Using Traditional Chinese Medicine to Treat Eczema – The Eczema Podcast (S2E7)

Today’s guest is Olivia Friedman, a Traditional Chinese Medicine (TCM) Dermatologist, acupuncturist and an herbalist who specializes in working with skin conditions, including eczema, dermatitis, and topical steroid withdrawal (TSW). She has helped several members on the ITSAN board and also several people who I’ve met online, who are going through topical steroid withdrawal (TSW).

Did you know that TCM dermatologists are so specialized that there’s only 129 of them in the world? (You can search the TCM dermatology directory to find one in your area).

They’re so specialized that they need to study TCM, then herbalism, and then they branch off even more into studying TCM dermatology (I have so much respect for them!).

 

IN TODAY’S PODCAST, YOU WILL LEARN:

• How TCM works
• The amount of time it takes to heal on TCM medicine
• Whether people experience a healing crisis on TCM
• Whether it’s a myth if TSW patients really flare after eating licorice root – and the science behind it.
• Why 90% of TCM herbs can be contaminated (and how to choose safe, high quality herbs)

 

DID YOU ALSO KNOW THAT…

• Acupuncture alone is usually not enough to help the body heal.
• It’s a myth that licorice causes a flare up in TSW patients.
• Dr. Olivia shared that licorice mimics a steroid, but there are many types of steroids in your body. The one that everyone is concerned about that affects the HPA axis is a glucocorticoid, and licorice is not that – licorice is actually a mineralcorticoid, so it works very differently and has a very different affect on your body. It also does not have anything to do with the HPA axis, so your body would not respond to it in the same way as glutocorticoids.
• Most herbal formulas include licorice in it because it’s a great herb to harmonize all the herbs together.  However, it’s often used in such small amounts that it doesn’t cause issues in the body. .

 

Dr. Olivia also works closely with Dr. Peter Lio, a dermatologist and on the board of the National Eczema Association. They often refer patients to each other – which is incredible because I’ve never heard of a dermatologist referring patients to a TCM practitioner before!

 

WATCH OR LISTEN TO THE PODCAST BELOW:

 

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You can find Olivia here at Amethyst Holistic Skin Solutions.

Links to TCM herb contamination studies:

• Study reveals that nearly 90% of traditional Chinese medicines contain trace amounts of disturbing and toxic substances 
• Contaminants Found in 92% of TCM Herbal Products 

 

PODCAST TRANSCRIPT

Abby Lai: Hey guys, welcome to another episode of the Eczema Podcast. Today, I have a very special guest here and she is a traditional Chinese medicine dermatologist, also known as a TCM practitioner, but not just any TCM practitioner. TCM dermatologists are actually pretty rare. If you head to TCMdermatology.org, you’ll find that there are only 129 of them around the world and that directory will actually let you know what a TCM dermatologists are actually in your area. It says that in United States there are 50 of them, and in Canada there are only 8 of them. In the United Kingdom there are 23 of them. I am so honored to have my guests on the show today. She has a lot of experience and a wealth of experience, and the thing I love about it is she works really closely with Dr. Peter Lio, who I’ve had on the show on Season 1 and 2. He’s a dermatologist and also on the board of the National Eczema Association.

I love that they have a working relationship where they refer patients to each other. I’ve never actually seen or heard of a dermatologist who has referred patients to a TCM practitioner before. I think that is really, really amazing.

I had such a great talk with my guest today and I also want to point out that TCM dermatology is a very, very specialized practice. First, they need to study TCM and then they need to go into herbalism and then they study more into a specialized stream of TCM dermatology. It takes years and years of studying and it’s their specialty and I am just so honored to have my guests on the show. One thing that we did touch upon is even, the type of herbs that a lot of TCM practitioners actually prescribe. I love that my guest today, she prescribes herbs from a very, very high quality place with third party testing and lab testing.

I think that is so important because I just want to point out that there have been numerous studies where they have actually found contaminants in the herbs used in traditional Chinese medicine. For example, in 2015 there was actually a study done by the University of Adelaide where they purchased 26 TCMs from random markets and they tested the contaminants in them and 9 out of 10 of these medicines had some form of undeclared substance in them as either adulterated or contaminated and 16 of them had more than one contamination.

That is actually not really a good sign because we can be things and not really being sure of what’s in it because there can be other things. For example, among them they found things like anti-histamines, anti-inflammatories and even antibiotics and stimulants and significant levels of toxic heavy metals were found such as arsenic, cadmium, and lead in over half of the medicines in at least four of them.

