Comparison & Integration of Western and Eastern Medicine

1. Comparison & Integration of Western and Eastern Medicine Jing Liu, PhD, Lic.Ac 2011

2. A copy right is reserved for the materials in the following presentation

3. Integrated Medicine Western Medicine + TCM + Natural Medicine ( Nutrition, diet, herbs, natural therapies in the world) 11/10/10 Jing Liu 3

4. Natural Medicine • 从学科分类学的角度审视，一门学科不应是有地区属性的医学科学不应分属于西、东方，应该统一于现代医学范畴内。中医药学应属于现代医学的一个分支学科. • 从科学的定义上考虑，在中医药学最终能够被现代医学接受之前，将中医纳入到自然医学体系。 • 自然医学将逐步取代替代医学/中西医结合等名称而成为现代医学家族的( 而非西方医学）中的一个重要学术分支。 • 在自然医学的范畴中，国家的属性将被医学体系的自然性和科学性逐渐取代，成为世界医学界都容易被接受的一门医学

5. Content • Fatigue - Hormone Balance • Inflammation • Pain • Comments on acupuncture clinical trails: • Placebo, Specificity of acupoints

6. Cause of Fatigue • Insomnia Heart - kidney disharmony • Hormone dysfunction Kidney deficiency • Gut inflammatory status Spleen: Dampness / phlegm

7. Yin & YangInsomnia treatment • WM • Sedative-Hypnotics or antipsychotics • Adverse reactions: drowsiness, weakness, pseudo-depression in the morning • EM • Encouraging Yang energy in the morning and nourishing Ying in evening • Yang encouraging : Yin nourishing: Jing Liu

8. Yin & Yang Theory and Sleep A general principle in traditional Chinese Medicine (TCM) practice Morning Yang Time: adrenal, thyroid hormone awake and rise to peak - energetic, active Evening and Night Yin time: melatonin and serotonin dominant –calm and sound sleep Higher Yang in the morning, Deeper Yin control in evening and night, better quality of sleep 11/10/10 Jing Liu 8

9. Sleep and Hormone Balance

10. Insomnia - Cortisol Dysfunction Syndrome • Fatigue • Depression • Insomnia • Irritability/. Anxiety • Sweets craving • Poor concentration • Headache • Allergy Elevated sympathetic nerve tone and decreased cortisol • = Heart Kidney Disharmony 心肾不交?

11. Insomnia TreatmentBasic Formula (1) Kidney strengthening Mai Wei Di Huang Tang 麦味地黄 • Add: Ginseng人参, Royal jelly蜂王浆, Adrenal hormone promoting: Shan Zhu Yu山茱萸, Shu Di Huang熟地黄 Estrogenic phytohormone: Shan Yao山药(tocopherol, Coenzyme Q9, Cyloartenol, 1- feruloyl glycerol, hydro-Q9, chromene)

12. Insomnia TreatmentBasic Formula (2) 酸枣仁汤 • 酸枣仁 • 川芎 Anti-inflammatory • 茯苓 Reduce edema • 知母 Anti-sympathetic, Anti-inflammatory • 甘草 Anti-inflammatory, Detox • Add: hehuanhua合欢花， lianzixin莲子芯，baishao 白芍

13. Causes of Fatigue • Heart: Insomnia • Kidney: Hormone Dysfunction ( HPTA Axis) • Spleen: Gastrointestinal Dysfunction

14. Fatigue and Hormone HPA Axis • The current evidence supports the following factors of HPTA axis dysfunction in patients related with chronic fatigue syndrome (CFS): • Mild hypocortisolism • Attenuated diurnal variation of cortisol • Blunted HPTA axis responsiveness to body need. • hypothyroid function • Imbalanced sexual hormones

15. Adrenal Hormone Synthesis

16. Adrenal Hormone Synthesis

17. Estrogen Family

18. Adrenal Dysfunction / Fatigue • Adrenal glands are unable to keep pace with the demands of perpetual stress. • Stress signals > cortex > limbic system > sympathetic nerve > adrenal gland > cortisol release/thyroid hormone • The gland can't produce quite enough of the hormones our mind-body need. • Existing blood tests, aren't sensitive enough to detect the decline in adrenal function: cortisol panel test

19. The Symptoms of Adrenal Fatigue • Qi & Yin Deficiency • Fatigue, mostly Midday Fatigue • Unexplained Weight loss • Reduced tolerance for stress • Insomnia • Anxiety • Craving for sweets and salty foods • Body hair loss • Body aches • Depression • Low Cortisone Syndrome • Above symptoms plus: Increased susceptibility to infections Allergies to things you were never allergic to before Chemical sensitivities (Hyper Chemical Sensitivity)

20. Herbs for Adrenal Dysfunction • Panax Ginseng人参 • Elwutherococcus 西伯利亚人参 • Rhodiola 红景天 • Yin Yang Huo 淫羊藿 • Shan zhu yu 山茱萸 • Ocimum sanctum ( holy basil） 圣罗勒 • Withania 睡茄 • Glycyrrhiza 甘草 (Hypotension) • Other herbs for Kidney Yin/Yang deficiency

