An autoimmune disorder, in the simplest terms, is an overreaction of the body’s immune response system. This can trigger an immune system attack on a person’s own healthy tissue – joints, intestines, skin, nerve sheaths, bones, and even blood vessels.
Autoimmune disorders include disease such as rheumatoid arthritis, lupus, psoriatic arthritis, Celiac disease, psoriasis, Sjögren’s syndrome, polymyalgia, multiple sclerosis, vasculitis, alopecia areata, ankylosing spondylosis, and even immunodeficiency diseases such as HIV/AIDS. To manage these diagnoses, western medicine generally uses pharmaceuticals (immunosupressants, pain killers, steroids, etc.) to address signs and symptoms.
Don’t get bogged down in the medical jargon and terms that people bring in to you. The diagnostic titles patients walk in with can be intimidating. Your job is to listen, explore with questions, pulse, tongue diagnosis, and channel diagnosis, then reinterpret the information you find into affected channels and Zangfu. Your job isn’t to just treat signs and symptoms, but to address the root of the haywire immune response.
Who are you likely to see in clinic? Mostly women of child-bearing age. While women are the more likely patients than men, I’ve also seen my share of men with autoimmune problems. People with a family history of immune disorders (lupus, MS, etc.) are more likely to have it. You’ll also find that autoimmune disorders affect some populations more than others. Lupus is a good example, affecting African-American and Latino patients more severely.
When you encounter an autoimmune patient, you need a good history on these patients. Here’s what you want to know.
Find out if this is an acute or chronic problem
Ask to see the lab work. Don’t take another doc’s or even the patient’s word for their diagnosis.
Take blood pressure every time they come in. Track that puppy!
Ask for BMI, lipid panel, thyroid panel, and blood sugar/glucose test. Depending on where you are in the world, you may have to refer your patient to a doctor to get these numbers. Some states in the US and some countries will allow patients to self-refer and go directly to a lab to get these numbers. I live in Mexico where we can do this. I send patients who come to me for advice and lifestyle coaching in to local labs with directions about what panels I want, they come back with numbers the following day. How cool is that?
Ask about exercise – what kind, how often and intensity per week, how regularly
Ask about diet – what they eat, how much. Ask them to keep a food journal because most people don’t really have a good idea of what they eat.
Ask about profession, lifestyle, family life, hobbies.
Ask about family history
Ask about their overall health.
Why is it that some patients have an autoimmune disorder? Why do some members of a family with an autoimmune history have it and some don’t? It’s about triggers. Here are some of the things that can set off an autoimmune response:
Heredity
Malnutrition
Metabolic disease
Drug/chemical induced
Infection (HIV for instance)
Blood diseases
Cancer and all of its’ treatments
Surgery and Trauma
Great stress or trauma and very strong emotions
Remember the six main functions of Qi? You learned this in your Foundations of Chinese Medicine classes. I wrote two books on this: Chinese Medicine 101 and Chinese Medicine 102, both of which you can download to your Kindle reader (no matter what device you have) or get in paperback. If you want to know more about this than you remember from school, look at those books!
Here's the quick tutorial on the six functions of Qi:
Produces motion within the body and animates the body
Transforms Spleen Qi transforms food and drink into useable building blocks, Kidney Qi transforms fluids, and Lung Qi transforms the air we breathe into useable nutrients.
Transports Spleen Qi transports nutrients to muscles and organ tissues and Lung qi transports fluids to the skin to moisten.
Warms Yang qi warms the body
Protects Wei qi defends the body from external pathogens
Contains Spleen Qi keeps blood in the vessels, Ki Qi keeps fluids in the bladder, and so forth.
In the classics, the Su Wen 72 specifically, it says (and I'm paraphrasing here) that if your Zheng Qi is strong, then pathogens cannot invade the body. But if Zheng Qi is weak, pathogenic invasion (wind, cold, damp, etc.) is easy.
We start off in life with Yuan Qi, given to us by our parents when we are formed in the womb. After we are born we take our first dose of Qi we acquire for ourselves through Da Qi (Qi from the air) and Gu Qi (from food we eat). When you live a healthy life you produce good Qi for your body from what you take in both emotionally and physically. But if there are pollutants in the environment, food taken in is laced with GMO’s, preservatives, and chemicals, if the emotional environment is toxic, then all of this will affect Qi. These will set off the genetic triggers that enable disease.
