Practical guide to the identification and treatment of hormonal imbalance obesity body shapes in 8 extraordinary meridians

Jeonhee Jang Ed.M., L.Ac.

Overweight, ObesityObesity is a global epidemic and major concerns for public health. So, most health practitioners try to find the solutions and help to prevent obesity.

Subclinical disease

• Diabetes

• Hypothyroidism

• Hypertension

• Rheumatoid arthritis

Clinical disease

Subclinical disease

Obesity, OverweightPhysical change

Physiological change

Why we want to find the solutions? Many diseases, (including diabetes, hypothyroidism, hypertension and rheumatoid arthritis, )are frequently indicated as the subclinical (diseases) because they are not distinct signs and symptoms recognized, until they come out as clinical diseases. And these are linked with obesity or overweight, or sudden heavy feeling signs.

Background

Anatomical aspect

Physiological aspect

I am practicing body reshaping program with 6 body types. This program is designed for aligning body structure and balancing homeostasis which are the basic of acupuncture and moxibustion theory.

Adaptation process

Homeostatic imbalance

Hormone imbalance

Adaptation success

and restore

Adaptation fail /

disease

Adaptation Success

and transform

Homeostatic balance

Body homeostasis, balancing of organ function, is regulated by the endocrine system. From sudden or chronic stressors or triggers, body starts to adapt for balancing body functions. If body adaptation is failed, it goes diseases states.

If body adaptation success to restore quickly , then body goes to normal states. If body adaptation success

but it takes longer time or compensate with other functions, then body starts to transform, such as weight gain.

Interrelationship

Physiological change

Pathophysiological change

Body physical change

Body shape change

Internal and external changes are interrelated in our body. Because Physiological changes take place in the human body leading to change the biological functions and of the ability to metabolic stress. It affects to skin, muscle, joints and internal organs. It also leads to body structure changes.

Hormonal imbalance body patterns(Hypercortisolism)

Ferri's Clinical Advisor 2017

For example, Cushing syndrome,

This typical body shapes show weight gain around midsection, fatty deposits around face and upper back.

So, Some endocrine disorders are predictive of health risks and can be differentiated by typical body patterns, such as abdominal fat and frequently swollen legs.

8 extra ordinary meridian Type S

While I differentiated the patterns of body shapes through the similar sign and symptoms,

I noticed the several patterns of body shape can be connected with 8 extraordinary meridians.

DU REN CHONG DAI

YANG QIAO YIN QIAO YIN WEI YANG WEI

8 extraordinary vessel

• “The reservoirs that are able to absorb excessive qi and blood from primary channels”

• The abnormal status of channels, where it is turned into irrigation, warming the organs internally and irrigating the space between skin and muscle.

• The extraordinary vessels all drive directly or indirectly from the kidneys and they all contain the essence which is stored in the kidneys.

Actually, Some words are inspired and applied to support the 6 body typology idea.These are

Reservois, warming the organs, between skin and muscle, and contain the essence.

Characteristics of 8 extraordinary vessels

Pathogenic environments

• Shock

• Stress

Overflow surplus move

• Protect from outside pathogen

• Store the surplus

One direction

• Regular meridian weak

• Can not provide them

Because, regarding 8 extraordinary vessels,With many classical theories compounds, There are sequential characteristics.In certain pathogenic environment especially shock and stress, body regular function of qi and blood flow has disturbed and the overflow surplus move to another extraordinary path to protect from outside pathogenic factors and store the surplus.

But when the regular meridian is weak, the surplus cannot provide them. This mechanism seems like the immune protein migration to the subcutaneous tissue or lymphatic fatty tissue accumulated on those area.

The difference depth b/t Skin and Muscle • Between

Skin and Muscle

Skin and Tendon

Depth : Yin > Yang

Flexibility : Yin > Yang

Solidity : Yin < Yang

Line / wrinkle : Yin < Yang So I wonder if the suplus from main channel and accumulated on 8 extraordinary meridian, then I probably can palpate suplus on those channels. I started to observe Through Depth, Flexibility, solidity, and line and wrinkle on the channels, The tendency of yin and yang channel are different.

8 extraordinary meridians Pathologic patterns

• Heart and Digestive system

Chong (衝脉) and Yin Wei (陰维脉) type

• Liver and Immune system

Dai (带脉) and Yang Wei (陽维脉) type

• Lung and Circulatory system

Ren (任脉) and Yin Qiao (陰跷脉) type

• Kidney and Nervous system

Du (督脈) and Yang Qiao (陽跷脉) type

But, still I followed the 8 extraordinary vessels pathologic pairs.

