Paul K. Branch, M.D. - Holistic Medicine and Classical Homeopathy


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The Alternative Healer

Archive for the ‘Chinese Medicine/Vital Energy Dimension’ Category


Menopause: What is the Best Therapy?

Thursday, December 16th, 2010

Menopause is a time of transition, a crossing from one state to another. The key in all transitions is to find safe passage across what can be rough waters. From the point of view of traditional Chinese medicine, a key year in this transition lies in the 48-49 year range. When confronted with menopausal or peri-menopausal symptoms, there are three main paths that a woman can take:

▪ Conservative. This views menopause as a natural transition where treatment should be minimal. In my practice, women who choose this path use classical homeopathy and perhaps some nutritional and dietary therapy to manage symptoms.
▪ Energy Imbalance Perspective. This point of view reflects the understanding of Chinese medicine (TCM). From the point of TCM, hot flashes and other menopausal symptoms arise out of an energy imbalance that can easily occur at mid-life. The energy of the kidneys, which create cooling vital fluids, declines at menopause, and thus fall out of balance with the fire energy of the body. The water-fire balance tips in favor of heat and leads to hot flashes. In addition, when women stop menstruating, they may load extra toxicity which formerly was excreted through menstruation. If the body does not find a new balance, illness may develop. Women who choose the energy balance path can use herbal therapy to replenish their lost vital essence, and often hold this balance through the transition and beyond. They may or may not use classical homeopathy along with this approach.
▪ Hormonal Imbalance perspective. This is viewpoint of a segment of western doctors, particularly those involved in anti-aging medicine, and has been popularized by Suzanne Somers. In this view, the decline of hormones in mid-life leads to symptoms. To manage the symptoms, this view advocates replenishing the lost hormones with bio-identical hormones. The agreement among all doctors who work at the forefront of this field is that estradiol (estrogen) should not be taken orally. Doctors mainly prescribe transdermal (applied to skin) application for both estradiol and progesterone replacement, although many advocate taking the progesterone orally if there is insomnia. Within this group of doctors, there are many individual variations, but two main groups you should be aware of:

⁃ -Cyclers: This sub-group, whose chief proponent is Susie Wiley, maintains that        women should take hormones in a way that mimics the hormonal rhythms of a younger, menstruating women. In this method of hormone replacement, the first half of the cycle is an estrogen phase and the second half is a progesterone phase. When hormones are cycled in this way it will promote a menstrual period. The Wiley Protocol is the most extreme of the cycler group, because it advocates returning a woman to the higher hormonal levels of a young woman, attempting to exactly mimic the rhythm of young adulthood.
-Non-cyclers: This group usually gives static (i.e. the same dose each day) daily doses of hormones. If a diagnosis of “estrogen dominant” is given, then there will be a daily dose of progesterone alone. Other situations may call for giving both estradiol and progesterone. Some doctors always give a combination of estradiol and progesterone each day.

In reference, to the above three approaches, here is the approach of my practice:
1) If I had to choose only one therapy from the above three, I would choose classical homeopathy. The reason is that this treatment is so deep that it can manage most health problems. With a good homeopathic prescription, a woman feels better than using either Chinese herbal medicine or bio-identical hormone replacement alone, or together. I find that using bio-identical hormone replacement can be limited in cases where the health of the woman is not that good.
2) Treating with classical homeopathy and then supplementing with Chinese herbals to fine-tune and build the vital essence of the body is an excellent way to proceed.
3) Using all three approaches together. This has slowly been evolving into my treatment of choice. First I like to begin with classical homeopathy and see how things balance out. From there, if signs of deficiency exist, I will restore the balance with herbals. I find that then adding in bio-identical hormones optimizes how a woman feels, allowing her to move into a new and higher state of well-being.
4) Although I recognize arguments for both Cyclers and Non-Cyclers, my prescribing sides more with the Cyclers. Before prescribing a cycling regimen, though, a woman needs to be OK with the likelihood of menstruating beyond normal menopausal age. If you give bio-identical estrogen in the first half of the cycle, followed by progesterone in the second half, a woman will build up a uterine lining (assuming she has a uterus). When the progesterone is stopped at the end of the cycle, bleeding will occur. All doctors using bio-identical replacement therapy agree that taking some bio-identical hormones is healthier than not, even when given in a low-dose static way. I agree, however, with the Cyclers who argue that a static dose of hormones tends to “clog” the receptors, inhibiting them from regenerating.
5) Although I have seen no evidence, either in practice or in the literature, that bio-identical hormone replacement promotes cancer or any other disease, I have seen evidence that giving too much of either estradiol or progesterone can create toxicity. Thus, I do not want to say that bio-identical hormone replacement is without risks. It is important to tune in to how you feel when you start taking bio-identical hormones. If you do not feel better, you either need to change the regimen or stop them. When bio-identical hormone replacement works, this is reflected both in measurements (e.g. the Digimeridian I use) and in how you feel.

The above is a brief summary of an evolving field. Use it as general guidelines, asking questions to find answers that suit your individual needs and outlook. Trust that, for those in the know, there are profound interventions that can make the menopausal years healthy and joyful.

