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4/26/2019

In the News - Garlic and Your Vagina

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The last couple of days my news feed has been filled with quips about Dr Jennifer Gunter’s Twitter thread warning women not to put garlic in their vaginas. Her book, The Vagina Bible is being released in August of 2019, and this Twitter thread got her a LOT of social media traction that will go a LONG way toward promoting her book launch.

Why?

Well, first, because vaginas. Post something about glorious, magical vajayjays, and people are gonna click all over that ish.

Second, the idea of garlic IN the vagina is pretty foreign to some people, particularly those people without vaginas who have never heard of this, so, shock value.

Finally, there are a lot of people with vaginas who DO use this home remedy for yeast infections that are pretty staggered by her claim that this is a dangerous and ineffective practice.

So, let’s examine her argument for #vaginaisanogarliczone

Why you should not put garlic in your vagina.
A thread.
Garlic contains allicin, in THE LAB it MAY have antifungal (i.e. anti yeast) properties. This is in a lab, not even in mice. Just a dish of cells. Your vagina is not a dish of cells. #vaginaisanogarliczone 1/8

— Jennifer Gunter (@DrJenGunter) April 23, 2019
Garlic contains allicin, which gives it its antimicrobial properties. She states that allicin “MAY have antifungal properties” and that it has only been studied on “a dish of cells” (in vitro) and “not even in mice” (in vivo).

Actually, this is incorrect. Allicin to treat Candida Albicans has indeed been studied in vivo, with promising results. What many people don’t understand, is that in the world of research, it’s all about FUNDING. To get funding for clinical research, you need to write a compelling grant proposal to whatever entity has the money. No one is likely to get rich off garlic-based vag cream, so the smaller than ideal pool of clinical research studies really doesn’t surprise me.


Here’s a study you can take a look at though:
Comparison between efficacy of allicin and fluconazole against Candida albicans in vitro and in a systemic candidiasis mouse model. 
“A time-kill study showed a significant effect of allicin (P<0.01) against C. albicans, comparable to that of fluconazole.”
“These results demonstrate the efficacy of anticandidal effects of allicin both in vitro and in an animal model of candidiasis and affirm the potential of allicin as an adjuvant therapy to fluconazole.”

Lots of vaginal garlic aficionados (I SHOULDN'T HAVE TO TWEET THAT IN 2019, BUT HERE WE ARE) recommend inserting a clove. This means they don't understand for allicin to be released the garlic has to be cut or crushed. Sigh. #vaginaisanogarliczone 2/8

— Jennifer Gunter (@DrJenGunter) April 23, 2019
”Lots of vaginal garlic aficionados recommend inserting a clove. This means they don’t understand for allicin to be released, the garlic has to be cut or crushed. Sigh”

Wait, what? We...we don’t?? Um, yes, yes we DO. I mean...we cook with the stuff too, so I’m gonna go out on a limb here and say the odds in Vegas are pretty good that most women know how garlic works.

Garlic could have bacteria from the soil. Bacteria from the soil can be pathogenic -- bad for the body. That's why we clean wounds. If you actually happen to have an inflamed yeasty vagina that soil bacteria would be more likely to infect #vaginaisanogarliczone 3/8

— Jennifer Gunter (@DrJenGunter) April 23, 2019
“Garlic could have bacteria from the soil”...Could it? I mean...I guess, but if you’re doing anything with garlic, either eating it or putting it in your vag, chances are you’re peeling it beforehand, and not sticking it up there if it’s covered in dirt. Also, allicin has not only antifungal properties, but has shown antibacterial properties too, so, there’s that.
Antimicrobial properties of Allium sativum (garlic). 
“Garlic has a wide spectrum of actions; not only is it antibacterial, antiviral, antifungal and antiprotozoal, but it also has beneficial effects on the cardiovascular and immune systems.”

So for garlic to work you would have to crush it and stuff it up somehow. There is still the dirt thing. And the cut up garlic on raw tissues thing (OUCH). And the fishing of the garlic out by the gyno thing. #vaginaisanogarliczone 4/8

— Jennifer Gunter (@DrJenGunter) April 23, 2019
In my own informal survey of people who have put garlic in their vagina for whatever reason, none of them have complained of discomfort, most of them will wrap it in gauze for easy removal, and those who don’t say the clove comes out easily with the Valsalva maneuver or a bowel movement. If it does hurt? Well, don’t do it!!

Garlic can cause biofilms on braces, so could garlic contribute to biofilms in the vagina? Biologically plausible. Biofilms are bad. You do not want them to form especially when you have yeast. Effect of garlic good bacteria also unknown #vaginaisanogarliczone 5/8

— Jennifer Gunter (@DrJenGunter) April 23, 2019
“Plausible” does not equal facts. The good doctor herself makes a comment about the vaginal environment being anaerobic in this thread, so to compare biofilms on braces in the mouth, which is decidedly aerobic, doesn’t really seem a parallel. Moreover, the mouth  has a different indigenous microbiota than the vagina, (Read more about that HERE: http://textbookofbacteriology.net/normalflora.html) and is getting exposed to many other substances throughout the day, so this, in my opinion is apples & oranges, and a terrible, speculative hypothesis.

