Posted by Hombre on July 18, 2010, at 11:41:35
In reply to Re: PMDD and estrogen therapy?, posted by Hombre on July 17, 2010, at 3:09:53
Following up on my train of thought concerning liver enzymes, I decided to see if Chinese medicine addresses estrogen and depression in a direct manner. If anything, I hope it provides some leads to follow up on. Unfortunately, discussions tend to focus on menopause. I'm not so sure how relevant that is to PMDD. Please keep in mind that most educated discussions of Chinese medicine also include awareness of the Western model of the physiology.
Oh, why the liver. The liver is considered the primary culprit in depression. Perhaps when the liver cannot do its job correctly, hormones are not regulated properly.
o "Estrogen and Herbs" by John K. Chen, PhD,
PharmD, OMD, LAchttp://www.aaaomonline.info/ameracu/V34P16-Estrogen_and_Herbs-Parts1and2.pdf
Where's Part 3, John?
o This article discusses some of the issues around estrogen, cancer and herbs that may or may not elevate estrogen levels.http://www.itmonline.org/arts/estdep.htm
o In TCM, Essence (Jing) in part refers to the steroid hormones. The importance of Essence is such that it is considered the root of the body's energy:http://www.acupuncture.com/newsletters/m_feb09/menopause%20chinese%20medicine.htm
"Stored by the Kidney, Essence is the origin of all Yin (Blood and Moisture) and Yang (Qi and Warmth). Loss of libido, stamina, hearing, and vision, lower back pain, sore hips or knees, apathy, despair, dull mindedness, memory problems, vaginal dryness and atrophy, thinning of bones, and deterioration of teeth and gums are all symptoms of deficient Essence."
"When Essence becomes depleted, so do Blood and Qi, Yin and Yang. Lack of Qi produces fatigue, weakness, dull thinking, melancholy, and decreased motivation. Deficiency of Blood leads to weak vision, dizziness, night sweats, irritability, and restless sleep. Lack of Blood deprives muscles, tendons, and ligaments of sufficient nourishment and suppleness, so they become tight and inflamed, leading to muscle cramps, joint pain, and neck tension. The organism responds to this state of scarcity with anxiety and lability, for lack of Blood disrupts the smooth flow that preserves elasticity of tissue and emotional flexibility. As Kidney Essence declines, a domino effect engenders down line deficiencies that eventually impact the Liver, Heart, Spleen, and Lung."
"In sum, labile emotions and unpredictable surges and lapses of physical and mental energies result from the attrition of Yin and Yang Essences of the Kidney, causing the Qi of the Liver, Heart, and Spleen to become erratic and insufficient. Many women have signs of both Kidney Yin and Yang depletion. But because hot flashes, sweating, agitation, and dryness (Kidney Yin Deficient symptoms) are more attention-getting, herbs that treat Kidney Yin deficiency are often overemphasized at the expense of those that restore the true Yang of the Life Gate, an equally important goal."
o http://www.chineseherbacademy.org/articles/menopause.shtml"According to Subhuti Dharmananda, in his paper, "The Endocrine Effect of Chinese Medicine", "Chinese herbs act by stimulating the production of hormones, altering the condition of hormone receptors or changing the rate of catabolism of hormones, rather than by providing the hormones or hormone analogs that function the same as hormones."11 Many of the ingredients in formulas may have little or no hormonal effects, although the effect of the whole formula will substantially increase hormone levels. Chinese herbs work by improving the function of aging organs and glands."
"The Chinese Journal of Traditional and Western Medicine, 1991, reported a study of 2 months administration of Rehmannia 6 Formula to relieve menopausal symptoms in early post-menopausal women. The study showed an increase of 20% in estrogen, a decrease by 1/2 in FSH, and a decrease in LH to pre-menopausal levels; the number of estrogen receptors in leukocytes more than doubled. The Chinese Journal of China Materia Medica, 1993, reported a study of aged rats, in which Rehmannia 8 Formula increased estradiol in females and testosterone in males. The Journal of Traditional Chinese Medicine, 1992, reported a study of 58 patients with osteoporosis, using Chinese herbs for 10 to 12 weeks. Bone density improved an average from 4.0 to 0.9 (0=normal). A three month course of treatment for osteoporosis can be successful in increasing bone density back to near normal levels, and as long as the patient is following a good diet, exercises daily, and avoids harmful practices (smoking, etc.), they probably will not need further treatment, unless they become sedentary from illness or injury. If that occurs, then he or she might need a follow-up course of treatment. In many cases, the patients are instructed to continue herbal therapy at a much lower dose in pill form for long-term tonification, (for example, Rehmannia 6 or 8 Formula).
