Message from the AAMA Board

Acupuncture and Immune Modulation

— Joseph Audette, MA, MD, AAMA Treasurer

In reflecting over the last few years about the role of acupuncture in medicine, I have become convinced that more than pain modulation, acupuncture can play an important role in immune modulation.

When we view the immune system through the lenses of acupuncture, we think initially of the organ function of Lung in Chinese medicine. But even with the enhanced view that the Chinese have of the Lung, including that Lung is integral to the creation of Wei (defensive) and Ying (nutritive) Qi and so is instrumental in the function of our immune system. The beauty of Chinese medicine is that you cannot think about the function of Lung without immediately bringing in its yang pair Large Intestine. Then, when we energetically connect these two meridians of the hand to their corresponding meridians of the leg, we have the circuit of Yang Ming paired with Tai Yin. This points in the direction of bringing in Stomach and Spleen as part of a comprehensive approach to using acupuncture to modulate the immune system.  This holistic view of the immune function parallels our growing modern scientific understanding of the importance of the Gut and the microbiome to our immune function.

The gut microbiome can be affected by infections including bacterial, parasitic and importantly viral. The response can vary depending on an individual’s environmental and genetic make-up as well as overall gut health. There is a complex interplay between the gut microbiome and an individual’s immune system, as demonstrated by studies showing associations with allergy, inflammatory conditions, and respiratory diseases.[1]  It is now clear that COVID-19 can lead to GI symptoms but importantly, the state of an individual’s microbiome will have a major effect on the response of that individual to a COVID-19 infection.[2]  Some of the medical conditions that have been found to be major risk factors for severe COVID-19 infections including age, diabetes, cardiovascular, stroke, respiratory, and obesity  are also conditions where there is a significant adverse alteration in the gut microbiome composition.[3]

The autonomic nervous system plays a critical role in regulating our immune response.[4]  In particular, the cholinergic anti-inflammatory pathway involving activation of the vagus and parasympathetic system ties in well with the Chinese view of the Yang ming/Tai Yin circuit.  There is evidence that many of the immune effects of acupuncture, which are believed to be mediated by the down-regulation of specific cytokines, such as IL-6 and IL1β, can be regulated through the vagus.  One can hypothesize that the effect of acupuncture on the gut microbiome is also connected to vagus nerve modulation. More research is clearly needed to understand the mechanism by which acupuncture stimulation can influence the gut microbiome. However, a recent study of patients with Crohn’s disease showed that acupuncture was able to cause a significant enrichment of intestinal microorganisms.[5]

All of these leads to consideration of treatment options to help strengthen the Gut-Immune access to help reduce inflammation and potential disease in our patients.  Classically, the point Large Intestine 10 (LI10) is used to expel heat from the lung (reduce inflammation in the body). According to Nagano, a famous Japanese master, LI10 should be combined with KD6, GV14 and TW16 (Master Nagano’s immune points). Other points to consider are LU5 or the Lung He sea point, which is the influential point regulating the Lung organ. LU 8 is the metal on metal point in the five-element system and can be very tonifying to Lung. However, we also have to consider other aspects of the Yang Ming/Tai Yin circuit. In particular, we will want to regular the gut with key points on the Stomach and Spleen meridian. Classically SP6 and ST 36 are used to regulate digestion and help build Qi through the digestive function and can be combined with the Lung and Large Intestine points to enhance the immune modulatory effect with more direct influence on the gut.  However, there are other options including SP 3 which is the source point and SP 8 which is the Xi cleft point. In Japanese acupuncture, instead of using ST 36 a set of points are used along the lateral aspect of the tibia called the Stomach Qi line.

When treating the Stomach Qi line, you are in effect stimulating the Lower He Sea points of the Large and Small intestine. In Chinese Medicine, the points are BL 37 and BL 39 respectively. However, the Japanese approach it to stay closer to the tibia and find fascial holes as you drag your finder down the enthesis of the tibialis anterior muscle and place the needles down with the flow of the meridian superficially in these points (see Diagram 1).

Another approach to regulate the Yang Ming/ Tai Yin circuit is to use an extraordinary vessel (EOV) combination of Chong Mai with Ren Mai. This is regulating to the Gut (Chong Mai) and the Lung (Ren Mai). Based on Master Kawai theory, when combining the command and couple points of two EOVs, it is energetically better to cross the points from, for example, the right foot to the left hand. I usually check which side of the body has greater tightness in the region of ST 30 and use that side to treat SP 4, the command point of Chong Mai. Then I cross over to the left arm to add the coupled point PC 6. That leaves the right arm for the command point of Ren Mai, LU 7 and the left foot for the coupled point KD 6 (see Diagram 2).

In summary, acupuncture can play a vital role in regulating the immune system and part of the mechanism may in fact be by regulating the gut microbiome. More research is needed, but  early studies reinforce the Chinese theories of the energetic Yang Ming/ Tai Yin relationship.

