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5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
This course and handouts contain general information about medical conditions and treatments. The information is not advice, and should not be treated as such.
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The medical information in this course and handouts is provided “as is” without any representations or warranties, express or implied. Medigogy / pro D seminars / healthy seminars inc makes no representations or warranties in relation to the medical information on this website.
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The medical information in this course will be constantly available, or available at all; orThe medical information in this course is complete, true, accurate, up-to-date, or non-misleading.
Professional assistance
You must not rely on the information in this course as an alternative to medical advice from your doctor or other professional healthcare provider.If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider.If you think you may be suffering from any medical condition you should seek immediate medical attention.You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.
Ifsymposium.com
5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
5 Element Functional MedicineMetal - Water Relationship -
Gut/Fertility AxisA Powerful System Devising Treatment Strategies to Address
Complex Cases by Discovering the Root Pathology
Chris Axelrad, L. Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
DISCLAIMER:This is really, really simple.
Sorry, it’s not ultra-scientific or laden with big words. �
But it works. And it’s easy.So I thought I’d share it with you. ☺
And, over the years thinking in this way, I’ve found it to be amazingly effective
(i.e. A good number of pregnancies where it seemed nearly impossible)
Ifsymposium.com
5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
FREE videos and downloads related to this and other topics in integrating TCM and Functional
Medicine:
functionaltcm.org
Gut Fertility Axis - Five Element Functional Endocrinology
BODY FLUID (WATER)
IS A CRITICAL DETERMINANT OF EGG QUALITY
Ifsymposium.com
5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
THE ENDOMETRIAL BOUNDARYIS A KEY COMPONENT TO IMPLANTATION AND ONGOING PREGNANCY
Embryo appostition by scanning electron micrography.
(Bentin-Ley U, et al: Ultrastructure of human blastocyst-
endometrial interactions in vitro. J Reprod Fertil 120:337,
2000.)
Groll, J, Lessey, B, Glob. libr. women's med.,
(ISSN: 1756-2228) 2009; DOI
10.3843/GLOWM.10318
Gut Fertility Axis - Five Element Functional Endocrinology
Interesting, isn’t it??
Fallopian tube ciliaDon W. Fawcett M.D. The Cell Chapter 13 (Cilia and Flagella) Figure 316.
Endometrium Day 6 Luteal PhaseFigure 1. Scanning electron microscopy (SEM) of endometrial biopsy day... -
Scientific Figure on ResearchGate. Available from:
https://www.researchgate.net/figure/237513975_fig1_Figure-1-
Scanning-electron-microscopy-SEM-of-endometrial-biopsy-day-LH-6-The
[accessed Feb 13, 2016]
Bronchial tissue epitheliahttp://www.dkfindout.com/us/human-body/lungs-and-breathing/lungs/
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5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Five Element Functional Endocrinology
Nature’s Mind Map
Metabolic Fire /
Movement of Resources
Glycemic Regulation
and stability / Digestion and Incorporation
Protect / Provide
Boundary / Recycle
Making hormones /
Drawing upon reserves
Detoxification / Activation /
Deactivation
Liver / Gallbladder /
Glutathione / Methylation
/ Other Detox Pathways
Adrenal Axis / Steroidogenesis /
Circadian Rhythm /
Hypothalamic pulses
Heart / Thyroid / Circulation
Spleen / Pancreas / Glycemic
System / Insulin
Gut / Immune-Brain Axis
/ Histamine / Mucous
membranes / Barriers
It’s one of five
things. Actually
usually one of three
and sometimes the
other two.
Yes, it’s that simple.
Gut Fertility Axis - Five Element Functional Endocrinology
Gut / Metal Element• Boundary (Lung/Large Intestine) – “Wei Qi”
• “Gut/immune axis”
• Inner skin exposed to outside world via intake of food, air
• A continuous mucus membrane from cranial sinus cavities and ears all the way to rectum
• Fluid boundary• Excretion
• Reabsorption
• Mother of Water• Gut/adrenal axis
• Gut/brain axis
• Controls Wood• Hepatic portal system
Ifsymposium.com
5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
Think about this…Metal/Boundary/Protection
• Barriers:• Blood-brain barrier
• Blood-testis barrier
• Blood-follicle barrier
• Blood-gut barrier
• Blood-lung barrier
Barriers are barriers are barriers – they all fall under the body’s
sphere of survival, self-protection, and keeping things in their
proper place.
