Ask the Acupuncturist

Dr Nieters,
This October, it will be one year since I started listening to The Balancing Point – and what a year it’s been! I started listening to The Balancing Point after researching my symptoms online, and learning about candida from your Itunes podcast.

With the help of an acupuncturist, lifestyle changes and the three week Detox that you recommended, I no longer have the following issues: a chronic sinus infection including excessive phlegm and a constant cough, a ringing in my left ear, a droopy left eye that twitched, and a popping in my right ear.  All of this is gone – without the use of the antibiotics and daily steroid nasal sprays that my doctor prescribed for the same conditions.

And, the list goes on … I’ve had an improvement with my dry eye syndrome, dry skin, cracked feet, soft nails, and extremely rough elbows. Plus, although I have not lost as much weight as I’d like, I’ve lost inches, especially belly fat!

In addition – from listening to your show – I also learned that my leg length discrepancy might be able to be corrected.  I found a great chiropractor – discovered that my LLD is from a hip problem – and am still working on this issue, but, I’ve already been able to remove the lifts from my shoes.  None of the three doctors that I saw previously ever even mentioned this as a possibility.

And – as an added bonus – people are now noticing the difference and saying that I look younger.  I definitely feel younger – thanks to you and your show – and I am now back to exercising regularly.

So, a year later, I wanted to let you know that The Balancing Point show has changed my life – and I can’t thank you, your wife and your staff enough!

Best regard from an avid listener!

– Denise from Colorado

Dear Denise,
Thank you for sending this email. Nothing is more heartwarming than receiving an email like this. Thank you for letting us participate in your journey.
Be Happy!

– Dr. John Nieters, L.Ac. DAOM, FABORM

Hi Jennifer and John,
It was a pleasure meeting you both and listening to John’s lectures on Sunday.  So much information!  It was a great day!  Lot’s of aha moments. I had some questions for John.
1) Do you have any good recommendations for breakfast that include protein/fat and not eggs.  My  IGG was through the roof on eggs which is my favorite for breakfast.  I ate them everyday to help with hypoglycemic issues and I am wondering if that was a bad idea.
2) Along the same lines, I don’t eat cow dairy but I am wondering about whey protein
3) You mentioned herbs that support healing of the gut.  Can you give me some recommendations?
4) Where do you get you PGX fiber?
5) Do you have any resources (besides your awesome shows) that correlate western medicine with TCM D&D.
The information you shared was absolutely wonderful!  I am going to see if the school can have you back to talk about food allergies, autoimmune diseases and reading labs. I know you are extremely busy and I apologize for the many questions.  I am one of those people who has to chew on things for a bit so I can formulate questions.

– Colorado School of Traditional Chinese Medicine Student

Dear CSTCM Student,

You really know how to sweet talk a guy. Those classes, along with the Diabetes and Pi Wei Lun classes that I did last weekend, are my favorites! Chew well. There was a lot of information in the Diabetes class and I don’t want you to get indigestion.

1) Jenny’s breakfast favorites for gluten and egg free breakfasts include Salmon sausage patties from www.vitalchoice.com, avocados and wild boar bacon, Rudi’s gluten free toast.  I concur with her suggestions.  Any meat that you can tolerate or make a congee with meat or organ meat.  Ghee is great to add to everything as it is a yeast killer, supplies major fuel for the heart, and does not contain milk proteins.

Eating a food that you have a current IgG problem with will cause inflammation in a dose dependent manner; the more you eat, the worse it is.  It takes 4-6 months for the body to “forget” the specific immunity causing the IgG problem that has been created to foods.  Every time one eats those foods it basically starts the clock over, so it may take another 4 months.  Whenever there is severe food sensitivity long term there WILL be leaky gut problems. This is a Pi Wei Lun  (Treatise of the Spleen and Stomach) type of problem.  Following the 4 basic steps of Li-Zhu medicine:

• Fortify spleen to boost qi and cause proper upbearing of pure yang (and proper downbearing of turbid yin)
• Clear any of the 6 depressions involved to allow for proper coursing of the qi.
• Clear pathogenic heat
• Treat any branch problems

With food allergies we will typically see patterns such as: Liver depression qi stagnation assailing the spleen and stomach with damp heat in the middle jiao.  We often see a combination of a cold middle jiao with pathogenic heat, just to confuse things a bit more.  Long term this would lead to kidney yang xu and other patterns.

