ACCHS
Biochemistry Summer 2018
Professor
Spears
Sarah
Donnelly
The
Microbiome and TCM
The
microbiome is an enormously interesting area right now. With steadily
rising rates of gastrointestinal disorders, despite all the best that
western medicine has to offer, people are looking for a solution
which isn't worse than the illness. Clostridium difficile (C.diff)
infections alone have doubled in the United States in the last
decade. There are many variables which can contribute to all this
gut-sickness, but the underlying problem is our western medical
model.
Our
current model, with the finest technology and equipment at its
disposal, has distilled all functional parts of the human body –
flora and fauna, vitamins, probiotics, antioxidants, amino acids and
the like – down to their very basest constituents. We have the
machines which tell us exactly which nutrients we lack, and we pack
it into pills and swallow it down. This is our preventative medicine.
The body is seen as something to fight, something which betrays us
over time, and we turn to the advice of doctors, who have made
amazing advances in the areas of emergency medicine, musculoskeletal
therapies and repair. For the nuts and bolts of mechanical medicine,
western medicine can't be beat. But for preventative and internal
work, our highly advanced model isn't working.
'Microbiome'
is the name given to a collection of bacteria, viruses and fungi
which make up the environment of a particular area. In this context,
the term microbiome describes the enormous and varied populations of
flora which exist on and within the human body. Since it was first
discovered, researchers have astounded the world with studies showing
these colonies not only outnumber a person's own human cells, but are
essential in basic functions like metabolism, digestion, storage, and
even cognitive function.
Different
areas of the body will have such specific colonies of bacteria that
experts are labeling these regions OTU's (Operational Taxonomic
Units). Long story short, the greater diversity of
bugs/bacteria/microbes on your body, the healthier you'll be. I
should say - the greater the diversity of the correct
colonies of bugs – the healthier you'll be. It seems very specific
groupings of bacteria work best on certain areas of the body like the
head, the groin, the mouth, the lungs, etc. When certain bacteria
find themselves in the wrong neighborhood, or when disaster strikes a
neighborhood, the misplaced bacteria can create chaos and disrupt the
whole system. For example, the bacteria Clostridium
difficile (C.diff)
is a perfectly normal bacteria to have kicking around in your gut. A
healthy microbiome will contain other strains of bacteria which hold
any potentially harmful effects in check. It is not a bad bug in a
normal context. It's when a patient takes antibiotics that we get
into trouble. In the presence of antibiotics, C.diff
produces
spores to reproduce itself, and these spores are incredibly hardy and
difficult to kill. So the antibiotic which is making the C.diff
reproduce like crazy is also wiping out the populations of bacteria
which usually keep it in check. What happens? The C.diff
experiences an rapid overgrowth and begins causing symptoms like
nausea, vomiting, diarrhea, and if untreated, death. C.diff
infections are the cause of 29,000 deaths in the US each year –
which is double the number of infections seen over the last 10 years.
Because of this now-common back and forth dance between C.diff
and the antibiotics, C.
diff
has become even hardier, and is now one of several species of
bacteria completely immune to antibiotics, a modern monster called a
'superbug'. Unchecked by antibiotics, these superbugs continue to
reproduce in their host, causing more violent vomiting and diarrea –
further weakening the patient and shedding healthy bacteria and
fluids until the patient expires.
A
more diverse gut microbiome is associated with better digestion and
healthier weight, well-functioning immune, heart and brain systems,
and even lower risk for social anxiety, autism, and a myriad of
cardiovascular diseases. The best way to get a diverse microbiome is
to eat a wide variety of fiber-rich foods – fruits, veggies,
grains. Unfortunately, in the concern for feeding a growing global
population drives the need for a quantity of food, rather than a
variety. Of nearly 300,000 species of plants worldwide, humans
typically consume only 150 to 200 species, and 75% of what we
actually eat worldwide comes from only 12 plant and 5 animal species.
We are limiting our own potential.
The
Traditional Chinese Medicine (TCM) way of looking at the digestive
system is straightforward, and instead of looking at the separate
elements of each moving part, takes a step backwards and assesses the
organs of digestion within the context of the entire human system.
From this holistic birds eye view, things look very different.
The
Spleen is the primary organ of digestion, though all of the organs
contribute to an optimal digestion. Because the Spleen's function of
transforming and transporting nutrients is the closest equivalence to
environment of the microbiome's, we will focus here. Bearing in mind
the poetic language of Chinese Medicine, I'll first present the
Spleen's functions in TCM terms, then translate for accessibility.