If you followed the directions on the label, it would expose you to over 10 times the regulatory limit for heavy metals in medicines. You can see why it is so important to actually find herbs from a place that does third-party testing. We talk a lot more in this episode about it. But recently, I also had a talk with another TCM dermatologist and I remember asking him, do you see a difference when your patients use lab tested and third-party tested herbs to test for heavy metals and to make sure there’s no contaminants in it and he said yes. He finds that his patients when they take herbs that are not lab tested, they do tend to react more because sometimes they may contain sulfates in it as well and also lab tested herbs tend to be more effective as well. Not because they are lab tested but because they are higher quality.

I also want to let you know that if you want to follow me for more updates or even follow me, I post a lot on my Instagram and on my Facebook with tips and advice. You’ll also find updates on my journey and you can see a lot of my before and after photos there. I also have a free Facebook community support group for you to join. Just look for Eczema Conquerors support group and you’ll able to find it.

I also just want to make a quick note that the audio in this podcast was not the clearest because one of my main audio files was actually damaged, so I had to use a backup one. I hope that you’ll still be able to hear the recording clearly and take the time to listen to it because my guest really has a lot of information to share. That is so helpful. Without further ado, I just want to start today’s podcast and thank you for listening.

Abby Lai: ([07:17])

Hi, everyone! Welcome to another episode of the Eczema Podcast. I have someone who I actually met last month at the eczema expo and it was really great just learning so much about her. Her name is Olivia Sue Friedman. She’s a traditional Chinese medicine practitioner and an herbalist. I think that’s a really amazing combination. She runs a clinic in Chicago, but she actually practices worldwide. I’m really excited to introduce you to her and for her to share more about her story and how she got into it as well. Welcome, Olivia.

Dr. Olivia Friedman: ([08:01])

Hi, Abby! Thanks so much for having me on your show.

Abby Lai: ([08:03])

You are very, very welcome. I just wanted to know, how did you get into all of this?

Dr. Olivia Friedman: ([09:09])

It’s actually pretty interesting story from the standpoint of somebody who has eczema – because I had eczema. I had it all my younger life and it was really pretty bad to be honest. I had it when I was born and it just got worse and worse as I got older and older. I think at my worst point, I was on seven different medications all at once because not only did I have asthma, but I also had asthma and I had allergies. Then that compounded to having anaphylaxis from time to time. It was really bad and I got to a point where it was really hard to manage, all the different medications, all the flare ups and whatnot. I’d been to the hospital, one of the signs and it was just a really awful, we don’t live.

I actually got to the point where I was really desperate for help because it was just really too much [inaudible]. I opened myself up to a Chinese herbalist. It was the first time of my life that somebody had given me hope, because when I told them what was going on with me and he looked at my skin. He was like, “I think we can take care of that.” I was like, “Wait, what?” Because all the other practitioners I had gone to try that pretty much said they couldn’t manage my symptoms. They never told me that they could actually make it go away. So, the private practitioner said for maybe four to six months. I probably go to fairly [inaudible]. At first, it was very subtle that as time went on it became a lot more remarkable. At the end of working with him, my eczema went away, most of my allergies went away.

I still hadn’t seen an allergy. My environmental allergies went away and my asthma, so I no longer had to take any drugs. I was amazed. It’s like how profoundly that changed my life. I realized that if this guy could do this for me, how great would he be able to do it for somebody else. That really inspires me to go back to school and become an herbalist and to be able to do this kind of medicine, so that I could help other people who have had that same struggle that I have.

Abby Lai: ([11:21])

That’s so amazing. Yeah, it looks like you’re, you’re helping a lot of great people. I’m interested in knowing how you actually treat them. When someone has eczema or topical steroid withdrawal, how do you go about treating them in a way that helps them get better?

Dr. Olivia Friedman: ([11:43])

Chinese medicine works a little differently than conventional medicine. I think what happens a lot of times with conventional medicine. If we sort of look at a certain symptom and we tried to shut it down. A lot of like steroids and immunosuppresants and biologics. A lot of them are kind of looking at one particular mechanism in trying to like shut that thing down ’till it’s not responding. What Chinese medicine does and a lot of holistic medicine does is look at the body as like one big system that’s made of a whole lot of different systems. It sort of looks a little bit more like what’s causing all of these things to happen. Instead of looking at like a specific symptom, what is that root thing that’s causing all of these symptoms. The other thing we kind of looked at differently is that even though we’re saying that eczema, in Chinese medicine, we actually break it down into a lot of different patterns of eczema.