In treating this with TCM and supplements I would first determine how significant is the Liver depression.  If it is a core problem I might look to Qi rectification, stasis resolving formulae such as Shu gan San or Chai hu shu gan san as a starting formula.  If there is not liver qi as a core problem I would go with spleen fortifying, damp resolving, formulae such as Liu Jun Zi tang.  If more dampness I might use Xiang Sha Liu Jun Zi tang.  If more of the depressions are involved I might use Bu Zhong Yi Qi San as a core formula and add herbs for branch problems.  For example; if there is diarrhea with the other depression you could add Bu Gu Zhi or Shan Yao with the core Bu ZhongYi Qi San to make a very efficient formula.  Or add Huang Lian or Huang Bai to BZYQS for specific heat clearing.  The “three huangs” are all anti-bacterial and anti-candidal.  The spleen clearing medicinals were perfectly formulated for leaky gut problems. If there is cold stagnation in the middle burner or significant kidney yang xu, or the naturopathic concept of adrenal fatigue, I love Fu Zi Li Zhong Tang.  FZLZT dries the spleen, fortifies the spleen, lung and heart qi, warms the middle jiao, and warms and supports middle and lower jiao cold.

With IgG problems there is always a great deal of small intestine inflammation, which allows for much easier attack, adherence, and penetration between cell walls by candidial hyphae.  Often there is pathogenic yeast as an ongoing, perhaps non symptomatic, problem whenever we see significant IgG problems.  So, we must simultaneously:

• Avoid the foods for 4-6 months.  Rotate any other foods eaten.
• Resolve yeast in an ongoing manner  (I like TCM formulas and supplements such as undecyclenic acid, capryllic acid, grapefruit see extract, etc, for this)
• Increase Intestinal Secretory IgA to restore immune function (I like TCM formulas, saccharomcyes cerevisia if no allergy or Crohn’s disease, colostrum, cod liver oil, Vitamin D, Vitamin A, krill oil, etc for this)
• Increase beneficial intestinal flora ( increase fiber, use soured foods, take probiotics)
• Increase pancreatic enzyme output or ingest endogenous food enzymes (Spleen Qi tonics, herbs to resolve food stagnation, querecetin, endogenous enzymes)
• Heal the lining of the small intestine. (Spleen Qi tonics, middle jiao heat clearing herbs, Fish oil or Cod Liver oil, Evening primrose oil, black seed oil, etc.)
• Warm or cool the middle jiao as appropriate (TCM formulas)
• Liver and gallbladder support for circulating immune complexes, cic’s, caused by the IgG/macrophage/antigen process.  (TCM formulas, milk thistle or extracts such as sylimarin or sylibanin, artichoke, beet tops, dandelion, etc.)

2) By far the worst dairy allergies are to casein, particularly to beta casein A-1.  Whey is typically less than 10% as likely to be a problem.  If you tested positive to whey you should avoid it, otherwise I would go with it.  Rice protein works for many people.  Pea protein for some others.  Always avoid casein and soy proteins.

3) For healing the gut, see the formulas above.  All spleen tonic herbs are good in general.  phlegm/damp clearing medicinals are often important in small doses; such as chen pi, qing pi, ban xia, etc.

4) I use PGX fiber which is a konjak mannan product.  We get ours from “Natural Factors”.  I personally use their “slimstyles” product as a meal replacement rather than eating during the day at work.  I have my patients either do the slimstyles or take the PGX capsules before meals.

5) I love Treatment of Western Diseases in a TCM clinic and Evergreen herbs clinical manual as starting points.  They don’t cover supplements, but they do a wonderful job of creating correlations.

Thanks for the kind words. It was really great to meet you in person.  It was a very friendly group of students and I really enjoyed seeing Denny again.  Hope to see y’all soon.

Be Happy!

– Dr. John Nieters, L.Ac. DAOM, FABORM

Hi John,
I tested low for Vitamin D 25(OH) and 1,25 di-hydroxy Vitamin D at 89.7 and was told to start supplementing Vitamin D. I am a Type 1 diabetic with Lyme disease. What do you think?
Thanks,
– Jess

Dear Jess,
This can be a very confusing issue.  While it is one of the greatest things for the health of the nation that Vitamin D deficiencies have moved into the spotlight, most health care professionals don’t understand all of the issues involved.  I have personally explained the Vitamin D issues to several MD’s who have called to question me about testing that I have done on their patients.

Athough the Vitamin D test done by your other health care provider is indeed low, it is only one relevant test.  The test done was a 25(OH) Vitamin D, the more common test that measures the storage form of Vitamin D in the body.  Most labs report results of over 32 ng/dl as “normal”.  While this may be adequate for protection and creation of healthy bones, we need much higher levels to support immune function.  I place “normal” at 55-60 ng/dl because that is the typical level achieved by lifeguards and in cultures that get traditional amounts of sunlight exposure.  When serum levels of Vitamin D fall under 30 ng/dl there has been shown a proven increase in diabetes, 15 forms of cancer, Parkinson’s disease, Multiple Sclerosis, and several other neurodegenerative diseases.

It is virtually impossible to have too high a level of the storage form of Vitamin D, so very few people need to be concerned.  However, you are one of the people who must be concerned.  Anyone with very high levels of inflammation should get both vitamin D tests.

The test that I order for the more bioactive form of Vitamin D is called 1,25 dihydroxy Vitamin D or calcitriol.  This is the form that directly activates the immune system.  This is a very powerful hormone that can cause significant damage if the levels are elevated.