• Leg structure

• Blood vessels

• Horizontal pain

• Foot and leg problem

• Shock toward spine

• Vertical pain

• Thoracic cavity

• Internal pressure

• Breathing and Digestive system movement restriction

• Abdominal cavity

• Inflammation b/t skin and muscle

• Immune system

Dai

Yang Wei

Chong Yin Wei

Ren

Yin Qiao

Du

Yang Qiao

Characteristic Pathological keywords

And I started to gather the information from patients who had similar body shapes.Now we can see the each characteristics next slides.

Chong (衝脉) and Yin Wei (陰维脉) type ( heart and digestive system)

Characteristics

• Thoracic rib cage is wider and larger looking• Weak and lean extremities• Pressure, stress expression, skin(tension)• Abdominal area tight• Chest, neck, and face swollen

Chong and Yin wei type,At the first glance, the upper body wider and larger looking than lower parts. And relatively 4 extremities are looked weaker or thinner than torso area.And they look stressed, have some pressure and skin tension. If you see their complexion, face and neck area are swollen.

Chong (衝脉) and Yin Wei (陰维脉) type ( heart and digestive system)

• Under the xiphoid area and between the ribs : hard mass and tight feeling palpated

• If gathered the rectus abdominus muscle parts, then skin and fat prominent

• Upper back spine (winged scapular: scapulars wide apart, rhomboids muscle stretched and tight)

• Under the armpit area, breast, under the breast area accumulation)

• Pain : heartburn, neck soreness, shoulder pain, heart, stomach pain , lower abdominal pain

When you meet this type of patient in clinic, patients complaint indigestion and stuffy feeling on epigastric area. Actually you can feel hard mass or pressure on that area if you palpate. On the backside, winged scapular symptom is common, Under the armpit, breast area there are lots of lymphatic fluids congestion you can find during the observation.

Dai (带脉) and Yang Wei (陽维脉) type ( liver and immune system)

Characteristics

• Pear-shaped body• Love handles, skin (loose)• Square shape of body appearance if leg muscles are misaligned• Lower abdomen and hip area fat deposits

Side view Ribcage and pelvic bone narrow gap

This is dai and yang wei type. If comparing of chong and yin wei type, it looks loosened and less pressure, less stress types.The typical characteristics are pear shaped body, love handles, And skin flabby and loosen.

Dai (带脉) and Yang Wei (陽维脉) type ( liver and immune system)

• Overall looking flabby skin and entire darkish skin color

• History : sudden skin trauma such as growing and gaining weight fast, pregnancy etc.

• Temperature involved symptoms : aversion to cold, always sweat or no sweat

• Skin discoloration : locally or whole bodySkin looks lethargy : skin lacking elasticity

• Stretch mark

• Spine – lordosis

• Pain : whole body pain, sensitive, pain moved, headache, ear or eye infection easily

In clinic, you can notice they have overall darkish color of skin and flabby and lots of stretch marks.They may have skin trauma history, such as sudden growing fast or frequent weight gain and loss / or pregnancy. Sometimes, they may talk about their strange symptoms, sweating all the time, or no sweating.When you ask to stand straight, they make sway back posture (lordosis look like posture).If they have pain, it goes whole body pain, pain moved, headache, ear or eye infection are common.

Ren (任脉) and Yin Qiao (陰跷脉) type (lung and circulatory system)

Characteristics

• Abdominal tension and upper abdomen fat deposits• Apple-shaped body• X shape of legs• Flat feet• Shortness of breath

First impression of Ren and yin qiao type is the apple shape body, which can be indicated on abdominal tension especially upper abdominal fat deposits prominent.And another noticeable spot is the knee shape. They usually have knee tension and x-shape of knee you can find.They tend to be laugh loudly and breath shallowly.