I think lots of times in Western medicine we kind of saying, well you have eczema, therefore, we have this group of drugs that we use and it’s typically steroids, immunosuppresants, biologics, maybe some moisturizers or whatnot, maybe some antibacterials depending on what’s going on with you. But everybody uses the same arsenal of drugs. Whereas in Chinese medicine, we kind of look at you and say, all right, what are all the contributing factors in your particular eczema? How are all the external things happening that are actually compounding that too? Like what’s happening in your environment? What’s happening with your diet? What’s happening with your emotional-psychological makeup? What’s happening with like your basic constitution and how is that sort of playing into your eczema? There’s a lot of different factors, not just the physical mechanism inside

They kind of look at an eczema seven different patterns and we sort of look at each patient to see which one they actually fall into. Then once we sort of figure out that pattern then we also look at all those other contributing factors that sort of see what other herbs can we use to kind of address your unique presentation. I would say the biggest difference between Western and Eastern medicine is that Eastern medicine is much more customized and it’s much more based on how everything’s working out for you. As a result, we’re always changing the formula because as you’re sort of healed or it needs different things along that the treatment schedule, we’re sort of changing out the ingredients as well to sort of meet those needs. Whereas I feel like in Western medicine it’s sort of like you’re sticking with the same medication, you’re using the same amount.

Maybe you’re changing the dose a little bit, but you’re not really changing like the actual formulation of what you’re getting. I would say those are the biggest differences. Because people are so different in how they actually express their eczema, I mean, I’ve got some people who has only on the upper body. I have some people who it’s only in the lower body. I’ve got some people who are like extremely dry in a lot of identification. I’ve got other people who are like oozing and weeping. Each of those different presentations actually require completely different herbal medicines and completely different ingredients. Those are the kinds of things that you think about. We also think about where exactly is your eczema coming up because the location is really important. We have herbs that actually go to specific parts of your body or they actually help to shuttle all of the ingredients to that specific part of the body. Do you say to me, I’ve got eczema on my hands, like I’m gonna use some ingredients that are going to be very different from the people who [inaudible] my eczema is all on my face and my neck or my eczema is all like behind my knees and behind my elbow. It’s very different though.

Abby Lai: ([15:38])

That is super, super interesting. I just – yeah, I find that so interesting because in Western medicine you only give one medicine, but that goes everywhere in the body. It’s not customized at all. I want to – oh, sorry, go on.

Dr. Olivia Friedman: ([15:51])

[Inaudible] medicine that everybody gets. Because you all have eczema and you all get the same thing.

Abby Lai: ([15:56])

Yeah. I want to know, do you notice a common pattern in people that you treat who have eczema or topical steroid withdrawal?

Dr. Olivia Friedman: ([16:06])

No. Actually that’s where we really differ in that we really see a lot of different patterns for eczema. Like I mentioned, there’s seven different patterns that we’ve worked with as a starting point to figure out what people need in terms of ingredients and then it gets even more finite in all the other additional ingredients that we add, so we start with a seven. With [inaudible] I would say, it’s similar. I don’t know if it’s definitely seven. I would probably fit it at least three or four different patterns that I look at with [inaudible]. I start with that and then I changed the ingredients depending on other things that happen. I’ve got some people who have really, really rough nights where they get super hot and they’re itching and much more.

Unlike the people who are having those kinds of symptoms, like I’m going to give them different ingredients than people who aren’t having that. People who are super, super itchy versus people who are kind of itchy, not too much itchy. There’s completely different herbs for those too. It really depends on the severity of each of the different symptoms, the severity of between night and day and how much of that pattern is really coming through. Like when someone is weeping and goofy, like isn’t this a little bit, or they like pouring stuff out of their neck all day long. That’s really different types of patients. I would say you start with a bunch of patterns, but then you decide like where in the continuum are they in this pattern. Does that makes sense?

Abby Lai: ([17:43])

Yup. Then do you notice in the patients that you work with that certain organs are weak? Like that type of pattern.

Dr. Olivia Friedman: ([17:52])

Yeah. Chinese medicine kind of look at the body as a lot of different systems, very similar ways to Western Medicine. But we kind of name all of these different systems a little differently than they do in Western medicine. While we will saexcemay things like, your liver in Meridian is stronger, weaker, whatnot, we’re not necessarily saying like, they’re liver is not working. What we’re kind of talking more about is how does that particular system affect what’s going on in your body. In Chinese medicine, like for example, the liver is very responsible for your ability to get things done. If you have less than that ability to do that, we say that the liver Meridian is not quite as strong. The liver is also responsible for the blood. I think in the Western translation we say that too. We say it’s supposed to clean the blood and whatnot, but it’s slightly different understanding on from the Chinese viewpoint.

