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6 Tips To Keep You Strong and Healthy This Fall

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According to the Centers For Disease Control and Prevention (CDC), approximately 5-20% of people in the U.S. will catch the flu virus, 200,000 of whom will be hospitalized due to the complications (source).  Although you can catch the flu virus at any time of the year, it's far more prevalent during the fall and winter months. To protect yourself against the flu, colds and other illnesses this fall, check out the following 6 tips.

#1) Stay Active

Exercise plays a direct role in the human body's immune function. Whether it's running, jogging, playing tennis, or using your preferred machine at the gym, physical activity stimulates white blood cells and antibodies, sending them throughout the body. This improves the immune system's ability to fight off infectious diseases, so be sure to exercise on a regular basis this fall.

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#2) Increase Your Vitamin C Intake

Vitamin C is a naturally occurring antioxidant that can improve your health and protect against illness. A study conducted in 2007 found that a daily 200 milligram dose of vitamin C when taken at the onset of a cold shortened its duration by 8% in adults and 14% in children. With fall and winter being the prime time of year for colds, it's a good idea to supplement your daily diet with at least 75 milligrams of this powerful antioxidant.

#3) Cut Back on Refined Sugars

Consuming too much refined sugar can increase your risk of developing type II diabetes, obesity and cardiovascular disease. It's also been proven to suppress the immune system, leaving individuals more susceptible to disease and illness.

So, how sugar should you consume to stay healthy throughout the fall season? The American Heart Association (AHA) currently recommends a maximum of 37.5 grams of refined sugar per day for men and 25 grams for women.

#4) Eat Fall-Colored Foods

Yet another way to improve your health is to eat more fall-colored foods. Generally speaking, the more color you have on your dinner plate, the better. Foods that are bright orange, red and green are all excellent sources of vitamins and antioxidants. Some ideas include squash, bell peppers, zucchini and broccoli, all of which will help keep you healthy this fall season.

#5) Make a Soup

There's no better time than the chilly fall season to make a hearty soup. Avoid store-bought soups, which are usually loaded in sodium and preservatives, and instead make your own from scratch. This allows you to include a variety of beneficial vegetables and seasoning, tailoring it to your own personal preference.

Boost Your Immune System Using These Two Points

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Lieque (Broken Sequence) and Zusanli (Leg Three Mile)

Although they are invisible to the naked eye, we are exposed to millions upon millions of germs. Bacteria, viruses, fungi and protozoa are found on nearly every surface, including doorknobs, furniture, office supplies, phones, remote controls, and even the food we eat. Thankfully, most of these germs are harmless and pose no direct threat to our health, but there are others that aim to cause infection and illness. You can safeguard yourself against these foreign invaders, however, by utilizing the Lieque and Zusanli acupuncture points.

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Lieque Acupuncture Point

Lieque (also known as Lung 7 in our ordinalized and Anglicized system of points) is an acupuncture point that's commonly used to treat bodily infections while subsequently boosting the immune system. To locate it, form a "thumbs up" gesture with your hand and look for the small crease in your skin at the base of your thumb. The Lieque acupuncture point is found roughly 2 finger-breadths up the wrist from this crease. It's most easily identified by feeling around this area of your wrist for a subtle depression at the bottom of two tendons.

Lieque is known to offer relief of the following symptoms:

  • Sore throat
  • Runny nose
  • Nasal congestion
  • Chest congestion
  • Body aches
  • Fever
  • Headache
  • Muscle cramps

Zusanli Acupuncture Point

Zusanli (Stomach 36 in the English-speaking countries) is another powerful immune-boosting acupuncture point. Don't let its name fool you into thinking it's located on the stomach though. Zusanli is actually located on the lower leg, just past the ridge of the tibia where the fibers of the tibialis anterior muscle attach.

Zusanli receives its namesake for the symptoms it's used to treat. While Lieque focuses on cold and febrile symptoms, Zusanli is used more digestive problems.

Zusanli is known to offer relief of the following symptoms:

  • Constipation
  • Diarrhea
  • Acid reflux
  • Heartburn
  • Gas
  • Low energy

How Lieque and Zusanli Can Improve Immune System Function

The human body's built-in mechanism for defending against germs and foreign invaders is the immune system. This complex system is comprised of a variety of different white blood cells, such as neutrophilis, eosinopholis, monocytes and basophils, that actively seek out and neutralize harmful germs. Acupuncture treatments using the Lieque and Zusanli stimulate the immune system so it produces more of these "fighters," which in turn keeps us healthy while protecting against disease and illness.