[1] . Rajput S, Paliwal D, Naithani M, Kothari A, Meena K, Rana S. COVID-19 and gut microbiota: a potential connection. Indian J Clin Biochem. 2021:1–12.
[2] Segal JP, Mak JWY, Mullish BH, Alexander JL, Ng SC, Marchesi JR. The gut microbiome: an under-recognised contributor to the COVID-19 pandemic? Therap Adv Gastroenterol. 2020;13:1756284820974914.
[3] Hand TW, Vujkovic-Cvijin I, Ridaura VK, Belkaid Y. Linking the microbiota, chronic disease, and the immune system. Trends Endocrinol Metab. 2016;27(12):831–843. doi: 10.1016/j.tem.2016.08.003.
[4] Kavoussi B, Ross, BE. Integrative Cancer Therapies. 6(3); 2007 pp. 251-257.
[5] Bao C, Wu L, Wang D, Chen L, Jin X, Shi Y, Li G, Zhang J, Zeng X, Chen J, Liu H, Wu H. Acupuncture improves the symptoms, intestinal microbiota, and inflammation of patients with mild to moderate Crohn’s disease: A randomized controlled trial. EClinicalMedicine. 2022 Feb 12;45:101300.

Upcoming Professional Development & Educational Opportunities

2022 AAMA Annual Symposium Recordings
Affordable Medical Acupuncture CME
On-demand recorded sessions

HMI: Medical Acupuncture in Specialty Practice – Guidance for Generalists
Virtual Courses During October & November

Workshop: Treating Musculoskeletal Pain and Dysfunction without Drugs and Surgery: Integrating Dry Needling, Osteopathic Manipulation and Muscle Testing
October 8-9, 2022

35th ICMART World Medical Acupuncture Congress
From Research to Clinical Practice: towards Integrative Medicine
Bologna, Italy
October 14-16, 2022

AAMA Website: Education Listings
The AAMA maintains an ongoing calendar of educational events and professional development opportunities related to medical acupuncture. The calendar is accessible on the AAMA website. Members are encouraged to share events and calendar items from their regions and about educational topics that may be of wider interest among peers and fellow AAMA members.

AAMA News & Announcements

Welcome Our New & Returning AAMA Members

Please join us in welcoming the following new members who became part of the Academy in August 2022.

  • Eder Luis Gutierrez Carlock, MD, of Ann Arbor, MI
  • Eden G. Fromberg, DO, of Ghent, NY
  • Brian K. Goldberg, MD, of Windermere, FL
  • Stephen Wolfe, DO, of Redding, CA

And a special “welcome back” our members who have returned to the AAMA:

  • Jay B Danto, DO, of Kansas City, MO
  • Lowell L. Styer, MD, of Sault Ste Marie, MI

If you have peers or colleagues who aren’t currently members of the AAMA, please encourage them to learn more about the benefits of membership by visiting the website or contacting Janice Brown, the membership committee chair.

AAMA Legislative Committee Report

The Legislative Committee continues its work monitoring and responding to legislation relevant to our members and their practice of medical acupuncture. Currently, the committee is monitoring 40 bills regarding acupuncture, chronic pain, substance use disorder, and dry needling.

The Legislative Committee will continue to watch for bills that affect AAMA members and respond to the authors and co-sponsors appropriately. The committee members will contact YOU when legislation in your state may affect your ability to practice acupuncture. In that event, you are encouraged to write your representatives and senators since they prefer to hear directly from their constituents. If you learn of relevant legislative activity, please connect with the committee by email:

Physicians Earn ABMA Certification

Congratulations to the following physicians who have completed the process ( set by the American Board of Medical Acupuncture (ABMA) to be certified as a Diplomate for 10 years:

  • David Coggin-Carr, MD, PhD, DABMA ,of South Burlington, VT
  • Cassandra Rodrigues, DO, DABMA, of Morristown, NJ

Physicians Complete 10-Year Re-Certification Process

Congratulations to the following physicians who have completed the process ( set by the American Board of Medical Acupuncture (ABMA) to be re-certified as a Diplomate for another 10 years:

  • Seth Koss, MD, DABMA, of Wayne, PA
  • Gerald J. Leglue, Jr, MD, FAAMA, of Alexandria, LA

Call for Papers: Special Issue of Medical Acupuncture

Medical Acupuncture is planning a Special Issue focusing on how acupuncture and related therapies can be used for humanitarian purposes to support people affected by disasters, displacement, environmental devastation, poverty, and human conflict. In humanitarian crises, individuals, families, and entire communities are affected by traumatic events. These psycho-physical patterns can manifest as aggravated pain, chronic disease escalation, insomnia, anxiety, depression, disassociation, substance dependence, impulsive behaviors, suicidality, and other trauma-related symptoms. They require somatic and emotional processing support for trauma reduction and recovery. Acupuncture is a powerful somatic intervention that helps re-regulate traumatic dysregulation, so that emotional processing can occur. It can be used in a variety of clinical settings (private settings or in community group settings) and is effective as a primary or as an adjunctive therapy.

The editors invite manuscripts from clinicians who have utilized acupuncture and related integrative medical therapies to help people cope with physical and emotional injuries stemming from traumatic experience with a focus on humanitarian service efforts. We are interested in submissions from all cultural perspectives. We also welcome submissions that focus on the impact of traumatic stress on children and animals. Case series, original research, as well as review articles with a focus on practical application, are encouraged. The deadline for manuscript submission is: February 1, 2023. Learn more.

