Episode 43: Can Traditional Chinese Medicine treat eczema?
Traditional Chinese Medicine (TCM) uses biological extracts to treat disease. Eczema sufferers may take a herbal bath, apply a specially formulated cream or drink herbal tea as part of TCM treatment. Dr. Xiu Min Li from New York Medical College explains TCM and we ask: Is Traditional Chinese Medicine (TCM) safe for newborns? Can you use TCM and topical steroids simultaneously? Could TCM prevent the allergic march? And other questions. (And if you like our podcast, consider supporting it with a tax deductible donation). Read the transcript.
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[00:00:28] Lynita: Hello, and welcome to the podcast. I'm here with Christine Liu, an eczema parent and a Big Ideas competition winner. Today, we are exploring herbal treatments for eczema that have origins in traditional Chinese medicine, or TCM for short.
[00:00:44] Lynita: We're really excited to be speaking with Dr. Xiumin Li from New York Medical College. She treats allergic diseases including eczema with traditional herbs proven effective through clinical trials. She was educated in China in both traditional Chinese medicine and Western medicine before relocating to the US. Dr. Li has a triple professorship in immunology, otolaryngology, and dermatology. And is co-author of the book: Treating Eczema with Traditional Chinese Medicine, published last year.
Dr. Li and Christine, welcome to the podcast.
[00:01:23] Dr. Xiu Min Li: Thank you.
[00:01:23] Christine: Thank you.
[00:01:26] Lynita: Dr. Li can you give us a little background on what traditional Chinese medicine is, and how can it help with eczema?
Dr. Xiu Min Li: Classical traditional Chinese medicine is a mind-body approach to medicine that combines herbal medicine with other interventions. It is my job to find out how it works and how to make it work better through our research. For eczema, we adapted our therapy from TCM formulation for wounds and burns. We refined it using modern scientific tools to isolate active compounds
Lynita: Are the medications you use approved by regulators?
[00:02:17] Dr. Xiu Min Li: Not yet. although we are permitted to prescribe them as supplements like vitamins. In the meantime, we have generated substantial numbers of successful clinical cases.
We are looking forward to applying for the FDA's approval of our triple therapy as a new treatment. For severe eczema and for preventing severe eczema.
[00:02:51] Lynita: When someone uses TCM is the treatment different for every individual?
[00:02:53] Dr. Xiu Min Li: Most of my patients have complex conditions that include comorbidity of other conditions, such as food allergy, and so many patients have a history of being resistant to standard medical approaches, for example, topical steroids. I have to, in that case, use different protocols for those patients.
[00:03:21] Lynita: Sure. So the treatment can vary depending on the other comorbidities and sensitivities that a patient will have.
[00:03:29] Dr. Xiu Min Li: Right. But eczema affects the patient's quality of life. If they have multiple conditions, I prioritize their eczema so they can sleep better. I think that's the first priority.
[00:03:46] Lynita: That's the number one thing we want: to ease the suffering of our kids.
Can you give us a bit of a deep dive into your triple therapy and tell us how it works.
[00:03:55] Dr. Xiu Min Li: Yes, basically, patients must start the day with an herbal bath, that's one. They take teas, and then they must apply several different creams in rotation every two hours. In the evening, it's another herbal bath and more teas. The next morning they just start again, repeat.
So there's basically teas, bath and the cream, this triple therapy. So three medicines are necessary. because a single treatment has a limited ability to deliver enough active ingredients to all the organs involved. Eczema is more than skin deep, right? So the triple therapy works as a team.
Lynita: Okay, and there's several different phases to the therapy, right?
[00:04:50] Dr. Xiu Min Li: Yes, We divide the protocol into 3. Phase 1, when the disease is very severe. Two, the skin is clear and the itching is going away. Number three, you look great, and we start to reduce the treatment and finally stop the protocol,
[00:05:13] Lynita: Does the treatment change much between phases?
