I am treating a client who has been diagnosed as Bi Polar and is taking a lot of medication, including Lithium. She has severe psoriasis in her scalp and eyebrows mainly. It’s very dry, burning, itchy. I have been clearing heat and stagnation and this has helped emotionally and with her menstrual cycle. However, the psoriasis is not clearing. Do you think the treatment will be work while she is taking Lithium? Your opinions please!
As with all questions of this nature, what have you been doing treatment wise (how have you been “clearing heat and stagnation”? - in fairly precise terms, what is your diagnosis from a TCM perspective with supporting signs and symptoms. How many treatments have you given and how often and what results (good or bad) have you seen in the patient (again in exact terms - helped her menstrual cycle how? - how was it and what is it like now?). Then we can help. The short answer to your question is yes you can clear the psoriasis while she is taking lithium… With the rest of the info we can provide some help.
Apologies Chad, not long qualified and first time posting! Client was diagnosed as BiPolar 5 years ago. She feels her mood is suppressed constantly by the medication and is very groggy in the mornings (she is on meds for sleep also). She also has Raynauds Syndrome and low thyroid. Her menstrual cycle was short 23 days approx, bleeding lasted 10 days and was heavy with clots. She experienced PMT symtoms of mood swings, headaches/ She was also constipated - bowel movements were 4-5 days. Her energy is low, needs to be in bed by 9.30. She suffers with anxiety 24/7. Her tongue is red, coming to a point, with a yellow coating at times. I have been seeing her weekly since the 23rd Feb, sometimes twice a week, 15 treatments to date. Bowel movements are now daily, her last period was 28 days and bleeding was 5 days with no clots or PMT symptoms. Raynauds is much improved. My treatments have varied depending on where she was in her cycle. I am very inexperienced but I thought the best approach was to clear heat from the heart and liver, calm the shen and nourish blood. The only negative outcome was diarrhoea when I did St44 or Sp4. When the coating is there I use St40, Sp1 to stop bleeding when needed and otherewise varying treatments using LV3, or 2, St36, Sp6, Sp6, Ren 12, St25, Sp10, LI11, LI4, Ht7 or 8, yintang, P7, P6, Lu7, Du20, Du24, Ren 4 depending on what I see on the day. Overall things are improving but not the Psoriasis. I have advised her to rub cucumber on the scalp and that does help a little. Thank you for your help. Please let me know if you need any further information.
It sounds like she could benefit from long-term herbal remedy. What are her pulses? I have a patient with very similar circumstances that has been seeing me for a bit more than a month. She gave me the preliminaries on practically every facet of her life. Like your patient she also too had emotional distress, Reynauds, thyroid issues, “allergic” throat tightening, a sensitivity to chemicals, and morning grogginess. She had also been on long-term birth control (4 years), with very low energy in the morning waking with sweat, irregular and/or scanty menstruation, and joint pain. She also had intermittent esophageal spasm due to weak stomach qi with the yang failing to descend. First thing I did was recommend dietary changes. She has since eliminated almost all grains from her diet with marked improvement in joint pain issues almost instantaneously. We then decided on herbal treatment for a minimum 3 months.
On her first consultation it was immediately evident that she displayed Yang deficiency and internal cold at the blood level. All of her pulses were either deficient or not resonant with the exception of the heart and liver. Women are especially susceptible to blood deficiency and hormonal (read: thyroid) issues as they age.
Almost six weeks later she’s made a complete 180 degree turnaround–all without a single needle. I’ve only used herbs with fantastic results. I’ll keep you updated on her continual progress and maintenance.
From my understanding, when a great many pharmaceuticals which act on neurological reception and hormonal junction are used long-term this can engender cold pathogens at the internal level. If this progresses obviously it can transfer to the qi and thus the blood levels rather quickly–sometimes within a span of only a few years. The whole “one-size-fits-all” approach with dosing of Western medications can often serve only to harass and break down the spleen and kidneys. Due to my own self-exploration of methylation genetics that genetically many individuals suffer homozygous gene mutations of the chemical pathways regulating the metabolism of antidepressants. This is terribly overlooked even in this day of age.
So, given her background and initial pulses I began treatment by (1) tonifying the spleen, blood, and kidneys, (2) upbearing yang, and (3) gently releasing the exterior.
My prescriptions do vary slightly from week to week. Here’s what I’ve used to-date::
Tonify the spleen, blood, and kidneys:
- Dang Gui
- Dang Shen
- Bai Zhu
- Zhi Gan Cao
- Bai Shao (also helps to course the liver)
Assist the yang and warm the interior:
- Gan Jiang
- Rou Gui (this shouldn’t be used long-term however, but it greatly boosts the Ming Men fire)
- Ding Xiang
Move the blood:
- Jiang Huang (so far I’ve only had to use turmeric to invigorate the blood; it’s gentle but effective, and is also warming)
…To help the kidneys grasp the qi, I use Duan Ci Shi (soaking in apple cider vinegar, then in water, then drying works best)…
Release the exterior (and target neck swelling and nodules) and rectify the qi–this is important because with yang deficiency stagnation is an issue when one tonifies the blood and qi:
- Zi Su Ye
- Sheng Jiang
- Chai Hu
- Chen Pi
- (instructing the patient to eat more seaweed and/or kelp; authentic Japanese wakame is a great choice)
Calm the heart spirit:
- (Ci Shi also does this well)
- (diet incorporating the seaweed–wakame is rich in calcium, magnesium, phosphorous, and iodine; these minerals greatly assist anxious and manic disorders. As an added bonus, the salty flavor also enriches kidney water)
Within just one week of treatment she had showed tremendous improvement. Just last week her color has since returned, her eyes are shiny, she has energy, her overall disposition has made an amazing transition. She has since quit taking birth control as well. This was undoubtedly integral to her recovery. Again–no needles…yet. Her cycle is now regular and without stagnant flow. Her swelling in the neck is almost nonexistent, and her Reynauds only flares up one or two times per week instead of multiples times daily. Circulation could take 3 months of consecutive herbal decoctions to resolve, but it’s definitely now in sight.
I hope this case study can be of some assistance. It might be worth looking at boosting the spleen simultaneous to supplementing blood and clearing heat. Sometimes if the heat is cleared, there is only deficiency left. Deficiency will root evils more stubbornly. This is why the minesterial fire must not be extinguished but instead softened. Check to see if the fire in her liver is indeed in the liver, and not in the kidneys rather or could be due to true cold of the interior. This latter case was the root of my patient’s overall issues. I wish you and your patient the best and success.