What's the difference between regular Lyme fatigue and PTLDS?

Lyme fatigue is an acute symptom of the active infection. PTLDS is defined by symptoms that persist six months or more after completing antibiotics in patients with a confirmed diagnosis. The driver shifts from the bacteria itself to how the immune and nervous systems were altered by it.

Does acupuncture treat the Lyme bacteria?

No, and we do not claim that. What the research supports is acupuncture's ability to modulate the inflammation and autonomic dysregulation driving PTLDS symptoms. In the key 2022 animal study, bacterial levels were identical in treated and untreated animals, but inflammatory damage was significantly reduced in the treated group.

How many sessions are typically needed?

Most patients notice initial changes within two to four sessions. Meaningful autonomic and immune shifts typically require eight to twelve weeks of consistent treatment, after which many patients transition to seasonal maintenance care.

Should I continue with my prescribing doctor while doing acupuncture?

Yes, always. Acupuncture for PTLDS is integrative support alongside conventional care, not a replacement for it. If your physician has referred you for dysautonomia evaluation, that workup is important and complementary to what we do here.

Seasonal Allergies in Southern California: How Acupuncture and TCM Address Environmental Toxicity and Immune Dysregulation

Feb 12

Written By Shaun Menashe

Seasonal allergies affect more than 80 million Americans, and residents of Southern California face a particular challenge: a climate that extends allergy season nearly year-round combined with environmental factors that compound respiratory burden. For those living in Echo Park, Silver Lake, and surrounding Los Angeles neighborhoods, understanding the interplay between environmental toxicity and immune function has become increasingly relevant—especially in the aftermath of the January 2025 Eaton and Palisades fires, which introduced an unprecedented mix of airborne contaminants to the region.

Key Takeaways

Allergy seasons now start 20 days earlier and last 10 days longer than in 1990, with pollen production up 21 percent
Southern California's climate means something is always blooming; relief typically falls only between November and January
Acupuncture modulates immune function by inhibiting mast cell degranulation, reducing IgE levels, and restoring Th1/Th2 balance
The January 2025 LA fires created distinct concerns: urban wildfire smoke contains toxic metals and volatile compounds that differ from wildland fire smoke
Post-fire soil testing revealed elevated lead levels in 43 percent of intact home sampling grids downwind of the Eaton fire

Why Allergy Seasons Are Worsening in Southern California

A landmark study in the Proceedings of the National Academy of Sciences found that pollen seasons now start 20 days earlier, last 10 days longer, and feature 21 percent more pollen than in 1990—with human-caused climate change identified as a primary driver. Warmer temperatures and elevated carbon dioxide concentrations stimulate greater pollen production from allergenic plants.

For Southern California specifically, warmer winters mean tree pollen emerges as early as February, with grass pollen persisting from April through September and weed pollen peaking from August through October. The Asthma and Allergy Foundation of America reports that between 1995 and 2011, warmer temperatures caused pollen seasons to lengthen by 11 to 27 days nationwide.

With sustained emissions, the U.S. could face up to a 200 percent increase in pollen production by century's end. For children, the EPA estimates that 2°C of warming could result in a 17 percent annual increase in asthma-related emergency room visits due to pollen exposure.

The Los Angeles Environment

Los Angeles residents contend with compounding factors:

Year-round pollen exposure: Southern California's mild climate supports continuous pollination cycles without winter reprieve
Santa Ana winds: These periodic events transport pollen and particulate matter hundreds of miles, exacerbating symptoms even in areas distant from the source
Urban heat effects: Warmer urban temperatures accelerate pollen production and extend growing seasons
Pollution interactions: Research shows pollen collected along high-traffic roads exhibits higher allergenicity, suggesting pollution modifies allergen potency

A 2025 NOAA report warned that dry soils, stronger winds, and early heat in Southern California would likely produce elevated particulate matter—conditions that compound allergic sensitization.

Post-Fire Considerations: The 2025 Eaton and Palisades Fires

The January 2025 fires introduced environmental health concerns beyond typical seasonal allergies. When approximately 16,000 structures burned across Pacific Palisades and Altadena, the smoke contained compounds fundamentally different from wildland fire emissions.

UCLA air pollution expert Yifang Zhu characterized the emissions as a "toxic soup" including plastics from homes, car batteries, asbestos tiles, and decades of accumulated household chemicals. Official air quality monitors recorded high levels of lead and arsenic during the burns, with CDC data revealing that PM2.5 lead concentrations increased approximately 110-fold during the fire period.

