Med. Dr. Özaytürk, Mehmet Salih; Istanbul

Eylül 2011 Kızılcahamam Akupunktur Sempozyumu, Sunum

It's generally known that there would be overdose in medication when the dose is higher than therapeutic range. Is it possible to experience overdose in treatments which are performed with acupuncture as a method of treatment? If yes, what can be the symptoms? If not, how can this be explained?

Abstract;

Drugs are chemicals that are given to body from outside and they are not mostly produced in the body. Drugs are not included in genetic data, accordingly body is vulnerable -except excretion and degradation methods -to these substances. Because of individual differences and the usual changes which occur in the body, drugs may bring allergy, intolerance, cumulation and overdosage. Since they are artificial, they are not specific.[1] Unwanted effects can lead to unintended and unexpected consequences. However, the substances whose level is altered by method of acupuncture treatment, are original and specific. In addition, through receptors they are controlled and balanced continuously by CNS and opposing mechanisms.

A Brief Overview to The Action Mechanism of Acupuncture

The gate control theory of pain[2], put forward by Melzack[3] has played a leading role in efforts to lighting the action mechanism of acupuncture. However, it is not possible to explain all of the mechanism of action of acupuncture only with painful stimulus-dependent blockade, in other words the action-reaction method.

Studies have increasingly indicate that almost all known neurotransmitters take part interactions in peripheral and central nervous system.[4] In addition, hormonal mechanisms take part also in the action mechanism of acupuncture.

Currently, many metabolic parameters and enzymatic activities are waiting as an untouched area.

Apparently, behind the action mechanism of acupuncture, there is not only one or two organs or the system, but also whole body and its sub-systems and units are included.

In the following period, it will be put forward step by step that needling a point prompts the whole body and all of its units and the changing in the reaction -depending on where the needle plugged- is also related with body's sub-systems.

In vivo Balances in Acupuncture Treatment

The changes in neurotransmitter levels with the needling of acupuncture points; differentials in ACHT, cortisol, levels of insulin, or thyroxine have been put forward by relatively large number of academic studies and these studies still continue deepening.

In this section, I intend to explain above mentioned studies without mentioning name and content, but with reference. And also I want to talk about something overlooked in these studies.

It is a fact that the neurotransmitters released from the effect of acupuncture and endocrine disrupting hormones, induced peripheral and central systems activate mechanisms of their opposing.

In other words, certainly the cortisol released in the blood, with the mechanism known as negative feedback, making a negative impact, will supress the ACTH - which stimulates adrenal glands that release the cortisol to the blood and cause them to get bigger - released from hypophysis (pituitary gland), at the level of pituitary gland.

Even, cortisol released from blood, is also known to be in hypothalamus. This pressure is strong enough to stop hormonal production completely.

In other words, stimulation of the spinal cord centers will result in increased pressure and control on these centers of cortical. If it generates a sympathetic warning in the same way, a parasympathetic response to it will certainly develop. In details, there are too many contrasting and combined systems, stimulatory and inhibitory cells, neurotransmitters mutually complementary and stimulating or persuasive opposite effect in the central nervous system. And consequently, there is a "balance" which expresses itself with vividness in the body. As part of this balance, a parameter whose level is changed, will lead to the formation of a new balance by activating all other related parameters.

Accordingly, spatial effects of acupuncture acquired through the acupuncture treatment will disappear vaguely. Even during treatment session, opposing mechanisms will be activated and obtained effect will be gently balanced, thus it becomes meaningless to extend the duration of the session.

If we stipulate;

1. Cross-balancing relations between neurotransmitters: GABA -glutamat-glisin-seratonin-dopamin-asetilkolin-adrenalin- norepinefrin-endorfin-enkefalin, like the relationship betweeen the neurotrasmitter substances 5,

2. Hormonal opposing balances: Kalsitonin-parathormon, insulin-glukagon, antidiuretic hormon (ADH) - natriuretic hormon (NDH), etc.

3. Balancing relationship between sympatic and parasympathetic systems.

4. Opposing balances between neuronal and neuron groups in MMS.

5. End product negative feed-back mechanisms. For example, such as the supressing effects of thyroid hormones over TSH released from pituitary and TRH that is inducing it, and supressing effects of cortisol released from suprarenal gland over ACTH that is also released from pituitary and its inducer CRH

Through the oppsing systems, mechanisms or substances is acupuncture effect always balanced and the overdosage is entirely prevented in acupuncture treatment.

How does acupuncture work despite the opposing mechanisms?

If the acupuncture effect is already blocked already during the session by the opposing mechanisms, then the acupuncture shall theoretically remain ineffective against diseases. However, the real world practice is the other way around. Acupuncture is an effective method of treatment contrary to expectations.

Even during the session is acupuncture effect is blocked with opposing mechanisms, acupuncture is shall theoretically remain ineffective against diseases, yet the real world practice is exactly on the contrary. Acupuncture is an effective method of treatment contrary to expectations.

Because, even if the mechanisms that prevent the effect are engaged during the session, each session results in an optimal increase on action-reaction rates in the nueronal pathways and hormonal mechanisms. For example, the decrease in the reaction time in neuron - neurotransmitter axes which take part in neuronal pathways, will result in an increase of transmission; and the increase of transmission will result in the opening of the gate before the negative feedback mechanisms come into effect, thus this will result in some achievements of effect. The function of stopping the effect with negative mechanisms will be normalized and disappear until the next session. A new acupuncture session that will be carried in the period after, will speed up the effect to one level higher.

So, the periodical treatments that will free up the blocking mechanisms of the body, eventually will result in the re-establishment of "homeostasis" where the balance disorders will settle and the body, with all its systems can interfere the issues effectively within a correct information axe.

If we shall re-express this again within seperate points, the effect of acupuncture may continue due to

1. Accelerating the reaction speeds of neurons by generating a fasciculation on the neuronal pathways

2. Facilitating the production and release mechanisms of neurotransmitters

3. Speeding up the action-reaction speeds of end-product production centers

4. Reinforcing the final organ reaction

For the final word;

There is no possibility for overdosing at the acupuncture therapy. On the contrary, it seems to be a method that has an infinitely wide therapeutic interval that has a very little potential of harm.

For this reason, diseases that can be treated with acupuncture therapy, especially the chronical diseases that have chronic treatments, shall be listed at the bottom of the "diseases that can be treated with medicines and radical methods list".

I believe that acupuncture needs to be listed as one of the primary therapies in this kind of diseases, and if the acupuncture therapy fails to bring the desired level of effect or does not affect at all, then the other methods/therapies shall be considered as complementary or alternative methods.

Translated by Nedim Yavuz

[1] Differences between the effects of selective inhibitors of serotonin reabsorption show that these drugs are selective and hence they are not specific.

[2] The gate control theory of pain, put forward by Ron Melzack and Patrick Wall in 1962, is the idea that physical pain is not a direct result of activation of pain receptor neurons, but rather its perception is modulated by interaction between different neurons.

[3] Ronald Melzack, (Born, June 19, 1929, Montreal, Quebec) is a Canadian psychologist.

[4] As a comprehensive example, see that "Action Mechanism of Acupuncture and Clinical Practices