ifsymposium · pathologies are qi stagnation (unhealthy functional looping) and heat (inflammation)...

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5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM

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Gut Fertility Axis - Five Element Functional Endocrinology

5 Element Functional MedicineMetal - Water Relationship -

Gut/Fertility AxisA Powerful System Devising Treatment Strategies to Address

Complex Cases by Discovering the Root Pathology

Chris Axelrad, L. Ac., FABORM


DISCLAIMER:This is really, really simple.

Sorry, it’s not ultra-scientific or laden with big words. �

But it works. And it’s easy.So I thought I’d share it with you. ☺

And, over the years thinking in this way, I’ve found it to be amazingly effective

(i.e. A good number of pregnancies where it seemed nearly impossible)

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FREE videos and downloads related to this and other topics in integrating TCM and Functional

Medicine:

functionaltcm.org


BODY FLUID (WATER)

IS A CRITICAL DETERMINANT OF EGG QUALITY

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THE ENDOMETRIAL BOUNDARYIS A KEY COMPONENT TO IMPLANTATION AND ONGOING PREGNANCY

Embryo appostition by scanning electron micrography.

(Bentin-Ley U, et al: Ultrastructure of human blastocyst-

endometrial interactions in vitro. J Reprod Fertil 120:337,

2000.)

Groll, J, Lessey, B, Glob. libr. women's med.,

(ISSN: 1756-2228) 2009; DOI

10.3843/GLOWM.10318


Interesting, isn’t it??

Fallopian tube ciliaDon W. Fawcett M.D. The Cell Chapter 13 (Cilia and Flagella) Figure 316.

Endometrium Day 6 Luteal PhaseFigure 1. Scanning electron microscopy (SEM) of endometrial biopsy day... -

Scientific Figure on ResearchGate. Available from:

https://www.researchgate.net/figure/237513975_fig1_Figure-1-

Scanning-electron-microscopy-SEM-of-endometrial-biopsy-day-LH-6-The

[accessed Feb 13, 2016]

Bronchial tissue epitheliahttp://www.dkfindout.com/us/human-body/lungs-and-breathing/lungs/

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Five Element Functional Endocrinology

Nature’s Mind Map

Metabolic Fire /

Movement of Resources

Glycemic Regulation

and stability / Digestion and Incorporation

Protect / Provide

Boundary / Recycle

Making hormones /

Drawing upon reserves

Detoxification / Activation /

Deactivation

Liver / Gallbladder /

Glutathione / Methylation

/ Other Detox Pathways

Adrenal Axis / Steroidogenesis /

Circadian Rhythm /

Hypothalamic pulses

Heart / Thyroid / Circulation

Spleen / Pancreas / Glycemic

System / Insulin

Gut / Immune-Brain Axis

/ Histamine / Mucous

membranes / Barriers

It’s one of five

things. Actually

usually one of three

and sometimes the

other two.

Yes, it’s that simple.


Gut / Metal Element• Boundary (Lung/Large Intestine) – “Wei Qi”

• “Gut/immune axis”

• Inner skin exposed to outside world via intake of food, air

• A continuous mucus membrane from cranial sinus cavities and ears all the way to rectum

• Fluid boundary• Excretion

• Reabsorption

• Mother of Water• Gut/adrenal axis

• Gut/brain axis

• Controls Wood• Hepatic portal system

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Think about this…Metal/Boundary/Protection

• Barriers:• Blood-brain barrier

• Blood-testis barrier

• Blood-follicle barrier

• Blood-gut barrier

• Blood-lung barrier

Barriers are barriers are barriers – they all fall under the body’s

sphere of survival, self-protection, and keeping things in their

proper place.


Other functional relationships• Lung/Large Intestine relationship

• “Gut immune axis”

• Metal (Large Intestine / Lung) is mother of Water (Kidney – Marrow -Brain)

• “Gut brain axis”• “Gut adrenal axis”

• Kidney Yin – Liver Blood relationship• Adrenal/cortisol � Liver/glycogen

• Liver – Spleen relationship• Hepatic role in metabolic syndrome / insulin resistance

In other words – they figured this stuff out a long time ago.

