Month: October 2015

Once You Decide To Consult a Traditional Chinese Medicine (TCM) Professional, What Can You Do in Advance To Select the Best Possible Match for Your Needs?

Here at Vitamin Insider we have explored strategies to identify qualified, accessible TCM professional practitioners. Using those resources, how should you move forward in narrowing down your choice of a provider? Which expert(s) are likely to offer the best results? What can you do in advance to assure that you and your provider are likely to be compatible? How might you coordinate professional care to reach your wellness goals? Read on for practical suggestions to make your selection process efficient and rewarding.

Questions and Concerns To Resolve in Advance 

Before choosing any practitioner — TCM professional or conventional healthcare provider — it is almost always best for you to discuss in advance your specific needs and health problems. What else? Be sure to inquire about fees for services. Ask about other issues that impact the situation. In addition, determine the provider’s treatment style and qualifications.  If you have done your research beforehand, then likely you know some of this important information already. You should also screen in advance for education, training, licensing and certifications. Remember: the credentials required for complementary health practitioners can vary tremendously from state to state and from discipline to discipline. Generally speaking, “buyer beware” is good advice.

You are well within your rights to request a conference in advance of your first appointment. How? You can ask for a meeting either by phone or in person.  Just make sure that you arrange a convenient time. Provide advance notice of your intention of course. Ask in advance, too, to determine that you will not be charged for the preliminary consultation.

Areas To Cover During the Preliminary Meeting 

1.) Find out whether the TCM professional is willing to work with your current conventional health care providers.  Why? For safe, coordinated care, all of the professionals will need to communicate and cooperate with each other. Inability or unwillingness to do so should raise a red flag immediately.

2.) Find out about the practitioner’s training and prior experience in treating the diagnosis. Choose a professional who understands how to work with your specific needs. Disclose all your health conditions. This recommendation applies even if general well-being is your only immediate goal. Remember: Certain health conditions can affect the safety of complementary approaches. For example, if you have glaucoma, certain yoga poses may not be safe for you. Be prepared to ask about long-range effects of therapies you are considering.

Caution: Beware of those providers pushing extreme plans or trying to sell complicated, expensive packages at the outset. Ask the practitioner to tell you about some success stories of other patients at the office. If it sounds as if the very same steps are taken and the same advice is offered to every patient, be cautious.  You need treatment tailored to your specific situation, not a “cookie cutter” approach.

3.) Equally important, tell your conventional health care provider about all the complementary approaches you are considering. Also ask for particular advice or precautions based on your prior medical history. In other words, look at both sides of the coin before you undertake a new treatment approach. Keeping all your health care providers fully informed will help you stay in control to manage your health effectively.

4.) Any other areas of specific concern to you.

Some Final Considerations

• The TCM professional you are considering might boast impeccable credentials and display a long roster of happy clients. Ultimately, though, very little of that will matter if the two of you don’t have good chemistry together. You should feel that the practitioner genuinely listens to what you say, understands and cares about your situation. It is important that you come away from the preliminary meeting feeling energized and hopeful. You should not feel burdened or obligated.
• Don’t assume that your current health insurance will cover this practitioner’s services. Ask what specific insurance plans are honored at this office.  Contact your health insurance provider beforehand and ask specifically what coverage and reimbursements might be available. Remember: Insurance plans differ widely in coverage of complementary health treatments. Even if your plan does cover a particular approach, some restrictions may still apply. In summary, be certain of your financial obligations before you commit to a course of therapy.

How Can I Locate the Right Traditional Chinese Medicine Practitioner for My Specific Needs?

Vitamin Insider has assembled a practical guide for locating  Traditional Chinese Medicine (TCM) providers. 

Remember: When you are seeking a TCM professional, it is important to be every bit as careful and thorough in your search as when looking for conventional care.

Professional Referral 

To begin, if you need names of competent TCM practitioners in your area, first check with your healthcare team. Your doctor, pharmacist or another trusted health care provider is most likely to be familiar with local colleagues. A nearby hospital, medical school or local college of Oriental medicine/naturopathic medicine may also be able to provide referral services. Even your health insurance provider might be helpful with suggesting good sources of nontraditional care. Always be sure at the same time to ask your insurance representative about the terms and limitations of your policy coverage. Ask about provisions to reimburse for any alternative services you are considering.

