Thyroid

healthy thyroid VS nodule thyroid Thyroid and Simple ways to balance it

Knowledge about thyroid disorder has increased recently. Earlier people were unaware about the seriousness of this disorder and how it can affect many other bodily functions along with leading to other deadly diseases.

Thyroid disorder is found more commonly in women as compared to men. About one in 10 women who are over the age of 50 face this problem. But even there is increasing number of younger women now who are having thyroid disorder due to the unhealthy eating habits and stressful lifestyle.

What does thyroid do?

Thyroid is a tiny gland which is located  in your neck below the Adam’s apple around the windpipe. It looks somewhat like a butterfly. Thyroid plays an important role of secreting several hormones which are very important for proper functioning of body. The two important hormones produced by thyroid are thyroxine (T4) and triiodothyronine (T3). These hormones are essential for absorbing oxygen in your body cells and for proper metabolism of your body.

Classification of thyroid disorder

 Thyroid is classified into two types according to the amount of hormone secreted by the thyroid gland. The two types are hyperthyroidism and hypothyroidism.

  1. Hyperthyroidism: In this condition, the thyroid gland produces more T4 and T3 hormones.
  1. Hypothyroidism: In this condition, there is less production of thyroid hormones like T4 and T3.

Symptoms of Thyroid

There is very little awareness about thyroid disorder and people are very ignorant when it comes to the symptoms which are commonly seen in this disorder. But if we pay little more attention and listen to our body, we may be able to detect that something is not right and correct it or prevent it beforehand.

Hyperthyroidism Symptoms

Hyperthyroidism shows the following common symptoms:

  • Nervousness
  • Sleeping problems
  • Perspiration
  • Irritation
  • Skin thinning
  • Anxiety
  • Trembling of hands
  • Brittle hair
  • Fast heart beats
  • Weakness in muscles
  • Frequent bowel movement
  • Significant weight loss

Underactive Thyroid Symptoms

Hypothyroidism shows the following common symptoms:

  • Significant hair loss
  • Slow pulse rate
  • Fatigue
  • Dry and rough skin
  • Always feeling cold
  • Short breaths
  • Heavy menstrual periods in women
  • Hearing problem
  • Limbs swelling
  • Abnormal sensation
  • Constipation
  • Significant weight gain

If you witness these symptoms, then it is time to perform a thyroid diagnosis test. If your test reveals that you have thyroid disorder, you can choose any tropical treatments available. There are many treatments available for controlling the thyroid problem which include taking various medicines as well as undergoing surgery. But it is always good to control it by taking care of what you are eating and making some minute lifestyle changes.

The below listed steps are very helpful in controlling the thyroid and minimizing the ill-effects caused due to it.

Avoid these vegetables: It is always good to have lots of vegetables in our diet . But if you are victim of thyroid disorder, you should avoid the following vegetables

  • Cabbage
  • Kale sprouts
  • Mustard
  • Rutabagas
  • Kohlrabi
  • Broccoli
  • Turnips

These are Cruciferous vegetables that disrupt the production of thyroid hormone.

Drink water: This is the common health tip which is beneficial for all body problems. Drinking at least eight glasses of water is recommended for overall good heath. Drinking water helps in flushing the harmful toxins from the body. This good habit of drinking water will not only keep you hydrated, but also make your skin glow and body energetic. So always carry a bottle of water with you to complete your daily quota.

Avoid Soy:  Soybean is very harmful if you are suffering from thyroid problem. Soy intake decreases the production of hormones by thyroid gland. Avoid the following form of soy products in your diet

  • Soy milk
  • Tofu
  • Soy mixed sausages and other food products which contains soy
  • Soy flour

Avoid carbohydrates: Consuming high amount of carbohydrate is not good in thyroid problems. Try to stay away from eating junk food and processed food as it contains high amount of carbohydrates. Eating more carbohydrates also increases the risk of obesity.

Less or no Sugar: It is always good to avoid sugar in any medical condition. Consuming higher amount of sugar has many health risks including Diabetes. Also if you want to be in shape, try to use little or no sugar in your daily diet.

Eat thyroid boosting fats: Eating good fats like saturated fat is good for people with thyroid disorder. Try incorporating the fats like coconut oil, ghee, , red palm oil and olive oil in your daily diet.