Ren (任脉) and Yin Qiao (陰跷脉) type (lung and circulatory system)

• Spine looks straight when standing

• Abdominal area protruding (round shape): not tight feeling if palpated

• Extremities : Yin channel area accumulation and tight

• Shallow breathing and laugh loudly

• Thigh area front part accumulation

• Ankle and knee not straight

• Pain: lower back pain, foot pain, knee pain

When you see Ren and Yin Qiao patients in clinic. Their spine looks straight when standing. But, abdominal area looks very big and heavy, even tight feeling. However, you will realize their abdominal area softer than chongand yin wei type if you palpate epigastric area.Other key points are their inner side of legs and front parts of thigh are bigger with fatty fluids accumulation.And ankle and knees are not straight either standing or lying down position.

Du (督脈) and Yang Qiao (陽跷脉) type (kidney and nervous system)

Characteristics• Round shoulders and upper back fat deposits• Smaller hips than upper back• Lower abdominal fat but not prominent • O shape of legs (Bow legs), or Hyperextended

knee shape• Hyper plantar flexion • Short neck

The first glance of du and yang qiao type, they are not necessarily huge body or heavy feeling, more like lookThey have postural problem especially upper body bending forward. And they look comfortable when their legs are wide apart when they stand.Sometime, you can find their o shape of legs.

Du (督脈) and Yang Qiao (陽跷脉) type (kidney and nervous system)

• Spine area : thick layered accumulation (when insert needle : 1-5 cm deep toward 90 degree spinal bone)

• Extremities : first look relatively normal, ankle area not straightened, Side Gall bladder channel area tight

• Hip gluteus muscle weak ( eccentric contraction)

• Pelvic open widely (especially woman : lower back lumbar spine area thick accumulation with horizontal stretchmark)

• Pain: Shoulder pain, neck pain , wrist pain, foot pain• Sinus, TMJ or facial issues.

This type of patients tends to be little aggressive or over protective in clinic. Their back side especially spine area very tight and fat accumulation you can find. If you insert needle toward spinal bone with 90 degree, the needle goes deeper than you think.Their legs are thinner than other types, but along side of gall bladder channel has tension, pelvis, looks wide open.If they complaint the pain then they are mostly shoulder, neck, wrist, foot and face area.Sometimes, they have sinus problem but they think they have allergies.

Pattern Identification

Treatments

• Between Skin and Muscle

• Skin

• Muscle

Homeostatic balance

• Breathing

• BM / GI issues

• Less pain / stress

Body shape Change

• Local area

• Posture

• ROM

Type P,T,SType M1, M2, M3

Treatment tools

Moxatreatment

Scraping with Moxa Cream

8 extraordinary

meridian needling

technique

0.16 acupuncture needleMoxa oil Tongue depressorMoxa cone Cupping

1. Du, Yang Qiao

2. Chong, Yin Wei

3. Dai, Yang Wei

4. Ren, Yin Qiao

Half Body bath with moxa oil

For treating neck and facial area, I recommend half body bath with moxa oil at home. Du and yang qiao and chong and yin wei type patients have most dramatic improvements so far.

Treatments

• Grip gently followed by channels ( extremities)

• Distal to proximal parts of body (M,C points)

• Distinguish of the gap between skin and muscle

• Find the tension area

• Target the tension loosened

• Twitching, electric sensation, releasing sensation

• Allergic reaction ( Dai and Yang wei channel)

Grab the tight area

Du and Yang Qiao channel Name Initial E.V. S.Y. W.M. C.S. L.L. C.L.

Panic attack yes yes yes yes yes yes

Always cold or

hot

cold n/a hot cold hot cold

Hip and leg pain Hip and legs Hip and legs Hip and legs Hip and legs Hip Hip and legs

Hormonal meds. Antidepressant n/a Thyroid Antidepressant n/a Birth control

antidepressant

Change size

U.S. woman

size

12->8 10->6 4->4 4->8->6 10->6 4->8->4

This chart indicates patient’s initial name and common symptoms. Blue color means resolved problem, and red color is for not resolving the issues yet. du and yang qiao patients 6 cases. They have several common symptoms, resolved after 8 extraordinary meridian treatments.such as panic attack, subjective temperature sensitivity, hip and leg pain . And some are taking hormonal medications, some are not.

This group shows the internal change more than external especially body sizes after treatments.

Chong and Yin wei channelName initial A.N. N.S. Y.C. S.T. M.K. K.T.