Researchers also detected hexavalent chromium exclusively in nanoparticle form—a finding that surprised environmental scientists, as this carcinogenic compound had previously been identified only in post-fire soils. The nanoparticle form is particularly concerning because these particles can penetrate deep into lung tissue and potentially enter the bloodstream.

Documented Health Impacts

Cedars-Sinai researchers tracking emergency department visits in the 90 days post-fire documented significant increasescompared to seven-year baselines:

118 percent increase in emergency visits for general illness
46 percent increase in heart attack presentations
24 percent increase in pulmonary illness visits

Kaiser Permanente Southern California data similarly showed approximately 35 percent increases in virtual care seeking for cardiovascular and respiratory conditions among highly exposed members in the week following ignition.

Lingering Contamination

Post-fire soil testing conducted by Los Angeles County Public Health revealed that 43 percent of sampling grids from intact homes in the Eaton fire region exceeded California's residential lead threshold of 80 mg/kg. The contamination source is believed to be homes with lead-based paint, common in structures built before 1979—comprising over 70 percent of houses in the Eaton fire region.

UCLA research found that volatile compounds including toluene and carbon tetrachloride became more concentrated inside homes weeks after visible smoke cleared, as these chemicals absorbed into drywall, furniture, and soft materials continued off-gassing.

For allergy sufferers, this creates compounding burden: an immune system already sensitized to pollen faces additional toxic insults that may further dysregulate inflammatory responses.

The TCM Perspective: The Gut-Lung Axis

Traditional Chinese Medicine recognizes a functional relationship between digestive and respiratory systems—the gut-lung axis. The Lung organ system governs Wei Qi (defensive energy), which protects against external pathogens including allergens. The Spleen, responsible for digestion, generates the substrates from which Wei Qi is produced. When digestive function is compromised, defensive energy weakens, manifesting as increased susceptibility to allergens.

Modern research on intestinal permeability, microbiome health, and mucosal immunity parallels these classical observations. Environmental toxicity affects this axis at multiple points: inhaled particulates irritate respiratory mucosa while also impacting gut barrier function when swallowed; heavy metals disrupt the microbiome; and inflammatory signaling from one mucosal surface propagates to others through shared immune circuitry.

Acupuncture and Immunomodulation: The Research

The mechanistic research on acupuncture's immune effects has expanded considerably, with particular attention to allergic conditions.

Mast Cell Regulation

Mast cells release histamine and inflammatory mediators upon encountering allergens. A 2025 systematic review in the Journal of Asthma and Allergy examining 365 studies found that acupuncture inhibited mast cell degranulation, reducing histamine and IgE levels. Acupuncture downregulated pro-inflammatory cytokines (TNF-α, IL-4, IL-5, IL-13) while upregulating anti-inflammatory IL-10 through suppression of NF-κB, MAPK, and TLR4/MyD88 pathways.

Th1/Th2 Balance

Allergic conditions reflect an overactive Th2 immune response, which promotes IgE production and allergic sensitization, relative to Th1. Research in Frontiers in Allergy noted that acupuncture may restore Th1/Th2 balance, reducing IgE-mediated responses. This represents a fundamentally different mechanism than antihistamines, which suppress symptoms without addressing underlying immune dysregulation.

Clinical Evidence

A multicenter RCT of 238 participants with allergic rhinitis found total nasal symptom scores significantly reduced in the acupuncture group compared to both sham acupuncture (p = 0.03) and waitlist controls (p < 0.001). The authors concluded acupuncture appears to be an effective and safe treatment option.

Another trial comparing acupuncture to cetirizine for moderate to severe persistent allergic rhinitis found acupuncture demonstrated greater durability. While both groups improved during treatment, the acupuncture group maintained significantly lower symptom scores one month post-treatment—suggesting effects persist beyond the treatment course.

A meta-analysis of 13 Randomized Control Trials including 2,365 participants concluded that acupuncture produced significant reductions in nasal symptom scores compared to controls.

Allergic Asthma

A study in allergic asthma found 79 percent of the acupuncture group reported improvement versus 47 percent of controls (p = 0.049), with significant decreases in serum IgE and eosinophil counts—indicating broad immunomodulatory effects.