[00:05:17] Dr. Xiu Min Li: Phase 1 is most stringent, the creams / bath more frequent. Once we reach 80, 90 percent improvement and stable for at least two months, we move to phase two. Phase two, I start to reduce the bath from two baths to one bath, and cream from every two hours to every 3, 4, 5 hours, but not stop the treatment. Only when we reach to phase 3, I start to gradually taper and stop the treatment.
[00:05:52] Lynita: So it sounds to me with your triple therapy that you're, you're treating the skin with the baths and with the creams, but you're also treating the internal health of your system.
[00:06:03] Dr. Xiu Min Li: Yeah, you're right.
[00:06:04] Lynita: So it might seem quite simplistic, take a bath, put some creams on. But there is a lot of science behind the treatments that you've developed.
[00:06:12] Dr. Xiu Min Li: That's right.
[00:06:13] Lynita: Christine, have you had experience using traditional Chinese medicines?
[00:06:18] Christine: Yeah, I was first introduced to TCM through my daughter who had eczema starting when she was about 5 months old. And so we actually reached out to some family friends who are in Korea, and they connected us with a woman who does TCM with a Korean origin. And she had created a cream using some herbal ingredients that she had used on her child, and that was the cream that actually ended up helping our daughter as well. Dr Li you mentioned topical steroid treatments. I was curious to learn how do other treatments such as steroids affect the efficacy of your treatments?
[00:06:55] Dr. Xiu Min Li: My primary mission is to relieve suffering, For eczema patients, the tendency is to over rely on steroids, Just at the beginning, I encourage the patient to continue what they are using: don't stop away. We can treat these patients with TCM simultaneously and gradually get them off the steroids. Once the skin becomes healed, they have a capability to gradually taper.
[00:07:28] Christine: That was a really helpful answer. Thank you.
[00:07:32] Dr. Xiu Min Li: Once you are on steroids, you feel that you are dependent on that. That's very critical to get them better before you start to taper the steroids.
[00:07:44] Lynita: So, what you're saying is when kids have very severe eczema, it takes time for the therapy to work. And during that time, they can continue to use topical steroids. Which is a relief, because if kids are suffering, stopping steroids immediately would be quite a scary thought.
[00:07:59] Dr. Xiu Min Li: It is. I see the kids, how severe. I call that catastrophic. It's unbearable. And then kids cry, mom cry, everybody crying. So later on, they get better. They start to communicate. They say, hi, they give you a hug. So make you feel good. Yeah.
[00:08:22] Lynita: Thank you. How long does it take for treatment to work?
[00:08:26] Dr. Xiu Min Li: We have many patients who show improvement in a few weeks, if they respond very well, but others may take a longer time, depending on the severity and how long they have severe conditions. Sometimes, you know, they are so severe, I say that their skin is destroyed. It takes time to heal, right? But the most important thing is not to stop taking the medicines when your skin clears and the itching is better. You must stick with it long enough to resolve the deeper pathology. Our goal is no flares.
[00:09:10] Lynita: Fantastic, and Christine, where's your daughter at in her journey?
[00:09:15] Christine: She actually hasn't had flares in quite a while. The cream that we used helped repair her skin and it is far better than what it was just over a year ago.
[00:09:26] Dr. Xiu Min Li: That's beautiful.
[00:09:28] Christine: I'm very thankful. And I mean, you were talking about the experiences you've had with children who just like struggle with sleep and just are constantly itching and have so much empathy for those patients and those families it was an unimaginable period. And thankfully for us, it was short lived, but I know for everyone, it's a different journey.
[00:09:47] Lynita: our listeners are mostly Parents who worry about where the disease came from and whether they could have done something to prevent it. Does your research and clinical practice hold any hope for us?
[00:10:00] Dr. Xiu Min Li: Is my dream to be able to stop the allergic march. To not only cure eczema, but also prevent this progress.
