Expert: R. Scott Malone L.Ac. - 12/12/2008

Question
QUESTION: Hi Scott,

I'm in my mid-30's and my husband and I are trying to start a family.  I had a miscarriage in April and my period has been irregular since.  I've also really been struggling with my weight.

I saw a doctor of chinese medicine on the weekend who told me that my hormones were very very imbalanced, which is effecting my period and also my metabolism.  He recommended acupuncture treatment.

I'm willing to try the acupuncture - although I don't understand how it works, if it helps, I'm game.  My concern  is something else that he said.  He told me that because my hormones are so imbalanced if I get pregnant right now I will likely miscarry again because my body is not prepared to handle a pregnancy.  He said that if I do carry a baby to term it may have developmental disabilities, for the same reason.

I've never heard of such a diagnosis and I'm wondering how to proceed.  Should I get a second opinion?  Should we stop trying to conceive while I do the treatment?  The doctor couldn't estimate how long the treatment would take and I really don't want to put our plans for a family on hold indefinitely. Of course I don't want to carry a child if my body can't give it proper nourishment.

Do you have any experience with this?  Any suggestions on how to proceed?

Thanks so much,
Lisa

ANSWER: Hey Lisa,

Well, I will say that in TCM (traditional CHinese medicine), we don't talk about hormones. This is not really in the traditional paradigm.

In my practice, the most common cause of infertility and miscarriage is Spleen qi deficiency. Qi is the motive energy in the body. It travels throughout the body in the channels and we access it through the acupoints, which is where it tends to pool.

THink of an electrical blueprint where most of the circuits home to an internal organ.

In TCM the spleen qi is in charge of holding. Bruising, prolapse, vericosities, hemmroids are all signs of spleen qi deficiency, as well as fatigue, loose stools and when it's extreme, cold hands and feet.

If the spleen qi is not strong, the body doesn't have enough energy to hold the baby to term.

I would highly recommend not trying to conceive until you are strong and balanced. If the body dosen't have enough energy to hold the baby to term, most of the time it simply won't allow itself to get pregnant.

Developmental issues are governed by the kidney.
Chances are, if the spleen is weak, the kidneys are weak.
Signs of a weak kidney are sore/cold, knees and low back.
If the kidneys are weak and a baby comes to term, there definately can be developmental issues.
If the spleen is weak and the baby makes it to term, it will most likely be constitutionally weak or frail.
There is often a blue mark around the eyes/nose/forehead of a constitutionally weak infant. THis CAN be reversed with proper nutrition and chinese herbs.

So I think that the recommendations are correct, but the language is not, according to TCM. Talking this over with our nutritionist, she says that if the thyroid is imbalanced or weak, this can cause developmental problems, but again this is not TCM. She also recommended that you read Sally Fallon's book Nourishing Traditions which is a book on nutrition and food that has a section on preparing for pregnancy.

From a TCM perspective,
spleen qi weakness = infertility and miscarriage
kidney qi weakness = developmental issues.

"Hormones" are NOT in our lexicon.
I would not try to conceive while your cycle is imbalanced, and you have the above weaknesses.

I worry about a TCM pratitioner not using the lingua franca of our tradition. Are they mixing eastern and western? Is he an MD and practices TCM? Is he just simply trying to speak in a language that he thinks you will understand?
Make sure that they do SOLELY TCM. Don't go to an
MD/Chiro-puncturist, their training is poor at best.
Find somone dedicated to doing one thing.

Treatment can take several months to recover from deficiency, and should consist of tonifying the spleen/stomach/kidneys and regulating the cycle by regulating the liver channel, Ren and Chong.
herbal formulas can include Si Jun Zhi tang for qi def. and or Ba Zhen Tang for qi and blood deficiency. QI and Blood are crucial components to a healthy pregnancy.

You might also consider going to the Standard Process site and finding someone in your area to perscribe and test you for the proper nutrition. They have the best products on the market and are only perscribed by a physician.

