Autoimmune disorder

February 10, 2009

I have a patient (a relative) that has lab work that has a positive

anti-nuclear ab (ana -320 with a speckled pattern). The c-reactive

protien and SED rate are normal. All other blood work is normal.

She is 35 years, old has 4 small children, and has an array of

symptoms. I wanted to treat the main symptoms {soft thready pulse

with deep ki pulse, flabby tongue with teethmarks, dizziness,

bloating, low back pain, knee pain and leg weakness with poor

memory.} as a pretty obvious spleen Qi and KI xu. I was going to

prescribe Bu Zhong Yi qi tong and liu wei di huang, but the family

Doctor, who is an MD and is also an MD trained in TCM in China feels

that tonifying (supplementing or reinforcing whichever term is

correct) would not be a good thing right now because it might induce

a latent autoimmune disorder into activity by boosting the immune

system. I normally do not try to correlate tcm with western medicine

in this way, but because she is highly trained in both systems and I

don't have a lot of experience in autoimmune disorders, I will

probably defer. The MD wants a rheumatology consult before any herbs.

Does anybody who treats autoimmune disorders have any experience or

thoughts on this?

I had also learned in school that Huang Qi in low doses supplements

the immune system and in large doses (over 20 grms) it suppreses the

immune system. Can anybody verify that?

Thanks - Ken Cherman, L.Ac.

February 10, 2009

Hi Ken:

--Ken-

I normally do not try to correlate tcm with western medicine

in this way, but because she is highly trained in both systems and I

don't have a lot of experience in autoimmune disorders, I will

probably defer.

---

TCM practitioners trained in China can have a weird mix of competence and

damage (Fruehauf 1999, Scheid 2006).

I have never aggravated an autoimmune system disorder with herbs that

(supposedly) " increase immune system activity " .

Churg Strauss, Lupus, Sjogren's etc etc etc all respond well to CM pattern

differentiation and sensitive dosing / prescription.

The line you are being fed is absolute speculation and is worth very little.

We weaken ourselves when we doubt based on these lines. The only legitimate

doubt you should impose on yourself, Ken, regards *your experience treating

people with these presentations*. But you know what? It could simply be a case

of yin-deficiency for god's sake. Or, actually, as you described, it really

looks like qi-deficiency. Notice how " immune system " is not in there.

If I were you, I would avoid cases (for now) that are volatile with severe

exacerbations (whatever the diagnosis is), and take cases where the patient is

stable and on few meds (whatever the diagnosis is, even if it is a " severe " case

of lupus, for eg). I would also avoid cases where you may end up being the

scapegoat if something were to go wrong.

Beyond that, do your assessment and prescribe and treat with care.

--Ken-

I had also learned in school that Huang Qi in low doses supplements

the immune system and in large doses (over 20 grms) it suppreses the

immune system. Can anybody verify that?

---

The important question here, Ken, is " what does enhancing or suppressing immune

function mean? " WIthout the answer to that, it really is a meaningless question.

If a patient fits what is listed as the requisite presentation for use of a

particular herb, use it. Simple as that. Know the herbs well, review them,

differentiate accurately. Have you noticed how many chinese people there are?

Best information below:

Huang Qi is sweet and warm, enters the lung and spleen, dosage 9 to 30g.

Huang Qi works to tonify the spleen and lung qi, and saises the spleen and

stomach qi. Huang Qi can also tonify the Wei Qi and therefore stabilise or

consolidate the exterior.. It can be used to tonify the Qi and Blood due to loss

of blood, for example in cases of postpartum bleeding leading to fever. Huang Qi

can promote the disharge of pus and promotes the generation of flesh.

(etc etc)

For example, Huang Qi's use in Yu Ping Feng San:

Tonifies Qi, stabilise the exerior, stops sweating

Huang Qi 30g

Bai Zhu 60g

Fang Feng 60g

* in acute conditions, the Huang Qi dosage may be increased 200 to 600%.

Indications: aversion to wind, spontaneous sweats, recurrent colds, shiny pale

face, pale tongue with white coating, and a floating, weak, soft pulse.

Hope that helps!

Hugo

ps- I think the doc you talked to is off their rocker and has some control

issues.

________________________________

Hugo Ramiro

http://middlemedicine.wordpress..com

http://www.chinesemedicaltherapies.org

________________________________

" kncherman " <kncherman

Chinese Medicine

Tuesday, 10 February, 2009 1:11:49