21. Treatment of Adrenal Fatigue • Progesterone cream • Iodine / tyrosine • Phosphorylated serine / He Shou Wu何首乌 • Pregnenolone / Cortisol • Melatonin at bed time

22. Hypothyroidism (1) Qi & Yang Deficiency • Fatigue • Shortness of breath with a shallow and slow respiratory pattern • Lowbasal body temperature, Cold intolerance • Thyroid-Related Depression • slow heart rate • Sluggish reflexes • Constipation • Poor muscle tone (muscle hypotonia) • Slow speech and a hoarse, breaking voice Depression Kidney deficiency • Decreased libido • Hair loss • Lower renal function with decreased glomerular filtration rate • Impaired memory • Abnormal menstrual cycles • Thin, brittle fingernails Female infertility

23. Hypothyroidism (2) Spleen deficiency • Weight gain and water retention • Enlarged tongue • Yellowing of skin due to impaired conversion of beta-carotene to vitamin A • Impaired Puffy face, hands and feet (Non-specific Edema?) • Impaired cognitive function (brain fog) Yin & Blood deficiency • Dry, itchy skin • Decreased sweating • Others • Elevated serum cholesterol • Muscle cramps and joint pain • Hyperprolactinemia and galactorrhea

24. Wilson's Temperature Syndrome • Temperature lower than 98.60F • Hypothyroidism symptoms with normal T3, T4 • Typically brought on by stress • often exist with chronic fatigue syndrome, fibromyalgia’ • Improved by treatment of T3 or herbs / supplements; not respond to T4 treatment

25. Causes of Hypothyroid Syndrome • Iodine deficiency • Stress • Hushimoto disease ( chronic lymphocytic thyroiditis), 25% • lithium-based mood stabilizers, usually used to treat bipolar disorder (previously known as manic depression) • Congenital hypothyroidism is very rare accounting for approximately 0.2‰

26. Thyroid Hormone • 90% T3 (effects fast, short term) • 10% T4 (effects slow, long term) • T3 is only form of thyroid hormone to supply energy to heart from breaking down fat • Over dose of T3 cause cardiac overloading

27. Conversion of T3 or RT3

28. Conversion of T4 to T3 Promoters (1) • Kelp (iodine, Iron), selenium • Zinc, potassium, cupper • High protein diet • Vitamin A, E, C, B2, B3, B6, B12 • Growth Hormone • Testosterone • Ashwaganda (India herb)

29. Inability to convert T4 to T3 • Excessive alcohol • Low protein/fat diet • Too much cruciferous vegetables • Walnuts

30. Low T3 / High reverse T3 Promoters • Stress - epinephrine / NE, cortisol • Free radicals • Aging • Fasting • Diabetes • Toxic metal exposure • Inflammation-elevated inflammatory factors: IL-6, TNF-alpha, IFN-2

31. Iodine Deficiency • 88% America women are in iodine deficiency. • Low iodine cause hyperestrogenic state and higher free estrogen level up to 80 to 90%, normal is 40 to 60%. • When Iodine is enriched, the estrogen receptor activity in the breast is reduced. • Iodine promote apoptosis and disrupt proliferation • Low iodine cause fibrocystic breast; Effective therapy (82%) in treating fibrocystic breast disease and prevent breast cancer • TCM: Hai Zao, Kun Bu 海藻，昆布

32. Iodine Deficiency

33. Causes of Iodine Deficiency • Diet in shortage of iodine • Iodine Taken Up: Thyroid: 6mg; breasts: 5mg /day; other tissues: 2mg/day • Japanese women: 13.8mg daily, lowest in breast cancer • Diet high in pasta/bread containing bromide (bind to iodine receptor) • Fluoride use (inhibiting iodine binding • Vegan and vegetarian diet

34. Drugs for T3/T4 replacement • T3: Liothyronine, Triiodothyronine • T4:Levothyroxine (Synthroid) Transfom to be T3, but take up to 8 weeks to reach the required level of T3. • Armour® a naturally derived from porcine thyroid glands. (T3 liothyronine is 4x as potent as T4 levothyroxine; so 38 mcg T4and 9 mcg T3 per grain of thyroid.

35. Thyroid Hormone Replacement Failure • After increase dosage still feel fatigue: • Magnesium deficiency • Adrenal deficiency • Overdose • Poor absorption from unhealthy gut

36. Side Effects of T3 Therapy • Fluid pretension • Achiness • Jitteriness • Irritability • Dull headache • Increased heart rate • Can not be used for severe Adrenal or cardiac deficiency

37. Herbs for Thyroid Function • Huang Qi黄芪 • Huang Qi Wu Wu Tang黄芪五物汤 • Or add: Xiao Chai Hu Tang小柴胡汤, in case of autoimmune • Prolonged hypothyroidism cause adrenal fatigue • Adrenal: Ying Yang Huo淫羊藿, Shan Zhu Yu山茱萸 • When the herbs not effective enough, add T3, to reduce the dose of T3 and reduce the side effect of T3