Michael Barr is a board certified acupuncturist and herbalist and can be reached at Manhattan Acupuncture Associates, with offices at Columbus Circle and Flatiron. His expertise and interests include sports acupuncture, pain syndromes, liver health, immunological support, low energy, mood disorders, anxiety, insomnia, GI complaints, and herbal and acupuncture approaches to getting off/putting off prescription medications of unsatisfactory or unclear benefit, and in helping to manage the side-effects of other necessary and life-saving biomedical interventions. He has also been busy exploring the application of Chinese herbal therapies, and specific acupuncture protocols, for all aspects of sexual health and anti-senescence.

Photo Credit:  Thunderchild7 via Flickr Creative Commons

Half-Off Saturdays @ Turning Point Acupuncture

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For the month of October I will be offering half-price weekend appointments to readers of Poz and HepMag at Turning Point Acupuncture (Saturdays) on Broadway and 60th, and at Suite 904, on West 21st Street (Sundays). Each visit entails a comprehensive East Asian medicine evaluation, pulse reading and meridian balancing or neurofunctional adjustment (for musculoskeletal complaints). Suggestions for herbal therapies are generally not made until after the second or third visit--unless specifically requested in advance.

Founded by Dr. Naomi Rabinowitz in the 1980s, Turning Point Acupuncture was one of only two acupuncture practices (the other being Eleven Eleven Wellness) in town who welcomed HIV+ persons at that time.

Appointments can be made during weekday business hours by calling (646) 583-0904. Or, on Saturdays, at (212) 489-5038.

Dr. Rabinowitz has since relocated to the great Colorado outdoors, leaving TPA in the more than capable hands of a new clinical director, since 2007 I believe, E. Shane Hoffman. I am thrilled and honored to be included in their company.

As readers of my writings for Poz over the past 18 years likely already know, I am especially interested in liver health, immunological support and herbal (and sometimes acupuncture) approaches to getting off/putting off prescription medications of unsatisfactory or unclear benefit. And in helping to manage the side-effects of other necessary and life-saving biomedical interventions.

I have also been busy exploring the application of East Asian herbal therapies, and specific acupuncture protocols, for all aspects of sexual health and well-being--a topic that gets precious little attention in our Chinese-influenced curricula.

Mike Barr is a board certified acupuncturist and herbalist and can be reached at Manhattan Acupuncture Associates, with offices at Columbus Circle and Flatiron. His expertise and interests include sports acupuncture, pain syndromes, liver health, immunological support, low energy, mood disorders, anxiety, insomnia, GI complaints, and herbal and acupuncture approaches to getting off/putting off prescription medications of unsatisfactory or unclear benefit, and in helping to manage the side-effects of other necessary and life-saving biomedical interventions. He has also been busy exploring the application of East Asian herbal therapies, and specific acupuncture protocols, for all aspects of sexual health and anti-senescence.

This sort of Op-Ed piece in this coming week's JAMA sort of sums up the present and near future therapeutic landscape as well as attempting to address the pricing issues. I plucked out what I thought were the most important bits, but the full text is free at the JAMA Network site.

http://jama.jamanetwork.com/onlineFirst.aspx

(If, instead, you are looking for July 23/30 JAMA paper on the cure rates in co-infected folks that kind of made the news overnight, that link (also full free text) is here.)

Treatment of infection with hepatitis C virus (HCV) has changed substantially in the last 3 years, with new therapies now reaching cure rates (defined by sustained virologic response) higher than 95%. As little as 3 years ago, treatment involved an arduous course of pegylated interferon and ribavirin, which caused serious adverse effects in more than 80% of patients; less than 50% of patients could finish the treatment course.

In 2011, introduction of the first generation of protease inhibitors, particularly telaprevir and boceprevir, heralded change. ... However, these agents were much more expensive than standard therapy, at a cost of more than $80‚ÄČ000 per course of therapy, and were associated with high levels of viral resistance ... if patients did not strictly adhere to therapy.

In 2014, the introduction of polymerase inhibitors set a new standard. The first in this class, sofosbuvir ... in patients with genotype 1 HCV. Sofosbuvir also can be combined with another new protease inhibitor, simeprevir, to treat patients in whom interferon-based therapy has failed. These regimens provide interferon-free treatment protocols that are shorter and well tolerated and have 80% to 95% cure rates. This fall, an oral combination of sofosbuvir and ledipasvir will be introduced ... and has been shown to reduce treatment to an 8-week course with cure rates of more than 95%. Now, a chronic disease that affects millions of Americans can be cured by well-tolerated oral medications.