HMI Virtual Course: AAMA Members Invited

Helms Medical Institute has announced a new intermediate-level medical acupuncture course, presented fully virtually in two parts:

Part 1) HMI teaching faculty who are board-certified specialists in the areas of neurology, cardiology, gynecology, and pediatrics have prepared video lectures on their use of medical acupuncture in their practices. These lectures will be available for streaming online at your convenience over the month of October. The presentations will be particularly useful for generalists who wish to learn directly from specialists about their clinical strategies.

Part 2) On Saturday, November 5, 2022, a live webinar will be presented featuring the four HMI faculty members and an HMI faculty moderator for additional case presentations and Q&A. This course offers 4.5 ama pra category 1 credits™. Cost: $225.00. Learn more.

Workshop: Treating Musculoskeletal Pain and Dysfunction Without Drugs and Surgery: Integrating Dry Needling, Osteopathic Manipulation, and Manual Muscle Testing

October 8-9, 2022
Presenters: Dr. Jay Sandweiss and Dr. Joseph Audette

AAMA members are invited to attend a new workshop presented by Drs. Audette and Sandweiss, which will present a highly effective approach for diagnosing and treating common musculoskeletal problems, such as tennis elbow, golfer elbow, rotator cuff syndrome, carpal tunnel syndrome, knee pain, ankle pain, neck, hip and back pain. Attendees will learn to integrate osteopathic manipulation, dry needling and manual muscle testing. Space is limited. Early registration discount expires August 15, 2022.

ICMART 2022 – New Agenda Details Released

Reminder: AAMA members are invited to attend the 35th ICMART World Medical Acupuncture Congress in Bologna, Italy, October 14-16, 2022. The AAMA’s organizational membership in ICMART extends to all AAMA members, who can register for this event at the discounted member rate. This year’s theme is From Research to Clinical Practice: Towards Integrative Medicine. A detailed agenda is now available on the ICMART website.

Learn more and register.

Are You Following Us?

Join the conversations online with fellow physician acupuncturists from around the country! You can find AAMA on:

There’s even a closed group on Facebook for discussion between members:

In Case You Missed It Last Month

NIH Office of Dietary Supplements Strategic Plan – Invitation to Comment

The Office of Dietary Supplements (ODS) at the National Institutes of Health has initiated a strategic planning process that will culminate in the ODS Strategic Plan for 2022-26. To assist with this process, ODS requests input from research communities—academic, government, and industry—and from other interested parties. The overall purpose of the strategic planning effort is to identify both new opportunities and emerging needs for incorporation in the programmatic efforts of the office. At this time, ODS desires comment on the Draft Strategic Plan regarding these important issues:

  • Are there additional emerging public health issues that ODS can help address?
  • Are there existing knowledge gaps that ODS can help address (not included in the current plan)?
  • Is there anything that ODS can do differently to meet the needs of its stakeholders?

Responses will be accepted until October 15, 2022. Learn more and submit comments.

New Scientific Research Related to Acupuncture 


Auricular Acupuncture Using Battlefield Acupuncture Protocol Following Total Knee Arthroplasty
[Proceedings of UCLA Health]
Our preliminary results find no significant difference in pain scores, opioid use post-operatively, or functional outcomes between the treatment and sham groups. Both treatment and placebo groups improved in function as measured by POQ-SF and KOS-ADL over time, but there was no between-group difference at any time point. The study ended with fewer than anticipated subjects enrolled and is underpowered to draw firm conclusions. Our study has also seen intermittent slowdowns in enrollment due to operating room closure for cleaning and remodeling, as well as closures due to the COVID19 pandemic.

The Role of Acupuncture in Pain and Swelling Control for Postoperative Tibial Fracture Treatment
[International Journal of Surgery Case Reports]
Electro-acupuncture has a significant analgesic effect 24 h–48 h after surgery. The effect of electroacupuncture on bone healing was not different between the two groups. Electroacupuncture is a safe, effective method with few side effects.

Acupuncture Treatment is Associated with Reduced Dementia Risk in Patients with Migraine: A Propensity-Score–Matched Cohort Study of Real-World Data
[Neuropsychiatric Disease and Treatment]
Patients with migraine who received acupuncture treatment were found to have a lower risk of dementia (adjusted hazard ratio [aHR] = 0.51, 95% CI = 0.40– 0.65) than those who did not undergo acupuncture treatment. The cumulative incidence of dementia was significantly lower in the acupuncture cohort than in the non-acupuncture cohort (Log rank test, p < 0.001).

Efficacy of acupuncture in animal models of vascular dementia: A systematic review and network meta-analysis
[Frontiers in Aging Neuroscience]
Acupuncture significantly improves cognitive function in rats with vascular dementia. Compared to other acupuncture plans, (GV20 + ST36, MA) and 14 -day manual acupuncture can be used to obtain better results. The main mechanism of acupuncture in the treatment of vascular dementia is reduced oxidative stress, neuronal inflammation, and apoptosis, as well as the increased synaptic plasticity and neurotransmitters.

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