Herbal Support

Beyond the needles, Golden Mean Acupuncture incorporates specific herbal medicines to address acute respiratory flare-ups.

Important: Herbal medicines can interact with prescription and over-the-counter medications. Always consult with a qualified healthcare provider before beginning any herbal protocol, particularly if you take antihistamines, corticosteroids, immunosuppressants, or blood thinners.

Reishi (Ganoderma lucidum)

Reishi possesses immune-modulating capabilities through two key constituents:

Triterpenes (ganoderic acids): These compounds have molecular structures similar to steroid hormones, which may explain their ability to modulate inflammatory responses. They are fat-soluble and concentrated through alcohol extraction.
Beta-glucans: These polysaccharides influence mast cell activity and may inhibit histamine release during allergic reactions.

Chinese clinical studies involving over 2,000 patients with chronic bronchitis found 60 to 90 percent showed significant improvement within two weeks, with older patients and those with asthma benefiting most. I use a dual-extracted tincture (hot water and ethanol) to obtain both water-soluble beta-glucans and fat-soluble triterpenes.

Cang Er Zi San

This classical formula, documented in the Jishengfang compendium, has been used for rhinitis and sinus conditions for over 700 years. Recent research provides rigorous support:

A double-blind RCT of 126 patients found Shi-Bi-Lin (a modified form) safe and effective for perennial allergic rhinitis, improving nasal condition and quality of life compared to placebo
A 2024 meta-analysis of 15 RCTs including 1,361 pediatric patients found Cang Er Zi San demonstrated significantly superior efficacy with better symptom relief and lower recurrence rates

Practical Strategies for Southern California Allergy Sufferers

Environmental Modifications

Monitor air quality: The South Coast Air Quality Management District provides real-time monitoring; limit outdoor exposure when AQI exceeds 100
Use HEPA filtration: Air purifiers with HEPA filters significantly reduce indoor particulate matter
Create clean sleep environments: Keep windows closed during high pollen periods and shower before bed to remove accumulated allergens
Address post-fire contamination: For those near fire-affected areas, consider soil testing and use wet-cleaning methods (damp mopping rather than dry sweeping) to minimize particulate redistribution

Timing and Lifestyle

Pollen timing: Counts typically peak in early afternoon; late afternoon and evening often offer lower exposure windows
Post-rain awareness: Rain initially clears pollen but can rupture grass and weed pollen into smaller particles that penetrate deeper into airways
Santa Ana awareness: These events dramatically worsen air quality; plan indoor activities during high-wind periods

Supporting Immune Function

Adequate hydration: Supports mucosal membrane function and hepatic clearance of toxins
Fiber intake: Promotes beneficial gut bacteria that influence immune regulation
Anti-inflammatory nutrition: Vegetables, omega-3 fatty acids, and reduced refined sugar support balanced immune responses
Stress management: Chronic stress can shift immune function toward Th2 dominance

When to Seek Professional Support

Consider working with a practitioner if symptoms significantly impair quality of life, allergies have progressively worsened, OTC medications provide incomplete relief, allergies are complicated by asthma, you've experienced new respiratory symptoms following fire smoke exposure, or you're interested in reducing long-term medication dependence.

Navigating Allergy Season at Golden Mean Acupuncture

For residents of Echo Park, Silver Lake, and greater Los Angeles, seasonal allergies reflect the immune system's response to a changing environment. At Golden Mean Acupuncture, located at 1292 West Sunset Boulevard, treatment integrates classical TCM assessment with contemporary immunology and environmental medicine. Whether concerns involve seasonal rhinitis, post-fire respiratory symptoms, or chronic sinus congestion, individualized plans address both immediate symptoms and the underlying patterns that perpetuate them.

Schedule your appointment today

FAQ

Antihistamines block symptoms; acupuncture addresses the underlying immune dysregulation that produces excessive histamine. Research shows acupuncture's benefits can persist after treatment ends, whereas antihistamine effects cease when the medication stops.
Yes—soil testing has documented elevated heavy metals in intact properties downwind of the burns, and volatile compounds can off-gas indoors for weeks. Consider HEPA filtration, soil testing through LA County Public Health, and professional consultation if symptoms persist.
Most patients notice improvement within the first few sessions, though meaningful immune shifts typically require four to eight weeks of consistent treatment. Following an initial course, many transition to maintenance sessions during peak allergy seasons.