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Menopause: What you Need to Know

Saturday, October 16th, 2010

A lot of medicine revolves around  the care of women during menopausal and peri-menopausal years.  This time brings a lot of suffering to a lot of women.  Complaints I often hear are fatigue, hot flashes, insomnia, brain fog or difficult concentration, low sex drive, depression, and, occasionally, breast cancer.  Medicine has struggled to successfully help women during these years.

Much attention goes to the hormones that are associated with menopause–estrogen and progesterone.  Production of these hormones begins to drop in a woman’s 30s.  By the time she reaches peri-menopause in her mid-40s, there is quite a drop from the hormonal levels of her teens and 20s.  At a certain point, estrogen production falls so low that a woman is unable to build up a uterine lining, and menstrual bleeding stops altogether.

These hormones are indeed important, but there is more going on here than meets the eye.  Focus only on hormones and we miss the big picture.  Let’s walk it through:

An important matter is that menstrual bleeding is a detoxification of the blood.  This has become increasingly apparent to me in my treatment and clinical studies of women.  The Digimeridian, which measures acupuncture meridians, usually reflects when a younger woman is about to have a heavy period, because it registers toxicity around the heart and blood.  The menstrual bleeding comes and flushes this out, hopefully completely.

The extent to which uterine bleeding can detoxify was impressed upon me by a story Dr. Yongli Ni told to me a couple years ago.  It was a case of a pregnant woman who  developed vaginal bleeding early on in her first trimester.  She was told that if it did not stop, it would likely mean a miscarriage.  Yet, the bleeding continued.  Fearful of losing her baby, and alarmed because her gynecologists did not know what to do,  she consulted Dr. Ni.  After examining the case, Dr. Ni told the woman everything was OK, and that the bleeding was necessary for her to keep her baby.

Why?  The story goes like this.  This was a Russian woman who grew up near Chernobyl, and suffered exposure to radiation.  In Chinese medicine understanding, radiation exposure is a “fire toxicity.”  This woman had this fire toxicity in her uterus and reproductive system.  In order to have a healthy baby, her body had to flush out the fire toxicity of the radiation.  It did this through bleeding.  She was treated with acupuncture and reassurance and had a healthy baby.

Clearly, detoxification through menstrual bleeding represents an advantage for women over men.  Up until they reach menopause, women have an extra route to shed toxicity.  As they cross into menopause, things switch and women catch up with men in their risk of developing debilitating disease–particularly heart disease.  Not surprisingly, the heart, which is closely linked with blood, is most affected by extra toxicity loaded in the blood.

This makes an argument for the Wiley Protocol.  The Wiley Protocol is a bio-identical hormone replacement protocol for menopausal women that mimics the cycle of a younger woman, producing a menstrual bleed.   Susie Wiley, who created the protocol, believes that women are protected when they cycle and bleed.  This argument has some credence.  Nevertheless, things are not quite as simple as the Wiley Protocol suggests.  More on that when I discuss  cutting edge treatment in a future newsletter.

So, why do some women do fine going through menopause and others do badly?  In other words, there is more than just hormones involved.  If it were simply about hormones, then every woman would have difficult symptoms, and this is not the case.  In my studies, women that are heavily toxic before the advent of menopause run a major risk of trouble.  Toxicity creates inflammation.  Inflammation in turn creates disease symptoms.  Our ability to unload toxicity is key.  We take on toxicity from our emotions, our food, our metabolism and our environment.

What does the drop in hormones at mid-life have to do with this?  Hormone production drops gradually because the energy of the kidneys drop.  The energy of the kidneys, in Chinese medicine, is where  vitality and hormone production resides.  In other words, if you keep the kidney energy strong, there would be no reason for hormone production to fall off at all.

This drop in energy also reflects a decreasing ability to detoxify.  Replacing  hormones appears to be the equivalent of giving a kidney tonic, i.e. to some extent they build the energy of the kidneys.  Bio-identical hormones are no cure-all.  I currently debate how much merit there is in saying “This woman has lost her hormones and therefore needs them replenished to help her symptoms.”   It is useful, but it is oversold.  The problem is better set up as “The kidney energy is weakened, and this has produced toxicity in the body and caused symptoms.”   This sets up an entirely different approach to treatment.  This approach yields better treatment results overall.  What role bio-identical hormones should play is an ongoing question that may require a different answer for every woman.

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Reflections on Traditional Chinese Medicine

Saturday, July 10th, 2010

In response to my previous post, our reader wrote the following:

I find your blog one of very few on alternative medicine that dares to speak some of the truths rarely spoken – for example, the one on myths about weight loss – you are clear, concise and to the point – i find that refreshing.  Your answers make a lot of sense, but also provoked a few more questions –here they are:

1) From your answer and articles on your blog, as well as my own observations and experience with TCM, it is not a modality primarily used to address emotional and spiritual healing – is that true?

