resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
January, 2003, Vol. 03, Issue 01
Working With Clients Who Have Hyperthyroidism
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
In my previous article on thyroidism (October 2002 issue), I discussed how insufficient levels of thyroid hormones circulate in the bloodstream, or receptor cells become resistant to these hormones (or both).Hypothyroidism is a fairly common condition, but getting an accurate diagnosis can be challenging. Its symptoms can overlap with those of fibromyalgia syndrome, candidiasis, chronic fatigue syndrome and other conditions. Furthermore, current measuring standards for "normal" hormone levels are rough at best, which means a person with a borderline case, but significant symptoms, may have difficulty getting a useful diagnosis.
This article focuses on a corollary disorder: hyperthyroidism. Hyperthyroidism and hypothyroidism are closely linked. Both may result in the development of a goiter - a painless enlargement of the thyroid gland. People who begin with hyperthyroidism may end up with hypothyroidism as a result of their treatment. Also, as one reader informed me, a baby born to a mother with hypothyroidism may develop hyperthyroidism as an overcompensation response.
Before we begin this discussion, I'd like to include an excerpt from a correspondence I had with David Ponsonby, a massage therapist from Dallas, Texas, who generously shared his experience with hyperthyroidism:
My mother had the iodine deficiency variety of hypothyroidism, which I believe initially causes the thyroid to enlarge in an attempt to meet demand, then to fail. My mother was the Anglo-Australian equivalent of a "G.I. bride." She went to Western Australia and had two babies. Away from fish and pre-iodized salt, she developed goitre (English spelling). I came across one reference that suggested the fetus will overcompensate for a deficiency and become hyperthyroid - i.e., me. She had two surgeries in the next four years, and a third almost 50 years later that resulted in pneumonia and death. Throughout the 50 years, her breathing, speech and activity level were impaired.
My own hyperthyroidism had some curious "coincidences" at initiation. I developed an apparent cellulitis after being bitten by a mosquito near a city sewer plant. (No association, they tell me?)
My lower right leg swelled up. When the swelling went down, it was very lumpy -- pretibial myxedema. The parathyroid is mixed in, with calcium deposition around the periosteum - like a soccer player's shin. I am a former soccer player, and it was interesting that the site of some of my old injuries seemed to be the focus.
My eyes popped out, I became very hot, my skin was flushed and itchy, my blood pressure went up, my heart pounded in my ears, and I fainted on two occasions -- very scary. I tried to maintain my exercise, although the sweating and fainting made it scary because there was always the possibility that I could collapse while riding my bike, etc.
I tried acupuncture, which seemed to relieve the swelling on one side, under the eye. I tried detoxification, energy therapy, homeopathy, etc. Gradually, most of the symptoms went away. I still have some swelling under one eye.
What Is Hyperthyroidism?
Hyperthyroidism is a condition in which the thyroid gland produces excessive amounts of two forms of thyroid hormone (T3 and T4), resulting in the metabolism of fuel into energy - lots and lots of energy. A person with hyperthyroidism has an engine that runs hot all the time, and never really lets up.
Demographics: Who Gets It?
Hyperthyroidism affects between 1 percent to 2 percent of all people in the United States at some time in their lives. About 500 thousand new cases are diagnosed each year. Women are affected more often than men, by a margin of about 3 or 4 to 1. Most cases are diagnosed between the ages of 20 and 40.
Etiology: What Happens?
Hyperthyroidism is usually caused by one of three things: a thyroid infection; a nodule or group of nodules that become hyperactive for unknown reasons (this is called toxic nodular or multinodular goiter); or an autoimmune attack against the thyroid gland that causes it to secrete excessive amounts of metabolic hormones (also called Grave's disease).
Grave's disease is by far the most common variety of this disorder, accounting for 70 percent to 80 percent of all cases. In this situation, antibodies called thyroid-stimulating immunoglobins (TSI) mistakenly attack the thyroid gland, causing it to grow to huge dimensions (this is called a goiter) and so to secrete excessive levels of both forms of thyroxine.
