"I've always been healthy, so I've never had to rely on doctors," says Sarasota resident Tomara Kafka. "People drop around me from the flu, and I never get it."

But four years ago, Kafka began losing weight. Her mind raced constantly, and she couldn't sleep at night. Doctors traced the problem to a node on Kafka's thyroid and began drug treatment for hyperthyroidism. "That medicine poisoned me," says Kafka.

Practically narcoleptic at work, she gained 40 pounds. She could barely move and suffered constant colds and flu. Doctors warned her that the treatment wasn't a cure; and when her original symptoms recurred two months after she stopped the drug regimen, Kafka looked elsewhere for relief, to Sarasota's East West College of Natural Medicine.

"Within a month, I was feeling better," she says. Three years later, Kafka still has that node on her thyroid, but keeps its symptoms in check with weekly acupuncture treatments. "I'm a thorough believer," she says.

She's not alone. Americans make more than five million visits every year to acupuncture practitioners. The World Health Organization (WHO) lists more than 40 medical conditions that acupuncture may be able to ease, and nearly half of the United Kingdom's primary physicians use acupuncture in their practices. In Germany, 77 percent of pain clinics provide acupuncture, and the Viet Nam National Association of Acupuncture has 18,000 members; 4,500 of those work in public hospitals.

The United States has come late to the acupuncture party, in part because of the lack of rigorous clinical trials. Most studies have taken place in Europe, and few are published in English. Plus, unlike the Western diagnostic system that treats individual symptoms, acupuncture focuses on a holistic, energy-based approach to patients.

Still, in 1997, the National Institutes of Health (NIH) acknowledged that acupuncture is being practiced "widely" by thousands of physicians, and it's since funded research to measure its effectiveness. The NIH concluded that acupuncture is effective for treating postoperative and chemotherapy-associated nausea and vomiting and nausea in pregnancy and could assist conventional medical treatment of migraines, menstrual cramps, and carpal tunnel syndrome.

In its National Health Interview Survey of 2002, NIH found that more than 8 million adults had used some type of acupuncture. Forty-four percent of respondents tried it when conventional medical treatments failed, and 25 percent tried it on the advice of their doctors. It is second only to chiropractic care in popularity among complementary medical procedures.

"We've seen some excellent results," says Bruce Benner, who runs the acupuncture program for HealthSouth Rehabilitation in Sarasota, where students of Sarasota's East West College of Natural Medicine treat an average of 30 patients a week for pain and stroke. Benner says he's seen stroke patients afflicted with complete paralysis on one side able to walk out of HealthSouth's 30-day program that incorporates acupuncture and traditional rehabilitation techniques.

While research indicates acupuncture won't help you quit smoking or lose weight, here are some of the things doctors know it will help.

DEPRESSION

More than 3 million people have sought some sort of alternative medicine for depression. Western medicine commonly involves drug therapy, some of which has come under increasing scrutiny for leaving patients more depressed than before they started treatment.

But acupuncture physicians seek underlying causes of depression, rather than treating the depression itself, because in Chinese medicine, "every organ has its own emotional function," says Steve Roensch of Sarasota Sports Acupuncture. "Fear is the emotion of the kidney, grief is the lungs, the heart is joy." Hence, emotion can cause illness, and injury to an organ can create emotional problems.

NIH researchers agree that acupuncture can work for mental illness, although no one is sure why. Studies indicate that acupuncture may alter brain chemistry, and more than half the depressed women in one clinical trial showed significant improvement after acupuncture treatments.

ASTHMA

In the West, asthma is typically treated with drugs, including steroids, which relax muscles, widen airways, and prevent the inflammation that many physicians believe causes asthma attacks. But side effects that range from headache and insomnia to weight gain lead nearly 800,000 sufferers to seek some type of alternative medicine instead.

"In Chinese medicine, there can be five or six different causes for asthma," says HealthSouth's Benner. "They treat each perceived cause differently." Benner used acupuncture with one 28-year-old female patient who'd had asthma since childhood and couldn't walk up stairs without panting. "Eight months after starting treatment with acupuncture and herbal therapy, she was training for a marathon," says Benner. Under the guidance of her regular physician, she was eventually able to discontinue her other medications.

ARTHRITIS

By the age of 70, nearly everyone develops some osteoarthritis, an incurable condition that causes joint cartilage to deteriorate from normal wear and tear.

Non-steroidal drugs and steroid injections can help relieve the pain, but more than 3 million patients each year turn to some sort of alternative care, including acupuncture.

"In my opinion, even if it is a placebo effect, if it works, then people should use it," says Dr. Richard Yonker of Sarasota Arthritis Center. Yonker has recommended acupuncture for five years to patients who do not respond to traditional therapies. "It won't hurt you," he says, "and it has given some people relief."

The National Center for Complementary and Alternative Medicine (a division of NIH) says acupuncture points are strategic conductors of electromagnetic signals that release endorphins and opiods into the central nervous system, which may explain its ability to reduce pain. It also seems to spark immune cells to injured or diseased sites. The Arthritis Foundation says osteoarthritis patients in one Scandinavian study were so pleased with the results they received from acupuncture that a quarter of them canceled scheduled knee surgeries.