More Vitamin C: Eating food rich in vitamin C is very good for regulating the thyroid hormone. Try consuming ample amount of citrus fruits like Oranges, Grapefruit  and lemons to get more vitamin C in your body. Vitamin C is also good for your skin.

Eat protein: Eat food which contains higher amount of proteins. Protein consumption has shown results in controlling the thyroid disorder. Eating foods such as Eggs, sprouts, and meats which contain proteins is very necessary in balancing the thyroid.

Avoid Stress: This is little difficult, as we really have a super busy life with lots of problems which contribute in increasing the stress levels. But if you need to avoid further complications of thyroid and also be safe from the deadly diseases like heart attacks and brain hemorrhage, then try avoiding the stressful situations. If you are constantly living in stressful condition, this will increase your thyroid problems. Try using stress buster solutions like:

  • Listing to soothing music
  • Taking rest interval between work
  • Watching comedy
  • Avoiding tension creating situations and fights

Proper sleep: Human body normally needs about eight hours of sleep to function properly. If you are getting less than that, then it will surely contribute in increasing your thyroid problem. Do not make this mistake of not sleeping for adequate time and increasing thyroid with other health problems. Having proper sleep every day will make you feel fresh and energetic whole day.

Exercise: Exercise can be very beneficial for people with under active thyroid gland. Daily exercise will offer natural antidote to depression, low energy level and muscle loss. It is also very effective if you are trying to loose weight. Also daily exercise will help you maintain high energy level throughout the day.

Thyroid disorder will be effectively balanced if you follow the above instructions with the prescribed medications by doctor. These are very small things, but they will have huge benefit on your overall health. Also they do not have any adverse effect on your body and will also help you to be healthy and active throughout your day.


Diabetic Retinopathy

Diabetic Retinopathy

Diabetic retinopathy is a complication of diabetes that affects the eyes, specifically retina which is situated at the back of the eyes. This can develop in anyone who has type 1 or type 2 diabetes mellitus. At the early stage of the disease, diabetic retinopathy may cause no symptoms or just mild vision problems. Eventually, this condition can lead to blindness. This is more especially true for patients with uncontrolled blood sugar levels.
Signs and Symptoms

Stages of Diabetic Retinopathy
Diabetic retinopathy usually affects both eyes and is generally asymptomatic at first. As the condition advances, patients may experience symptoms such as blurring of vision, fluctuating vision, distortion, spots or dark strings floating in your vision – floaters, and eventually loss of vision.
Signs of diabetic retinopathy include

  • Microaneurysms – early sign of diabetic retinopathy; these appear as small, red dot in the superficial retinal layers secondary to capillary wall outpouching due to pericyte loss.
  • Macular edema – leading cause of visual impairment in diabetic patients
  • Flame- shaped haemorrhages – splinter hemorrhages which occur in the more superficial nerve fiber layer
  • Dot and blot haemorrhages – when small, these appear similar to microaneurysms; they look like microaneurysms rupture in the deeper layers of the retina, such as the outer plexiform layer and inner nuclear layer
  • Cotton wool spots – These are nerve fiber layer infarctions bordered by microaneurysms and vascular hyperpermeability secondary from occlusion of precapillary arterioles
  • Retinal edema and hard exudates – these occur due to the breakdown of the blood-retina barrier allowing leakage of lipids, serum proteins and protein from the vessels
  • Venous loops and venous beading – These usually reflect increasing retinal ischemia and frequently occur adjacent to areas of nonperfusion; most significant predictor of progression to proliferative diabetic retinopathy (PDR)
  • Intraretinal microvascular abnormalities – These usually occur on the borders of nonperfused retina; these are remodelled capillary beds without proliferative changes

Types of Diabetic Retinopathy

 

Nonproliferative diabetic retinopathy –  more common; nonproliferative since new blood vessels are not growing (not proliferating) yet; also called early diabetic retinopathy

In this type of retinopathy, retinal blood vessels weaken. Microaneurysms protrude from these vessel walls of the smaller vessels, sometimes leaking blood and fluid into the retina. Dilation of the larger vessels occurs and becomes irregular in diameter. As more vessels become blocked, nonproliferative diabetic retinopathy can progress from mild, moderate to severe.

