Thursday, March 31, 2011

Acupuncture no better than placebo???

You must be wary of studies that make such bold conclusions. This article will discuss problems with research into acupuncture.

There is a fundamental incompatibility with using Western methods to evaluate Eastern techniques. In the West, the gold-standard of research is the Randomized, Controlled,double-blind Trial (RCT). In this design, subjects are randomly assigned to either a treatment group or a control group that receives either no treatment or a placebo. There are concerns that if patients know that they are receiving the real treatment, that this expectation could alter their response (they think they should be getting better and therefore do get better, independent of the treatment they receive). This is why the patients are blinded- that is they don't know whether or not they are receiving the real treatment. And the subjects in the control group do not know that they are not receiving a real treatment. There is also concern about the influence that the treatment provider can have if he or she knows who is receiving the real treatment vs. placebo. If I know you are getting the real treatment, I may treat you differently somehow and that could alter your response. For this reason, the one providing the treatment is also blinded. This is what they mean by a double-blind study. Both the person receiving the treatment and the one administering the treatment do not know who is getting the real thing and who is getting placebo. This design works best for pills.  It is arguably impossible to use this model for acupuncture research.
But the RCT not the only way to determine something's effectiveness. I have read skeptic columns who assert that the lack of RCT evidence is PROOF that acupuncture does not work by anything more than placebo. My response to this is, "Can someone show me the RCT that show's that hip replacements work? If not, then any benefit that the patients experience must be due to expectations." Think about it; it is impossible for a surgeon to do the procedure and not know whether or not she performed the real replacement. Hip replacements have helped a lot of people and we don't need an RCT to prove it.

I find the placebo argument amusing. Although the number of skeptics has dropped significantly over the past 15 years (with the Mayo Clinic, John Hopkins, the World Health Organization, the National Institute of Health, and the American Medical Association all concluding that acupuncture DOES work), there are still a few die-hard skeptics that insist that acupuncture only works as a placebo. Most patients do not come to acupuncture as a first-line approach to a problem. For low back pain, a lot of my patients will start with over-the-counter medication, then see a physician, then physical therapy, then a chiropractor, and then finally come to see us. And then 90% of our back pain patients experience relief. For the placebo hypothesis to hold up, that patient must have had no faith that medication, Western orthopedics, physical therapy NOR chiropractic could possibly help them. But for some reason, they were sure that the acupuncture (their fifth choice) would be effective. I'm confident you see the flaws in that logic.  Why do acupuncturists give the best placebo?  If it is truly that we take more time with our patients and that alone truly improves patient outcomes, then don't all physicians then have the obligation to provide this "placebo" care? 

Another argument against the placebo hypothesis regards animal acupuncture. There are points that, when stimulated, produce measurable changes in animal physiology. For example, there are points that will increase the t-cell counts of rats. Even skeptical rats experience this improvement. The camel at the Brookfield Zoo in Chicago had an arthritic hip a few years ago and could not run. She was treated with acupuncture and was soon running again. This story was covered in the Chicago Tribune and the WGN news. Again, this was a skeptical camel.

But there are studies out there with headlines that read, "Acupuncture no better than placebo". First let's talk about what is placebo acupuncture. In fact, it does not exist. One method that researchers (usually MD's and not acupuncturists) use is called "Sham Acupuncture" where they pretend to put a needle into an acupoint but do not insert it all the way. Traditional Chinese Medicine acupuncture typically inserts needles, but not all forms of acupuncture do. Japanese style frequently uses this superficial technique and get great results.

