Chinese herbs as a substitute for warfarin?

[Guest guest]

Thanks for the clarification of my original question Charlie. The essence of

what I'm getting at is the use of western diagnostic labs to monitor the effects

of herbal medications. I've seen practitioners use herbs for hyperlipidemia and

monitor results with blood tests, or use herbs to control HTN and measure the

results with a blood pressure cuff. I wanted to explore the idea one step

further with the monitoring of a patient's PT, PTT, and INR as affected only

through herbs. I'm assuming we're all well aware of the dangers of combining

warfarin and herbal medicines, and using both in combination is not the

intention of the question.

 

The reason the patient's wife asked me this question was because of the nausea

and abdominal pain caused by warfarin. He was hoping there might be an

alternative remedy that would still keep him anticoagulated, but not cause the

side effects. I explained to her that from a CM approach to treatment,

addressing the a-fib itself through pattern identification, not keeping him

anticoagulated forever would be the underlying approach I would take...but her

initial question prompted me to start researching. I was surprised that with

all of the studies regarding interactions between herbs and warfarin, none that

I could see documented the effects of PT, PTT, INR solely from the herbal group.

 

Danny

 

On May 13, 2010, at 7:01 AM, wrote:

 

> What makes Danny's original question interesting to me is the idea of using

the PT/INR test in conjunction with . It's not about finding an

herbal substitute for warfarin. Do the standard diagnosis and

treatment. A favorable change in INR is a positive " side effect " of the CM

treatment, which shows that the therapy is " working " from a western medical

perspective. It may not be replicable or may not even be a valid protocol for

other patients, but it could improve the quality of life for this particular

patient. And it's an ideal situation that the patient and his MD wife are

willing to give it a try and to do the necessary monitoring for safety and

effectiveness (from a WM perspective). I would otherwise not be experimenting

with warfarin / herbs. Not from a philosophical perspective of not using herbs

as substitutes for pharmaceuticals, but for safety and liability reasons.

 

 

 

 

[Guest guest]

You might look into Nattokinase as an anticoagulant. It's been used

and studied quite extensively in Japan, so you could probably find

some data that looks at the serum values related to it's anticoagulant

effects.

 

Allergy Research Group (ARG) has a very high quality Nattokinase

(although ARG is pretty pricey), and they also have a few studies on

their website related to this product.

 

Here is the link:

http://www.allergyresearchgroup.com/Nattokinase-NSK-SD-100-mg-180-Softgels-p-268\

..html

 

Ray Rubio, DAOM (FABORM)

President/ABORM

Reproductive Medicine Department Chair/Yo San University DAOM Program

 

Westlake Complementary Medicine

910 Hampshire Road, Suite A

Westlake Village, CA 91361

Phone: (805) 497-1335

FAX: (805) 497-1336

email: rtoo

www.westlakecomplementarymedicine.com

 

 

 

On May 13, 2010, at 10:00 AM, Danny Johnson wrote:

 

> Thanks for the clarification of my original question Charlie. The

> essence of what I'm getting at is the use of western diagnostic labs

> to monitor the effects of herbal medications. I've seen

> practitioners use herbs for hyperlipidemia and monitor results with

> blood tests, or use herbs to control HTN and measure the results

> with a blood pressure cuff. I wanted to explore the idea one step

> further with the monitoring of a patient's PT, PTT, and INR as

> affected only through herbs. I'm assuming we're all well aware of

> the dangers of combining warfarin and herbal medicines, and using

> both in combination is not the intention of the question.

>

> The reason the patient's wife asked me this question was because of

> the nausea and abdominal pain caused by warfarin. He was hoping

> there might be an alternative remedy that would still keep him

> anticoagulated, but not cause the side effects. I explained to her

> that from a CM approach to treatment, addressing the a-fib itself

> through pattern identification, not keeping him anticoagulated

> forever would be the underlying approach I would take...but her

> initial question prompted me to start researching. I was surprised

> that with all of the studies regarding interactions between herbs

> and warfarin, none that I could see documented the effects of PT,

> PTT, INR solely from the herbal group.

>

> Danny

>

> On May 13, 2010, at 7:01 AM, wrote:

>

> > What makes Danny's original question interesting to me is the idea

> of using the PT/INR test in conjunction with . It's

> not about finding an herbal substitute for warfarin. Do the standard

> diagnosis and treatment. A favorable change in INR

> is a positive " side effect " of the CM treatment, which shows that

> the therapy is " working " from a western medical perspective. It may

> not be replicable or may not even be a valid protocol for other

> patients, but it could improve the quality of life for this

> particular patient. And it's an ideal situation that the patient and

> his MD wife are willing to give it a try and to do the necessary

> monitoring for safety and effectiveness (from a WM perspective). I

> would otherwise not be experimenting with warfarin / herbs. Not from

> a philosophical perspective of not using herbs as substitutes for

> pharmaceuticals, but for safety and liability reasons.