Spleen
Function: TCM
|
Spleen
Function Translation
|
|
transform
and transport fluids and food, controls muscles and 4 limbs
|
transforms
ingested food and drink to extract qi from it. It transports these
nutrients to every aspect of the body.
|
Impaired
= muscle weakness, atrophy, fatigue
|
processes
fluids to be used and excreted
|
Impaired
= edema, phlegm
|
|
Controls
the blood
|
makes
blood from consumed nutrients, prevents pathological bleeding
|
Impaired = pathological bleeding (nosebleeds,
hemorrhage, menorrhagia)
|
controls
ascending of qi, raising of the qi
|
prevents
organ prolapse, depression
|
|
opens
into the mouth and manifests in the lips, controls saliva
|
functionally
linked to mastication: smelling, tasting, chewing, excretion of
oral digestive enzymes.
|
Impaired = compromised
sense of taste and smell, lack of appetite
|
houses
the intellect, affected by pensiveness
|
Cognitive
function associated with digestive function: especially thinking,
remembering, memorizing, studying.
|
Impaired
= digestive function compromised by stress/overthinking/obsessive
thoughts.
|
When
the Spleen is not functioning properly, TCM medicine dictates we
first diagnosis, assess and clear the damage – phlegm, profuse
bleeding, impaired digestion – and then we apply ourselves to the
underlying cause. An impaired Spleen usually presents as a weakness,
or deficiency, and other organs may overpower it, no longer checked
by the balance a healthy Spleen provides. Each case is taken on an
individual basis, depending on the presenting symptoms and the
overall constitution of the patient. A patient suffering from a
C.diff
infection who is overweight, overheated, with a high stress job and
matching temper will have a very different diagnosis and cure than
another C.diff
patient who is pale and tired and sweats easily, speaking with a low,
quiet voice. In TCM, the patient doesn't possess their diagnosis.
It's not a static label they carry around with them in their medical
charts for eternity. An illness is a temporary condition – in
treating both the illness and the underlying causes, the practitioner
helps the patient to remove obstacles in healing. Healing is what the
body is already designed to do, given the proper tools.
These
tools of prevention are where TCM really shines. To keep the Spleen
happy and healthy, one is advised to live moderately: eat mainly
cooked, balanced meals of vegetables and whole grains and protein; to
take breaks when studying too hard; to avoid foods which cause
pathological changes like dampness (sugar, dairy, highly refined
foods). The main tool, though, is the awareness which permeates the
Chinese culture – a frequent check-in with the body for
pathological issues such as dampness, cold, heat, emotional balance
and fatigue. Each one of these pathologies, if noticed early enough,
can be counteracted with food, herbs, spices, exercise, meditation.
If a condition gets severe enough, the patient is encouraged to seek
out a medical practitioner for additional help. But the first steps
are awareness and self-responsibility. We are the only ones who live
in our bodies day in/day out. We are all potentially our own best
doctors.
Our
current medical model in this country fascinating, but frequently
misses the forest for the trees. Our medical experts specialize so
sharply that a cardiologist can't help you if you have a gut problem,
and your psychiatrist wouldn't know where to start with your feet.
Both are medical doctors, but not much use as holistic practitioners.
However, if I had a broken arm, or if I was worried about a lump in
my breast, I wouldn't hesitate to hit up my western specialist! Where
our system needs a fresh perspective is in the realm of prevention.
Sometimes we are so focused on the emergency that knowing the cause
becomes secondary, or even unimportant. We focus on after-the-fact
medicine, so-called heroic medicine. A proper integration with the
TCM mindset of self-responsibility and prevention would be the best
possible of both worlds.
One
of my teachers shared this story:
Thousands
of years ago in China, there was a very famous physician. One day,
the king called him to his side and said, 'You must be the very best
doctor in all of China! If anyone is sick, even near to death, you're
able to heal them - it's as if they had never been sick at all.”
The
doctor protested “I am only an average doctor, my younger brother
is better than me, and my oldest brother is the best doctor of all.”
The
King said “How can this be? You are the most well-known of your
entire family.”
The
doctor replied, “I am talented at bringing patients back from
near-death. My younger brother is gifted at seeing and treating the
illness before it becomes severe. My oldest brother, the best doctor
of all of us, makes sure his patients remain healthy with good food
and moderate living. He is not famous because his patients never get
sick at all.”
What you need to know about Clostridium difficile
https://apic.org/For-Consumers/Monthly-alerts-for-consumers/Article?id=what-you-need-to-know-about-clostridium-diffi
https://www.healthline.com/nutrition/gut-microbiome-and-health#section9
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426293/
Defining the microbiome
https://journals.lww.com/jbioxresearch/Fulltext/2018/06000/Human_microbiome_brings_new_insights_to.8.aspx
Human
microbiome brings new insights to traditional Chinese medicine
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812548/
Reconciliation
between operational taxonomic units and species boundaries
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480553/
Burden of Gastrointestinal Disease in the United States: 2012 Update
http://www.openbiome.org/clinical-research/
http://thefecaltransplantfoundation.org/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837298/
*varied gut microbiome
http://www.popsci.com/modern-lifestyles-may-dramatically-reduce-diversity-human-microbiome
http://thefecaltransplantfoundation.org/what-is-fecal-transplant/
http://www.hopkinsmedicine.org/gastroenterology_hepatology/clinical_services/advanced_endoscopy/fecal_transplantation.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4995824/
*mice fmt obesity
https://www.sciencedaily.com/releases/2017/01/170123094638.htm
*autism improved after FMT
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-017-1175-y
http://thepowerofpoop.com/wp-content/uploads/2013/04/An-overview-of-fecal-microbiota-transplantation-techniques-indications-outcomes.pdf
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