Mild NPDR is characterized by the presence of at least 1 microaneurysm. Moderate NPDR is characterized by the presence of microaneurysms, hemorrhages, and hard exudates. Severe NPDR follows the 4-2-1 rule which is characterized by microaneurysms and haemorrhages in 4 quadrants, presence of venous bleeding in at least 2 quadrants and intraretinal micrvascular abnormalities in at least 1 quadrant.

Proliferative diabetic retinopathy – advanced diabetic retinopathy; damaged blood vessels close off resulting to the growth of new but abnormal blood vessels in the retina and these abnormal vessels can leak into the vitreous, the clear jelly-like substance that fills the center of the eye

The hallmark of the disease is neovascularisation. Other signs of PDR are fibrovascular tissue proliferation, preretinal hemorrhages, macular edema and traction retinal detachments.
Who are at risk?
Anyone who has diabetes can develop diabetic retinopathy, however risk of having this condition increases for patients who are of black, Hispanic or Native American race; pregnant; tobacco use; patients with high blood pressure, high cholesterol, poor control of blood glucose level and depends on the duration of being diabetic. The longer you have diabetes, the greater chance of you developing the disease.
Diagnosis
Test for diabetic retinopathy is best being done with eyes dilated. Drops are placed in your eyes to dilate your pupils allowing your doctor to get a better view inside your eyes. The drops may cause your close vision to blur but this effect subsides later on.
Upon examination, your doctor will look for any swelling, blood or fatty deposits in the retina, abnormal blood vessels, retinal detachment, neovascularisation, scar tissue, bleeding in the vitreous and optic nerve abnormalities. At the same time, your eye doctor may test your vision, look for evidences of cataracts and measure your eye pressure to test for glaucoma.
Imaging studies used in the diagnosis of retinopathy include:

Retina
Fluorescein angiography wherein the doctor takes pictures of the inside of your eyes while your eyes are dilated. After which the doctor will inject a dye into your arm and take ore pictures as dye circulates through your eyes.

Microaneurysms appear as pinpoint, hyperfluorescent lesions in the early phases of the test and typically leak out as the test goes on.
Optical coherence tomography provides cross sectional images of the retina showing the thickness of the retina and selling within the retina which will help your doctor determine whether fluid has leaked into retinal tissue. This can also be used to monitor how treatment is working later on.
Complications
Diabetic retinopathy if left unattended can lead to serious visual problems such as retinal detachment, vitreous hemorrhage, glaucoma and eventually blindness.
Treatment
Depending on the type and severity of diabetic retinopathy, your doctor may suggest treatments gearing towards to slowing down or stopping the progression of the condition. During early diabetic retinopathy, good blood glucose level control can usually slow the progression. This may not need treatment right away however close follow up with your doctor will help your doctor determine when you might need treatment.
For advanced diabetic retinopathy, prompt surgical treatment is needed. The type of treatment depends on the specific problems with your retina. Some options include:
Focal laser treatment – also called as photocoagulation. This procedure treats leak from abnormal blood vessels with laser burns which can slow down or stop blood and fluid leakage in the eye.
Scatter laser treatment – also called as panretinal photocoagulation. This procedure treats areas of the retina away from the macula with scattered laser burns causing abnormal new blood vessels to shrink and scar.
Vitrectomy – This procedure is done in a surgery center o hospital using local or general anesthesia. This is done by putting a tiny incision in your eye to remove blood and scar from the vitreous.
Prognosis
Favourable prognostic factors include well defined leakage, good perifoveal perfusion and recent onset of circinate exudates. Unfavorable prognostic factors include macular ischemia, hypertension, diffuse edema, lipid deposition in the fovea, and preoperative vision of less than 20/200.


Diabetic Neuropathy

Diabetic NeuropathyDiabetic Neuropathy
Background
Diabetic neuropathy is a type of nerve damage caused by diabetes. While high blood sugar levels can injure nerve fibers throughout the body, diabetic neuropathy most often affects nerves in your legs and feet. Overtime, patients with diabetes can develop nerve problems. Risk rises with age, duration of diabetes, overweight, high blood pressure, high levels of blood fat and if blood sugar level is controlled.
Signs and Symptoms