Feel free to ask me any other questions.

R. Scott Malone L.Ac.







---------- FOLLOW-UP ----------

QUESTION: Scott,

Thank you so much for your answer.  

I've actually been told before that I have Spleen Qi deficiency.  It was informal though, someone who I met socially who I discussed my symptoms with and who looked at my tongue. I do seem to have many of the symptoms you describe with Spleen Qi deficiency.

The doctor I saw is a doctor of Chinese Medicine from China.  He actually didn't speak English well so we had someone translating.  It was less than ideal but I thought I'd give it a try.

What kind of practitioner would you recommend for me? A naturopath, acupuncturist, other?

Thanks again!
Lisa

ANSWER: Hey Lisa,

I think you are just having a communication problem with the Doc.

I would trust him to know what he is doing.

TCM is top notch for this kind of issue and I think you'd be best served by sticking with him.

I would recommend that you check out the following link.
http://www.standardprocess.com/display/referrals.spi

I was introduced to standard process nutrition through the chiropractor that I work with. He's a great nutritionist, and all of my family is currently on them, from my 3 year old son to my wife and I.

Nutrition is key in pregnancy. Most of what you get as far as vitamins and nutrition from a store is synthetic.

Standard Process uses only natural products grown at their farms.

Take your time and get healthy so you can have a safe, healthy pregnancy, and a perfect child.

All the best,

Scott

---------- FOLLOW-UP ----------

QUESTION: Hi Scott,

I wanted to follow up with you on my progress and ask more questions. :-)

I've been having acupuncture treatments twice a week and I have been taking Chinese herbs 5 days a week.  I have eliminated wheat, dairy, sugar, coffee, chocolate, and alcohol from my diet. I try to eat a green leafy vegetable every day.

I'm not really feeling any different, but I got my period after only 32 days from my previous which was very encouraging. For your reference I live an active and healthy lifestyle. I eat plenty of whole natural foods, and I exercise regularly.

My doctor has said that my tongue looks good, but there is still a bit of white at the back that she would like to see it eliminated completely.  She said that once its gone it should be a few more months before she gives us the go ahead to try to conceive.  She said that I will need to continue acupuncture twice a week, plus herbs, until my 13th week of pregnancy to ensure the best outcome.  

I had thought going into this that I'd go for a few months, clear up whatever problem I'm experiencing, get pregnant, and live happily ever after.

Obviously I don't want to risk a miscarriage or have a baby that is not 100% healthy, but is so much treatment really necessary?  It's costing a small fortune on a weekly basis.  How do I know when it's enough?

Thank you in advance for your answer.

Answer
Hey Lisa,

Sorry it took so long to reply, emails piled on top of yours and I lost track of it.

I have to say that in my practice, if I were treating you, I would have you come in for an initial visit for diagnosis and acupuncture and then I would see you for acupuncture 4 more times once a week.

After that I would have you on herbs alone for several months.
Every week you came in I would take a few minutes to see how you were doing on your formula and make changes accordingly, although for building, the formula dosen't usually change that much if at all.

What you may be running into is that if he is from mainland China then he has most likely worked in a Chinese hospital.

In China, healthcare under Communist rule is free, so the doctors have their patients come in for acupuncture quite often in order for them to get well as soon as possible. This is my understanding unless things have changed.

He may just be used to seeing patients as often as needed.
That's a little tough when it's all out of pocket though.

In my opinion, the herbs are the most important aspect of building Spleen qi.

Talk to your doctor and tell him this is putting you under an enormous financial strain and see what he's willing to do.

If you like, tell him that you would like to continue on herbs and see him maybe once every other week for acupuncture.

Remember, just as with a medical doctor, you are in control of your treatment. Listen to his recommendations and then tell him what you are willing to do. Once a week, every other week, once a month, you decide what fits your budget.

The most important thing in your treatment is the herbs.

Feel free to ask any more questions, it's been great fun answering your questions.

R. Scott Malone L.Ac.