State Credentialing Services 

Also consider contacting your state licensing/registration boards or professional regulatory agencies. This way you can identify practitioners who have qualified for licensure, registration or certification. These individuals are expected to practice in accord with professional standards set within the jurisdiction.

You might also contact a state professional association to locate nearby TCM practitioners. For example the acupuncturists’ group is often designated by the state name followed by “Acupuncture Association.” Look online or in the telephone directory for Illinois (or other state) Acupuncture Association.

Be aware: Credentialing requirements can vary widely from state to state and from discipline to discipline.

National Professional Associations 

On a nationwide scale you can find acupuncture and Oriental medicine foundations or associations which provide referrals. Among the best known are the following:

• The National Commission for the Certification of Acupuncture and Oriental Medicine (NCCAOM). This commission provides diplomas in acupuncture and in Chinese herb prescribing as well as maintains a listing of diplomates with the searchable web page.

          http://mx.nccaom.org/FindAPractitioner.aspx

• The American Association of Oriental Medicine (AAOM). The association offers referrals to acupuncturists nationally and maintains a website for searching. 

          http://www.acufinder.com/

• The Institute for Traditional Medicine. The institute maintains a practitioner reference guide listing professionals in the U. S. and Canada.

          http://www.itmonline.org/practitioner_guide.htm

• American Academy of Medical Acupuncture (AAMA). The academy is a professional society of physicians (M.D. and D.O.) in North America. These doctors have incorporated acupuncture into their traditional medical practice. The academy offers referral service at their website.

           http://www.medicalacupuncture.org/

Federal Government Directory 

The MedlinePlus Directories webpage provided by the National Library of Medicine lists organizations for some professions. It also provides links to directories of libraries and various types of health professionals, services and facilities at the web page:

https://www.nlm.nih.gov/medlineplus/directories.html

Family and Friends’ Referral

If a trusted family member or friend has previously had favorable experiences with a Traditional Chinese Medicine practitioner, many people will feel safer consulting that same professional on the basis of a friendly recommendation. Informal referrals like that are relatively easy to come by in places such as large cities or fortunate geographic areas like California or Oregon, where there are thousands of qualified practitioners. In those locations most people probably know somebody who has already received acupuncture or herbal therapy. In many other areas, though, this unfortunately is not the case.  Then it may become necessary to find a practitioner without the advice of a friend or relative.

Telephone Directory or Yellow Pages 

Additionally it may be helpful — or necessary as a last recourse — to look in the yellow pages of your local telephone directory or that of a nearby major city. Search for “acupuncturists,” for “physicians–naturopathic” or for similar headings to locate TCM practitioners.

As in most other professions, skill levels are likely to vary over a wide range. It is also important for best results to work with somebody with whom you feel comfortable; so, do not necessarily settle for the very first person you contact. When you hang up the phone, you should feel hopeful and energized, not obligated. As always, be a savy consumer and keep asking questions until you find the answers you really need … and deserve.

Remember: It is well within your rights to call an office in advance to ask about that practitioner’s training and experience. If you are seeking treatment for a specific condition, be sure to ask how much experience he/she has in treating that particular malady.

Last-Case Options

In the event that there are no viable options whatsoever for you to locate a Traditional Chinese Medicine practitioner anywhere nearby, what else can you do?

To start, even if it is not convenient, you might need to travel some distance to arrange an initial consultation. For herbal therapy, after the initial face-to-face meeting, you may subsequently be able to receive additional treatment by phone. Then, too, you could have necessary herbal supplies sent to you by mail.

In the case of serious ailments requiring more intense treatment, perhaps you could make special, one-time arrangements. Possibly you could contact a friend or relative in a major city. If you travel and stay there for a short while, then you could receive regular treatments at that location. The initial treatment may be sufficient to get the therapy under way. Then you might look at long distance follow-up treatment for later on.

