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cushings using TCM
Consistent results seem to be able to be achieved in hyperadrenocorticism using Chinese herbal medicine, often to the point that improvement in symptoms and laboratory values can be obtained without using pharmaceuticals. A small number of cases may even experience a normalization of cortisol output demonstrable in ACTH stimulation and dexamethasone suppression tests. Whereas Hypoadrenocorticism seems to represent difficulty in accessing Yang energy, Hyperadrenocorticism seems to represent an overabundance of Yang energy, albeit of pathogenic origin.
The Yang pathogen, as in diabetes mellitus and hyperthyroidism, appears to be Damp Heat. Since Damp Heat accumulation arises in small animals from Spleen deficiency due to an inappropriate diet, nutritional problems are firmly implied to underlie hyperadrenocorticism. Ample research now exists to suggest that functional pituitary and probably even adrenal tumors are intimately associated in humans, small animals, and equines with insulin resistance, a nutritional disorder. Consequently, success in hyperadrenocorticism depends on introduction of a low glycemic index diet, such as those described in the section on diabetes above.
Even animals that appear Cushingoid with high liver enzyme elevations, but are not able to be confirmed as such using low dose dexamethasone and ACTH stimulation tests, will also benefit from use of this formula. The formula is especially indicated in patients that appear heat intolerant, weak but agitated, restless, and thirsty. They have an increased appetite and increased urine production. Their pulses may vary from thin and weak to rapid and forceful. The tongue often is red or purple-red on the underside. It is not necessary for Cushing’s disease to fully develop before the animal can be treated.
The main formula for consideration in the treatment of Damp Heat Cushing’s patients is Si Miao San (Four Marvels Powder):
Cang Zhu
Atractylodes rhizome
Huai Niu Xi
Achryanthes root
Yi Yi Ren
Coix seed
Huang Bai
Phellodendron bark
Cang Zhu (Red Atractylodes) warms and dries the Spleen, and dispels Damp. Huang Bai (Phellodendron) dries Damp and Clears Heat from the lower burner. Yi Yi Ren (Coix) leeches Damp and clears Heat while providing mild support to the Spleen.
This formula is used in Cushingoid animals with a clear Spleen deficiency underlying the accumulation of Damp Heat. Carbohydrates appear to be the chief dampening influence in small animal diets, and must absolutely be restricted for great success in Cushing’s disease. The reason for the efficacy of Si Miao San is not known, although the berberine in Phellodendron promotes insulin sensitivity while its content of beta-sitosterol can help normalize adrenal cortisol output.

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