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I was wondering how Clomid would be described in Chinese Terms? I recently got

two new patients who are on it and both report feeling warmer, one is getting

mild hot flashes. So could one describe this drug as a Yang Tonic or at least

hot in nature?

 

Also, to folks feel it's better to have the patient stop Clomid & do herbs or

keep taking it?

Steve

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Hi Steve,

 

You are correct to say that Chlomid seems hot in nature. Whether it is a yang

tonic per say, I would hesitate to agree. Chlomid's action is to block estrogen

and so it's main side effects are reduced mucus production, a thinner

endometrial lining, as well as the hot flushes, thirst, irritability, and

aggravation of skin diseases like eczema (my own clinical observation). So all

signs of excess heat.

 

There has been studies done showing a better overall effect when CHlomid is used

with chinese herbs. One in particular was done with Wen Jing Tang.

 

My basic strategy is to just use acupuncture to support if it is their first

time using chlomid. This usually makes their western doctor happy as well. Then

if they do not get good results I add in herbal treatment, which is based purely

on the pattern I see manifesting.

 

For example I treated a PCOS patient quite successfully who did not respond very

well to chlomid on it's own, but did very well in combination with Chinese

herbs. This woman had very delayed menses and very aggressive acne. The formula

I used was Wu Wei Xiao Du Yin modified with blood invigorating and Qi rectifying

medicinals. Her cycle became very regular, her acne dissipated, and she became

pregnant. None of which happened with the Chlomid being used singularly.

 

Best

Trevor

 

, " snydez99 " <snydez99 wrote:

>

> I was wondering how Clomid would be described in Chinese Terms? I recently got

two new patients who are on it and both report feeling warmer, one is getting

mild hot flashes. So could one describe this drug as a Yang Tonic or at least

hot in nature?

>

> Also, to folks feel it's better to have the patient stop Clomid & do herbs or

keep taking it?

> Steve

>

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Wen yang & #28201; & #38451; yang-warming. If you go to www.bluepoppy.com, then to

the TCMinfoline, type the word " clomid " in the search box, you will get a number

of Chinese articles on CM and clomid/clomiphene citrate. Perhaps type in both

names for the best search.

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Steve -

 

I agree with Trevor's assessment of Clomid (Clomphine Citrate) and

it's energetics/side-effects.

 

I would also add that there was a poster presentation of a Meta

Analysis at last year's ASRM Conference in San Francisco which pooled

somewhere in the neighborhood of 10-12 RCT's from China that had

looked at PCOS patients using Clomid alone for ovulation induction, vs

patients using Chinese Herbal Medicine + Clomid for ovulation

induction. The Meta-Analysis definitely showed a statistical

advantage for PCOS patients using both Clomid and Chinese Herbal

Medicine together in terms of the outcomes looked at: ovulation rates,

clinical pregnancy rates, and ongoing pregnancy rates.

 

This RCT's looked at in this Meta Analysis were, however, someone

heterogeneous in-so-far as some of the trials treated patients with

herbs based upon classical TCM pattern differentiation, while some

treated patients with herbs based upon empirical formulas for

ovulation induction/infertility.

 

The side effects of irritability, hot flashes, even night sweats are

not uncommon in patients taking Clomid, and as Trevor said, this is

because Clomid is a SERM (Selective Estrogen Receptor Modulators),

which means that it's molecular make-up allows it to bind to receptor

sites that Estradiol would normally bind to - i.e. hypothalamus,

endometrium, etc. - and therefore it elicits the the symptoms of

Estrogen Deficiency/Perimenopause. These symptoms definitely manifest

more commonly in a subset of patients who are already exhibiting

either Liver Qi Depression/Depressive Heat, or Kidney Yin

Insufficiency/Empty Heat. Clomid will only aggravate their pre-

existing conformation. In addition to the side-effects of the

medication, these patients don't typically have very promising

clinical pregnancy rates either. Clomid definitely seems to work

better clinically in the Kidney Yang Deficient patient or the Spleen

Qi/Damp type patients.

 

For your patients, you might suggest that it looks like their body is

not handling the Clomid very well, and maybe they should consider

given you some time to get them balanced before continuing ovulation

induction with Clomid again - but I'm not sure it's our place to tell

them to stop a med that their doctor has prescribed.

 

You might also consider using acupuncture to offset some of the heat

symptoms you are seeing with the Clomid, instead of prescribing herbs.