If visiting a practitioner in person is not an option at all, there are still some treatments that you might be able to obtain for yourself. In the case nutrition therapy, for example, perhaps you could rely on products marketed nationwide. You could make choices after due diligence in studying the literature. Vitamins, minerals herbal remedies and other substances can be researched online or at a library. Then you can carefully follow the published recommendations. This approach, though, should not substitute for seeking direct, in-person care whenever an office visit is possible.

One More Caution

Sad to say, many products sold in stores or via the Internet and other routes do not deliver all that the label promises. Despite the hype and advertising, they actually may contain too little of the active components to meet recommended dosage. Beware of any vendors without a well-established reputation and a history of excellence.

TCM Qualifications: What Credentials Identify Competent Practitioners?

As you probably know by now, the legal/ethical practice of Traditional Chinese Medicine (TCM) involves more than merely inserting a few acupuncture needles. TCM qualifications for practitioners in the United States require three to four years of full-time post-graduate study at an accredited educational institution.

Just like your allopathic physician, a TCM practitioner must adhere to rules that ensure his or her licensing and training is up-to-date.

TCM Qualifications – at the Federal/National Level

When you are looking for a skilled practitioner of TCM, investigate in advance the quality of training and experience for the professional(s) you are considering. It may also be wise for you to look for someone who is skilled/credentialed in a range of TCM therapies rather than in only a single modality. You can find information about the credentials and licensing of complementary health practitioners on the U.S. Department of Health & Human Services – National Institutes of Health (NCCIH) website.

https://nccih.nih.gov

As you initially consider the use of TCM, a certified practitioner is likely to be your safest choice. Recognized at the federal level by the U. S. Department of Education, the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) accredits schools that teach acupuncture and TCM. Only about one-third of the states that license acupuncture providers, though, actually require graduation from an ACAOM-accredited school. You can access their resources at the following website:

www.acaom.org   

Another reliable source you might consult is the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), which offers separate certification programs in acupuncture, Chinese herbology and Oriental bodywork. NCCAOM also maintains a database of diplomates who are nationally certified practitioners at their website.

www.nccaom.org

TCM Qualifications – at the State Level

Most states do license acupuncturists, but not all of them include other various components of TCM. All but a few states have regulations in place concerning the practice of acupuncture. Regulation at the state level usually includes licensing requirements for non-M.D. practitioners and specifications on scope of practice for M.D.s and other health professionals. Most of these states require national board certification as a prerequisite for state certification or licensure. Practitioners must complete at least three years full-time schooling before they can become eligible for the national board certification. Most states, though, allow conventional medical doctors and chiropractors to practice acupuncture with little or no additional formal training.

TCM qualifications and credentials required for complementary health practitioners can vary widely from state to state. There are also differences from discipline to discipline among  integrative health providers. Even so, it is still a good idea to contact your state licensing boards and/or regulatory agencies. That way you can identify practitioners who have qualified for credentials in accord with standards for the jurisdiction. Just remember: not all care providers are created equal. It is in your best interest to investigate the training and credentials of a nontraditional practitioner well in advance of your first appointment.

Caution

While excellent professional credentials are important, it is essential, also, for you to select providers with whom you feel comfortable and able to communicate.  How can you find the best TCM practitioner for your specific needs right now? Vitamin Insider explores some ways to locate the very best professional(s) for your specific needs in the topic: ______.

How Can Americans Incorporate Nontraditional Care Strategies To Improve Their Health?

More Americans today than ever before are investigating the benefits of nontraditional care. In one recent year more than 38 percent of American adults used some form of alternative medicine. The field of nontraditional therapies is diverse. The benefits are hotly contested. Moving forward more research is needed to determine the true efficacy of many of these practices.

Some of the disciplines included in nontraditional care include:

• acupuncture
• acupressure
• Reiki
• homeopathy
• naturopathy
• chiropractic
• biofeedback
• aromatherapy
• ayurvedic medicine
• Traditional Chinese Medicine
• balneotherapy
• reflexology

Alternative practices may not always exclude traditional/conventional Western medical techniques. For example nontraditional treatments can sometimes work along with mainstream measures in a combination of practices.​

Complementary Treatment

The term “complementary therapy” includes forms of nontraditional care used together with conventional medicine. People sometimes try such treatment(s) to relieve symptoms or side effects while they are undergoing standard/conventional treatment to address the actual diagnosis. For example, cancer patients might use nontraditional care for pain relief. At the same time they could be using conventional oncology protocol for treatment of the disease.

