resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
October, 2002, Vol. 02, Issue 10
Working with Patients Who Have Hypothyroidism
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
In my last article on cerebral palsy, I was happy to find lots of material not only on the condition itself, but on how massage can play a part in the life of a CP patient.I duly related this latter point in my article, expecting little controversy, since this is a well-researched and well-understood condition. Well, duck, because the fallout is still coming down.
I made a few errors in the CP article that I'd like to clear up. First, I misstated the locations in the brain where the damage takes place. Unable to find any specific information on this issue in my pathology resources, I pulled out my anatomy texts and listed the movement centers I know about: the basal ganglia, frontal lobe, and cerebellum.
Gary Bruce, LMT, NCTMB, who works extensively with special needs individuals, corrected me in an e-mail he sent me:
Second, I referred to the tight muscles of a CP patient as a "spasm"- this is quite incorrect: the proper term is spasticity, and the way it responds to massage is quite different. (For more information, please refer to my spinal cord injury article in the May edition of Massage Today.) These are technical errors, and I take full responsibility for not catching them.
At this point I'd like to restate (or state for the first time) what my job is: I am a translator. I read through scads and scads of material: some boring, some fascinating. Then I try to translate that material into accessible terms, so I can share it with anyone who is interested. Sometimes I get lucky and I find people who help me understand a topic, either because they themselves live with it, or they work with people who do. Sometimes, unfortunately, I don't get in contact with a valuable resource until it's too late. Such was the case with the CP article.
I want to voice my appreciation to everyone who wrote me with their own opinions about this issue, which proves that we are people who take our work and the well- being of our clients very seriously. It also proves that what the mainstream medical community promotes is not always the last word. To illustrate this fact, I'd like to quote from another response I got to the CP article, from Mary Green, LMT. Her comment relates to the statement that CP is non-progressive, but nontreatable. (Remember, I just report this stuff, I don't make it up!)
And that's all I'm going to say about CP for the time being.
In my last article, I asked what people would like to read about next, and thyroid disorders won the election in a landslide. I had planned to combine both hyper and hypothyroidism into one article, but it's just too much information, so I decided to limit this discussion to one of the most frustrating and controversial issues in chronic disorders: hypothyroidism.
What Is Hypothyroidism?
Hypothyroidism is a condition in which circulating levels of thyroid hormones are abnormally low, or in which levels of thyroid hormones may be normal, but target cells have become resistant to their action. This interferes with the body's ability to generate energy from fuel.
Demographics: Who Gets It?
Hypothyroidism may be a fairly common condition, affecting about one-tenth of one percent of the population overall. Women are five times more likely to develop hypothyroidism than men. Statistics rise with age; within women over 65 the incidence of this disorder may be as high as 10%. These numbers reflect reported cases; many people may experience hypothyroid symptoms without achieving a diagnosis.
Etiology: What Happens?
Before we get into the specifics of this disorder, we need to discuss some massage school anatomy. You may remember that the thyroid gland, that butterfly-shaped structure that wraps around the trachea, is an endocrine gland that secretes hormones related to metabolism: the use of fuel for energy or growth. It does this under orders from the pituitary gland, which secretes thyroid-stimulating hormone (TSH).
The primary hormone associated with the thyroid gland is called thyroxine. When thyroxine levels are high, metabolism is fast - hyperthyroid symptoms include weight loss, heart palpitations, minimal menstrual periods, and bulging eyes. When thyroxine levels are low, metabolism is slow. Weight gain, low energy, and hypersensitivity to cold may ensue. As with most things concerning hormones, this description is an oversimplification.
The thyroid actually secretes several different substances, including T4 (also called thyroxine, this is a molecule with four iodine atoms) and T3 (a molecule with three iodine atoms). T4 is generally secreted in greater amounts than T3, but T3 is more potent. Enzymes elsewhere in the body may help to convert T3 to T4, or vice-versa. In the etiology of hypothyroidism, it is the presence of T4 that is usually tested and treated with a synthetic version of thyroxine (Synthroid).
Beyond simple low levels of circulating hormones or cellular resistance, several other contributing factors to hypothyroidism have been identified:
Signs and Symptoms
Signs and symptoms of hypothyroidism are often subtle but steadily progressive. A person may not realize the extent of the problem until someone points it out. The result of not being able to convert fuel into energy means that a person gains weight, feels fatigued and depressed, and has a sluggish digestive system with chronic constipation. The person will have poor tolerance of cold, and the skin will be puffy, but dry. Hair will be flat and brittle, and may even fall out. In women, menstrual periods tend to be heavy and long-lasting. Some hypothyroidism patients will develop goiter: a painless enlargement of the thyroid.
It is common for hypothyroid patients to develop atherosclerosis, as liver function to produce the chemicals that expel cholesterol from the body is sluggish. High cholesterol levels from hypothyroidism do not respond to cholesterol-lowering medications. Fluid retention in the arms and wrists raises the risk of carpal tunnel syndrome; fluid retention in the neck along with goiter may cause chronic hoarseness. Very severe cases may cause patients to become so cold and drowsy that they becomes unconscious. This is called myxedema coma, and it is a significant cause of death among elderly hypothyroidism patients.
Many people who fit the profile for hypothyroidism also have symptoms of fibromyalgia syndrome, depression, candidiasis, or chronic fatigue syndrome. It can be a daunting and frustrating process to sort out which is which, since none of these conditions is well-understood or easy to treat.
Physical exams for hypothyroidism look for goiter, along with a significantly slowed heart rate. Reflexes are often slow in hypothyroid patients.
Blood tests may be conducted to look for elevated levels of antithyroid antibodies, which would point to a diagnosis of Hashimoto's disease. Levels of thyroid stimulating hormone (TSH) might also be evaluated. If the thyroid is underactive, the pituitary usually will pour more of this chemical into the bloodstream.
It is especially important for pregnant women to be tested for thyroid function. Pregnancy can hide some symptoms of hypothyroidism, which can create serious repercussions for the unborn child. Most newborns are tested for thyroid function as a matter of course; early intervention in the rare cases when thyroid function is subnormal can prevent stunted growth and mental retardation.
The most common treatment for hypothyroidism is to supplement thyroid hormone. In the early days of understanding this disease, desiccated thyroid glands of a variety of animals were prescribed to treat hypothyroidism. The doses were difficult to regulate, since potency could vary widely. Today, thyroxine is replaced with a synthetic version of the hormone, called Synthroid.
Some researchers, however, suggest that the symptoms of hypothyroidism may be related to other factors: general toxicity, for instance, or cellular resistance to thyroid hormones, or a need to supplement T3 instead of or in addition to T4. And of course the added challenge for treatment lies in the possibility of fibromyalgia syndrome, chronic fatigue syndrome, candidiasis, and any number of other chronic disorders that may mimic or accompany hypothyroidism. These factors, which are often neglected by some "mainstream" medical professionals, may account for why many people who have hypothyroid symptoms do not feel that taking synthetic thyroxine successfully treats their disorder.
Can Massage Help?
Outside of the risk of atherosclerosis (which is a risk for many mature clients regardless of thyroid function), massage is a perfectly appropriate choice for hypothyroidism clients. Although it is unlikely to restore the normal production of thyroid hormones or cellular sensitivity to them, massage can certainly improve the quality of life of people who feel chronically drained and lethargic.
In my next column, I'll examine hyperthyroidism. I'd love to hear from any readers who live with this disorder, or whose clients do. How has it impacted the quality of your life? What have you done, or what are you doing to treat it? What kind of impact has massage had on your situation? Share your experiences and wisdom - pathology readers want to know!
Ruth Werner, LMT, NCTMB
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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