The other method of "placebo" acupuncture is to do traditional needling at points other than the main acupuncture points, which I will call "wrong point" acupuncture. There is no spot on the body that is energetically inert. Every point will fall within an acupuncture meridian's path and inserting a needle there will affect the physiology.  There was one study I read that found that "real acupuncture" was 50% effective in treating back pain, "wrong point" acupuncture was 40% effective, and standard Western care was 13% effective. The conclusion: Acupuncture does not work, because real acupuncture was not significantly more effective than "placebo".  My take on this data is: one set of points helps 40% of people, another set of points helps 50%, and both are more effective than Western care. This is like saying Vicodin doesn't work because it was not significantly more effective than Ibuprofen.   What they call "placebo" is not a true placebo.
And lastly, a big problem is that the RCT treats everyone the same. Chinese medicine treats everyone individually. If I have to treat everyone the same in a study, I am not practicing Chinese medicine and the results say nothing about Chinese Medicine's effectiveness. If the study does not show benefit, then the conclusion is: "This set of points does not work for everyone".   And every acupuncturist already knows that using the same points for everyone will not be effective. 
So don't worry about the studies that try to discredit acupuncture. For some reason, most of the literature that is arging against acupuncture is coming from the UK lately. There seems to be a real campaign to deter people from using natural (translated - affordable) remedies. Believe in the Billions of people who know first-hand that it does work. Of course it does not work for everyone, nothing does. But it's safe, effective, and should be our first line of defense.   If it doesn't help, then you can proceed to the newer, less-studied, and riskier pharmaceutical and surgical interventions. 


Jason Bussell MSOM, L.Ac

President Emeritus - IL Assn of Acupuncture and Oriental Medicine

Tuesday, March 29, 2011

Invited to participate in the National Headache Foundation conference

I was honored to be invited as the only acupuncturist involved with this year's Midwest Regional conference of the National Headache Foundation.  The event will be June 25th, 2011 at the Marriott Hotel in Downtown Chicago.  If you suffer from chronic headaches, check out the NHF at and come to the conference. 

Thank you to the organizers for inviting me.  I look forward to educating the public and the doctors about how acupuncture can help ease the suffering from headaches.

Monday, March 21, 2011

an email sent to me about The Asian Diet

Dear Mr Bussell,

I stumbled on your book at the Pilates Center on Morse Avenue in Chicago and read it within a week. I love how you break down the different functions of each food item we eat and the yin and yang.  I just bought my first home and have no clue which box I packed it in and my issues are surfacing again.  I would love to schedule a session with you.   I am a 31 year old fairly healthy 130lb female who is lactose intolerant and who just realized eating healthy is key (as I have a family history of breast cancer and diabetes). So any tips would be appreciated. Thanks a lot for your help and for sharing your knowledge in your book "The Asian Diet", it definitely made an impact on my life.

Sunday, March 20, 2011

12 things you really should get organic

This  is from

1.  Beef
You've probably read plenty of stories about the risks of eating chicken. But the most important protein to buy organic may well be beef. "Research suggests a strong connection between some of the hormones given to cattle and cancer in humans, particularly breast cancer," says Samuel Epstein, M.D., professor emeritus of environmental and occupational medicine at the University of Illinois at Chicago School of Public Health.

Specifically, the concern is that the estrogen-like agents used on cattle could increase your cancer risk, adds Ted Schettler, M.D., science director at the Science and Environmental Health Network.

Though there are strong regulations about the use of hormones in cattle, "not all beef producers are following those regulations strictly, and some studies continue to find hormone residue in cattle," Dr. Schettler says.

When you buy beef that's been certified organic by the United States Department of Agriculture (USDA), you're not only cutting out those hormones, you're also avoiding the massive doses of antibiotics cows typically receive, which the USDA says may lead to the development of antibiotic-resistant bacteria in people.

2. Strawberries
Strawberries may be a superfood -- but they pose a potential risk unless you go organic. In addition to having up to 13 pesticides detected on the fruit, according to an Environmental Working Group (EWG) analysis, conventional "strawberries have a large surface area and all those tiny bumps, which makes the pesticides hard to wash off, so you're ingesting more of those chemicals," explains Marion Nestle, Ph.D., a professor of nutrition and public health at New York University and author of "What to Eat."

If you can, also skip conventional peaches, apples, blueberries, and cherries, which are typically treated with multiple pesticides and usually eaten skins-on.

3. Cookware
Your pots and pans are just as crucial to upgrade as the food you cook in them: "Most nonstick cookware contains a fluorochemical called PTFE that breaks down to form toxic fumes when overheated," says Olga Naidenko, Ph.D., a senior scientist at the EWG. "Those fumes can coat the inside of the lungs and cause allergy-like symptoms."

Tests commissioned by the EWG showed that in just two to five minutes on a conventional stove top, cookware coated with nonstick surfaces could exceed temperatures at which the coating emits toxic gases. Switch to stainless steel, ceramic, or cast iron cookware.