A lot of it is because the Chinese methodology or Chinese medical system was based on not even seeing the inside of the body. Because if you think about it, Chinese medicine came about like two, three thousand years ago and we didn’t have microscopes back then. We didn’t have cadaver labs back then. We weren’t able to open up the body and look and see like all these different mechanisms. All of the ways that the Chinese people look at the body and how it works based on observations, some scenes that they actually could see and that was nature. They looked out into the environment and they sort of likened, what’s happening in this macro system of the world and how do we relate that to the body. It’s really kind of interesting that their observations were so good because I mean a lot of everything that they looked at and kind of likened it to hold up now. What’s interesting is I think Western medicine is actually starting to look at some more holistic view of how do we actually interact with the environment and how does that actually affect us. The whole idea of the microbiome is something that was always part of Chinese medicine and only recently we’re starting to go, Hey, I think this has a big part of how people are healthy or not healthy or whatnot. It’s very interesting.

Abby Lai: ([20:20])

I just did a really, really fascinating podcast for my last episode on probiotics and the gut microbiome. How do your herbs target the gut microbiome or do they even target the gut microbiome?

Dr. Olivia Friedman: ([20:34])

I would definitely say that every single herbal formula affects all different parts of your body. I don’t think there’s any way that you did say that it avoids any part of your body. I will say that every system is affected whenever you have a skin condition, it’s a matter of to what degree. I will say that a lot of people who have eczema for a while oftentimes find that it’s really difficult for them to eat certain foods. Not necessarily because of they’re allergic to it, but because they develop a sensitivity all of a sudden and it makes it really difficult for them to eat or it actually makes them actually have their skin break out more. Right? In Chinese medicine we definitely say that anything that happens to his skin is definitely going to impact you know, the other systems in the body.

If you think about it and they said the skin in the larger system in your body, the largest organ of your body, how can it not affect everything else? Right? If the skin is basically the barrier between outside world and the inside world, that’s the only thing that’s standing between you. If it’s compromised, of course it’s going to affect everything else that [inaudible]. The skin is also what divides you between your oral mucosa and your stomach and all that. Also, that skin is like being exposed to the outside world as well. That’s also the way that we take in food, we take in air and whatnot. It’s funny when people say that, Oh, they’re totally unrelated, they can’t be, can’t have anything to do with each other. You’re like, How are you sure about that? I think it’s [inaudible].

Abby Lai: ([22:16])

That makes a lot of sense. I’m interested in knowing how long does it usually take for a treatment to work? I know that everyone will be slightly different, but I’m just wondering if there’s like an estimated range for that you notice for how long it takes.

Dr. Olivia Friedman: ([22:32])

Yeah. It’s really hard to say for sure because it really depends on to what degree your eczema has affected you. People who are pretty healthy, but just have the – more superficial expression of eczema probably will take a lot less time. But people who have had it for a lot longer and it’s affecting all their other systems and whatnot, it’ll probably take longer. And if you think about it, it’s because you’re not just trying to get rid of what’s happening on your skin. You’re trying to change your body so that the [inaudible] all of the systems that are now becomes damaged or impaired as a result of your skin barrier being compromised, right? In order to do all that work, you have to like do all that work from the inside out. I think a lot of people get frustrated because they’re like, well, I’m just dealing with this stuff that’s on my skin, so why can’t it just go away?

Dr. Olivia Friedman: ([23:28])

I’m like, Oh, it’s kinda happening because there’s all these other things going on underneath the skin. I liken it to exercise. I mean, a lot of people are like, Hey, I want a six packs abs. Right? When you came to go to the gym once and do like few sit ups and go, all right, done. I’m all better. I can have my six packs abs now. We kind of have to work at it. Right? You have to like consistently do things that are sort of like rebuilding your system, to bring more blood into the system, bring more nutrients into the system so you can build muscle so that you can actually become stronger. It’s very much the same thing when you’re actually trying to repair your skin. You’re trying to repair a lot of different systems underneath it and make it healthier so it can actually go back to the way it’s supposed to work.

Abby Lai: ([24:16])

I find that so funny because even in my practice, I find so many people want to heal so quickly and they just expect a fast healing. But then, we have to heal from the inside out and it can take a long time, sometimes like months and yeah, some people even get worse before they get better. I guess with your herbs, you noticed the same thing where people get worse before they get better.