Under normal circumstances, pituitary secretions of thyroid-stimulating hormone (TSH) tell the thyroid when and how much to metabolize fuel into energy. When Grave's disease is well-established, the thyroid produces its own TSH for local action, so circulating levels of this hormone drop significantly. At the same time, levels of TSI, the antibodies that attack the thyroid, increase systemically throughout the circulatory system. The result is that the conversion of fuel into energy increases by 60 percent to 100 percent.
While genetics clearly play a major part of developing Grave's disease, its onset often seems to be connected to a stressful situation like a death in the family or a job change. Other risk factors for developing this disorder include exposure of the thyroid to X-rays, or previous use of antiviral medications such as interferon or interleukin.
Signs and Symptoms
The primary symptom of Grave's disease is the development of a goiter: the thyroid becomes enlarged enough to create a visible, painless swelling in the neck. Other signs and symptoms are mostly related to the emphasis on metabolizing fuel for energy, rather than growth or storage.
Grave's disease patients may show anxiety, irritability, insomnia, rapid heartbeat, tremor, increased perspiration, sensitivity to heat, and unintentional weight loss. Skeletal muscles, especially in the arms, often become weak. Other symptoms may include a lighter flow during menstrual periods, dry skin and brittle nails. Grave's disease can also affect the muscles that lift the eyelids. When the eyes seem to protrude, this is called exophthalmos. (Think of Marty Feldman in Young Frankenstein - he was a famous hyperthyroidism patient.) Grave's ophthalmopathy is a rarer disorder that causes the eyeball to protrude beyond its protective orbit because tissues and muscles behind it swell. The front surface of the eye can dry out, causing light sensitivity, double vision, decreased freedom of movement within the orbit, pain, and excessive tearing.
Some Grave's disease patients develop red raised patches of skin on their shins and feet. These rashes are called pretibial myxedema, and they are generally not painful or dangerous.
One of the most serious complications of Grave's disease is the risk of episodes of dangerously accelerated metabolism called thyroid storms. In these episodes symptoms may include rapid heartbeat, fever without infection, intolerance to heat, confusion, agitation, and finally fainting or shock. Thyroid storms can be medical emergencies and require immediate intervention to slow the heart and bring down the fever.
Grave's disease is usually diagnosed through a physical exam, a blood test, and an examination of how the thyroid takes up radioactive iodine. The physical exam concentrates on issues like goiter, temperature, heart rate, muscle weakness, and tremor. Blood tests will look for low levels of TSH combined with high levels of TSI, along with abnormally high levels of thyroxine. The ingestion of radioactive iodine shows how quickly the thyroid absorbs iodine (a primary component of thyroxine), along with which parts of the thyroid appear to be hyperactive. This test helps to delineate between Grave's disease and nodular hyperthyroidism.
Hyperthyroidism can be treated in a number of ways, depending on the underlying causes and the severity of the symptoms.
Alternative therapies for hyperthyroidism focus on the use of certain foods and/or vitamins that inhibit thyroid activity, but I couldn't find any information on modalities that can actually interrupt the immune system attacks on the thyroid gland.
What About Massage?
As long as the skin is healthy and intact, and the cardiovascular system can adjust to the changes we bring about, massage of all types may be beneficial to clients with hyperactive thyroid glands. The calm, relaxed response bodywork creates may provide a welcome change to the sympathetic-like symptoms of hyperthyroidism.
In my next article, I will discuss reflex sympathetic dystrophy syndrome (RSDS). Also referred to as causalgia, sympathetic maintained pain syndrome, or complex regional pain syndrome, this chronic pain syndrome presents special challenges for massage therapists. If any of you live with this, or have clients who do, I'd love to hear from you.
Until then, many thanks, and good health and happiness.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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