Diabetic Neuropathy Symptoms
Symptoms depend on which nerves are affected and the type of neuropathy. Symptoms can involve motor, sensory, autonomic or involuntary nervous system. Most patients experienced symptoms such as pain, numbness, tingling of the toes, feet, legs, hands, arms, and fingers. Symptoms are often minor and mild cases often go unnoticed until after several years where symptoms go worse. In some patients with focal neuropathy, onset of pain may be severe and sudden. Other symptoms include wasting of the muscles of the feet or hands; problems with urination; weakness; dizziness or faintness due to a drop in blood pressure after standing or sitting up; indigestion; nausea or vomiting; erectile dysfunction in men or vaginal dryness in women
Types of diabetic neuropathy
There are four main types of diabetic neuropathy, namely peripheral, proximal, autonomic and focal.
Peripheral Neuropathy
This is the most common type of diabetic neuropathy which causes pain, cramps, tingling or burning sensation, numbness or loss of feeling first in the feet, legs, and toes then later in the arms and hands. Some experienced increased sensitivity to touch and serious foot problems like infections, ulcers, bone deformity. These symptoms are often worse at night.
Autonomic neuropathy
This type of neuropathy affects the eyes, lungs, heart, blood vessels, digestive system, urinary tract, sex organs and sweat glands. It affects blood pressure and cause hypoglycemia unawareness wherein people no longer experience the warning signs of low blood sugar levels. Other symptoms include difficulty in swallowing, gastroparesis, increased or decrease sweating, increased hard rate even at rest, inability to adjust blood pressure and heart rate which may cause you to faint or feel lightheaded due to sharp drops in blood pressure after sitting or standing, urinary retention, erectile dysfunction in men, vaginal dryness in women and other sexual difficulties.
Proximal Neuropathy
Also called as radiculoplexus neuropathy, diabetic amyotrophy or femoral neuropathy. This type of neuropathy affects the buttocks, thigh, hips causing weakness of the legs. Patients with this type of neuropathy often have difficulty in rising from sitting position and weight loss. This is more common in patients with type 2 diabetes and older adults. Symptoms sometimes improve partially overtime, however, symptoms may worsen before they get better.
Focal Neuropathy/ Mononeuropathy
The onset of symptoms for this type of neuropathy is most common in older adults and is experienced as sudden and severe weakness of one or a group of nerves causing muscle pain or weakness. Any nerve in the body can be affected such as the eyes, ears, facial muscles, chest, lower back, thighs, buttocks, legs and feet. Although mononeuropathy causes severe pain, it usually diminishes and disappears on its own over a few weeks or months.
Causes
The exact cause on why prolonged exposure of delicate nerve fibers to high blood sugar is unknown, but nerve damage is likely due to a combination of multiple factors, including complex interaction between nerves and blood vessels. Other factors include inflammation in the nerves caused by autoimmune response, lifestyle factors such as alcohol abuse and smoking, mechanical injury to nerves such as carpal tunnel syndrome or other genetic factors unrelated to diabetes that make people more susceptible to nerve damage.
Complications
Diabetic neuropathy may cause several complications. Because nerve damage can cause a lack of feeling in your feet, small cuts and sores may go unnoticed and eventually become seriously infected and ulcerated. This condition may even go worse when infections spread to the bone and cause tissue death – gangrene. Gangrenous feet are very difficult to treat and may require amputation of a toe, foot or even the lower leg. Charcot joint occurs when a joint deteriorates because of nerve damage. This condition is marked by swelling, instability, loss of sensation and sometimes deformity of the joint. Other complications involving gastrointestinal, urinary and sexual dysfunction also occur.
Diagnosis and Tests
Physicians usually diagnose diabetic neuropathy based on the symptoms presented. Upon clinic visit, your doctor will check your blood pressure and heart rate, examine your tendon reflexes, muscle strength and tone and your sensitivity to touch, position changes, vibration and temperature.
Your doctor may conduct other tests as well as part of diagnosis. These tests include filament test to test your sensitivity to touch using monofilament; electromyography (EMG) which measures electrical discharges produced in your muscles; nerve conduction studies which measure the transmission of electrical current through the nerve or how quickly the nerves in your arms and legs conduct electrical signals; quantitative sensory testing which is used to assess how your nerves respond to temperature changes and vibration.
Treatment and Management
Goals of treatment include slowing the progression of the disease, relieving pain and managing complications and restoring function.
By keeping blood sugar level within target range can help delay the progression of diabetic neuropathy and may even improve some of the symptoms you are already experiencing. Your medical doctor will determine the best target range for you depending on your age, duration of diabetes, presence of other medical conditions and your overall health. Avoiding alcoholic beverages, smoking cessation, keeping your blood pressure under control, good foot care, maintaining a healthy weight and being active are some measures to help slow down nerve damage.
Most pain relievers have side effects and must be weighed against the benefits they offer. Not all pain relievers work for everyone. Alternative therapies that may help relieve pain include acupuncture, physical therapy or capsaicin cream. These therapies can be used alone or in conjunction with medications.
Some of the pain relieving medications include antidepressants and anti- seizure drugs. Antidepressants such as tricyclic antidepressant medications (TCA) may provide temporary relief for mild to moderate symptoms. Examples of TCA include desipramine, imipramine, amitriptyline.
Depending on the organ or system involved, specific treatment exists for many complications of neuropathy. For example, antispasmodic drugs and behavioural technique and devices such as timed urination and pessaries can help in treating loss of bladder control. For digestive problems like gastroparesis, reducing fat and fiber in the diet and smaller meals may help prevent symptoms of indigestion, nausea, vomiting and belching. While several medications may be used to treat orthostatic hypotension, this condition is often helped with simple lifestyle measures (i.e. drink plenty of water, avoid alcohol, sitting or standing slowly). Some doctors recommend compression stockings or an abdominal binder.
Prevention
Below are some recommendations on how to prevent diabetic neuropathy:
Consistently well controlled blood sugar levels.
Eat a well balanced diet.
Well controlled blood pressure.
Be active.
Stop tobacco and avoid alcoholic beverages.
Daily foot care.