4.  Popcorn
The linings of microwave-popcorn bags may contain a toxic chemical called perfluorooctanoic acid, or PFOA, which is used to prevent the food from sticking to the paper. According to the Environmental Protection Agency (EPA), PFOA is a likely carcinogen.

"We don't know all of the hazardous effects of PFOA yet, but we have some evidence of a link to cancer, as well as to effects on the immune, nervous, and endocrine systems," says David Carpenter, M.D., director of the Institute for Health and the Environment at the University at Albany.

Pick up an air-popper or make your popcorn in a pan on the stove top.

5. Yard pesticides
Some lawn and garden pesticides contain suspected carcinogens, according to EPA data. Long-term pesticide exposure may be related to changes in the brain and nervous system, the Fred Hutchinson Cancer Research Center reports.

"Not only are you breathing the chemicals in, but you bring them indoors and onto carpets via your shoes," says McKay Jenkins, Ph.D., a journalism professor at the University of Delaware and author of What's Gotten Into Us?

Healthier brands like BurnOut and EcoClear are made from vinegar and lemon juice, and are effective weed-killers. To find less-toxic lawn-care companies in your area, go to

6. All-purpose home cleaners
Time for spring-cleaning? Using common household cleaners may expose you to potentially harmful chemicals. Ammonia and chlorine bleach can irritate the skin, eyes, and respiratory tract. And some cleaners contain phthalates, some of which are endocrine disruptors, meaning they interfere with normal hormone activity, says EWG senior scientist Becky Sutton, Ph.D..

Although there's no definitive proof that phthalates cause problems in humans, "the greatest concern is how early-life exposure will affect male [reproductive] development," Dr. Carpenter says. There's weaker evidence, he adds, that phthalates affect the nervous and immune systems.

Go natural with the cleaner you use the most frequently and in the most places, such as kitchen-counter spray -- look for brands approved by Green Seal or EcoLogo, two organizations that identify products that have met environmental label guidelines.

7. Water bottles
You've probably heard that many hard, reusable plastic water bottles could be bad for you because they may contain BPA, or bisphenol A, another endocrine disruptor according to the National Institute of Environmental Health Sciences.

"For adults, the biggest concern with BPA is that it may increase the risk of breast cancer in women and reduce sperm counts in men," says Dr. Carpenter, who explains that BPA can leach out into the water in the bottle. To be safe, sip from an unlined stainless steel or BPA-free plastic bottle.

8. Food storage containers
BPA strikes again: Many food-storage containers are made of the hard, clear polycarbonate plastic that may contain BPA. As is the case with water bottles, the BPA can leach out of the plastic in these containers and seep into your leftovers.

"The leaching is increased during heating, but it also leaches to a smaller degree even when cold foods are stored," Dr. Carpenter explains. Glass containers are your safest -- not to mention planet-friendly -- bet. Both Rubbermaid (at left) and Pyrex make glass ones with BPA-free plastic lids.

9.  Milk (although you would do better to eliminate it completely)
The milk you're drinking may not be doing your body good: Dairy products account for a reported 60 to 70 percent of the estrogens we consume through our food. If that seems like a shockingly large number, it's mainly because milk naturally contains hormones passed along from cows.

What worries some experts is that about 17 percent of dairy cows are treated with the hormone rBST (or rBGH), which stimulates milk production by increasing circulating levels of another hormone called insulin-like growth factor (IGF-1).

"Elevated levels of IGF-1 in people are associated with an increased risk of cancer, including breast cancer," Dr. Schettler explains. In fact, the use of rBGH is banned in Europe and Canada. Although research has yet to definitively conclude whether drinking rBGH-treated milk increases your IGF-1 levels high enough to cause concern, Dr. Schettler says it's advisable to buy milk that hasn't been treated with it. So pick up milk that's labeled rBGH-free, rBST-free, or is produced without artificial hormones.

10.  Celery
When researchers at the EWG analyzed 89,000 produce-pesticide tests to determine the most contaminated fruits and vegetables, celery topped the chart. "In terms of the sheer number of chemicals, it was the worst," says Sonya Lunder, senior analyst at the EWG.

Celery stalks are very porous, so they retain the pesticides they're sprayed with -- up to 13 of them, according to the EWG analysis. Lunder also advises buying organic bell peppers, spinach and potatoes because they scored high for pesticides, as well.

