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Ear-Seeds & Ear-Acupuncture - what's the Evidence?

Since the controversial 'Acu-Seed' Dragon's Den episode last week I have received an increase in inquiries for ear seeds and acupuncture for ME and chronic fatigue syndrome. I have also been asked if ear seeds and acupuncture can help sufferers of these conditions.

I emphasize, in my comments below to my local paper, that ear seeds, magnets and pellets are often used by qualified acupuncturists as an adjunct to a traditional Chinese medicine treatment plan.

Luckily, I am a member of the British Acupuncture Council (BAcC) and I refer to their response to the questions this episode has raised.

Their educational Blog, Ear acupuncture - What's the deal? explores the history of ear acupuncture, or auricular acupuncture, from it's origins in North Africa in the 1950's to it's more modern applications - such as the NADA 5 acu-point protocol often used for addictions (see photo below).

They have also published a response to the issues raised:

Statement on ear seeds for CFS/ME – Dragon’s Den Here I quote directly from the BAcC statement (from the line below to the image of burning moxa on the abdomen)

The current evidence-base: acupuncture ME/CFS

In the last 20 years a considerable amount of research has been conducted into acupuncture. However, the majority of the high-quality clinical trials have investigated chronic pain conditions such as: low back pain, headache, osteoarthritis of the knee and shoulder pain. These have been compiled in individual patient data meta-analysis that indicates acupuncture is effective for these chronic pain conditions, the benefits last for at least a year and is not purely placebo effects (Vickers et al, 2018).

Unfortunately, chronic fatigue syndrome has not been investigated to the same degree. The studies that have been conducted are often of low quality. The vast majority of studies have been conducted in China. This creates an extra layer of difficulty in assessing the relevance of this evidence to people in the UK. The number and frequency of treatments given in Chinese studies is often higher than typically given in the UK. As many people must access acupuncture privately the expense can limit the number of treatments. The recent systematic reviews suggest that acupuncture may be beneficial for those with chronic fatigue syndrome (Factsheet). However, these reviews also note that until high-quality clinical trials are conducted, it is not possible to be confident in these results.

CFS and traditional acupuncture

CFS/ME is a complicated condition. The BAcC represents practitioners fully trained in the traditional theories. This is a holistic practice. A traditional acupuncturist does not base treatment on the diagnosis of ‘chronic fatigue syndrome’ or ‘myalgic encephalomyelitis’. They will take a full case history and arrive at a diagnosis using the traditional theory. This diagnosis is called 证 zhèng. Zhèng is usually translated as pattern. Even for conditions where the signs and symptoms are fairly consistent, such as osteoarthritis of the knee, patients can be diagnosed with different zhèng-patterns.  This means that patients with osteoarthritis of the knee we will get slightly different treatments depending on their overall signs and symptoms.

CFS is far more complicated, beside the tiredness there may be other significant symptoms such as pain, headaches, insomnia, flu-like symptoms. A standard Chinese medicine textbook may list 20 zhèng – patterns associated with tiredness, 17 with headaches, and 9 associated with insomnia. Therefore, people with CFS/ME will often receive different treatments. Whilst there is some overlap, different acupuncture points will be selected depending on the pattern. In addition, some of these patterns may require the use of moxibustion not just needles.  This is a complicated issue and probably can only be fully understood through studying the traditional theories. However, hopefully, the central point is clear: there is no one-size-fits-all treatment for conditions such as chronic fatigue syndrome.

The evidence from China suggests that combinations of acupuncture and moxibustion plus Chinese herbal medicine may lead to the best outcomes. It may well be that an integrated approach, where individuals select the modalities that they find most useful, is the best way forward. However, this level of complexity does not readily fit with the current gold standard research of randomised controlled trials.

Ear seeds and ear-acupuncture

At present, we are unaware of any clinical research that has evaluated ear seeds alone for CFS/ME. The clinical research conducted in China uses body acupuncture as the first line treatment which is often combined with moxibustion. Ear seeds may be used as an adjunct to the acupuncture treatment. From a traditional acupuncture perspective the ear seeds need to be located precisely on specific points. Therefore, it is not possible to self-administer the ear seeds. The advantage of ear seeds is that they are held in place by tape and can remain in the ear for days. Once in place, people can stimulate the points themselves by pressing the seeds.


Unfortunately, due to the lack of high-quality clinical trials it is currently not possible to draw firm conclusions about the benefits of acupuncture for chronic fatigue syndrome. However, the evidence that does exist indicates that acupuncture and moxibustion may have positive benefits.

For those with chronic fatigue syndrome, who are interested in trying acupuncture, we recommend finding a BAcC practitioner who will be able to tailor the treatment to address your ‘zhèng-pattern’. An initial course of four to six treatments should enable you to gauge whether acupuncture is beneficial for you.

To assess the benefits of acupuncture in the UK setting, it is essential that high quality clinical research is undertaken. This will require funding. The British Acupuncture Council is willing to collaborate in research projects with universities, charities, government bodies."

The BAcC is the UK’s largest, member-led, professional body for traditional acupuncturists. Not all acupuncturists are eligible to be a BAcC member - only those who have extensive training to degree level on BAAB accredited courses. Visit their website for further information:


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