However, it is very difficult to get to these patients at a young enough age to make a difference. Many of my patients end up with younger siblings and their parents. Can bring them for treatment at the first sign of eczema, but not the first child, for newborns and very young babies.
I only use external protocol with good outcomes in general. My hope is that more doctors are trained to use these treatments,
[00:10:47] Christine: I'm curious to hear, are you seeing that trend, even in like medical schools are people exploring these paths?
[00:10:55] Dr. Xiu Min Li: I see people are more and more open-minded to accept integrative medicine. Now most of the hospitals like Hopkins, Stanford, Yale, they all have integrative medicine centers, so gradually become a system. The medical school has not incorporated that system yet.
In my lab, I have quite a number of medical school students. They are very, very interested natural products, herbal medicine, they want to learn more. They listen to the parents' voice to understand what they want. I think it will be improved and can halt the allergic march.
[00:11:37] Lynita: it would be wonderful if we could really help babies not go down this allergic, atopic march. That would be fantastic.
My next question is about the safety of the treatments that you use because that is a huge concern for parents.
[00:11:54] Dr. Xiu Min Li: Right. I will say that generally traditional Chinese medicine has a high safety profile, but specifically, I can only speak for my practice and products used for my patients. Our medicines are made from very carefully grown toxin free herbs. We meet very stringent regulations. We test for microbial, heavy metals, and the pesticide residual to ensure the safety.
[00:12:25] Dr. Xiu Min Li: In addition I start gradually also because some patients are very sensitive. They have regular follow up, on the liver, kidney functions. We believe it's safe, we know it's safe, but we need the evidence to see it is safe. So I think we have multi layers to ensure safety.
[00:12:48] Lynita: Thank you. I'm curious. Could this triple therapy be beneficial or even harmful for a mother that's pregnant?
[00:12:56] Dr. Xiu Min Li: Generally it's safe because long human use
history with TCM formulation help women with morning sickness and so on. But in general the research is very limited. I generally advise that during the pregnancy, the parents should not continue or start the herbal treatment, but as soon as they have baby, that's a good time to start.
[00:13:22] Christine: Are there certain things that you recommend to women in the preconception / prenatal period? Whether it's other TCM approaches or lifestyle approaches that are potentially tied to prevention?
[00:13:38] Dr. Xiu Min Li: Yeah, there are quite a number of studies, but the results are not very consistent yet. And plus many things may penetrate the placenta and affect the fetus. So, from the safety perspective, I would not try something at the supplement level, but I'm very comfortable to treat newborns. So, my advice is that, you observe carefully once you see the signs, like baby acne, you need to start to pay attention, right? Because baby acne has a very, very strong connection to eczema. Soon as you found that, what I use for bath, for cream, I see it's quite effective. But bottom line, once they are born, I feel that we have a good opportunity to start the protocol earlier and prevent severe eczema and prevent unnecessary strong, medications.
[00:14:41] Christine: That's super helpful.
[00:14:43] Lynita: If mothers are breastfeeding, it's safe then for the mother to use traditional teas?
[00:14:51] Dr. Xiu Min Li: Yeah, actually, sometimes the mothers can drink the tea because some of the ingredients will come to the milk and actually help. The baby tolerate that better, but generally, that's a only reserved for a very severe eczema.
[00:15:07] Lynita: And do you see a connection between mothers that have eczema and babies?
[00:15:13] Dr. Xiu Min Li: Yeah, we did some research on that too. That’s called epigenetics. If you have even seasonal allergy then you have children, they could develop eczema and then food allergy too.
Lynita: Thank you. So I guess parents with the allergic conditions themselves should be particularly vigilant for the first signs of eczema.
[00:15:35] Dr. Xiu Min Li: Yeah
Lynita: Coming back to the components in your triple therapy, one of your papers, and I'll share it in the links, list the top 10 components as licorice root, sophora root, scutellaria root, ginseng, honeysuckle flower, forsythia fruit, a powder made from indigo plants, gromwell root, cicada shells and phellodendrum bark. This last ingredient contains the compound berberine.