Alternative Treatment

Other individuals may decide to pursue so-called “alternative therapy” approaches. In this case the nontraditional care measure would  be used alone in lieu of all standard or allopathic treatment.

Integrative Treatment

“Integrative therapy” is generally understood to incorporate nontraditional care into mainstream health protocols.  This approach may include different combinations of alternative, complementary and standard treatments. Each treatment needs to be individualized on a case-by-case basis.

Caution

It is essential to tell your conventional healthcare provider(s) about any/all nontraditional care or complementary health approaches you are using or considering. In conclusion always be certain to give your medical team a full picture of everything that you are currently doing or planning to do to manage your health. This disclosure then will help ensure coordinated and safe care for your best outcome overall.

 

How Frequently Do People in the U.S.A. Use Nontraditional Healthcare Strategies Today?

The exact number of individuals currently using nontraditional healthcare in America is not well documented. It has been estimated, though, that at least 10,000 practitioners now serve more than one million U. S. patients each year.

Nationwide, the National Center for Complementary and Integrative Health (NCCIH) estimates that more than 30 percent of adults now use health care approaches developed outside of mainstream Western, or conventional/allopathic, medicine. Additionally about 12 percent of American children also currently receive nontraditional services.

Data collected in the 2007 National Health Interview Survey (NHIS) included a comprehensive survey on the use of complementary health treatments.  Findings there document that an estimated 3.1 million U.S. adults had used acupuncture in the previous year. The number of visits to acupuncturists tripled between 1997 and 2007. Also, according to the NHIS study, about 2.3 million Americans practiced tai chi and 600,000 practiced qi gong in the previous year.

What Insurance Coverage Is Available for Nontraditional Healthcare?

Many Health Maintenance Organizations (HMOs) nationwide currently offer at least one form of alternative health care coverage. Services most often covered are chiropractic care (87%) or acupuncture (47%).

There seems to be less reluctance on the part of insurers in America now than there was 10 years ago to cover nontraditional treatments. Insurance coverage for acupuncture, for example, has increased significantly during the past decade.  Now the benefits package, more often than ever before, also includes treatments such as moxibustion, herbal medicine and massage.

In 1999, according to the Landmark Report, only about one quarter of all HMOs provided some kind of acupuncture benefit. A 2004 survey, funded by the Kaiser Family Foundation and Health Research and Educational Trust, evaluated coverage five years later.  That study reported 47% of all employers then offered acupuncture as a covered health benefit, up from 33% in 2002. In contrast, 52% of the POS plans were found to cover acupuncture in 2004. About 47% of the PPO plans offered such coverage, while 44% of conventional plans included acupuncture benefits then.

The most common form of insurance coverage is reimbursement of patients for acupuncture treatment under physicians’ referral. The most prevalently covered conditions are pain-related.

Traditional Chinese Medicine: TCM Practice — What Is It?

 

Chinese researcher Youyou Tu won the Nobel Prize in Medicine on October 5, 2015. In fact she received the award for her innovative work using a Traditional Chinese Medicine (TCM) approach. Since then, interest in TCM practice, including functional herbal remedies, has skyrocketed. As a complementary or alternate approach, TCM techniques overall may offer benefits in managing a variety of symptoms.

History and Objectives of TCM

Historically TCM practice has encompassed a broad range of techniques and approaches. These methods share common concepts which were developed in China. For the most part they are based on ancient Taoist philosophy dating back more than 2000 years.

Included in the discipline are combinations of herbal medicine, acupuncture, massage (Tui na), exercise (qi gong) and dietary therapy. The system aims to identify functional entities which regulate digestion, breathing, aging, etc. TCM practitioners perceive health as harmonious interaction among these entities and with the outside world. In like manner they interpret disease as a disharmony in interaction.