The price of sofosbuvir is essentially $1,000 per pill, or $84,000 for a standard 12-week course. The fact that pricing in the United Kingdom for a similar regimen is $54,000, and perhaps as low as $900 in Egypt and other developing countries, indicates that the pricing in the United States is a purely financial decision by Gilead and has outraged many. Indeed, some pharmacy benefit managers are calling on their clients to boycott these products until alternatives are available late in 2014.

While a daily oral medication that costs $1000 per pill gains attention, the more important issue is the number of people eligible for treatment. With broader screening, the pool of eligible patients may be as high as 3 million in the United States alone. The simple math is that treatment of patients with HCV could add $200 to $300 per year to every insured American's health insurance premium for each of the next 5 years. Thus sofosbuvir is not really a per-unit cost outlier but is a "total cost" outlier ...

These costs will be especially burdensome over the next year. Presently, Gilead has a monopoly, and its investors expect it to make a profit during this period. However, it is anticipated that by December, another highly effective oral regimen will become available.

Given this context, how should costs be managed? In some state Medicaid programs, the new medications have not been added to the formulary, despite the new practice guidelines. Physicians for whom the drug is denied by the state are going to Gilead, and, by report, the company is quietly subsidizing the costs--there is an official assistance program offered by Gilead. 

... 

Some private insurers have added sofosbuvir to the formulary and are absorbing the costs but also are taking steps to ensure appropriate utilization by developing prior authorization programs based on practice guidelines. Some insurers are asking physicians to treat only patients who absolutely need therapy now.

The ultimate approach to cost will be lower prices, which will occur as more products create competition. However, it will likely entail narrower formularies, in which the physician choice of a particular medication is limited by the deals negotiated by insurers and pharmacy benefit managers.

Mike Barr is a board certified acupuncturist and herbalist and can be reached at Manhattan Acupuncture Associates, with offices at Columbus Circle and Flatiron. His expertise and interests include sports acupuncture, pain syndromes, liver health, immunological support, low energy, mood disorders, anxiety, insomnia, GI complaints, and herbal and acupuncture approaches to getting off/putting off prescription medications of unsatisfactory or unclear benefit, and in helping to manage the side-effects of other necessary and life-saving biomedical interventions. He has also been busy exploring the application of Chinese herbal therapies, and specific acupuncture protocols, for all aspects of sexual health and anti-senescence.

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For more on the business side of HCV drug development, as well as a bit of a look into the future of hep C rx, have a look at Matthew Herper's piece in Forbes magazine last month: Why Merck Just Spent $4B On New Drugs for Hepatitis C

Read about AbbVie's all oral, 3-in-1 combo regimen, expected in October at (and one state's efforts to play the two off one another for a 50% price reduction), among other places, Pharmalot.

Drs. Feeney and Chung (Mass General, Boston) in a July 7th clinical review for the BMJ report that over the next 1-2 years, "several new agents and classes of direct-acting antiviral are likely to be licensed," expanding the options for interferon-free regimens. "These interferon-free regimens," they write, "could enable many patients with HCV (even those with cirrhosis and those who have not responded to previous PI-based treatment) to be cured with an oral course of antiviral without the use of interferon and its associated side effects."

A year or so ago, I came across a journal article reporting the use of weekly ear (aka auricular) acupuncture for help managing the side-effects of interferon therapy. While the number of people treated was small (14) and effectiveness was assessed by self-report, the results are intriguing nonetheless.

Severity of fatigue, muscle aches (myalgia), irritability and nausea were all reported to decrease.

If  you're curious, the ear points these clinicians used were Shen Men, Thalamus, Lung, Liver "and/or" Sympathetic. Interestingly, they used 32-gauge (0.18 x 25 mm) needles. Retention time: 30-45 minutes. All results were statistically significant, although the nausea change just barely so. Reductions in irritability showed the most impressive decrease, followed by muscle aches (myalgia).

One wonders if the results might have been even better if the treatments could have been performed more frequently (it appears that folks had only 4 treatments over a period of 6 months), maybe using ear seeds, tacks or magnets for home or office stimulation between visits, and if some body points could have been added. (BaiHui and HeGu were employed in an undisclosed number of cases, presumably in accordance with individual pattern presentations.)

There does not appear to be much published research on the use of acupuncture--ear or otherwise--to manage the side effects of interferon therapy. And except for a few lucky souls (mostly those with genotypes 2 and 3) who can expect to clear the virus with a non-interferon based hep-C combo, it seems we are stuck with at least 12 weeks of weekly sub-Q interferon injections.

I contacted the author of the paper, an acupuncturist MD at the VA in Portland, OR, to try to find out additional information on her study and any plans for follow-up investigation. She explained their plans for a larger and "cleaner" study in order to tease out the exact contribution of the acupuncture intervention, as well as to better understand the optimal timing of the acupuncture treatment in relation to self-administration of interferon injection.

