“The Hot Flash” is written and produced by Dr. Brian Grosam. Dr. Grosam holds a Ph.D. in Acupuncture and is a leading specialist in treating hot flashes and perimenopausal symptoms. He resides in Minnetonka, Minnesota and owns and operates Sun Acupuncture, an acupuncture, Chinese medicine, and tuina-shiatsu clinic located in Hopkins, Minnesota.

As many of you know, I have conducted extensive acupuncture and Chinese herbal research in the area of hot flashes. I try to keep current with the latest research and am always looking for new theories and effective treatment options from other practitioners and researchers. By looking within and outside my own modality, I can find new and useful ideas to learn from. Here is my latest commentary, I hope you enjoy! -Dr. Brian Grosam

I ran across some recent press I found quite interesting regarding the treatment of hot flashes. The research, conducted by Northwestern Memorial Hospital studied the effects of a nerve block injection to stop severe hot flashes. I found a few interesting connections to acupuncture in this research. Here is a link to the article:

http://medicalxpress.com/news/2013-10-neck-ease-tough-to-bear-hot.html#inlRlv

Right of the bat, we understand the researchers are using a shot, but a shot of what? It’s an anesthetic by the name of bupivacaine hydrochloride, which is commonly used as a “nerve block.” A nerve block does just what it says, it blocks the nerve signals thus disrupting the pain signals. It is commonly used as a local anesthesia for oral surgery, baby delivery, etc. But, anesthesia does carry its own risk potentials. So, I wonder right away, is the reward worth the risk? Here is a link to the side-effects:

http://www.nhs.uk/medicine-guides/pages/MedicineSideEffects.aspx?condition=Local%20anaesthesia&medicine=Bupivacaine%20hydrochloride

The injection is into the stellate nerve ganglion located deep within the neck. It has the potential to communicate with neurological and hormonal centers of the brain that regulate body temperature and heart rate. Here I would like to mention two classic Chinese medical theories: 1.) In one aspect of Chinese medicine we attribute hot flashes to heat in the body; 2.) Another aspect we talk about is an increase in restlessness and heart rate attributing to an increase in hot flashes. Acupuncture can reduce heat and also regulate the heart rate by relaxing the nervous system, thus, treating hot flashes in a similar fashion.

What I first find quite interesting is the stellate ganglion is situated in the neck and level with an acupuncture point on the back of the neck that is classically used for treating heat in the body. Secondly, the ganglion is located in the same vicinity as another classic acupuncture point located alongside the trachea, that is classically used to control blood flow and relax the patient.

I found these two connections quite valuable. I have studied acupuncture points on the neck to investigate their effects of regulating hot flashes. I now can see a potential biomechanical link to acupuncture. This is truly amazing and valuable!

The research information we should also pay close attention to is the “delivery of treatment.” What I find most interesting is the injection needs to be done with guided imaging (X-ray fluoroscopy) deep into some very sensitive and potentially dangerous areas of the neck. This procedure carries substantial risks and potential serious side-effects if administered improperly. This is not something I would necessarily want to gamble on, again, risk versus reward! Acupuncture uses a thinner needle, approximately 30x thinner than a hypodermic injection needle. What’s more, is acupuncture theoretically doesn’t necessarily need to be inserted deep into the same potential dangerous areas of the neck, simply because the needle can naturally stimulate the ganglion through the local nervous system, reducing the risk of deep needling and extreme discomfort.

This pilot research demonstrated about 50% relief for six months. This means only half of the women in the Northwestern study are experiencing a temporary reduction in hot flashes. In research though, 50% is not all that much, but still promising. I strive for a higher percentage of around 85% effective and long-term relief with the use of acupuncture alone in my private practice.

The potential final price tag for this procedure: $750-$1,000 per injection. We can also speculate that one would potentially need follow up injections. This increases risk potentials and possible adverse effects. This price tag can buy you 10-15 acupuncture treatments and a piece of mind that acupuncture is a safe and effective treatment option for hot flashes and is more cost effective.

Ultimately, what I love about this particular piece of research is that it shows promising evidence that we can possibly control and regulate the body temperature mechanisms by focusing on the nervous system. It also highlights a specific area where we can target future acupuncture research.

Dr. Brian Grosam
Sun Acupuncture
1007 Main Street
Hopkins, MN 55343
952-935-0600
www.sunacupuncturemn.com