All patients, but especially autoimmune patients need to manage Qi well, in order to build toward health. The goal is healthy, functional Ying Qi and Wei Qi to protect the body appropriately.
Su Wen 43 informs us that the Wei Qi runs within the skin and muscles and “steams the membranes, spreads in the chest and abdomen.” It goes on to say that if the Ying and Wei Qi are disordered that disease will occur. This is what seems to be happening in an autoimmune patient. The Wei Qi and disease response system are on too-high alert, attacking even healthy tissue in what looks like a PTSD response.
So how do you arrive at a diagnosis for autoimmune patients? One thing that TCM doesn’t teach us well is that you will very likely have a different diagnosis for acupuncture than you will for herbs.
Acupuncture is based on channels, dysfunction of the channels (excess, deficiency, stagnation, etc.), and interrelationship between the channels. Some key points for your acupuncture diagnosis and treatment plan:
Identify signs and symptoms. What channels do those point to?
Palpate the channels and find the ashi points that are reactive. This confirms your channel identification based on signs and symptoms.
Focus your point selections based on movement and transportation of Qi, excess and deficiency of Qi.
For your herbal diagnosis, look at signs and symptoms, tongue diagnosis, and pulse diagnosis. Again, your herbal diagnosis is based on Zangfu theories, while your acupuncture diagnosis is based on channels.
All of this said, is acupuncture and herbs going to cure your patient? No. They buy the patient time to change their lifestyle and really get well. This is where you get to be a lifestyle consultant. Educate yourself on what build health in everyday life. This is a big topic and is far past the scope of this post. But here are a couple of gems to get you started.
Food and drink intake
High fructose corn syrup and fructose are the devil. They must be metabolized by the liver, can lead to fatty liver, and that leans the patient toward liver cancer.
Organic, non-GMO, dark, green, leafy vegetables should play a big part in the diet. These have phytonutrients the body needs. If you combine these with legumes you get a complete protein. Eat more fruits and vegetables.
Drink better water and drink lots of it – preferably reverses osmosis filtered. Water is a universal solvent and is required for life.
Learn to breathe. Most people breathe shallowly. Fuller breathing oxygenates the blood to balance the pH better than any commercial product can even legitimately claim to.
Avoid packaged foods. That stuff is full of chemicals to keep them longer on the shelf. Deadly stuff.
Eat the proper amount of protein. You only need .2g of protein per kilo of body weight, which means a 200lb person needs about 10grams of protein. . . that’s one fried egg, one deck-of-cards sized slide of beef. In other words, not much. Anything else is excreted out and stresses the intestines/digestion.
STOP with the bags and bags full of supplements! Your body has to filter and excrete most of that out, stressing the Liver and Kidneys.
Move your body
That means moving your thighs. Walk ½ hour at a time, 2 times per day. That’s a great start. For immune compromised patients that don’t have a lot of energy, that may be the most they can manage. If they can do it, have them add weight training in moderate amounts.
Manage stress and chill out
Patients can really benefit from qigong and tai chi. These are amazing for a healthy immune system because they focus on long slow deep breathing and on directing Qi. I realize that a lot of people don't have access to qigong and tai chi in their communities, so yoga can be good too. But not all yoga is created equally. Ampy, fast moving flow, hot yoga isn't yoga - it's an aerobics class in disguise. Honest to god yoga was designed to relax the body and prepare it for meditation.
Saunas and massages are great for autoimmune patients too. Additionally, mindfulness meditation is magical for the emotional stuff that goes along with an autoimmune disease.
Sleep
Six to eight hours per day are critical. 30 minute naps are find, but not if you have to do this to get through the day. Autoimmune patients (all of us, really) need to keep regular hours whenever possible.
Is lifestyle change a hard sell. Yep. I’ve had a lot of patients who want to come to acupuncture for a quick fix and change nothing. That's not healing, but enabling dysfunctional behavior.
This can require a lot of patience on your part. But this is your job. We are part teacher, part practitioner, part coach, part therapist. You are not selling acupuncture and herbs, you are selling personal revolution, health awareness, and coaching people toward greater love and respect for the bodies that carry them through this life.