IMHO, it takes a fairly significant degree of experience and knowledge

- both with western reproductive medicine and chinese herbal medicine

- to safely and effectively use both types of medications together.

 

Good luck and let us know how it goes,

 

Ray Rubio, DAOM, L Ac. (FABORM)

President/ABORM

Chair: Reproductive Medicine Department/Yo San DAOM Program

 

 

On Sep 30, 2009, at 12:22 PM, trevor_erikson wrote:

 

> Hi Steve,

>

> You are correct to say that Chlomid seems hot in nature. Whether it

> is a yang tonic per say, I would hesitate to agree. Chlomid's action

> is to block estrogen and so it's main side effects are reduced mucus

> production, a thinner endometrial lining, as well as the hot

> flushes, thirst, irritability, and aggravation of skin diseases like

> eczema (my own clinical observation). So all signs of excess heat.

>

> There has been studies done showing a better overall effect when

> CHlomid is used with chinese herbs. One in particular was done with

> Wen Jing Tang.

>

> My basic strategy is to just use acupuncture to support if it is

> their first time using chlomid. This usually makes their western

> doctor happy as well. Then if they do not get good results I add in

> herbal treatment, which is based purely on the pattern I see

> manifesting.

>

> For example I treated a PCOS patient quite successfully who did not

> respond very well to chlomid on it's own, but did very well in

> combination with Chinese herbs. This woman had very delayed menses

> and very aggressive acne. The formula I used was Wu Wei Xiao Du Yin

> modified with blood invigorating and Qi rectifying medicinals. Her

> cycle became very regular, her acne dissipated, and she became

> pregnant. None of which happened with the Chlomid being used

> singularly.

>

> Best

> Trevor

>

> , " snydez99 " <snydez99

> wrote:

> >

> > I was wondering how Clomid would be described in Chinese Terms? I

> recently got two new patients who are on it and both report feeling

> warmer, one is getting mild hot flashes. So could one describe this

> drug as a Yang Tonic or at least hot in nature?

> >

> > Also, to folks feel it's better to have the patient stop Clomid &

> do herbs or keep taking it?

> > Steve

> >

>

>

>

 

 

 

 

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Hi Trevor & Ray,

 

What about those patients that do not tend to yang xu & dampness who

actually feel better when taking Clomid? I have seen one such person

in my office that was yin & blood xu with some heat, very thin body

type who reported that while taking Clomid she felt more energetic,

had no hot flashes and her skin cleared up. Also, her endometrial

lining did not thin according to ultrasound and cervical mucus

production was normal. According to the CM view of Clomid energetics

this doesn't fit. WIth this particular patient Clomid appeared to act

like a yin tonic. Any thoughts on this?

 

Kelley

 

 

 

Kelley McDaneld L.Ac., Dipl.OM

PO Box 883143

Steamboat Springs, CO 80488

www.yvacupuncture.com

kmcdaneld

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Hi Kelley,

 

I'd say that based on the hundreds of women I have seen using chlomid over the

past several years, the experience you just described is not very common. It is

way more common for me to see the opposite.

 

That being said, perhaps the case you mentioned is one similar to how I have

heard Wen Jing Tang's action described. Cold has blocked the proper production

of blood and yin, with dryness as a consequence. By " melting the ice " , the flow

and production of blood and yin is freed up and thus moisture is restored.

Perhaps chlomid melted the ice, so to speak, in your patient??

 

Just a guess.

 

Trevor

 

, Kelley McDaneld <kmcdaneld

wrote:

>

> Hi Trevor & Ray,

>

> What about those patients that do not tend to yang xu & dampness who

> actually feel better when taking Clomid? I have seen one such person

> in my office that was yin & blood xu with some heat, very thin body

> type who reported that while taking Clomid she felt more energetic,

> had no hot flashes and her skin cleared up. Also, her endometrial

> lining did not thin according to ultrasound and cervical mucus

> production was normal. According to the CM view of Clomid energetics

> this doesn't fit. WIth this particular patient Clomid appeared to act

> like a yin tonic. Any thoughts on this?

>

> Kelley

>

>

>

> Kelley McDaneld L.Ac., Dipl.OM

> PO Box 883143

> Steamboat Springs, CO 80488

> www.yvacupuncture.com

> kmcdaneld

>

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