Gut Fertility Axis - Five Element Functional Endocrinology
Other functional relationships• Lung/Large Intestine relationship
• “Gut immune axis”
• Metal (Large Intestine / Lung) is mother of Water (Kidney – Marrow -Brain)
• “Gut brain axis”• “Gut adrenal axis”
• Kidney Yin – Liver Blood relationship• Adrenal/cortisol � Liver/glycogen
• Liver – Spleen relationship• Hepatic role in metabolic syndrome / insulin resistance
In other words – they figured this stuff out a long time ago.
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5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
The disseminated effects of unhealthy gut barrier (damage to Metal)?• Serotonin/mood disturbance
• Adrenal/sympathetic up-regulation
• Hepatic portal system overload
• Chronic inflammatory cascade
• Poor or diminished nutrient absorption
• Alteration of insulin / glycemic dynamics
Gut Fertility Axis - Five Element Functional Endocrinology
Serotonin / mood disturbance
• Sleep issues
• Difficulty relaxing
• Appetite regulation disturbances
• Effects on dopamine/pleasure axis
• Brain fog / concentration issues
Ifsymposium.com
5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
Adrenal/sympathetic up-regulation
• Over-emphasis of sympathetic NS function
• Immune system down-regulation (conflicting signals)
• Difficulty resting / sleeping / relaxing
• Altered circulatory patterns – do not favor reproductive system / uterine artery
• Eventual adrenal fatigue / possible depletion of DHEA, pregnenolone
Gut Fertility Axis - Five Element Functional Endocrinology
Hepatic portal system overload
• Liver’s methylation and glucoronidation pathways disrupted
• Possible estrogen dominance and thyroid involvement
• Vicious inflammatory cycle – overabundance of inflammatory cytokines
• Possible damage to liver tissue and elevation of liver enzymes
• Disruption of liver’s glycogen mechanics – increased cortisol PLUS increased energy demands within liver itself
• Potential autoimmune trigger
Ifsymposium.com
5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
Chronic inflammatory cascade • Up-regulates cortisol release – adrenal axis overstimulation
• Adrenal overactivity can cause the infamous “pregnenolone steal”
• Also can deplete DHEA reserves and alter steroidogenic pathways
• Chronic immune dysregulation – possible effects on uterine barrier/clotting potential/homocysteine levels/CRP (remember, inflammation thickens the blood)
• Effects on CNS / brain that are not helpful for HPO axis – cortisol / LH / prolactin relationship
• Continual stimulation of cell-repair processes deplete or divert growth factors and collagen precursors essential to reproductive health, connective tissue function
Gut Fertility Axis - Five Element Functional Endocrinology
Poor or diminished nutrient absorption
• Inability to process foods properly
• Difficulty with absorption of minerals, metals (i.e. zinc, iron, selenium) due to gastritis / enzyme issues
• Possible proteolytic enzyme deficiencies
• Biliary insufficiency due to hepatic overload – poor absorption of fats
Ifsymposium.com
5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
Alteration of insulin/glycemic dynamics
• Chronic cortisol up-regulation alters blood sugar levels
• Stress on glycogen stores
• Stress on insulin-producing and insulin-sensitive tissues
• Brain effects
• IGF dynamics changed
Gut Fertility Axis - Five Element Functional Endocrinology
So, what the heck does any of this have to do with fertility?
Ifsymposium.com
5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
In a nutshell… EVERYTHING.• Kidney/Water axis – Adrenals/CNS - steroidogenesis, activation of energy
reserves, immune regulation, growth factors – EGG GROWTH AND DEVELOPMENT
• Liver/Wood axis –Hepatic Portal System - hormone clearance and detox, energy storage, cholesterol regulation – HORMONAL EXPOSURE
• Heart/Fire axis – Circulatory/Thyroid - sustained metabolic power, movement of resources, thyroid function – DELIVERY OF NUTRIENTS AND POWER TO USE THEM
• Spleen/Earth axis – Pancreas/Lymph/Metabolic - transformation of food into particles for cellular function, lymph/body-fluid dynamics, insulin output/response, stabilization of blood sugar/metabolism – STABLE METABOLISM
• Gut/Metal axis – Immune/Barrier System - Boundary between self and not-self, entering/exiting, barrier tissues, immune strength and coordination – PROTECTION OF FOLLICULAR FLUID
Gut Fertility Axis - Five Element Functional Endocrinology
But, it’s really not that complicated.Functional patternFunctional patternFunctional patternFunctional pattern TCMTCMTCMTCM patternspatternspatternspatterns
Serotonin / mood disturbance Disturbance of shen
Liver Qi Stagnation
Adrenal / sympathetic up-regulation Heat disturbing heart/shen
Liver Heat
Kidney Yin / Liver Blood Deficiency
Hepatic portal system overload Liver Qi stagnation
Damp Heat
Liver overacting on Spleen
Chronic inflammatory cascade Heat
Blood Stasis
Blood Heat
Poor or diminished nutrient absorption Stomach Heat
Spleen Qi / Heart Blood Deficiency
Qi and Blood Deficiency
Alteration of insulin/glycemic dynamics Spleen Qi Deficiency
Dampness
Liver Qi Stagnation
Ifsymposium.com
5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
In other words…
YOU KNOW THIS ALREADY.