>

>

[Guest guest]

Danny -

 

Here is the link to ARG's research page on Nattokinase:

http://www.allergyresearchgroup.com/Nattokinase-Landmark-Development-sp-36.html

 

Interesting stuff.

 

Ray

 

On May 13, 2010, at 10:00 AM, Danny Johnson wrote:

 

> Thanks for the clarification of my original question Charlie. The

> essence of what I'm getting at is the use of western diagnostic labs

> to monitor the effects of herbal medications. I've seen

> practitioners use herbs for hyperlipidemia and monitor results with

> blood tests, or use herbs to control HTN and measure the results

> with a blood pressure cuff. I wanted to explore the idea one step

> further with the monitoring of a patient's PT, PTT, and INR as

> affected only through herbs. I'm assuming we're all well aware of

> the dangers of combining warfarin and herbal medicines, and using

> both in combination is not the intention of the question.

>

> The reason the patient's wife asked me this question was because of

> the nausea and abdominal pain caused by warfarin. He was hoping

> there might be an alternative remedy that would still keep him

> anticoagulated, but not cause the side effects. I explained to her

> that from a CM approach to treatment, addressing the a-fib itself

> through pattern identification, not keeping him anticoagulated

> forever would be the underlying approach I would take...but her

> initial question prompted me to start researching. I was surprised

> that with all of the studies regarding interactions between herbs

> and warfarin, none that I could see documented the effects of PT,

> PTT, INR solely from the herbal group.

>

> Danny

>

> On May 13, 2010, at 7:01 AM, wrote:

>

> > What makes Danny's original question interesting to me is the idea

> of using the PT/INR test in conjunction with . It's

> not about finding an herbal substitute for warfarin. Do the standard

> diagnosis and treatment. A favorable change in INR

> is a positive " side effect " of the CM treatment, which shows that

> the therapy is " working " from a western medical perspective. It may

> not be replicable or may not even be a valid protocol for other

> patients, but it could improve the quality of life for this

> particular patient. And it's an ideal situation that the patient and

> his MD wife are willing to give it a try and to do the necessary

> monitoring for safety and effectiveness (from a WM perspective). I

> would otherwise not be experimenting with warfarin / herbs. Not from

> a philosophical perspective of not using herbs as substitutes for

> pharmaceuticals, but for safety and liability reasons.

>

>

[Guest guest]

Danny said 'I was surprised that with all of the studies regarding interactions

between herbs and warfarin, none that I could see documented the effects of PT,

PTT, INR solely from the herbal group.'

 

Thank Danny stating his case here. I don't know how " many " studies were there as

indicated but I will find it interesting if there are any. Most studies coming

out from the graduate thesis in China's higher institution will be Chinese

medicinals-based, while western drug is adapted as a sample group. They will

probably use some 'new' drugs rather than using established one like warfarin

(Coumadin or others).

 

We, as Chinese medicine physician, cannot determine or prescribe, anticoagulant.

It is an all-purpose fix that do not go along with the teachings of Chinese

medicine.

 

In your case, I would suggest using a fix dosage of coumadin, prescribed by the

cardo. and formulate herbals according to Chinese medical diagnosis. You can

monitor the blood test weekly. Very few literature, if any, will you find the

match with your particular patient's pattern. Besides, isn't that the patient's

wife request/wish eliminating nausea, abdominal pain?

 

It always reminds me Zhang, Zhong-jing saying, look up to the ancient teachings

laborously. He himself has a lot to offer.

 

In the book of Understanding the Jin Gui Yao Lue: A Practical Textbook by PMPH,

there is a whole chapter discussing cardio issue with many useful formulas. The

chapter of Pulses, Signs, and Treatment of Chest Impediment, Heart Pain, and

Shortness of Breath includes everything we need to know to understand this

disease: etiology, pathomechanisms, signs, treatment methods, and formulas used.

It will back us up in court (if necessary).

 

Take a look.

 

I Pathomechanism of Chest impediement and Heart pain

 

LINE 1

 

ʦԻ£º·òÂöµ±È¡Ì«¹ý²»¼°£¬Ñô΢ÒõÏÒ£¬¼´ÐرԶøÍ´£¬ËùÒÔÈ»Õߣ¬ÔðÆ伫ÐéÒ²¡£½ñÑôÐéÖªÔÚÉÏ\

½¹£¬ËùÒÔÐرԡ¢ÐÄÍ´Õߣ¬ÒÔÆäÒõÏÒ¹ÊÒ²¡£

The master says, ¡°While examining the pulses, one should pay attention to

excess and insufficiency. Faint yang and wiry yin indicates chest impediment and

pain. This is due to extreme deficiency. Deficient yang reflects the upper

burner, but chest impediment and heart pain are also associated with wiry yin.

