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Biochemistry Paper: The Microbiome and TCM


ACCHS Biochemistry Summer 2018
Professor Spears
Sarah Donnelly


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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.”










Sources:

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://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
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983973/gut bacteria in health and disease”
https://www.nap.edu/read/18433/chapter/12#274 *microbiota targeted therapies
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
http://www.medscape.com/viewarticle/846487 *fermented foods social anxiety
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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