(Readers might also want to check out the medhelp.org (or other) online community forum for other peoples' experiences. The one I happened onto this morning yielded several helpful first-hand experiences: One person writes that s/he heads to acupuncturist the morning after the previous night's interferon jab, and that it really helps. Of course, not everyone can afford or has the required insurance plan to cover weekly (or, perhaps better: biweekly) visits to an acupuncturist in private practice. But as someone from the Bay Area wrote in, communal or group acupuncture places (officially called "community" acupuncture) offer scaled-down but completely adequate services for a fraction of the cost of a private session. This person was going to a community acupuncture place in Berekley, CA for all of $15 a visit! And don't forget massage. Many folks report that a monthly massage also really helps.

I haven't seen any $15 price points in NYC (more like $40, $45, $55), but there are a handful of group/community acupuncture places in metro NYC: Manhattan Community Acupuncture (UWS), New York Community Acupuncture (West 36th Street),  Harlem Village, Olo, City Acupuncture, Bae (Williamsburg) and Third Root (Ditmas Park). (I have first-hand experience with only Olo Acupuncture (West 23rd Street, between Sixth and Seventh), City Acupuncture (Fulton Street) and Third Root (on the Q and M trains! And I once studied with the woman who started NYCA); the others I found through a search engine.) I am told that City Acupuncture is  soon to open a second location across the Hudson in Hoboken or Jersey City. Anyway, there seem to be more community acu places in the Garden than Empire state at the moment. Stay tuned...)

Housing Works, with Positive Health Project centers in East New York, downtown Brooklyn, West 13th Street and East 9th Street in Manhattan, offers an acupuncture option to its HIV+ clients ("every Tuesday and Thursday from 1pm-5pm") but to my knowledge is not currently offering acupuncture services to their HCV+ folks. (Please correct me if I am wrong!)

Of course, for hep-C infected folks who are not ready (or willing) to take the peg-interferon/ribavirin-PI plunge or waiting for easier-to-take, better tolerated drug combos and are concerned about their liver health, there are quite a few good herbal formulas out there reported to support healthy hepatocyte regeneration, prevent further liver damage and reduce the risk of fibrosis. (This would apply equally to HBV-infected folks who are not on suppressive antiviral therapy.) More on that in a future post though! In the meantime, I would love to see some of the HCV service centers in the city begin to offer this ear acu option to their clients.

Mike Barr is a board certified acupuncturist and herbalist and can be reached at Manhattan Acupuncture Associates, with offices at Columbus Circle and Flatiron. His expertise and interests include sports acupuncture, pain syndromes, liver health, immunological support, low energy, mood disorders, anxiety, insomnia, GI complaints, and herbal and acupuncture approaches to getting off/putting off prescription medications of unsatisfactory or unclear benefit, and in helping to manage the side-effects of other necessary and life-saving biomedical interventions. He has also been busy exploring the application of Chinese herbal therapies, and specific acupuncture protocols, for all aspects of sexual health and anti-senescence.

CL found that because coconut water contains lots of potassium (and very little sodium), sports drinks might actually be a better choice. Large quantities of potassium could impart a laxative effect (desirable or undesirable, you decide) while coconut water drinks without added sodium are probably not as good as sports drinks after "intense, prolonged exercise."

And they add, "plain water may be sufficient for simple rehydration." In a 2012 study all 3--sport drink, coconut water (both pure as well as reconstituted from concentrate), water--were shown to be of equal utility.

Or you could give the Mother Earth a break and just make your own electrolyte post-workout beverage.

Basically these drinks are just a quarter cup or so of fruit or fruit juice (containing variable proportions of glucose, fructose, sucrose) with a little salt (sodium chloride +/- potassium iodide and possibly some other trace minerals if it's fancy) mixed into water. For help choosing from among isotonic, hypertonic and hypotonic options, this BBC page might be useful.


Michael Barr is a board certified acupuncturist and herbalist and can be reached at Manhattan Acupuncture Associates, with offices at Columbus Circle and Flatiron. His expertise and interests include sports acupuncture, pain syndromes, liver health, immunological support, low energy, mood disorders, anxiety, insomnia, GI complaints, and herbal and acupuncture approaches to getting off/putting off prescription medications of unsatisfactory or unclear benefit, and in helping to manage the side-effects of other necessary and life-saving biomedical interventions. He has also been busy exploring the application of Chinese herbal therapies, and specific acupuncture protocols, for all aspects of sexual health and anti-senescence.





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