ADDICTION

The Lancet medical journal recently reported that 82 cocaine-addicted patients received acupuncture treatments five times a week for eight weeks (during this period they were drug tested three times a week). Some were given auricular acupuncture, with needles placed in four specific points in the outer ear, and some received sham acupuncture, where needles were inserted into four ear points not thought to elicit any response. By the seventh week of treatment, 54 percent of those undergoing the auricular acupuncture tested free of cocaine, compared to 24 percent of those receiving the sham treatments. Those who completed the auricular acupuncture also had longer periods of sustained abstinence.

Acupuncture has been offered as a treatment option for convicted offenders of Bradenton's Drug Court since October of 2003, according to coordinator Alfred James. "For those who continue regularly, there does appear to be a positive overall effect," says James. "Our experience is those who use opiates usually have a good result; but we actually have seen other groups, such as cocaine users, benefit as well."

FYBROMYALGIA

Marked by chronic pain, fatigue, insomnia and tender joints, fibromyalgia affects nearly 4 million Americans, most of them women between the ages of 35 to 55. The cause is unknown, and the first lines of defense are usually sleep aids and muscle relaxants to treat the insomnia that doctors believe is a strong contributing factor. Many patients must also endure cortisone injections.

But one study involving 70 patients found "statistically significant benefits for acupuncture," according to the Department of Health and Human Services. An estimated 20 percent of fibromyalgia patients at one American clinic tried the technique within two years after being diagnosed, and studies are underway to see how long the benefits last.

"Western medicine is the best emergency care in the world," says Sarasota Sports' Roensch. "But it tends to treat the symptoms instead of the root of what is causing the pain. The body knows how to heal itself. Acupuncture physicians help your body try to do that. It isn't magic, but it isn't smoke and mirrors, either."

ABOUT ACUPUNCTURE

o Needles. The U.S. Food and Drug Administration requires acupuncture needles to be sterile and single-use. Multi-use and unclean needles can spread hepatitis and other diseases. (If they're not handled properly, they can even puncture organs.)

o Pain. Acupuncture needles are about as thick as a human hair, so they rarely cause bleeding. You can't even see the puncture marks, according to Steve Roensch of Sarasota Sports Acupuncture, so you should not feel any pain. "The placement of needles comes across as dull pressure, even tingling," says Roensch. "Without that sensation, no redirection of energy will take place." But if it really starts to hurt, speak up.

o Treatment time. Treatment does not always produce immediate results. Roensch tells his patients, "Giving up after just one session is like having a screaming migraine and taking half an aspirin." Still, an estimated 20 percent of all acupuncture patients don't respond at all. If you haven't seen any results within three or four appointments, this may not be right for you.

o Cost. Acupuncture averages $65 a session here in Sarasota (but can go as high as $125). Medicare rarely covers it, although private insurers are starting to; but the acupuncture program at HealthSouth Rehabilitation offers treatments for little or no cost. For information, call (941) 921-8700, or (941) 951-2944. The East West College of Natural Medicine also offers $25-sessions by students under the guidance of a licensed acupuncture physician. Call (941) 355-9080.

o Accreditation: Florida is one of 40 states that regulates acupuncture. Every practitioner must be licensed by the Florida State Board of Acupuncture. The Department of Education has accredited several teaching programs, and there is a national credentialing agency for non-medical doctors. Sarasota's East West College of Natural Medicine is one of the nation's foremost colleges of acupuncture and offers Master's level education. You can check accreditation through the National Certification Commission for Acupuncture and Oriental Medicine at www.nccaom.org, or the American Academy of Medical Acupuncture (AAMA) at www.medicalacupuncture.org.

FACE-OFF

Sarasota doctor of Oriental medicine Anna Baker claims her acupuncture needles can wipe decades from your face. And for $85 a session (with required prepayment for 10 sessions), it costs thousands less than traditional surgery.

During each 25-minute session, Baker, who came to acupuncture six years ago after using it to ease chemical sensitivities she developed as a ceramics engineer, inserts two needles into the forehead at the hairline, two above the ears and one in the scalp, to tighten the entire upper face and jaw line.

"It takes 10 treatments to get to the first level of facial refreshment," says Baker, who learned the technique from a Chinese Orlando acupuncturist. "The jowls start to shrink, the eyelids tighten, and space between the brows opens up." Recently, Baker isolated seven points in the neck that she believes will shrink fatty deposits and tighten skin there as well.

Baker claims the effects last as long as a surgical facelift, but the younger the patient, the quicker the results. "If you're 40 and doing this, it'll take 10 years off you."

Though she has documented each of her nearly 200 procedures with before-and-after photographs, Sarasota plastic surgeon James Marsh remains skeptical. "Physiologically, there's no way I can conceive it would work," he says, but "I've never had anybody say they weren't happy with an acupuncture facelift and could I fix it. If you go get one and look great, let me know, and I'll learn how to do it."

NEWS BRIEFS

Just in time for Breast Cancer Awareness month comes news that postmenopausal women who took the osteoporosis drug Evista daily for eight years were 59 percent less likely to develop breast cancer. The researchers who discovered the link warn of a small increased risk of blood clots (particularly in the legs), so they recommend women stop using the drug before long airplane flights or surgeries.