Dr. Olivia Friedman: ([24:42])

I don’t know if that’s necessarily a path that you have to go through. I will say that oftentimes what happens is that when you start taking herbs, you’re not going to eliminate the flare immediately. What’s going to happen is that the flares will probably become less intense over time and they will probably become less frequent. I think when people start taking the herbs at first and then they have a flare, they’re like, Oh my gosh, this just caused a flare. It’s like, no, you actually have been having flares. The thing is like, we just want to get you to the point where you can repair a little bit more so that the flares are not happening as much and they’re not and they’re not affecting you intensely. I don’t think that people necessarily get worse. I think what happens is they actually are going through a flare that they would have gone through and then as they’re continuing to treat, they just don’t have as many of those things happened.

Abby Lai: ([25:35])

Then do you find that people with topical steroid withdrawal tend to take longer to heal compared to people who are just going through regular eczema?

Dr. Olivia Friedman: ([25:45])

I would say it’s all different too. I mean it really depends on like how much of your body has been affected. I mean I definitely have some people who have TSW and it’s like really localized, it’s just one area and I’ve had people who their entire body has been affected. I think people are also at different points in their healing when they come to me. Like some people, I’ve had it for many, many years and they actually started to get better and then it’s like easier to move them to the next phase. Then there’s other people who like just started I think TSW and their reaction is really strong. It really depends. I don’t know that I can say for sure that there is a timeline. It really depends on how much it has compromised your own body.

Abby Lai: ([26:29])

That’s actually a really good point because you’re right, like everyone will come see you at different points and everyone’s at different stages of their healing. Yeah. That’s also one thing that I do. I want to remind the listeners is never to compare your journey with other people as well because some people might be further along than other people. You’ll all be at different stages and everyone heals at different points. Just like Olivia mentioned, everyone can take a different amount of time depending on your severity as well. You mentioned something really interesting to me last time when I saw you was that you work really closely with Dr. Peter Lio, who’s the other dermatologist. He’s on the, also on the national eczema association, scientific advisory board. You mentioned to me that he’ll actually refer patients to you and then you’ll refer patients to him too. That’s the first time I’ve heard of a dermatologist referring patients out to a traditional Chinese medicine practitioner. I just wanted to hear more about that too cause I think it’s really fascinating.

Dr. Olivia Friedman: ([27:33])

Yeah. Well I give Dr. Lio a lot of credit. He’s really open to really doing the best things for all of his patients. I can say it’s a really great way to approach things. I think all doctors should really be thinking about what is the best thing for their patients. If I’m not the right person, who was the right person that I can send them to? I really liked the way he thinks about things. I think that there’s a place for Western and Eastern medicine. I never want to come across like I have anything against anything about Western medicine. I think there’s a lot of cases where I’ve seen Dr. Lio do amazing things with people. All of the medicines that I mentioned before, like steroids and immunosuppressants and biologics and whatnot.

I mean they, they’ve come from a lot of people. I’m never going to say that’s not the option to go with. I would say that there are some people that this is really the right option for them. Then there’s some people that probably Eastern medicine is a better option for them. It really depends on who you are and what your requirements are. Some people want an actual option, in which case Eastern medicine is probably a good way to go. I think there’s also people who respond better to some medicines versus others. I think every single kind of medicine, there’s always somebody who just does not respond well to it. I think that’s fair to say that herbal medicine is also something that there’s a few people who just do not respond to it well or they have a bad reaction to it.

In those cases, like I send them to Dr. Lio because there’s nothing else I can do with them, and maybe there’s a medicine that he has that will help them. There’s times when people try different medicines and then they have reactions or side effects or whatnot. In which case, there is no Western relation for, and in the case of TSW, I mean, Eastern medicine is definitely a great way to go because at that point in time, he probably are a little gun shy to use any other pharmaceutical and here is a natural answer for you. I think it really depends. I also think it depends on where you are financially. I think, Eastern medicine, typically people can’t get insurance coverage for. Herbal medicine is not recognized by most insurance company by this point. Flexible spending account and health spending accounts oftentimes can be used.

But the insurance companies themselves will not just let us feel bad directly. People can afford that and it’s a great option, but if they can’t and they have to rely on their insurance companies to pay for their healthcare, then it’s the better option for them to go to someone like Dr. Lio. I think you really have to look at your own situation and see what makes the most sense for you. Depending on what your responses from different medicines, whether they’re East or West, it really will determine the direction that makes sense to you.