2) The other question is, can TCM suppress a disease, and/or cause the body to develop a deeper illness?

i am asking questions of this kind because I am troubled by how alt. med. is still being practiced the majority of the time – i.e. focus on or treat only one level, usually the physical, with little or no regard to the other levels, nor the possibility of suppression – yet i know there is a purpose that all modalities are serving… i am trying to understand, to complete the picture for myself

Thank you once again.

Thanks for your questions.  It makes blogging fun.  So please keep them coming.

As for the first question, I agree with you that TCM is not a modality primarily used to address emotional and spiritual healing.  The key word here is “primarily.”  TCM certainly encompasses the emotional and spiritual, it simply rarely creates therapeutic intentions at that level.  As I discussed early on in my blogging, the “therapeutic intention” of a healer is critical, because you are unlikely to accomplish things you do not intend.  This is the greatest weakness of TCM, which is a brilliant modality.  Observe one great Chinese practitioner and you understand what an astonishing accomplishment TCM is.

TCM springs out of a distinct perspective, which has to do with Chinese culture itself.  I find it to be ‘impersonal,” particularly when compared with other ancient cultures, such as the Greeks and ancient India.  The essence of Chinese spirituality is the Tao.  The Tao describes cosmic forces that are orderly, harmonious, mysterious, yet impersonal.  Compare it to the myths of Hinduism and the Greeks, where there is an encounter between the human and personal, even intimate, cosmic forces.  Feel the ecstasy of union of  a Hindu worshiping Krishna.  I am no expert, but such an experience seems rare in China.

Chinese medicine reflects this, and it has a powerful objectivity.  The ancient Chinese were exact observers of nature.  Yet our understanding of the  “spiritual” and “emotional,” which necessarily include the subjective, gets lost.  I have found this out recently in working with top-notch Chinese practitioners.  They conceive the mental and emotional in terms of the energy terminology of TCM.  They listen as you talk about treating a different dimension, but they have no framework to fully understand it.

TCM never developed deeper methods to help the psychologically or socially challenged patient.  It probably is because the nature of Chinese society does not produce such conditions often.  If a society does not recognize psychiatric illness, people are less likely to develop it.  Calling this a “weakness” of TCM is subjective.  Nevertheless,  TCM does not translate perfectly to western culture, where experiences such as “alienation” and “cultural mal-adjustment” are rampant.  “Depression” is an interesting concept here.  For the Chinese, depression is primarily a disease of heart or liver energy.  They are right, yet they miss the possibility of a energetic, spiritual perspective lying hidden beneath it.

As for question #2, I think bad Chinese medicine can promote deeper illness, but you would have to work at it.  A person can usually feel the imbalance produced by wrong treatment and stops it.  For example, if I am very yang and hot, and you give me herbals that rev up my yang energy, I am not going to like you much.  “Suppression” is not a good word for this.  Working with elemental forces of the universe, TCM is not given to harsh suppression.  Acupuncture I think is even more benign.  You can throw a person off with bad acupuncture, but, unless you have quite a sick or depleted person, you would have to work hard to cause any major problems.  There may be those out there whose experience contradicts this.  I would love to know about it if so.

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Energy & Weight Loss

Sunday, April 25th, 2010

Here’s something you intuitively know but probably haven’t thought much about:  weight loss is a matter of energy.  

What you know is that if you feel like you have no energy, the pounds come off slowly.  People usually put it this way, “'I'm tired. I don’t feel like exercising, and therefore I can’t lose weight.”  It’s true that having no energy points to a problem, but if your energy were great, you would be unlikely to be overweight in the first place.  Exercising is unlikely to solve your problem.

Every inch your waist expands represents a loss of energy in your system.  Put a different way, an increase in waist size represents a decrease of the “energy-of-the-middle.”  In Chinese medicine this is associated with the energy of the stomach and the spleen.  Note, this is a little bit different than putting on weight in your hips and thighs, which I will discuss another time. 

The energy-of-the-middle is what takes in food, transforms it, and sends it to your muscles as energy.  In other words, it is your metabolic energy. 

I hear the following complaints a lot: 

    “My metabolism is shot.”
    “I just eat a little bit  and I still gain weight.” 
    “My appetite is low.” 
    “I have to work so hard to just lose an ounce.” 

These are just a few statements that point to weakness in the energy-of-the-middle.  I also get statements like

    “My thyroid is shot. I have no energy.” 

The energy of the stomach is closely associated with the thyroid in Chinese medicine and, I suspect thyroid issues occur along with weakness in the energy-of-the-middle.

Metabolic energy is important for losing weight.  It would be difficult to get too much of it.  The key strategy for maintaining a healthy weight is to first focus on where energy is weak.  Then you devise a strategy to build up where you are weak.   If you are interested in your own specific energetic issues, then I recommend you come in and let me test your energy meridians with the Digimeridian machine.   This can lead to some precise recommendations on how to help your own system with weight loss.  

Not always is weak energy the main cause for becoming overweight.  Often there is an excess or toxicity that leads to weakness of the-energy-of-the-middle.  The number one culprit here is the liver, which gets overheated and "invades" the-energy-of-the middle, weakening it.  In fact, it appears that a poorly functioning liver is at least a partial cause of most obesity. 

The liver is a subject for a future blog. 

 

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