 

ANALYSIS

 

This line discusses the pathomechanisms of chest impediment and heart pain as

reflected by the pulses. The first step in pulse diagnosis is to differentiate

excess and insufficiency, since the manifestations can be associated with both

evil exuberance and upright qi deficiency. Faint yang pulses indicate yang

deficiency of the upper body with devitalized chest yang. Wiry yin pulses

indicate excess yin-cold causing rheum collecting internally. Yin evils such as

rheum and phlegm will, when combined with yang deficiency, cause blockage and

obstruction in the chest with pain.

 

If we can explain the mechanism in CM, it is more helpful for the patients.

 

In the conclusion of the chapter, we list all the formulas and treatment

methods. As a matter of fact, there is a table of chapter summary for readers.

 

The etiology of chest impediment and heart pain involves yang deficiency in the

upper and yin cold exuberance in the middle and lower. There are many pattern

variations, and these two conditions often occur interchangeably. The

pathomechanism involves yang debilitation and excess yin evils, with deficiency

as the root pattern, with excess manifestations as the branch. The treatment

principle is to dispel phlegm, flush rheum, dissipate cold, eliminate dampness,

and descend counterflow.

 

There are two main approaches to treatment; the first is in accordance with the

presenting patterns of excess and deficiency and the relative severity of the

manifestations.

 

For chest impediment with deficiency patterns, select R¨¦n Sh¨¥n T¨¡ng (Ginseng

Decoction) to supplement the center and assist yang.

 

For excess patterns, select Gu¨¡ L¨®u Xi¨¨ B¨¢i B¨¤n Xi¨¤ T¨¡ng (Trichosanthes,

Chinese Chive and Pinellia Decoction) and similar formulas to free yang,

disperse bind, and dispel phlegm.

 

For mild cases characterized by rheum, select F¨² L¨ªng X¨¬ng R¨¦n G¨¡n C0Œ0o

T¨¡ng (Poria, Apricot Kernel and Licorice Decoction) to diffuse the lung and

transform rheum.

 

For predominant qi stagnation, select J¨² Zh09 Ji¨¡ng T¨¡ng (Red Tangerine

Peel, Unripe Bitter Orange and Fresh Ginger Decoction).

 

For mild cases of heart pain, select Gu¨¬ Zh¨© Sh¨¥ng Ji¨¡ng Zh09 Sh¨ª T¨¡ng

(Cinnamon Twig, Fresh Ginger and Unripe Bitter Orange Decoction) to transform

rheum and check pain.

 

For severe cases of chest impediment, select Zh09 Sh¨ª Xi¨¨ B¨¢i Gu¨¬ Zh¨©

T¨¡ng (Immature Bitter Orange, Chinese Chive and Cinnamon Twig Decoction), Y¨¬

Y09 F¨´ Z09 S0Œ0n (Coix and Aconite Powder) and Gu¨¡ L¨®u Xi¨¨ B¨¢i B¨¤n

Xi¨¤ T¨¡ng (Trichosanthes, Chinese Chive and Pinellia Decoction).

 

For heart pain due to yin cold congealing, select W¨± T¨®u Ch¨¬ Sh¨ª Zh¨© W¨¢n

(Aconite Main Tuber and Halloysite Pill) to expel yin cold and check pain; with

predominant abdominal and epigastric pain, select J09u T¨°ng W¨¢n (Nine Pains

Pill).

 

For moderate cases, treat the root by supplementing upright qi with R¨¦n Sh¨¥n

T¨¡ng (Ginseng Decoction); in acute cases use Y¨¬ Y09 F¨´ Z09 S0Œ0n (Coix

and Aconite Powder).

 

The second approach to treatment is more flexible, modified as the pattern

changes. Gu¨¡ L¨®u Xi¨¨ B¨¢i B¨¢i J09u T¨¡ng (Trichosanthes, Chinese Chive and

White Liquor Decoction) is a typical formula to treat chest impediment.

 

For severe phlegm counterflow with an inability to lie flat, select Gu¨¡ L¨®u

Xi¨¨ B¨¢i B¨¤n Xi¨¤ T¨¡ng (Trichosanthes, Chinese Chive and Pinellia Decoction)

to strongly dispel phlegm.

 

We need to have some ideas of such anti-coagulant but digging more is not that

helpful clinically for us. Besides, we will never do a better job than a MD and

we will always end up the followers.We should always look up to the teachings of

the classics instead.

 

My 2 cents,

 

Sung, Yuk-ming