Infertility Yes Yes n/a n/a Yes Yes

PCOS Yes Yes n/a Yes Yes n/a

Facial swollen Yes Yes Yes Yes Yes Yes

Alcohol Yes Yes Yes n/a Yes Yes

Palpitation Yes Yes Yes Yes Yes Yes

Hormonal meds. Estrogen Estrogen Thyroid Estrogen Birth control Thyroid

Change sizeU.S. woman size

8->8 10->8 6->6 18->12 12->8 10->6

This group of patients have Chong and Yin wei channel treatments for several months. Then these common symptoms were resolved except several conditions. This group of patients most concerns are fertile so several people had been treated by hormone regulation for growth of lining of uterus for IVF.

Dai and Yang Wei channelName initial C.L. J.S. C.T. S.C. K.M. J.W.

Waist line swollen Yes Yes Yes Yes Yes Yes

Allergy Yes Yes Yes Yes Yes n/a

Low pain tolerance Yes Yes n/a n/a Yes n/a

Autoimmune disorder YesR.A.

YesR.A.

YesH.D.

YesC.D.

YesC.D.

YesC.D.

Muscle weakness Yes Yes Yes Yes Yes Yes

Hormonal meds. Birth control Blood pressure Thyroid n/a Thyroid Birth control

Change sizeU.S. woman/ mansize

14->10 18->16Pants44->38

8->4 10->6 12->8 6->4Pants12->8

There are Dai and Yang wei channel,Most patients had inflammatory issues as an autoimmune disorders such as Rheumatoid arthritis, Hashimoto’s thyroiditis and celiac disease. Their treatments reactions were dramatic and react very quickly than other types of group.

Dai and Yang Wei Channel

Type M2 Treatment

One week after treatment

If you look at these pictures, you can find the red arrow area back and abdominal area posture differences.

Ren and Yin Qiao channelName initial T.H. E.V. P.R. R.B. J.B. E.K.

Digestive issues yes yes yes yes yes yes

Legs pain yes yes yes yes yes yes

S.O.B. yes yes yes yes n/a yes

Neck soreness yes yes yes yes yes yes

Back pain yes yes yes yes yes yes

Hormonal meds. Birth control n/a Birth control Thyroid Thyroid Birth control

Change sizeU.S. woman size

8->4 12->8 6->4 26->22 10->6 6->4

Ren and Yin Qiao channel patients have these common symptoms and signs. Digestive issues, legs pain, shortness of breath, neck soreness and back pain.

Ren and Yin Qiao channel Treatment before and after

What causes?

Du and Yang Qiao

• Irregular exercise

• Running

• Childhood trauma

Ren and Yin Qiao

• Surgery

• Sprained ankle or knee

• Ski accidents

Chong and Yin Wei

• Arm muscle weakness

• High heel

• Surgery breast area

Dai and Yang Wei

• Diet

• Pregnancy

• Surgery

While I had patient’s history taking, patients talked about the point of view regarding their body change or something wrong feeling.Most Du and Yang qiao patients thought their problem started from irregular exercise, running too much, childhood trauma. Ren and Yin Qioa pateints had surgery, sprained ankle or knee, and someone had ski accident. Chong and Yin wei type patients had arm muscle weakness from trauma, wearing high heel all the time, or breast area surgery they mentioned.

Dai and Yang wei type, they had been diet plan, pregnancy, or surgery.

• Possibility of helping to restore body comfortable size

• Prevent to overuse hormonal medication.

• Change the lifestyle and behavior

• Acknowledge to connect the body shape and body homeostasis

• Health promotion and health education based on behavior change techniques to achieve risk reduction through life style change and for chronic disease management.

With this clinical observations, there are possibility to help to get the normal feeling body size and stop to take hormonal medications. And it also can be changed the patient’s life style and understanding their body.

These experimental design shows the possibility that acupuncture and moxibustion therapy can be the important role for health promotion and health education as an behavior change techiques in public health. This treatments may apply to plan for public health and health promotion, Especially for managing the chronic disorders, prevent diseases and improve health conditions.

Limitation and discussion

• Time and commitments

• New approach to acupuncture treatment

• Patients education

• Each channel affects to other channel

(Mutual interconnections with channels

Shows at least one or more pathologic patterns

Treatment should follow the order of major types if multiple types are shown)

This treatment program takes time to engage and commitment with patients because more time needed than medications.Acupuncture technique and methods are new and nor following the usual way in U.S. So patient education is needed prior to treatments.

But, if we focus to the purpose of obesity solution, which is the balancing body homeostasis and body structure alignments. Then this treatments can lead to long term plan for treating obesity and overall wellness.

Thank You.