38. Natural Supplements for Thyroid Function • Guggul (Commiphora mukul) increase iodine intake and thyroid hormone production, enhance thyroid perocidase enzymes • Seaweed (algae) : Kelp (kun Bu) bladderwrack fucus vesiculosus (best antioxidant among seaweeds) • Seaweed contain diiodothyoinine (DIT), which may promote thyroid function • Zinc, Selenium • Blue Flag - potent detoxifier of thyroid • Improvement usually occurs within 3 to 4 weeks

39. Hushimoto’s Disease • Reduce autoimmune response and inflammation • Xiao Chai Hu Tang 小柴胡汤 • Curcumin • Boswellia • Lycopus virginicus（lycopus lucidus 泽兰) • inhibit iodine metabolism, inhibits release of thyroxine from thyroid, binds with TSH, decrease pulse and BP • 95% improvement rate, officially recognized in Germany as prescription • Rosemary extract (迷 迭香100:1), reduce antibody

40. Hormone: Progesterone • Produced mainly in ovary, little in adrenal gland; Increase 100x during pregnancy • Enhance: thyroid function, apoptosis, estrogen sensitivity, brain cell growth in fetus • Decrease: breast cell growth, breast cancer, atherosclerosis, • Decrease Brain degeneration, neuro-blastoma, MS; anti-depression • Burn fat for energy; hair growth; • Progestins are NOT equal to progesterone

41. Herbs for Progesterone • Juglans regia (England Walnut核桃), progesterone detected • Progesterone-like steroids in Dioscorea mexicanaof yam family native to Mexico, containing steroid  diosgenin converting into progesterone. •  Diosgenin and progesterone found in other Dioscorea species. • Dioscorea pseudojaponica from Taiwan, containing saponins —converted to diosgenin -> progesterone. • Other Dioscorea species:  Dioscorea villosa andDioscorea polygonoides. • Dioscorea villosa contains 3.5% diosgenin. • Dioscorea polygonoides contain 2.64% • Dioscorea family: Shan Yao山药, Bi Xie, Chuan Shan Long穿山龙, Shan Ci Gu山慈姑I • Sheng Ma升麻 • Maca • Fu Pen Zi覆盆子

42. Hormons: Estradiol(E2) • Neuro-protective • Breast cancer promoting • Cell proliferation with alveoli formation (hyperplasia) and even cyst formation

43. Effects of Estrogen Therapy • Prevent osteoporosis • Decrease LDL and increase HDL • Increase blood pressure, triglyceride • Gallstone • Elevated liver enzyme • Increase carbohydrate craving • Decrease thyroid function by increasing binding thyroid binding globulin

44. Estrogen Balance • In the 1960s and 70s Dr. Henry Lemon concluded: • Estrogen Quotient • EQ=E3/E1+E2 • EQ<1: high risk for breast cancer • EQ>1.5: low risk for breast cancer

45. Hormone: Estriol • Anti-inflammation • Promote shift from T helper (Th) 1 to Th2 • Reduce autoimmune disease • Prevent osteoporosis • Breast caner protection • Menopause improvement 92 • Don't seem to increase risk of breast cancer Estriol binds to estrogen receptors with much weaker activity, competing stronger estradiol binding to receptors - protective against breast cancer

46. Estrogen Dominance Fatigue Hypothyroidism by decrease conversion of T4 to T3 • Decreased sex drive • Depression / anxiety / Migraines / Insomnia • Memory loss or foggy thinking • Mood swings / Memory loss or foggy thinking • Weight gain secondary to insulin resistance / Fat gain • PMS / Menstrual disturbances--irregular and heavy bleeding. • Bone loss / Hair Loss • Breast cancer / Fibrocystic breasts /Uterine cancer / fibroids • Water retention, bloating. • Tendency of autoimmune disorder Correction: Progesterone therapy

47. Estrogen Dominance After menopause, Progesterone decreasesby over 99% from its original youthful baseline levels; while estrogen production only decreases by about 40%.  • New research show that almost all the uncomfortable symptoms of PMS and of Menopause are actually caused by low progesterone levels in the body.

48. Breast Cancer prevention • Bio-identical Estrogen therapy • E3:E2 = 4:1 • DIP • D Vitamin D deficiency • Iodine deficiency • P Progesterone deficiency

49. Hormone: Testosterone • Testosterone • Improve insulin resistance, belly fat • Improve: sleep, vitality, libido/orgasm/arousal • Not necessary cause prostate cancer • Herbs：Yin Yang Huo淫羊藿, Rou Cong Rong肉苁蓉，Lu Rong鹿茸, Ren Shen人参

50. Hormone: DHEAthe first anti-aging hormone • Improve motivation, well being, memory, libido/orgasm • Anti-atherosclerosis • Antidiabetic • Anti-inflammatory • Antiosteoporotic • Anti-senility • Reduce fat • Protect thymus and immune function • 50mg daily anti-age without significant side effects