Kidney Transplant Patient on Immunosuppressives

[Guest guest]

Has anyone ever treated patients on immunosuppressive drugs (for their

transplants)?

 

I have a new patient with obesity, fatigue, and digestive problems - the

challenge here is finding herbs that are effective but DO NOT boost the

immune system. Knowing that the wei qi comes from good Sp function makes it

more complicated- can I not even boost her Sp qi without possibly causing

rejection of the kidneys?

 

I realize I haven't given the zang fu diagnosis- just initially curious if

anyone has already done some herbal work-arounds for this issue.

 

Thanks!

B

 

===================================

Brian B. Carter, MSci, LAc

 

Licensed Acupuncturist & Herbalist

Professor, Pacific College of Oriental Medicine

Columnist, AcupunctureToday.com

Founder, The Pulse of Oriental Medicine

250+ free articles for the layperson.

http://www.pulsemed.org/

 

San Diego Private Practice:

6629 Convoy Ct. SD CA 92111

(619) 208-1432 Voice

(619) CLUB-619 FAX

===================================

[Guest guest]

We had a thread on CHA a few years ago with myself and Simon Becker, I

believe, (or Simon King, I forget) about this same problem. My point

of view, based on a couple of cases I had years ago, was to not treat

patients on immunosuppressive drugs for transplants, either with

acupuncture or herbal medicine. One of my patients 20 years ago would

develop fevers after acupuncture treatments, and the physician

confirmed that it was a rejection response, so I stopped treating the

patient. Of course, I was unable to separate the herbal medicine from

the acupuncture to see which (or both) was the culprit.

 

Simon countered that his experience (if I remember correctly, Simon,

please correct me if I am wrong) was that over time, that patients

became less sensitive to using herbal medicine and/or acupuncture in

transplant cases. I assume this is because the transplant becomes more

stable and secure over time, and also dosages of immunosuppressive

drugs are gradually decreased.

 

I have not seen any Chinese studies on this topic, I assume that there

must be some articles on this in the Chinese journals.

 

While I've modified my point of view on this subject, I would proceed

with caution, especially in cases of recent organ transplant (in the

last 1-3 years).

 

 

On Mar 30, 2004, at 12:21 PM, Brian B. Carter, MS, LAc wrote:

 

> Has anyone ever treated patients on immunosuppressive drugs (for their

> transplants)?

>

> I have a new patient with obesity, fatigue, and digestive problems -

> the

> challenge here is finding herbs that are effective but DO NOT boost the

> immune system. Knowing that the wei qi comes from good Sp function

> makes it

> more complicated- can I not even boost her Sp qi without possibly

> causing

> rejection of the kidneys?

>

> I realize I haven't given the zang fu diagnosis- just initially

> curious if

> anyone has already done some herbal work-arounds for this issue.

>

> Thanks!

> B

>

> ===================================

> Brian B. Carter, MSci, LAc

>

> Licensed Acupuncturist & Herbalist

> Professor, Pacific College of Oriental Medicine

> Columnist, AcupunctureToday.com

> Founder, The Pulse of Oriental Medicine

> 250+ free articles for the layperson.

> http://www.pulsemed.org/

>

> San Diego Private Practice:

> 6629 Convoy Ct. SD CA 92111

> (619) 208-1432 Voice

> (619) CLUB-619 FAX

> ===================================

>

>

>

>

>

>

[Guest guest]

Thanks, Z'ev.

 

For good or bad, it's no longer an issue with that patient, because together

she, her MD, and her husband felt it would be best to go without herbs.

 

Still, it's an interesting paradox, that I would have to conspire with the

medications to keep her in an unnaturally unhealthy state in order to live.

I had fun for a bit trying to find the herbs that, as far as our literature

in English says, would not stimulate the immune system, but would also

benefit her other problems.

 

I believe that one of acupuncture's modes of action is via the immune

complement system, and of course we know there are certain immune responses

to certain points... so here's the same problem.

 

B

 

===================================

Brian B. Carter, MSci, LAc

 

Licensed Acupuncturist & Herbalist

Professor, Pacific College of Oriental Medicine

Columnist, AcupunctureToday.com

Founder, The Pulse of Oriental Medicine

250+ free articles for the layperson.

http://www.pulsemed.org/

 

San Diego Private Practice:

6629 Convoy Ct. SD CA 92111

(619) 208-1432 Voice

(619) CLUB-619 FAX

===================================

 

Message: 2

Tue, 30 Mar 2004 21:23:00 -0800

" " <zrosenbe

Re: Kidney Transplant Patient on Immunosuppressives

 

We had a thread on CHA a few years ago with myself and Simon Becker, I

believe, (or Simon King, I forget) about this same problem. My point

of view, based on a couple of cases I had years ago, was to not treat

patients on immunosuppressive drugs for transplants, either with

acupuncture or herbal medicine. One of my patients 20 years ago would

develop fevers after acupuncture treatments, and the physician

confirmed that it was a rejection response, so I stopped treating the

patient. Of course, I was unable to separate the herbal medicine from

the acupuncture to see which (or both) was the culprit.

 

Simon countered that his experience (if I remember correctly, Simon,

please correct me if I am wrong) was that over time, that patients

became less sensitive to using herbal medicine and/or acupuncture in

transplant cases. I assume this is because the transplant becomes more

stable and secure over time, and also dosages of immunosuppressive

drugs are gradually decreased.