The body produces cytokines which are chemicals that attract the other immune cells, such as the white cells in the bloodstream, to infection sites.  This is a very important process.  With inflammatory disease conditions the body often produces an overabundance of cytokines and will even lose it’s ability to turn off the reactions.  These excess cytokines can then block the vitamin D receptor sites, tricking the body into thinking it needs more of the “active” Vitamin D.  The body then over converts the storage to active forms, which can be a very serious problem. Your 1,25 di-hydroxy Vitamin D (calcitriol) level is too high at 89.7.  The “normal” range at Labcorp is 10-75.  This will cause a lot of inflammation and even increase osteoporosis risk if it stays high.

You should not take any vitamin D supplements until this goes down, as you will over-convert from the 25(OH) Vit D in the supplements to this active form. The cytokine storms from your infections are likely blocking the vitamin D receptor sites. Although you need vitamin D to activate the immune system, getting this calcitriol level down would take priority. Even sun exposure could be a bit problematic at this time.

Be Happy!

– Dr. John Nieters, L.Ac. DAOM, FABORM

Hi John,
I went to the Tai chi Class yesterday.  They do something called Guang Ping Yang Tai Chi.  Some of the moves are similar to the set that you teach, but the set is in different sequence and includes some moves we did not study.  Some basic differences in movement but same principles, for the most part.  Are you familiar with this type of Tai Chi?
Thanks for any feedback.
Tai Ji Student

Dear Tai Ji Student,
My first Tai Chi Instructor was one of the two main teachers of this type of Tai Ji in the US.  I studied this form with him in the early 1970’s.  I later studied Dayan Qigong, the QiGong form that I used to teach, with his wife.

This form was originally taught by the son of the founder of yang style Tai Ji so it is certainly authentic.  As such, it is based on exactly the same principles as the set that you studied with me.  I have found that the set that I taught to you and the group is a much easier form to learn than the Guang Ping Yang style.

People who are devotees of Guan Ping Yang Style say it is the “real family style Tai Ji” and is more powerful than the Cheng Man Ching style that you learned.  That may be true.  I do know that the most competent and powerful Tai Ji practitioners that I have seen do the set that I taught.  So they are all great.

I learned them both and think they are both fabulous. .

Be Happy!

– Dr. John Nieters, L.Ac. DAOM, FABORM

Hi John,
I ran this lab for one of my fertility patients.  She is female, 42 years, never been pregnant, tried for 3 years actively but has not been using contraception for 7 years.  Wants to give it another shot.  This is the first test. Wondering about her pH and Thyroid specifically.  Everything else looks good to me.
Your time is appreciated!
SF Acupuncturist

Dear SF Acupuncturist,
These are some of the healthiest labs that I have ever seen.  None of the things that I would  consider at all a potential problem are here.
– Blood sugars are perfect
– Thyroid is perfect ( on the surface at least – could do a reverse T3 to confirm)
– No signs of allergy or inflammation
-uric acid low
-CRP low
-eosinophils normal
– liver enzymes great.
– No signs of infection
– since no pregnancies, vs miscarriage, not too likely to be antibody problem

It’s great , which is of course a problem.  So the next most likely problems would be:
1. male problems – up to 40% of fertility issues are male problems
2. Healthy uterine cyclical hormonal development
3. Healthy cycle – luteal phase defects or ovarian defect
4. patency of fallopian tubes.
5. Healthy uterine structure

My personal next steps, to minimize cost with maximum effectiveness, would be in this order:

1. Test the male.
a. complete sperm work up is not expensive
b. STD testing – a very high percentage ( maybe 40%) of male sperm problems are from occult chlamydia infections
2-3. Cycle
a. Continue Basal Body Temp chart to be certain of 12 day high temp luteal phase with sharp rise and fall
b. Check LH:FSH ratio just to make certain no polycystic ovarian problems (very unlikely with the labs and glucose levels, but..)
c. Check day 21 progesterone levels for evidence of good luteal phase Pg levels
d. Have her check the amount of stretch to her Spinnbarkeit, mid cycle cervical mucus.
e. Ultrasound of ovaries to check follicular development during follicular phase
4. Have her MD test Fallopian tubes
a. ultrasound helpful
b. Hysterosalpingogram; much more accurate
c. STD testing and history; primarily for Chlamydial fallopian damage. This is particularly important with the high urine pH. (occult infections by certain STD’s can settle in the kidneys.  These bacteria  split urea which creates ammonia which will raise the pH.  This also puts her at higher risk for kidney stones so should be followed up on at any rate.  Since the specific gravity was moderately high, it might have just been a very concentrated urine sample however).  At any rate, I would have her hydrate normally and then do another urine test.
5. Uterine issues – her MD
a. View uterus to see that it is structurally sound and properly shaped
b. View uterine lining to be sure she is developing good uterine lining.

Be Happy!

– Dr. John Nieters, L.Ac. DAOM, FABORM