Abby Lai: ([30:33])

Yeah, that’s so true. I think that’s really neat that you have that working relationship with Dr. Peter Lio. For those of you who haven’t heard my other podcasts, I’ve done two podcasts and interviews with Dr. Peter Lio, which you can check out on Season 1 and Season 2 of my podcast. The other thing I’m going to get a ton of questions about and you might as well, but I think a lot of people are going to ask like what’s the expected budget that they should be spending on – which they should expect to spend on Chinese medicine?

Dr. Olivia Friedman: ([31:02])

Well, every practitioner is different. I can just tell you about what I usually charge. Usually people come to me for an initial intake and that’s usually 225 that’s usually for 60 minutes. The reason why it is so long is because we have to really talk about your entire health history and your whole skin history and every single component that has played a part in this, so that we can really understand like what herb to give you.

Abby Lai: ([31:24])

From there, do you usually see people every couple of weeks?

Dr. Olivia Friedman: ([31:24])

The reason is because as you feel you’re going to need completely different ingredients and I really need to understand like where you’re at, what’s happening, what’s coming up for you. Those appointments are basically $100 each. They’re usually – they’re 30 minutes. Then from there, usually the herbs come in a liquid form, they are drop shipped to your house from the pharmacy that I work with, [inaudible] pharmacy located in New York City. Usually, take away [inaudible] in their packets, like the size of a smaller cell phone. It’s like one out there now. Usually, they’d run somewhere between $70 and $100 a week depending on what ingredients we use. Sometimes they use some topicals and the topicals are a great way to handle, getting rid of that itch cycle or just handling, having a way to treat the external as well as internal components, it’s going in both directions and usually treating them a lot faster. That’s usually been somewhere between $20 and $40, but they usually for like depending on how often you use it and how many parts of your body you’re using it on, it can be like up to a month or so, maybe even more depending on how much you use.

That’s the basic, just what it’s like to work with an herbalist. I think the basic idea is to get you to a point where you don’t need any herb at all. That’s the goal. I would get as a definite in your health because you’re sort of like trying to rebuild your body to the point where it’s healthy enough – enough to work on its own without having to do something. I know there’s things like a piston and whatnot, which is an ongoing cost. It’s something that your insurance company will have to pay for forever until you’re not using it anymore. A lot of the things that I think people are using right now, the idea is to kind of manage more than it’s actually dissolve the situation. I look at it as an investment in your health and to get to the point like myself where I’m not using anything. I don’t use anything to maintain my healthy skin now and I pretty much live drug and herbal free.

Abby Lai: ([33:48])

That’s great. Yeah, that’s really great. I have had someone who mentioned to me that they were seeing another Chinese medicine practitioner and they gave them licorice root and they’re going through topical steroid withdrawal. I know that that can sometimes mimic steroids and some people have had a flare after using that and they mentioned to me that when they saw you, you didn’t give it to them. They were really happy about that. That’s just something I wanted to point out.

Dr. Olivia Friedman: ([34:13])

I actually did a little research paper on licorice root because it kept on coming up with a lot of TSW patients that I saw. I really wanted to understand like what exactly was the chemical constituent of – like risk that was causing this or is it really an issue? What I found in my research is that yes, in fact it mimics a steroid, but there are many other kinds of surveys in your body. The one that everyone is really concerned about that affects the HPA access is a glucocorticoid. What – literally, it’s not bad, it’s actually a mineral corticoid. It works very differently and it has a very different effect on your body and it does not have anything to do with the HPA access. What I usually tell patients is that it’s not something that you should be concerned about as far as the TSW goes, which is not going to be responding in your body in the way that glucocorticoids are.

However, if it’s really something that scares you and you have a lot of fear for, I will just eliminate it from your formula altogether. I think most Chinese herbal formulas actually include licorice root in it. The reason is because it actually is a great or piece sort of harmonize all the different herbs together and actually take the harshness of some of the herbs that can be a little bit more strong. I think most herbal formulas that have it in it actually melt together a lot better than those that don’t use it. The other thing is we use it in such small amounts that it’s really, really not enough to cause any issues at all. I think there was a study that I could put in my research paper that talked about what level do we have or the mineral corticoid to actually become a factor in your body. It has to be whole lot more than what we actually use in a typical formula. Like I said, I take it out for anybody who is really concerned about it, but if it’s not a concern, it actually does do a lot of good things for the formula.

Abby Lai: ([36:27])

Thank you for clearing that up. That is very helpful. Another thing we talked about when I last saw you in person was that I know my acupuncturist that I used to see a long time ago, she said that acupuncture alone wouldn’t be able to help the skin get better or at least my condition when it was really severe. I know you mentioned that that’s true. I just found that really interesting that acupuncture alone won’t help but herbs will need to be supported as well to help support the process.