And YOU KNOW HOW TO TREAT IT.
Gut Fertility Axis - Five Element Functional Endocrinology
Here’s the key:
You don’t have to fix anything.
The system has the entire blueprint.You simply have to find the source of the stress, clear
the blockage or bolster the deficient tissue…
AND EVERYTHING ELSE HEALS.(Are you feeling a little relieved?)
Ifsymposium.com
5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
AND SECOND. JUST AS IMPORTANT.In USA and Westernized cultures, the dominant
pathologies are Qi Stagnation (Unhealthy Functional Looping) and Heat (Inflammation)
which THEN cause depletion.
Working too much, eating too much sugar, processed foods, chronic unmanaged stress, lack of sleep…
Excess is primary, depletion is secondary to this.
Do not be fooled into simply tonifying kidneys.
Gut Fertility Axis - Five Element Functional Endocrinology
Differentiation of Metal Element Root Pattern• ALWAYS : Some type of unhealthy bowel
pattern• Infrequent – most common and often
relatively asymptomatic• Loose• Painful• IBS-like symptoms – more cramping• Reactivity to “certain foods” – esp. rich, spicy,
dairy, flour
• OFTEN : • Upper GI Issues
• Indigestion / reflux
• Frequent or chronic allergy (skin, sinus, food)• Depression
Key story element:Key story element:Key story element:Key story element:“I’ve always had
problems going to the
bathroom”
“I’ve never been
regular”
Ifsymposium.com
5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
Treatment of Metal Element Root Pattern
Treatment strategy:• #1 Priority - Support integrity of gut tissue (mucoid tissue)
• NAC – if more heat/inflammation signs• L-Glutamine – if more fatigue / deficiency signs• Proteolytic enzymes – assist healthy gut function, anti-inflammatory effects• Probiotics – if stools not well-formed• Hi-Lignan Flax
• #2 Adrenal support• Adaptogens (Ashwaghanda, American Ginseng, Astragalus) – ALWAYS.• Inositol – if unstable energy / energy swings• B-Complex – always (low to moderate dose)
• #3 Liver support• NAC• Hi-Lignan Flax• Chinese herbal formula that fits liver pattern (is there heat/blood stasis, etc.?)
Gut Fertility Axis - Five Element Functional Endocrinology
Diet/Lifestyle Recommendations for Metal Element Root Pattern
• Eliminate wheat flour (not gluten unless proven celiac)
• Eliminate animal dairy
• Paleo-style animal protein/vegetable diet
• Avoid overconsumption of beans, fruit, sucrose
• Low caffeine
• 8-10 hours of sleep
• I personally discourage smoothies/juicing
• No meals within 2 hours of bedtime
• Balance between raw/cooked
• Careful with spicy/oily/cold/greasy
Ifsymposium.com
5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Gut Fertility Axis - Five Element Functional Endocrinology
References
• Gut–brain axis: how the microbiome influences anxiety and depression, Trends Neurosci. 2013 May;36(5):305-12. doi: 10.1016/j.tins.2013.01.005. Epub 2013 Feb 4; Jane A. Foster and Karen-Anne McVey Neufeld
• Upper intestinal lipids trigger a gut–brain–liver axis to regulate glucose production, Nature. 2008 Apr 24;452(7190):1012-6. Penny Y. T. Wang, Liora Caspi, Carol K. L. Lam, Madhu Chari1, Xiaosong Li, Peter E. Light, Roger Gutierrez-Juarez, Michelle Ang, Gary J. Schwartz & Tony K. T. Lam.
• Hypothalamic-Pituitary-Gut Axis Dysregulation in Irritable Bowel Syndrome: Plasma Cytokines as a Potential Biomarker? Timothy G. Dinan, Eamonn M.M. Quigley, Salah M.M. Ahmed, Paul Scully, Sinead O’Brien, Liam O’Mahony, Siobhan O’Mahony, Fergus Shanahan, P.W. Napoleon Keeling; Gastroenterology, Volume 130, Issue 2, February 2006, Pages 304–311
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5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM
Ifsymposium.com
5 Element Functional EndocrinologyChris Axelrad, M.S.O.M., L.Ac., FABORM