteria of  incorporating in examination. The frequency of disc degeneration in symptom-less patients increased from 37% in patients aged 20 to 96% in patients aged 80. The frequency of disc bulging increased form 30% in patients aged 20 to 84% in patients aged 80. Disk protrusion prevalence increased from 29% of those 20 years of age to 43% of those 80 years of age. Frequency of annular fissure increased from 19% in patients aged 20 to 29% in patients aged 80.

Conclusion:

Imaging findings of spinal degenerations are present in a high percentage of symptom-less patients, increasing with age. A lot of degeneration characteristics based on imaging is probably a natural part of growing old, and is not connected with pain sensations. Those results should be interpreted in the context of the clinical state of the patient.

Table below shows the percentage of symptom-less patients with spinal deviations.

Patients affected by the knee pain problems, and with degenerative changes conditions, often ask if they should take prescribed supplements. The research determining the correlation, show that degeneration does not always mean pain i.e., the same kind of joint deviation often does not cause any pain to a part of the population. On the other hand, a smaller deviation can cause intensive and chronic pain.

According to our experience, joint pain is caused mainly by the state of soft tissue locally and distally, and by the general physiological situation (diet, medications, lack of physical activity), therefore, it is curable by natural methods.

But let’s get to the point. We scrutinized the research of the influence of the popular joint supplements. The main stars were glucosamine and chondroitin. As it turns out, their effectiveness is true only in advertisements, in other words, they won’t bring the desired effects. Statistically, those two supplements start showing results after approximately 6 months of intake.

This means, that until the 6th month of intake, any noticeable improvements were a placebo. The structural impact appears only after 2 years of taking those substances and doesn’t hold much significance. The effects of visibly decreased loss of the cartilage appear only after 6 years of regular intake. Those research does not include the information whether or not the improvements are connected to the change of lifestyle – whether the patient started to eat healthily, increased his physical activity, kept hydrated, reduced stress, or underwent effective physiotherapy. Another problem is the lack of clear statistics.

Therefore, if we want the statistical improvement, why not give it a try? 6 years and the results will be there, not significantly great, but there, nonetheless. Although, from our perspective, taking into consideration the statistics, it is not the cartilage loss that is responsible for the pain sensations.

Visceral therapy is the essence of holistic approach, it focuses on the interactions between muscle system, internal organs, and spine, and on the stimulation of the vagus nerve in order to regulate emotional tensions, i.e.: anxiety, apathy, fear, withdrawal.

The inter-influence of particular muscle areas directly influences the placement and tension of internal organs, and vice versa, internal organs have great influence on the medical condition of the spine, muscles, fascia, pelvis, ribs, and shoulders.

Modern lifestyle (lack of physical activity, dehydration, processed foods, certain anatomical features of our body, postoperative scars) causes hardening of fascia network, where all of our organs are located. It leads to restricted mobility of organs and muscles. The organs with restricted mobility have a tendency to develop lymphatic stagnations, which in turn result in the „sickness” of a given organ. If an organ, or its area, falls ill, then the muscle which cooperates with it will also face a problem.

Fascia system is a network entangling all of our body, starting from the basic building unit – cell – to large agglomeration like organs or muscles. Therefore, everything in our body is in constant communication, no matter the distance.

The purpose of visceral therapy is to restore communication in this network, eliminate lymphatic stagnations, and to restore the initial shape, softness, and slide of the fascial and internal organs areas. This effect can be obtained by massaging abdominal wall, and by deep penetration of areas between organs, or by putting pressure on the organs directly.

We work on unblocking the areas pivotal for the proper functioning of the flow in iliac and femoral arteries, aorta, veins, and lymphatic vessels, and also in lumbar and sacral plexus.

All those actions bring harmony to the body.

We equalize the abdominal wall tensions and flows, which causes the decrease in the spinal tensions (self-healing of herniations), and restores the proper functions of internal organs, e.g.: heart, lungs, diaphragm, liver, pancreas, stomach, spleen, small and large intestine, kidneys, bladder, testicles, ovaries, prostate, anus.

Releasing the blockages from visceral system stops the redundant stimulation of the vagus nerve, which translates to restoring the viscera-brain communication, and to reducing the states of tension, fear, and apathy.

In this way we treat the following conditions:

• Back pain
• Post-operative adhesions
• Post-operative scars
• Respiratory problems, i.e. respiratory efficiency, pain during breathing, asthma
• Leg pain and numbness
• Sciatica
• Leg swelling
• Stomach ache
• Heartburn
• Reflux
• Post Inflammatory kidney pain
• Renal colic
• Hepatic colic
• Bowel cramps
• Bloating
• Frequent burping
• Pain sensations in the penis, prostate, testicles, ovaries
• Vaginal pain
• Vaginal dryness
• Bladder pain
• Frequent cystitis
• dysmenorrhea
• premature ovarian insufficiency
• premature menopause