Dr. Olivia Friedman: ([36:57])

Yeah, I would say acupuncture is definitely helpful. But I think the problem is that most people can’t do it every day. A little bit difficult to get you an acupuncture every day and it’s probably very expensive. I don’t know how to send you something that affects your body every day. It’s something that you can do on your own. You don’t need somebody to actually administer the treatments. I think that herbs in general are just so much better for skin conditions because they can be so specific about the location of the lesion and like dealing with the severity of a particular thing by changing the dosage of the amount of that particular ingredients. Whereas, with acupuncture maybe there is a point that’s worked with the dampness in your body, that cropping, this oozing and weeping and stuff. It’s like one point, right. Versus I can take an ingredient and go, wow, Abby probably needs a little bit more than Jane or this particular ingredient, so I’ll just add a little bit more. That’s a little bit easier to customize.

Abby Lai: ([38:01])

Got it, got it. That’s interesting. Another thing I wanted to touch upon is actually the herbs side of things. I recently read an article that said 9 out of 10 herbs that are used are contaminated. Sometimes they can contain antibiotics or even other types of medicines in it or pesticides or heavy metals. I read a lot about that, and also my naturopath a long time ago also told me that a lot of herbs are not regulated and a lot of them come from China. The lead levels are also very high. I’ve been actually looking into this a lot about how it’s really, really important to get herbs that are third-party tested that actually get just tested even by a third party. If you can ask them for a certificate of analysis, that’s really helpful too. I love that you’re using a company that actually does third party testing cause I’ve looked them up and I think that’s so important. I’m so glad that you use them.

Dr. Olivia Friedman: ([39:04])

Yeah, well that was a really important thing for me. When I started practicing, I thought really strongly like if I am going to be promoting natural medicine, like everything has to be naturally good. I spent a lot of time researching companies that could be good partners to work with. I did find a lot of variation in what people did in terms of sourcing herbs, what they felt was adequate and satisfactory versus higher levels of satisfaction. It really became apparent to me that it was important to work with a company that really had high standards, that really did their homework and made sure that all the herbs are sourced from really good farms that are not using some pesticides, that are not using all kinds of new things, that are making sure it’s not mixed and contaminated with other things.

I think Chinese medicine has gotten a bad rep from a few companies that have adulterated some of their formulas with steroids and things like that. It’s unfortunate because it’s really not the majority of people out there. It’s like one or two companies that are basically ruining it for everybody else. I just think the best thing you can do is try your best to do the right thing. It’s good to be aware about these things and to make sure that the people that you’re working with are not doing these kinds of things.
But I would not say that the majority of people are doing things like that. I would say most people are like myself, tried really hard to do the right thing. You have to do the right thing for our patients. I know there’s a lot of fear out there for those particular products. Always go to somebody that you know is, did try a lot harder to be a lot more reputable enough or just they’re actually administrating.

Abby Lai: ([40:58])

Yeah, I actually had to Google one in my area just to check for one. I think I Googled third-party testing for herbal medicine and I was able to find one, which is really, really interesting. The old Chinese medicine practitioner that I used to see, she wouldn’t let me like go get herbs from another pharmacy. I’m guessing like that could be the case for some people. Like if they see certain Chinese medicine practitioners, maybe it’s because the Chinese medicine practitioner earned some money from like if they have their own herbs, I’m not sure. But yeah, that’s the case that I found.

Dr. Olivia Friedman: ([41:36])

Well, I had see – because I’ve tried really hard to find an a pharmacy that’s upheld really high standards. I am very reluctant to work with other pharmacies. Like some people would come to me and say, Hey, can we meet and they live somewhere else. They’re like, Can you just put together a formula, I can bring it to my nearby pharmacy and they’ll fulfill it. And I’ll say, well that’s great that it’s convenient for you. But like, I don’t know anything about this pharmacy and I still want to put my formula in with them if I don’t know whether or not they’re actually sourcing their herbs and if they’re placing all these tests in place to make sure that whatever they have is good. I think sometimes patients are a little frustrated with me because I’m pretty strict about that kind of stuff. I want to make sure that we’re getting good stuff that. But my reputation’s at line too. If I were to give them the formula and they could sell this in other pharmacy and something happened to them, I mean, they would come back to me and something.

Abby Lai: ([42:39])

That’s true. Yeah.

Dr. Olivia Friedman: ([42:42])

I do not do that at all. They have to go through this one pharmacy and because I’ve done it them and I know that they have good stuff and it’s all going to be safe.

