patient w/psoriatic arthritis and migraines

[Guest guest]

I have a new patient, a 26-yr old female, who has psoriatic arthritis (the

psoriasis since 3 yrs old, after chickenpox, stiffness in joints of one hand in

the last year), migraines (almost monthly @ beginning of menses since she was

16). Right now she also has a chronic vaginal yeast infection for one month

that has not responded to biomed tx.

 

I have many questions, but one I would like to ask the group about is about

the psoriasis. I guess I am trying to understand whether she still has a

lingering pathogenic factor from the chickenpox 23 yrs ago, or whether something

about the chickenpox disrupted the function of her immune system, due to a

constitutional deficiency or disharmony. She told me both her father and

grandfather have autoimmune diseases - the father RA, and the paternal

grandfather,

lupus.

 

Almost all her lesions are on the " yang " side of the body - back of her body

and along yang channels of the lower arms. (Her migraines also start around

UB 10 and then project through her head to UB 2 area on R. side.) One thing

I don't understand exactly is why the psoriatic lesions respond favorably to

sunlight. (which would seem to be adding more 'yang')

 

The patterns as I identified them in the first intake are:

 

Blood deficiency and Blood dryness

SP def w/damp accumulation (and possibly damp-heat?)

LIV Qi stag

HT heat

Blood stasis

Disharmony of wei and ying (?)

 

It is hard to say what the lesions really look like in terms of color and

moisture because she uses a topical steroid almost constantly. But she said

they are not wet or weepy, but more red and dry and very itchy. They are worse

in the winter and dry weather.

 

I'm not very good yet with pulse, but I could say that the pulse was thin,

somewhat wiry, and that the upper burner pulses felt different from the others -

more erratic or choppy.

 

Her T. was a bit puffy, med. red w/ some dusky cast to the color, and the

front third was very red; there were also red dots over front 2/3 of T.

 

She is tired, irritable, with periodic anxiety; she is thirsty, drinks a lot

of water; her sleep, stools, urination and digestion seem OK.

 

So again, for now, my questions are:

 

Does she still have a pathogenic factor that needs to be cleared (such as

with herbs that clear heat and toxicity) or would herbs that clear heat in the

blood/heart be more appropriate?

 

What's going on with the yang channels? Do the lesions on the yang channel

represent a deficiency or excess pattern?

 

If the most root pattern is Blood Def and Blood dryness, why do the lesions

respond to sunlight and steroids?

 

thanks for your thoughts,

--RoseAnne S.

 

 

 

[Guest guest]

Dear RoseAnne S.,

 

This is another great opportunity to utilize two, in my opinion,

related systems: nutritional/functional medicine and Chinese herbal

medicine. Think about how the underlying enzyme systems and the

detoxification pathways may be malfunctioning, and address that first.

 

1.Clean up the diet, lessen the toxic load: gradually switch patient

to a whole food, preferably organic diet, with lots of veggies and

fruits, clean fish (3-4 times a week), limited land animal fat (and then

free-range, hormone-free), and daily intake of nuts and seeds. Reduce

or eliminate milk, coffee, alcohol, at least for a while.

 

2.Recommend a daily high-quality multi-vitamin/mineral (i.e. PureCaps

or Metagenics, they have high-potency/quality products and sell

exclusively to practitioners)

 

3.Probiotics to address the candida/intestinal dysbiosis.

 

4.Supplement with fish oil, flaxseed oil, EPO, etc. to support

anti-inflammatory pathways.

 

5.Provide liver support to maximize detoxification (steroids, toxins,

etc.)

 

Then apply herbal formulas according to pattern differentiation and

you will have much better results as you will be presented with

recognizable TCM patterns.

 

 

Just some thoughts,

 

Daniel C. Luthi

Nutritionist, Chinese Herbalist

Taichung, Taiwan

 

 

Chinese Medicine , ra6151 wrote:

>

> I have a new patient, a 26-yr old female, who has psoriatic

arthritis (the

> psoriasis since 3 yrs old, after chickenpox, stiffness in joints of

one hand in

> the last year), migraines (almost monthly @ beginning of menses

since she was

> 16). Right now she also has a chronic vaginal yeast infection for

one month

> that has not responded to biomed tx.

>

> I have many questions, but one I would like to ask the group about

is about

> the psoriasis. I guess I am trying to understand whether she still

has a

> lingering pathogenic factor from the chickenpox 23 yrs ago, or

whether something

> about the chickenpox disrupted the function of her immune system,

due to a

> constitutional deficiency or disharmony. She told me both her

father and

> grandfather have autoimmune diseases - the father RA, and the

paternal grandfather,

> lupus.

>

> Almost all her lesions are on the " yang " side of the body - back of

her body

> and along yang channels of the lower arms. (Her migraines also

start around

> UB 10 and then project through her head to UB 2 area on R. side.)

One thing

> I don't understand exactly is why the psoriatic lesions respond

favorably to

> sunlight. (which would seem to be adding more 'yang')

>

> The patterns as I identified them in the first intake are:

>

> Blood deficiency and Blood dryness

> SP def w/damp accumulation (and possibly damp-heat?)

> LIV Qi stag

> HT heat

> Blood stasis

> Disharmony of wei and ying (?)

>

> It is hard to say what the lesions really look like in terms of

color and

> moisture because she uses a topical steroid almost constantly. But

she said

> they are not wet or weepy, but more red and dry and very itchy.

They are worse

> in the winter and dry weather.

>

> I'm not very good yet with pulse, but I could say that the pulse was

thin,

> somewhat wiry, and that the upper burner pulses felt different from

the others -

> more erratic or choppy.

>

> Her T. was a bit puffy, med. red w/ some dusky cast to the color,

and the

> front third was very red; there were also red dots over front 2/3 of T.

>

> She is tired, irritable, with periodic anxiety; she is thirsty,

drinks a lot

> of water; her sleep, stools, urination and digestion seem OK.

>

> So again, for now, my questions are:

>

> Does she still have a pathogenic factor that needs to be cleared

(such as

> with herbs that clear heat and toxicity) or would herbs that clear

heat in the

> blood/heart be more appropriate?

>

> What's going on with the yang channels? Do the lesions on the yang

channel

> represent a deficiency or excess pattern?

>

> If the most root pattern is Blood Def and Blood dryness, why do the

lesions

> respond to sunlight and steroids?

>

> thanks for your thoughts,

> --RoseAnne S.

>

>

>