Cupping

CuppingCupping therapy or more commonly known as “ventosa”, is an ancient form of therapy, developed thousand of years ago, wherin local suction is created on the skin. Suction can either be created using fire (heat) or mechanical device (electric pump) using cups. Cups can be made from earthenware, glass, plastic or bamboo.

Through the years, techniques have modernized but philosophy remains the same. The main purpose of cupping is to enhance circulation, remove toxins and to relieve pain.

There are two types of cupping namely dry cupping and wet cupping. Dry cupping is done by creating a suction on particular points on patient’s body using either heat (fire) or vacuum to tug the skin upwards. Fire cupping involves soaking a cotton ball in alcohol using a clamp then lit it via match or lighter. The flaming cotton ball is placed into the cup, quickly removed, and the cup is then placed on the skin. By adding fire inside the cup, oxygen is removed which is replaced with an equal amount of carbon dioxide and suction is created by air cooling down again and contracting. Sometimes, massage oil or petroleum jelly may be applied to create a better seal as well as to allow the cups to smoothly glide over the muscles such as the trapezius and the lastisimus.

This is also called the “moving cupping”. While wet cupping is done similarly, with one additional step. After applying dry cupping, the practitioner performs tiny cuts using sterile three-pronged needles on the raised area to allow for the elimination of toxic blood and fluids. After which another cup is placed on the same area to suck up the blood.

Skin markings are common after the cups are removed. These discolorations are caused by ruptured capillaries just under the skin and disappear in a few days.


Acupuncture

Acupuncture

Acupuncture comes from the Latin word “acus” which means needle and “punctura” which means to puncture. It is a key component of Traditional Chinese Medicine (TCM) and is a form of alternative medicine which involves the insertion of extremely tiny needles through the skin at strategic acupuncture points. Not only that, it can also be associated with electroacupuncture, moxibustion, cupping therapy, Chinese herbs and guasha. Acupuncture can be done with the application of pressure, laser light or heat to the same points.

Traditional Chinese medicine views acupuncture as a technique for balancing the flow of “qi” or energy flowing through meridians or channels in our body. Eastern acupuncture practitioners believe that people get sick because there are imbalances between yin and yang and by inserting these needles, our energy flow will re-balance. On the other hand, Western practitioners view acupuncture points as places to stimulate nerves, connective tissue and muscles regulating blood flow and by this stimulation, our body’s natural painkillers will be released.