Abby Lai: ([42:53])

That’s very interesting. Thank you for sharing that. I think that also just shows like what kind of standards you have for your practice, that you have very high standards. It’s just great. I know maybe it can be frustrating for some people, but I do understand like you only want them to have the best. That’s why you’re using your pharmacy. I’ve also read articles where some people have had liver damage or like kidney damage from using Chinese medicine that has not been third-party tested and that has had contaminants in them. I think that’s why it’s so important to use like herbal medicine. Even like for myself, I’m finding it’s so important to look for supplements that are really, really high quality and like not contaminated at all.

Dr. Olivia Friedman: ([43:40])

Yeah, I mean I think every single fine benefit is really important to make sure that it’s the best. I mean, even vitamins. Like there’s a lot of different levels of vitamins and I think most people just go, Well, the one that my Tasco or whatever is good enough. But if you feel me do the research, there’s a big difference. I mean, very, very well-sourced vitamins versus not so good ones. I think that’s true of every single thing. But it depends on how much work people want to do to make sure that they get the right stuff. But I feel like with herbal medicine, it is [inaudible] to do that for my patients because they shouldn’t have to do that homework and it’s too much to ask them to do it. I think it’s my responsibility to make sure if I get good stuff.

Abby Lai: ([44:25])

Thank you for sharing that. That’s really important. I think we’ve reached almost the last couple minutes of our show. I just want to ask if you have any last words for people who might be listening or watching or any last words of advice that you might be able to give them?

Dr. Olivia Friedman: ([44:42])

Yeah, I think a lot of people are kind of not sure what the [inaudible], and they get contradictory insemination from different practitioners and sort of hard to figuring out like who should I be listening to? Because one practitioner, he says, you should be taking this and the other thing. The other practitioner said something else. The other said diet and other said allergies will get tested and whatnot. I think that eczema is a very interesting condition because there’s so many reasons why you can have it. The unfortunate thing for each person you have [inaudible] you have to figure out what their combination of factors is. I don’t think there’s any one magic bullet that’s going to be good for everyone. I think, if you’ve tried a lot of things in Western solutions, you’ve tried a lot of supplements and whatnot and you’re still not getting answers or you’re not getting resolution, like herbal medicine is probably a good thing to try.

Like I said, I worked very closely with Dr. Lio and that if I find somebody who [inaudible] herbal medicine, I’ll definitely send them to him. If they live in Chicago or if they’re willing to go to Chicago. I think it’s really important to find practitioners who know other practitioners in this discipline. Because it probably is the ones that you are really looking out for their patients in trying to find the best solution for them. I don’t think I have the answer for everyone, but I do think I can probably help a lot of people, but for the people that really are not meant for herbal medicine, I want to have an arsenal of people that I can send people too as well. I think it’s all about getting better and instead of like the flipping anyone medicine, I think it’s about doing what’s best for the patient.

Abby Lai: ([46:26])

Thank you. I think that’s a really, really great approach that you have. Yeah, it’s about finding the right practitioner and just the right medicine that works for the patient as well. I’m wondering if people wanted to contact you or find out more about you, where can they go to find you or contact you?

Dr. Olivia Friedman: ([46:44])

Oh, sure. The easiest way to get in touch with me and just go through my website, which is amethystacu.com. On the homepage, there’s basically a way to contact me if you want to set up a complimentary consultation, which I’m happy to do. I think it’s really important for people to meet me, kind of understand like how I work and also asking questions they have about herbal medicine. I’m pretty sure most people don’t know a lot about it. I would want to know as much as possible before finding out or something like that. Then if people feel like they feel comfortable with me, if this might be something they really want to try and then what would we do is like set up an initial intake and then go from there. It’s no obligation. I mean, it’s really just an opportunity to talk and you just learn a little bit more. The complimentary consultation is about 30 minutes, so it’s pretty generous and then, we can decide whether or not it’s for you.

Abby Lai: ([47:42])

Thank you. I think a, that’s really great that you shared all that information and yeah, it’s true. You want to find a practitioner who’s right for you as well. Thank you so much for sharing all the information. I think you mentioned some patients want to learn more about herbal medicine and find out if it’s right for them. This podcast will hopefully also help people out there who are just wondering more about it and the things that they can do to help it. I appreciate you for being on the show today and for answering so many questions and giving lots of great tidbits. Thank you again, and if anyone wants, they can head over to your website to find out more about you. Thanks again.

Dr. Olivia Friedman: ([48:24])

Well, thank you very much, Abby. It’s a pleasure talking to you today.

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