In fact, here’s a study on how allicin inhibits biofilms!!
Comparison between allicin and fluconazole in Candida albicans biofilm inhibition and in suppression of HWP1 gene expression.
“Allicin-treated cells exhibited significant reduction in biofilm growth (p<0.05) compared to fluconazole-treated and also growth control cells. Moreover, observation by SEM of allicin and fluconazole-treated cells confirmed a dose-dependent membrane disruption and decreased production of organisms.”

​

As 50-70% of women who self treat for vaginal yeast never actually had a yeast infection you can't say much, except half of them never had yeast to begin with so the irritation they had may have been a temporary thing and resolving wasn't garlic related #vaginaisanogarliczone 6/8

— Jennifer Gunter (@DrJenGunter) April 23, 2019
​This is actually true. There are many other infectious conditions that affect the vagina, and not everyone is able to accurately self diagnose. We are often not as educated about our bodies as we should be! Does that mean you should make haste to your OB/GYN? Well, as a practitioner, I can’t make a blanket recommendation on that, but it would seem to me that with the antimicrobial properties of garlic, it would be a relatively safe home remedy to try for a day or two before seeing your MD for more aggressive treatment.

And the placebo effect is strong. If you think vaginal garlic is going to make you feel better, you may very well feel better temporarily. #vaginaisanogarliczone 7/8

— Jennifer Gunter (@DrJenGunter) April 23, 2019
The placebo effect is indeed strong. I would argue that most people with vaginas who have experienced the itching, burning, and copious thick, white discharge that accompanies a yeast infection do not magically imagine that away after placing a clove of garlic in their nether regions. This statement actually pisses me off a bit, as women’s symptoms are constantly dismissed, often as “all in their heads” by the medical establishment...even when their doctor is a woman. Before this particular issue leaves me in an all out feminist rage, let me drop some knowledge on you with the following links.

Women and pain: Disparities in experience and treatment

When Doctors Downplay Women’s Health Concerns

Why Women Struggle to Get The Right Diagnosis

How Women's 'Health-Care Gaslighting' Went Mainstream - The Atlantic

((rage))

My advice, do not take medical advice from anyone recommending vaginal garlic for yeast or anything else. If you enjoyed this thread, you will like my book The Vagina Bible (August 27) #vaginaisanogarliczone https://t.co/G3azTcxTaI 8/8

— Jennifer Gunter (@DrJenGunter) April 23, 2019
MmmHmm….Ok.

Hey, listen, I’m an acupuncturist & herbalist with 20 years of clinical experience, but I am NOT a medical doctor, nor do I play one on TV. I’m not going to try to sway you either way, but personally, if I’m experiencing symptoms that could possibly be resolved with a safe, simple and effective home remedy I’m probably going to try that first, and if that doesn’t get me results in a reasonable amount of time, I’m calling my doctor.

My real advice on the matter? Do not take medical advice from anyone who brews up a Tweet-storm of fear mongering sensationalism and inaccurate information for the sole purpose of promoting their book launch.  If your MD can’t be bothered to spend 15 fact checking minutes on PubMed before going off on a self serving social media tirade about a harmless home remedy that’s been used for centuries, you might want to put your health in the hands of another practitioner.

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4/2/2019

Does MassHealth cover acupuncture?

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TL;DR: Yes it does, and we accept it!
For an UPDATE on this post, click HERE!


"Hi, do you take MassHealth?" "Does MassHealth cover Acupuncture?"
​
These are questions we get allll the time here in clinic, and we usually have to go through a lot of back and forth to help patients understand their benefits. The short answer is, yes and no.

"MassHealth" is a term that many people use interchangeably for the insurance plans offered through the MA Health Connector, such as Allways, Tufts, BMC Health Net, and Neighborhood Health Plan. Many of those plans actually DO have some coverage for acupuncture, which is wonderful. Insurance coverage for acupuncture can vary widely between plans, even though they might be through the same company, so we have to verify each individual's policy prior to starting treatment.

Unfortunately, in Massachusetts, Medicare and Medicaid do NOT cover acupuncture at all. MassHealth Standard (the blue card) says it covers acupuncture, but the way the policy is written, they will only pay medical doctors for it. Even though the policy covers acupuncture, does not require a referral, and by MA law, acupuncture can be performed by a Licensed Acupuncturist without MD supervision, they will not pay an acupuncturist for acupuncture. There are various groups who have been working to change this for years now, but so far, no luck.  For these patients, we typically try to refer them to a hospital based acupuncture program that might be funded by philanthropy, and therefore lower cost. 

It's a sad reality that the healthcare system has become driven by the almighty dollar. Premiums and deductibles are at an all time high, while fewer and fewer services are covered. It's now more important than ever to invest in your own health and wellness, to prevent catastrophic illness and chronic pain in the future! We remain committed to being one of the few acupuncturists in the Boston area who take insurance, but it's such a shame that MassHealth Standard patients can't access their benefits!
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    Allison Blaisdell, MSTOM, Lic.Ac. is a licensed acupuncturist and herbalist in private practice at Fitchburg Acupuncture, and also at Massachusetts General Hospital. She offers Acupuncture, Hypnosis, Nutritional Response Testing, and Frequency Specific Microcurrent, as well as online holistic health coaching and consultation. Her mission is to educate and empower her patients to achieve their best possible health.

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