Case Studies: Kidney Ailments

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A little knowledge is sometimes worse than no knowledge when it comes to our own good. Have you ever read about someone who had a terrible disease, and then you started thinking that you had the beginning symptoms of the ailment yourself? A simple cough could be the first sign of lung cancer, a gas pain an impending heart attack, and a big freckle, melanoma. Our minds are truly powerful in whatever way we choose to direct them, and if we don’t direct them, they may end up creating mischief.

Laura was a regular patient of mine, and she came to the clinic with an odd set of symptoms, including a feeling of pressure and pain in her upper right abdominal area around the liver, itching in the skin, fatigue, and memory problems. Laura looked weary as she slumped into a chair in the treatment room, and she reported unusual fatigue. Fatigue is a common symptom of many different causes, from insufficient sleep to stress and worry, or as a part of a disease process such as a bladder infection. Based on her symptoms, Laura felt she might have hepatitis.

A puzzling diagnosis

Laura’s set of symptoms intrigued me. As always, if the Western diagnosis wasn’t clear, I called upon my training in Traditional Chinese Medicine (TCM). Even if a patient has a clear Western diagnosis from a physician, TCM can often differentiate four or five syndromes.

Laura had a red tongue with no coating at all–a symptom of a well-established yin deficiency, common in people much older than her thirty-two years. Her pulses were very weak and rapid, and because her kidney pulses were the weakest, I started thinking about a deficiency in the kidney system, which in TCM relates roughly to the hormones. This syndrome could be treated with Chinese herbs, acupuncture, and a variety of other healthy habits, such as yoga.

At this point, I doubted whether Laura had hepatitis, based on her symptoms and the pulse and tongue diagnoses, which showed no liver weakness or liver heat. Just to be sure, I had Laura go to a lab for a liver panel and viral antibody test. Because I’d diagnosed kidney weakness, I also ordered tests involving the function of the adrenals, thyroid, and sexual hormones. People with weak kidney systems often have hormone deficiencies, leading to fatigue. Hormones involved with energy metabolism, such as adrenaline and thyroxine, are often involved.

A week later, Laura came back to the office with the results of her lab tests. Not surprisingly, her liver tests looked normal, and she was negative for hepatitis A, B, and C. Among her other tests, one stood out: Her thyroid function did not look good.

Thyroid function

The thyroid gland helps regulate the metabolic rate of the body. It is located in the neck and is one of several other glands that make up the human endocrine system. The thyroid produces two hormones, thyroxine (T4) and tri-iodothyronine (T3). In Laura’s case, the output of both hormones was lower than it should have been, so I came to the conclusion that she had a hypo (underactive) thyroid condition.

Because several hypothyroid conditions exist, I knew it was time to consult an endocrinologist. I wanted to work with a doctor who would be open to a team effort, not one who insisted that the only course was starting Laura on a synthetic thyroid hormone, with no changes to her diet and no herbs.

Another week passed, and Laura came in again to tell me that further tests confirmed she had a simple hypothyroid condition; her thyroid was producing a little less thyroxine than normal. A more serious, progressive autoimmune thyroid condition could have been possible, so this was good news.

Laura’s endocrinologist agreed to prescribe Armour thyroid hormone, which provides a natural source of thyroxine, rather than the synthetic drug levothyroxine sodium. The natural hormone is often milder and produces fewer side effects.

But before starting with the medication, I asked Laura if she would be willing to first try an herbal and dietary program for a month. She agreed, as long as she could see definite improvement in her symptoms over that time, and if a follow-up test showed some normalization of thyroid function.

A drug-free program

Laura began a series of ten acupuncture treatments to tonify the kidney yin and regulate her thyroid function. These treatments are used successfully in China in similar cases, as I saw firsthand when studying at the Hang Zhou Hospital of Traditional Medicine in Hang Zhou, China, several years ago. Besides the acupuncture, Laura’s program consisted of four parts.

First, we wanted to make sure her thyroid gland had all of the trace minerals it needed for proper function, especially iodine and zinc. I gave Laura capsules of a Western herb that is always mentioned for thyroid imbalances, a sea vegetable called bladderwrack (Fucus vesiculosus), which contains iodine. Because the thyroid gland is sensitive to iodine levels in the blood, I’m not in favor of iodized salt, which can lead to too much iodine in the system. Iodine from bladderwrack is a better choice because the iodine is accompanied by a balance of trace minerals in an organic form–a form that is more slowly released in the body due to the large amounts of polysaccharides in the herb. Some herbalists such as David Winston recommend adding sea vegetables to the daily diet in cooking to reduce the chance of overloading the body with iodine. The daily dose of bladderwrack is about 5 to 10 g.

Second, I wanted to try the gentle thyroid-stimulating herb guggul (Commi-phora mukul), an Ayurvedic herb. I recommended one 500-mg tablet, standardized to 25 mg of guggulsterones, three times daily with meals.

Third, to get to the root of the matter, I wanted Laura to take kidney yin tonic herbs to slowly help restore the underlying hormone balance. These herbs should be taken for at least two months before re- evaluating for effectiveness. These tonics can be continued for nine months or more under the supervision of an experienced herbalist. The formula I recommended for Laura consisted of the Chinese herb rehmannia (Rehmannia glutinosa), 4 to 8 g daily; American ginseng (Panax quinquefolius), 3 to 5 g per day; nettle (Urtica dioica), 9 to 12 g daily; and ligustrum (Ligustrum lucidum), 6 to 9 g daily.

And fourth, for Laura’s diet, I recommended that she be moderate with suspected goitrogens (substances that depress the function of the thyroid gland), including foods in the mustard family such as cabbage, Brussels sprouts, kale, turnips, and broccoli. These are thought to interfere with thyroid function in susceptible individuals when used to excess, although these effects are difficult to prove scientifically, and their effects are based purely on a few case histories. I suggested to Laura not to avoid these foods altogether, though, because they are also known to offer strong protective effects against certain cancers. One or two servings a day of these foods shouldn’t be a problem for most people.

I also suggested that Laura avoid taking a lot of calcium supplements, as the body may retain more of the mineral, possibly leading to calcium deposits later in life. Laura agreed to eat plenty of green leafy vegetables, carrots, and winter squashes that are high in beta-carotene. An underactive thyroid gland can interfere with the body’s utilization of this important vitamin. A 6- or 8-oz. glass or carrot-celery juice each day can be helpful.

Three weeks later, after six more treatments, Laura told me she was noticing a difference. She never did end up taking the thyroid hormones–her thyroid seemed to right itself after two months on the comprehensive program, and she has maintained that success.

Christopher Hobbs’s case studies are gleaned from his thirty years of studying and practicing herbalism. Hobbs, a fourth-generation botanist and herbalist, is an Herbs for Health editorial adviser and licensed acupuncturist. He is the coauthor of Vitamins for Dummies (IDG, 1999) and many other books.

“Case studies” is not intended to replace the advice of your health-care provider.

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