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Ear Acupuncture Helps Manage Side-effects of HCV Treatment

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I recently stumbled onto a journal article that reports 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 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.)
Now that genotype-1 infections (which are reported to account for around 90% of hep-C cases in the US) are being eradicated with the new protease inhibitors (in combo, lamentably, with the standby interferon/ribavirin "backbone"), it seems all the more important to find ways to help folks get through the course of treatment.

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 until these promised non-interferon based hep-C therapies (I don't know alot about Gilead's sofosbuvir, but some investment wags think this first "all-oral" combo hep-C regimen could gain an expedited FDA nod some time in the second half of 2013) are made available and time tested, seems we are stuck with at least 6 months 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 acupucture places in metro NYC: Manhattan Community Acupuncture (UWS), 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!); 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. Feel free to contact me with questions and ideas: mbarr@pacificcollege.edu

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