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The disseminated effects of unhealthy gut barrier (damage to Metal)?• Serotonin/mood disturbance

• Adrenal/sympathetic up-regulation

• Hepatic portal system overload

• Chronic inflammatory cascade

• Poor or diminished nutrient absorption

• Alteration of insulin / glycemic dynamics


Serotonin / mood disturbance

• Sleep issues

• Difficulty relaxing

• Appetite regulation disturbances

• Effects on dopamine/pleasure axis

• Brain fog / concentration issues

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Adrenal/sympathetic up-regulation

• Over-emphasis of sympathetic NS function

• Immune system down-regulation (conflicting signals)

• Difficulty resting / sleeping / relaxing

• Altered circulatory patterns – do not favor reproductive system / uterine artery

• Eventual adrenal fatigue / possible depletion of DHEA, pregnenolone


Hepatic portal system overload

• Liver’s methylation and glucoronidation pathways disrupted

• Possible estrogen dominance and thyroid involvement

• Vicious inflammatory cycle – overabundance of inflammatory cytokines

• Possible damage to liver tissue and elevation of liver enzymes

• Disruption of liver’s glycogen mechanics – increased cortisol PLUS increased energy demands within liver itself

• Potential autoimmune trigger

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Chronic inflammatory cascade • Up-regulates cortisol release – adrenal axis overstimulation

• Adrenal overactivity can cause the infamous “pregnenolone steal”

• Also can deplete DHEA reserves and alter steroidogenic pathways

• Chronic immune dysregulation – possible effects on uterine barrier/clotting potential/homocysteine levels/CRP (remember, inflammation thickens the blood)

• Effects on CNS / brain that are not helpful for HPO axis – cortisol / LH / prolactin relationship

• Continual stimulation of cell-repair processes deplete or divert growth factors and collagen precursors essential to reproductive health, connective tissue function


Poor or diminished nutrient absorption

• Inability to process foods properly

• Difficulty with absorption of minerals, metals (i.e. zinc, iron, selenium) due to gastritis / enzyme issues

• Possible proteolytic enzyme deficiencies

• Biliary insufficiency due to hepatic overload – poor absorption of fats

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Alteration of insulin/glycemic dynamics

• Chronic cortisol up-regulation alters blood sugar levels

• Stress on glycogen stores

• Stress on insulin-producing and insulin-sensitive tissues

• Brain effects

• IGF dynamics changed


So, what the heck does any of this have to do with fertility?

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In a nutshell… EVERYTHING.• Kidney/Water axis – Adrenals/CNS - steroidogenesis, activation of energy

reserves, immune regulation, growth factors – EGG GROWTH AND DEVELOPMENT

• Liver/Wood axis –Hepatic Portal System - hormone clearance and detox, energy storage, cholesterol regulation – HORMONAL EXPOSURE

• Heart/Fire axis – Circulatory/Thyroid - sustained metabolic power, movement of resources, thyroid function – DELIVERY OF NUTRIENTS AND POWER TO USE THEM

• Spleen/Earth axis – Pancreas/Lymph/Metabolic - transformation of food into particles for cellular function, lymph/body-fluid dynamics, insulin output/response, stabilization of blood sugar/metabolism – STABLE METABOLISM

• Gut/Metal axis – Immune/Barrier System - Boundary between self and not-self, entering/exiting, barrier tissues, immune strength and coordination – PROTECTION OF FOLLICULAR FLUID


But, it’s really not that complicated.Functional patternFunctional patternFunctional patternFunctional pattern TCMTCMTCMTCM patternspatternspatternspatterns

Serotonin / mood disturbance Disturbance of shen

Liver Qi Stagnation

Adrenal / sympathetic up-regulation Heat disturbing heart/shen

Liver Heat

Kidney Yin / Liver Blood Deficiency

Hepatic portal system overload Liver Qi stagnation

Damp Heat

Liver overacting on Spleen

Chronic inflammatory cascade Heat

Blood Stasis

Blood Heat

Poor or diminished nutrient absorption Stomach Heat

Spleen Qi / Heart Blood Deficiency

Qi and Blood Deficiency

Alteration of insulin/glycemic dynamics Spleen Qi Deficiency

Dampness

Liver Qi Stagnation

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In other words…

YOU KNOW THIS ALREADY.