To diagnose, TCM practice aims to trace symptoms linked to patterns of an underlying disharmony. Consequently it uses techniques such as measuring the pulse, inspecting the tongue, skin and eyes and looking at the eating and sleeping habits of the individual.

Holistic Principles of TCM Practice

In summary, then, holistic beliefs of TCM include the following principles:

• The human body is a miniature version of the larger, surrounding universe.
• Harmony between two opposing yet complementary forces, called yin and yang, supports health. Disease results from an imbalance between these forces.
• Five elements symbolically represent all phenomena including the stages of human life. These elements are thought to explain the functioning of the body and how it changes during disease.
  • fire
    
  • earth
    
  • wood
    
  • metal
    
  • water  
• Qi is a vital energy that flows through the body. It performs multiple functions in maintaining health.​

Preparation and Action of Traditional Herbal Remedies

In TCM practice the medicinal or herbal remedy is typically prepared as a decoction. In the first place practitioners blend together different parts of plants — leaves, roots, stems, flowers and seeds. Formulas are then administered as teas, capsules, liquid extracts, granules or powders. According to Xingwu Liu, Ph.D., an expert who specializes in traditional herbology from his headquarters in Chicago, the formula components interact synergistically to potentiate the overall effect. Collectively they nourish and activate the mind, the ears and the eyes. Additionally each individual constituent also is thought to exert its own unique effect in managing symptoms.

 

 

 

 

Authority: China Academy of Chinese Medical Sciences

The premier authority on TCM practice is the China Academy of Chinese Medical Sciences (CACMS). Located in Beijing, it is at the forefront combining ancient herbal traditions with cutting-edge scientific research today. CACMS was established in 1955. In effect it functions as a comprehensive institution for technical research, clinical medicine and medical education. Today CACMS links to and cooperates with the medical circles, research institutions, universities, pharmaceutical companies and non-governmental societies of more than 100 different foreign countries and regions.

Experts from a specialty board within CACMS sometimes oversee cultivation and local harvesting of raw herbs. As a result, this oversight assures the purity and effectiveness of top-quality functional herbal remedies.

What does it mean when I see the letter L- or D- printed in front of the molecule name on a supplement bottle label (e.g., L-arginine or D-fructose)?

 

 

 

Chemists use L- and D- distinction to differentiate between the two different forms of a chiral compound molecule.  Called optical isomers or enantiomers, the forms are chemically identical but structurally different. By convention, these are called L- and D- forms, analogous to left-handed and right-handed configurations (based on Latin words, laevus and dexter for left and right). In both forms of the molecule, atomic makeup is exactly the same in composition. That is, they both have the same identity, number and order/sequence of constituent atoms. The atoms, however, are arranged differently in space. In the most simple terms, optical isomers appear as mirror images of each other.

 

You might think of the situation like a pair of hands or a pair of gloves. The two of them seem to be alike. They have the same size, each with exactly four fingers and a single thumb. Because of the way they are flipped around (oriented differently in space), though, there is no way you could ever rotate a right hand to make it fit exactly like a left one, or vice versa. No matter how the two hands are oriented, twisted or moved, it is impossible for all the major features of both hands to coincide precisely. Similarly, for a chemical compound, the carbon atom with four different attachments has two possible unique configurations.  They, too, assume separate spatial arrangements that are not identical, just like the right/left hands in the hand-glove example.

What Difference Does It Make?

Because of the difference in form, necessarily the two isomers interact differently with receptors in the body. Going back to the hand-glove analogy,  shaking someone’s right hand is much less awkward to do with your own right hand compared to your left.  So, too, the different isomers also interact more or less easily depending on the placement of specific receptors. In the case of amino acids, for example, human cells manufacture only L-amino acids to incorporate into proteins. While amino acids can occur in both L- and D-forms, only the L-forms of the molecule are actually used by cells in the human body.

What Does It Mean If the Name Includes DL- ?

Occasionally you might see a label with DL- noted at the beginning of the supplement name, for example, DL-phenylalanine. This notation means the bottle contains 50% by weight the D- form of the molecule and 50% the L- form.