11.  Tomato Sauce
When picking up tomato sauce or paste, choose the glass jar or box over the can. "The lining on the inside of food cans that's used to protect against corrosion and bacteria may contain BPA," explains Cheryl Lyn Walker, Ph.D., a professor of carcinogenesis at MD Anderson Cancer Center and past president of the Society of Toxicology.

In 2009, Consumer Reports tested BPA levels in a variety of canned foods and found it in nearly all of the brands tested, suggesting that the chemical leaked in. "What can happen is that BPA in the lining can leach into the food," Walker explains.

12.  Mattresses
Some regular mattresses may have been treated with potentially toxic flame retardants called polybrominated diphenyl ethers (PBDEs), which have been linked to learning, memory, and behavioral impairments, according to Lunder.

Though PBDEs were phased out of mattresses in 2005, they can still be found in other household items, including carpet padding and some electronics. The EWG advises opting for products that haven't been treated with brominated fire retardants and choosing less-flammable materials, such as wool.

Thursday, March 17, 2011

new blog for my political opinions

In order to add come cohesion to my blogging, I have created another page which will house all my political rants.  the will remain the site for acupuncture, Oriental medicine, complementary therapies, and The Asian Diet.  If you are interested in following my political opinions, check out  

Monday, March 14, 2011

Acupuncture reduces breech presentations

Cost-effectiveness of breech version by acupuncture-type interventions on BL 67, including moxibustion, for women with a breech foetus at 33 weeks gestation: a modelling approach.

Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.


OBJECTIVES: To assess, using a modelling approach, the effectiveness and costs of breech version with acupuncture-type interventions on BL67 (BVA-T), including moxibustion, compared to expectant management for women with a foetal breech presentation at 33 weeks gestation.
DESIGN: A decision tree was developed to predict the number of caesarean sections prevented by BVA-T compared to expectant management to rectify breech presentation. The model accounted for external cephalic versions (ECV), treatment compliance, and costs for 10,000 simulated breech presentations at 33 weeks gestational age. Event rates were taken from Dutch population data and the international literature, and the relative effectiveness of BVA-T was based on a specific meta-analysis. Sensitivity analyses were conducted to evaluate the robustness of the results.
MAIN OUTCOME MEASURES: We calculated percentages of breech presentations at term, caesarean sections, and costs from the third-party payer perspective. Odds ratios (OR) and cost differences of BVA-T versus expectant management were calculated. (Probabilistic) sensitivity analysis and expected value of perfect information analysis were performed.
RESULTS: The simulated outcomes demonstrated 32% breech presentations after BVA-T versus 53% with expectant management (OR 0.61, 95% CI 0.43, 0.83). The percentage caesarean section was 37% after BVA-T versus 50% with expectant management (OR 0.73, 95% CI 0.59, 0.88). The mean cost-savings per woman was euro 451 (95% CI euro 109, euro 775; p=0.005) using moxibustion. Sensitivity analysis showed that if 16% or more of women offered moxibustion complied, it was more effective and less costly than expectant management. To prevent one caesarean section, 7 women had to use BVA-T. The expected value of perfect information from further research was euro0.32 per woman.
CONCLUSIONS: The results suggest that offering BVA-T to women with a breech foetus at 33 weeks gestation reduces the number of breech presentations at term, thus reducing the number of caesarean sections, and is cost-effective compared to expectant management, including external cephalic version.

Friday, March 11, 2011

Acupuncture helps polycystic ovarian syndrome

Undergoing acupuncture may help women with polycystic ovary syndrome (PCOS), according to a recent studyAmerican Journal of Physiology-Endocrinology and Metabolism. from the
For the study, researchers assigned 84 PCOS patients to 16 weeks of acupuncture, exercise, or no treatment. Members of the acupuncture group were given treatments in which the needles were stimulated both manually and with a weak electric current (a technique called "electro-acupuncture"), while members of the exercise group worked out at least three times a week. Study results showed that both acupuncture and exercise improved hormone levels and led to more regular menstruation.
The most common hormonal disorder for women of childbearing age, PCOS is marked by abnormally high levels of male hormones. In past research, scientists have found that certain Chinese herbs and medicinal mushrooms may also help enhance hormone health in PCOS patients.

Borrowed from