And YOU KNOW HOW TO TREAT IT.


Here’s the key:

You don’t have to fix anything.

The system has the entire blueprint.You simply have to find the source of the stress, clear

the blockage or bolster the deficient tissue…

AND EVERYTHING ELSE HEALS.(Are you feeling a little relieved?)

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AND SECOND. JUST AS IMPORTANT.In USA and Westernized cultures, the dominant

pathologies are Qi Stagnation (Unhealthy Functional Looping) and Heat (Inflammation)

which THEN cause depletion.

Working too much, eating too much sugar, processed foods, chronic unmanaged stress, lack of sleep…

Excess is primary, depletion is secondary to this.

Do not be fooled into simply tonifying kidneys.


Differentiation of Metal Element Root Pattern• ALWAYS : Some type of unhealthy bowel

pattern• Infrequent – most common and often

relatively asymptomatic• Loose• Painful• IBS-like symptoms – more cramping• Reactivity to “certain foods” – esp. rich, spicy,

dairy, flour

• OFTEN : • Upper GI Issues

• Indigestion / reflux

• Frequent or chronic allergy (skin, sinus, food)• Depression

Key story element:Key story element:Key story element:Key story element:“I’ve always had

problems going to the

bathroom”

“I’ve never been

regular”

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Treatment of Metal Element Root Pattern

Treatment strategy:• #1 Priority - Support integrity of gut tissue (mucoid tissue)

• NAC – if more heat/inflammation signs• L-Glutamine – if more fatigue / deficiency signs• Proteolytic enzymes – assist healthy gut function, anti-inflammatory effects• Probiotics – if stools not well-formed• Hi-Lignan Flax

• #2 Adrenal support• Adaptogens (Ashwaghanda, American Ginseng, Astragalus) – ALWAYS.• Inositol – if unstable energy / energy swings• B-Complex – always (low to moderate dose)

• #3 Liver support• NAC• Hi-Lignan Flax• Chinese herbal formula that fits liver pattern (is there heat/blood stasis, etc.?)


Diet/Lifestyle Recommendations for Metal Element Root Pattern

• Eliminate wheat flour (not gluten unless proven celiac)

• Eliminate animal dairy

• Paleo-style animal protein/vegetable diet

• Avoid overconsumption of beans, fruit, sucrose

• Low caffeine

• 8-10 hours of sleep

• I personally discourage smoothies/juicing

• No meals within 2 hours of bedtime

• Balance between raw/cooked

• Careful with spicy/oily/cold/greasy

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References

• Gut–brain axis: how the microbiome influences anxiety and depression, Trends Neurosci. 2013 May;36(5):305-12. doi: 10.1016/j.tins.2013.01.005. Epub 2013 Feb 4; Jane A. Foster and Karen-Anne McVey Neufeld

• Upper intestinal lipids trigger a gut–brain–liver axis to regulate glucose production, Nature. 2008 Apr 24;452(7190):1012-6. Penny Y. T. Wang, Liora Caspi, Carol K. L. Lam, Madhu Chari1, Xiaosong Li, Peter E. Light, Roger Gutierrez-Juarez, Michelle Ang, Gary J. Schwartz & Tony K. T. Lam.

• Hypothalamic-Pituitary-Gut Axis Dysregulation in Irritable Bowel Syndrome: Plasma Cytokines as a Potential Biomarker? Timothy G. Dinan, Eamonn M.M. Quigley, Salah M.M. Ahmed, Paul Scully, Sinead O’Brien, Liam O’Mahony, Siobhan O’Mahony, Fergus Shanahan, P.W. Napoleon Keeling; Gastroenterology, Volume 130, Issue 2, February 2006, Pages 304–311

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ifsymposium · pathologies are qi stagnation (unhealthy functional looping) and heat (inflammation)...

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