Can you tell us about berberine? It sounds quite promising.
[00:16:06] Dr. Xiu Min Li: Berberine is a small molecule found in many plants. It is a subject of much interest and research. We are looking at it for both food allergies and cancer. And it is included in some of our eczema regimens too. The trouble is, it doesn't stay in the body long enough to achieve efficacy.
So we are exploring berberine in combination with nanoparticles and other herbal constituents to increase the bioavailability for food, the allergies, and eczema.
[00:16:50] Lynita: So it's something that is promising and it is helpful, but when we take it orally, our body breaks it down very quickly and expels it.
[00:16:58] Dr. Xiu Min Li: Perhaps less than 1% will be absorbed, but if you take a big dose that will cause nausea, stomach pain and constipation or other things so you need to be cautious.
[00:17:15] Lynita: And the research you're doing now is to look at ways of getting berberine to stay in the body, but without giving too much of a dose
[00:17:23] Dr. Xiu Min Li: Yeah, that's our ongoing research.
[00:17:26] Lynita: And what sort of benefit do you see berberine having for eczema?
[00:17:32] Dr. Xiu Min Li: We do see at least several levels. One directly inhibit bacteria growth. Second, reduce bacteria triggered inflammation. Third is bacteria triggered histamine release.
[00:17:50] Lynita: That's really interesting. So berberine is taken orally and then it affects the growth or overgrowth of the bacteria, Staph aureus, which we know is a problem with eczema. And it affects it on the skin or… in the gut and the skin?
[00:18:08] Dr. Xiu Min Li: Right, that's a good question. The Staph aureus most of the time colonizes the skin. 90 percent they have a staph colonization, at the beginning, they have basically no any good bacteria left, so then with the treatment you see a good very rich diverse bacteria after 6 months of treatment. I think the triple therapy we are using has ability to restore the normal skin bacteria environment.
Lynita: So it sounds like the berberine, which is one component of your triple therapy, can we reduce the amount of Staph aureus on our skin, which then reduces all those unwanted effects that we get from Staph aureus, like inflammation and histamine releases. But it also gives the good bacteria an opportunity to grow back. And then we have a nice, healthy microbiome on our skin.
[00:19:06] Dr. Xiu Min Li: Right, but other herbal ingredients actually played a very important role. Right? Together with components like berberine.
[00:19:16] Lynita: Sure. So it's berberine in conjunction with all the other treatments.
[00:19:19] Dr. Xiu Min Li: Yeah
[00:19:20] Lynita: Fantastic. That's really interesting know how it works.
[00:19:25] Lynita: What is the cost of traditional Chinese medicine or the treatment that you do?
[00:19:30] Dr. Xiu Min Li: That depends on where you live. In some countries acupuncture and herbal medicine are fully covered by health insurance, but in some countries, such as in the US, only acupuncture is covered by most of the health insurance, but herbal medicines are not so…. compared to biologicals such as Dupilumab, we are a hundred times cheaper. Although those can be reimbursed by insurance. Right? In addition to a financial cost, it takes a lot of time and laundry because creams are messy, particularly in phase 1.
[00:20:12] Lynita: Thank you. My final question is what does the future look like for your treatment for eczema?
[00:20:20] Dr. Xiu Min Li: Yes, exciting. Okay. So we have to achieve approval of triple therapy for treatment or prevention of a severe eczema. And then we have to train doctors to be able to use it, then they can help more kids with severe eczema.
[00:20:43] Lynita: Sounds like you have a really great process that works here. And let's hope that it can be expanded to be available to more people.
[00:20:51] Dr. Xiu Min Li: Thank you
[00:20:52] Christine: Thank you so much. It's so great to meet you.
Lynita: Thank you. And for those listening, if you would like to learn more about Dr. Li's triple therapy, please visit our website at www.gper.org/podcast.