 

I have not seen any Chinese studies on this topic, I assume that there

must be some articles on this in the Chinese journals.

 

While I've modified my point of view on this subject, I would proceed

with caution, especially in cases of recent organ transplant (in the

last 1-3 years).

 

 

On Mar 30, 2004, at 12:21 PM, Brian B. Carter, MS, LAc wrote:

 

> Has anyone ever treated patients on immunosuppressive drugs (for their

> transplants)?

>

> I have a new patient with obesity, fatigue, and digestive problems -

> the

> challenge here is finding herbs that are effective but DO NOT boost the

> immune system. Knowing that the wei qi comes from good Sp function

> makes it

> more complicated- can I not even boost her Sp qi without possibly

> causing

> rejection of the kidneys?

>

> I realize I haven't given the zang fu diagnosis- just initially

> curious if

> anyone has already done some herbal work-arounds for this issue.

>

> Thanks!

> B

>

[Guest guest]

, " Brian B. Carter, MS, LAc " <

bbcarter@p...> wrote:

> Thanks, Z'ev.

>

> For good or bad, it's no longer an issue with that patient, because together

> she, her MD, and her husband felt it would be best to go without herbs.

 

Brian

 

I have found that doctors using immunosuppressive therapies for whatever

reason as well as most oncologists to be almost unanimously opposed to the

simultaneous use of chinese herbs during therapy. Transplant patients are one

example, but this also extends to autoimmune patients on methatrexate. Most

oncologists also oppose antioxidants during chemotherapy as much chemo

works by oxidative damage. As you know, many, many herbs have immune

stimulating and antioxidant properties, not just tonics. Bai hua she she cao

works by modulating the immune system for example, as does jin yin hua, lian

qiao, pu gong ying, xia ku cao, yu xing cao, zhi mu, shi gao, chai hu, gou qi

zi,

he shou wu, shu di huang, nu zhen zi, etc., etc. So there are really very few

types of herbs that would be safe from an MD's perspective. However some

such as Subhuti have suggested that the MD take on this matter reflects a

rather simplistic understanding of the immune system and there is no

evidence to support their concerns vis a vis autoimmune dz and cancer (though

in transplant cases, I think the caution is warranted).

 

[Guest guest]

Zev and Brian,

 

I have a little experience prescribing herbs to patients on

immunosuppresive therapy and am a transplant patient myself. So my

thoughts:

 

> I have found that doctors using immunosuppressive therapies for

whatever

> reason as well as most oncologists to be almost unanimously opposed

to the

> simultaneous use of chinese herbs during therapy.

 

I haven't found this to be true in my part of area in the UK. In the

case of kidney units it is often a case of the patient sounding out

just one sympathetic consultant from the team. Unit pharmacists can

be very helpful.

 

However some

> such as Subhuti have suggested that the MD take on this matter

reflects a

> rather simplistic understanding of the immune system and there is

no

> evidence to support their concerns vis a vis autoimmune dz and

cancer (though

> in transplant cases, I think the caution is warranted).

>

I have found that nephrologists, at least, are not at all impressed

by the simple conclusion that what we consider supplementing or

immune acting herbs are therefore unsafe in immune suppression. I

have found that what they are interested in in transplant cases is

the empirical evidence of how the herbs effect blood cyclosporin or

tacrolimus levels. Herbs can make the levels of the immunosuppresants

fluctuate so caution is necessary, there is alot to lose.

 

Most nephrotic syndrome patients I have treated have been on immune

supressants, it doesn't seem to be a problem using herbs as well and

prehaps can enable them to reduce or stop steroids. A less worrying

area than transplantation.

 

I think there is a case to be made that herbs can improve creatinine

levels post transplant so positively helping the new kidney.

 

I think the thing we discussed Z'ev, a while ago, was that over time

with a transplant the issue is not an immune type rejection but a

sclerosing of the vessels in the kidney so prehaps herbs are

positively benificial. The average survival time of a transplanted

kidney here is not very long, 10 years or so.

 

It is all a very uncertain area but I think worth exploring if some

sympathetic medics can help. I was talking to a nephrologist a couple

of weeks ago about a list of herbs they have which on the basis of

one patient they suspect of altering tacrolimus levels. I am promised

a copy.

 

Simon

[Guest guest]

Todd

 

> As you know, many, many herbs have immune

> stimulating and antioxidant properties, not just tonics. Bai hua she she cao

> works by modulating the immune system for example, as does jin yin hua, lian

> qiao, pu gong ying, xia ku cao, yu xing cao, zhi mu, shi gao, chai hu, gou qi

> zi, he shou wu, shu di huang, nu zhen zi, etc., etc.

 

Do you have a reference for this information?

 

David

 

*************************

David Bruce Leonard, L.Ac.

Medicine at your Feet

'Awapuhi Health Sanctuary

 

http://www.medicineatyourfeet.com

http://www.awapuhihealth.com

[Guest guest]

, David Bruce Leonard <

herbnerd@h...> wrote:

 

>

> Do you have a reference for this information?

 

Subhuti Dharmananda's chinese herbal therapies for immune disorders

summarizes this information.