It is significant that high levels of herbs are being prescribed in these studies, equivalent to 25 to 75 grams of raw herbs or 18 to 27 grams of freeze-dried herbs per day. It is more common for American patients to have difficulty digesting large amounts of herbs. Sometimes it is necessary to work on improving the digestion first, and to start off with a lower dose of herbs and work up to a higher dose."
* Rehmannia 6 = Liu Wei Di Huang Wan
Rehmannia 8 = Ba Wei Di Huang Wan/
Jin Gui Shen Qi Wan (more common)"Formulas that are commonly used during menopause are prescribed according to how the symptoms present. The following is a list of formulas that can be useful:
1. LIVER QI DEPRESSION WITH OR WITHOUT HEAT - Symptoms could include: irregular or short cycles, clots, fatigue, anger, frustration, depression, mood swings, cold extremities, PMS, breast tenderness or lumps. When there is stagnation (liver qi or blood stagnation), it is very important to treat the stagnation before or along with the tonic formulas for the kidney. The classic base formulas are Xiao Yao San and Jia Wei Xiao Yao San.
2. KIDNEY AND LIVER YIN DEFICIENCY - Symptoms could include hot flashes, night sweats, palpitations, thirst, weak knees and low back, chronic vaginal infections or cystitis. The classic base formulas I use are Rehmannia 6 (You can add phellodendron and anemarrhena for heat) or Left Restoring Decoction (Zuo Gui Wan).
3. KIDNEY YANG DEFICIENCY - With floating yang due to deficiency. Symptoms could include heat, dryness, upper body distress, severe hot flashes, insomnia, severe fatigue, teeth or bone problems. These women really need hormonal support and are frequently already on HRT. The classic base formula I use is Two Immortal Decoction (Er Xian Tang), to which I often add placenta and tortoise shell.
4. QI AND BLOOD DEFICIENCY - Symptoms could include dry skin, vaginal dryness, dizziness, insomnia, fatigue, digestive symptoms, muscle weakness, dry eyes or poor vision, scanty menses or excessive bleeding. The classic base formulas I use are Tang Quei and Peony (Dang Gui Xiao Yao San) or Ginseng and Longan Formula (Gui Pi Tang).
5. HEART FIRE -Symptoms could include forgetfulness, fear, anxiety, nightmares, hot flashes, palpitations and irregular periods. The classic formulas I use are Zizyphus Combination (you can add polygala, oyster shell, semen biota or albizziae.), Rehmannia 6 plus anemarrhena and phellodendron (Zhi Bai Di Huang Wan), or Heavenly Emperor's formula (Tian Wang Bu Xin Tang).
To these formulas, you can add sedating or cooling herbs to improve the treatment.
Herbs to calm the heart and sedate the spirit and for uprising qi include: oyster shell, dragon bone, magnetite, tortoise shell, fu shen, polygala, zizyphus spinoza, uncaria and schizandra. Heat clearing herbs include: phellodendrom, anemarrhena, coptis, moutan, raw rehmannia and tortoise shell.
Substances which can be added which have a stronger hormonal effect include: placenta (the strongest effect), ginseng, deer antler, lithosperum, epimideum, psoralea, centipede and astragalus seed. (These herbs should be avoided when treating someone with cancer, an estrogen-dependent tumor or endometriosis.) Other herbs in the category of strong hormonal effect include cynamorium, schizandra, lycium fruit, rehmannia, licorice and cyperus.17
I have found in my practice that these formulas can be very effective. They can take the place of using the natural or synthetic hormone replacement. Even if a women is already using hormones, she can benefit from using Chinese herbs for the symptoms which don't respond to HRT, to treat the underlying imbalance, or to help her get off of HRT. The synthetic hormones have side effects, especially liver qi stagnation and blood stagnation. I generally use freeze-dried herbs, at least 9 grams per day. Sometimes I use more if I decide to use two formulas at the same time, rather than adding or subtracting to the base formula for each patient's special needs. I treat with acupuncture once a week, emphasize a good diet with mineral rich leafy greens and seaweed, exercise, stress reduction and supplementing with vitamins, minerals and essential fatty acids."
poster:Hombre
thread:953868
URL: http://www.dr-bob.org/babble/alter/20100703/msgs/954877.html