Though acupuncture is used to treat a wide range of conditions, it is commonly used for pain relief. Majority of people who comes in for acupuncture do so for musculoskeletal disorders such as neck pain, shoulder stiffness, low back pain, knee pain, and fibromyalgia. Acupuncture can be used alone or as an adjunct to other treatment modalities. Below listed are the diseases, symptoms or conditions for which acupuncture has been proved – through controlled trials—to be an effective treatment by the World Health organization (WHO):

Adverse reactions to radiotherapy and/or chemotherapy

Allergic rhinitis (including hay fever)

Depression (including depressive neurosis and depression following stroke)

Dysentery, acute bacillary

Dysmenorrhoea, primary

Facial pain (including craniomandibular disorders)

Headache

Hypertension, essential

Hypotension, primary

Induction of labour

Knee pain

Leukopenia

Low back pain

Malposition of fetus, correction of

Morning sickness

Nausea and vomiting

Neck pain

Pain in dentistry (including dental pain and temporomandibular dysfunction)

Periarthritis of shoulder

Postoperative pain

Rheumatoid arthritis

Sciatica

Sprain

Stroke

Tennis elbow

 

Traditional acupuncture is not based on scientific research but rather on philosophy and intuition while in modern acupuncture, consultation is followed by tongue inspection and pulse taking on both arms. In Traditional Chinese Medicine, disease is usually perceived as an imbalance in energies such as yin, yang, zang-fu, qi, xue and disharmony of the interaction between our body and the environment. Therapy is based on which pattern of disharmony, for example, some diseases are believed to be caused by excess of cold, damp and wind invading the meridians. In order to determine which disharmony is at hand, four diagnostic methods are being used. First, inspection which focuses on observing the patient’s face, particularly the tongue, its shape, size, color, presence of teeth marks along the edges and tongue coating. Second is inquiry which focuses on the seven inquiries namely chills and fever; perspiration; appetite, thirst and taste; defecation and urination; pain; sleep; menses and leukorrhea. Third, auscultation and olfaction which involves listening for particular sounds such as wheezes, quality of breathing and attending to body odor. Lastly, palpation which focuses on bodily tender points or “A-shi” points and feeling of both radial pulses. Through these steps, practitioners then decide on which points to acupuncture. The number and frequency of acupuncture sessions vary, but most practitioners do not think one session is enough. Depending on the patient’s condition and response to therapy, a common treatment plan for a single complaint usually involves eight to twelve sessions to be carried out once, twice or thrice weekly over a few months. During acupuncture session, patients are either asked to sit or lie down while the skin is sterilized and a number of sterile needles are being inserted. This can be manipulated manually including flicking, spinning, moving up and down relative to the skin or can be attached to electrical stimulation (electroacupuncture), heat, laser light or moxibustion and will be left in place for thirty to forty minutes. A quick insertion of the needle is recommended to lessen the pain since most pain is felt in the superficial layers. Once the needle is inserted, patient usually feel a dull, localized, aching sensation that is called “de qi” or the arrival of qi.

De-qi refers to a sensation of distension, numbness or electrical tingling at the needling site which radiate along the corresponding channel or meridian. If de qi sensation is not achieved immediately upon needle insertion, various manipulations can be applied to promote it. Once de qi is achieved, further techniques can be used to influence the de qi which aim either to tonify or sedate qi. De qi is more important in Chinese acupuncture while some Japanese or Western practitioners may not consider it a necessary part of the treatment.

Acupuncture needles are usually made of stainless steel, making them flexible thus preventing them from rusting or breaking. Needle length varies, ranging from 0.51 to 5.12 inches (13 to 130mm) and diameter ranging from 0.006 to 0.018 inches (0.16 to 0.46) with shorter and finer needles used in the face and around the eyes and longer needles in areas with thicker tissues such as the thigh and buttocks.  Acupuncture needles are disposed after each use to prevent contamination. The tip of the needle is usually blunt to prevent breakage, though blunt needles cause more pain. Other needles used include three-edge needles, nine ancient needles, copper needles.

Generally, acupuncture is not painful. Patients usually feel numbness or heaviness where the needles are inserted and this is normal. In the hands of experienced, well trained acupuncturist, acupuncture is safe and has no side effects. Sometimes, patients get bruises but this will fade in 1-2 days with warm compress.

There are generally no contraindications to acupuncture but just some reminders to keep in mind. Patients are usually advised not to take shower or cold drinks three hours after acupuncture.  Pregnant and menstruating women can have acupuncture but they have to tell their acupuncturist that they are pregnant to allow your acupuncturist to avoid points that induce labor. Maintenance medications can be taken as usual. Patients can return to their usual activities after acupuncture, however, if you feel sleepy and tired after acupuncture, kindly do so. This will help you recover faster.

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