Traditional Chinese medicine (TCM) is a complete medical system with its own unique philosophy, diagnostics and treatment methods. The goal of TCM is to balance the yin (vital function) and the yang (vital essence). One analogy describes yang as the gear and yin as the grease that allows the gear to run smoothly. An excess of yang leads to the consumption of yin and the formation of heat, much as a gear that works too hard burns away the grease and builds up heat. The balancing of yin and yang stabilizes a person's energy, otherwise known as Chi, or Qi (pronounced chee). The purpose of TCM is fu-zheng, which means to support the true or righteous Chi to inhibit diseased Chi from progressing.

TCM includes extensive nutritional counselling. A proper diet supports health and vitality, thus promoting the proper or righteous Chi. Qigong is a form of exercise that focuses on breathing and meditation and is used to support and boost a person's Chi. Acupuncture, a third component of TCM, is used to treat illness by stimulating the righteous Chi and ensuring it circulates freely to nourish all parts of the body. Herbal treatments may be used to strengthen the righteous Chi in particular parts of the body, contributing to the balance of the whole.

TCM recognizes that the body and its Chi are vulnerable to damage both from internal and external sources, particularly from wind, heat, cold, dampness and dryness. Many experienced practitioners consider HIV a disease of "hidden heat." As HIV progresses, heat is produced through the consumption of yin in the body. Typical examples of the wasting of yin include symptoms such as night sweats and diarrhea. While the yin is consumed, a more vigorous form of heat or fire forms in the body. This occurrence creates a bodily environment that can support a variety of HIV-related infections. Thus one of the prime TCM treatment strategies for HIV is to counteract the environment of heat. This follows the ancient TCM saying, "Heat breeds many evils." (TCM practitioners often think of wind, heat, cold, dampness and dryness as specific disease-causing forces, or entities, thus treat them as proper nouns. For this reason, you may see these words capitalized in books and articles on the subject.)

Qualifications of practitioners of Traditional Chinese Medicine can vary.  The Chinese Medicine and Acupuncture Association of Canada recommends that people with complicated illnesses like HIV visit a fully qualified doctor of traditional Chinese medicine (TCMD) if they wish to use TCM.  To be qualified as a doctor of traditional Chinese medicine, a practitioner must graduate from a Chinese Medicine University or have completed a four-year program specializing in TCM after having completed an undergraduate degree.  A significant amount of clinical experience is also required.  As with any specific medical condition, it is best to seek a practitioner with extensive clinical experience relating to that condition.

Treatment can range from $35 to $100 per session, although some practitioners who sell the herbs they prescribe offer what they call free consultations. An initial visit to a TCM practioner will involve an extensive history, including a review of your nutritional health and a physical examination of various body pulses.

Acupuncture is a component of TCM widely used by HIV-positive people. It stimulates the flow of Chi in specific organs or areas through the insertion of needles at designated points on the body. These acupuncture points have been identified by acupuncturists in China and elsewhere over thousands of years. When undergoing this treatment, make certain that the practitioner uses sterile, disposable needles.

Acupuncture can be used to treat generalized symptoms, such as fatigue, and may be useful for localized symptoms, such as neuropathy (tingling or burning sensation in the hands and feet). Neuropathy, which may be a side effect of antiretroviral drug treatment or a direct result of HIV infection, is notoriously hard to treat. Although different approaches work for different individuals, many reports indicate that neuropathy symptoms and pain decrease for PHAs treated with acupuncture. Clinical trials have shown that acupuncture can reduce the symptoms of peripheral neuropathy in people with diabetes. However, in PHAs with peripheral neuropathy, clinical trials have not duplicated these results. Acupuncture has also been used to stimulate the immune system. Although there have been no studies of this use in HIV disease, acupuncture has been shown to increase CD4+ cells in people with cancer. Anecdotal reports suggest that acupuncture may be useful in the management of other conditions faced by PHAs, including diarrhea and addictions.

Several other forms of Chinese medicine focus on acupuncture points. Through massage, acupressure stimulates the acupuncture points without the use of needles. In moxibustion, the acupuncture points are warmed by applying burning herbs to protected skin. The herb used is mugwort (Artemisia vulgaris). Fat cigar-shaped bundles of the herb wrapped in rice paper are most commonly used. Moxibustion is frequently used to treat digestive complaints such as diarrhea, but it should be avoided if you are experiencing fever, numbness or neuropathy.

Regulations regarding acupuncture vary widely from province to province. Although acupuncture is an integral component of traditional Chinese medicine, other medical professionals are trained in its use, including naturopaths, chiropractors and medical doctors. In British Columbia and Quebec, only those trained and designated as registered acupuncturists may practise. In Alberta, trained acupuncturists are registered, but people who are not registered can practise too. Only medical doctors may be acupuncturists in the Yukon. In all other provinces, acupuncturists are unregulated. The cost of acupuncture treatments varies widely, but one can expect to pay about $45 to $65. The Acupuncture Foundation of Canada Institute (AFCI) can refer you to a medical doctor trained in acupuncture. The Canadian Association of Naturopathic Doctors (CAND) may be able to refer you to a naturopath trained in acupuncture. (See the section Getting Connected for contact information.)

TCM uses many herbal remedies, a number of which are sold in health food stores. This type of availability brings herbal remedies within reach of many people who don't have access to a TCM practitioner or who don't wish to visit one. But the quality of remedies sold unfortunately varies widely. We suggest you ask a TCM practitioner or Chinese herbalist to recommend the safest and most effective products. If you so choose, a TCM practitioner can tailor a combination of TCM treatments that may be more specific to your treatment needs than an over-the-counter single herb preparation. Astralagus, ginseng, Andrographis paniculta and other herbal therapies commonly used in TCM are discussed in A Practical Guide to Herbal Therapies for People With HIV, published by CATIE.