#95 Traditional Chinese Medicine: Dr. Xiu-Min Li's Groundbreaking Research

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Welcome to the Don't Feed the Fear podcast, where we dive into the complex world of food allergy anxiety. I'm your host, Dr. Amanda Whitehouse, food allergy anxiety psychologist and food allergy mom. Whether you're dealing with allergies yourself or supporting someone who is, join us for an empathetic and informative journey toward food allergy calm and confidence.

Amanda Whitehouse, PhD

Today's episode of Don't Feed The Fear might sound surprising to you at first, especially if you're used to hearing about food allergy treatments strictly from within the framework of Western medicine. My amazing guest today is Dr. Xiu-Min Li, a physician who is uniquely trained in both Western medicine and traditional Chinese medicine, often abbreviated as TCM. For decades. She has been conducting rigorous scientific research, exploring how carefully formulated traditional herbal therapies might help to treat allergic diseases and potentially even cure food allergies and eczema.

If that sounds too good to be true. I completely understand your reaction. That is what my local allergist told me when I was reading her research and asking them about it. What makes Dr. Li's work so remarkable is that it is not based on anecdote or tradition alone. It is evidence-based through research conducted through controlled laboratory and clinical studies through her work at major academic medical centers. Her research has focused on developing standardized herbal formulations and studying how they interact with the immune system and allergic disease.

Dr. Li's treatment is the first thing that we tried when we started down the food allergy treatment path for my son. Although ultimately we went in a different direction, I am incredibly grateful for the care that she provided Her mind and her drive amaze me and I continue to follow her work with great interest and might end up using TCM again because I truly believe the research that she's doing has the potential to completely change the way that we think about treating allergic disease.

Once again, just to clarify the acronyms that we use, so this episode doesn't get confusing. TCM, traditional Chinese Medicine and TSW Topical Steroid Withdrawal. Dr. Li brings a fascinating perspective that bridges ancient medical knowledge with modern immunology, and I'm so honored to have her here on the show to talk about the work that she's doing.

Amanda Whitehouse, PhD 2:12

Dr. Li, thank you so much. I'm so honored to have you here on the show.

Xiu-Min Li, MD 2:15

Thank you, Amanda. Thank you for having me.

Amanda Whitehouse, PhD 2:18

I'm, I'm so excited about it. I would love it if you would start just by telling us a little bit of your professional background and how you came to have this unique overlap of both Western Medical Training and traditional Chinese medicine training.

Xiu-Min Li, MD 2:31

Thank you. My uncle was a self-taught TCM practitioner in China. He gave me a book back to that time of TCM and said, there's a gold in this book, and advised me to study both Chinese and the Western medicine. So I trained in both and work as a pediatrician in China, Japan Friendship Hospital, which is a modern hospital devoted to integrative practice. My mentor, who was a very famous pediatrician, told me when I was in graduate school that I had to be excellent in GI, lung and skin condition. And furthermore in understanding patients feelings, which should be interesting to you as a, a psych psychologist. I had a practice and a research in the field of asthma, recurrent respiratory infections. That was my graduate. Thesis. My second mentor was trained in Western medicine, but I learned the TCMI learned both. I learned from her how to design and conduct the clinical trials. She told me I had to be good at statistical analysis. And I attended twice the statistical classes.

Now I am a professor and a principal investigator of research. I still feel that statistical analysis is a very important during the pandemic time, I went to public health school and got an MPH degree. I was able to update my statistical knowledge and the skills using advanced computational technology. For asthma. I was trained at the asthma center at John Hopkins. For food allergy, Dr. Hugh Samson, you know him, was my research mentor at Mount Sinai. I got a big boost in treating eczema when my colleagues start sending me their so-called give up patients, which describes the level of severity I have seen ever since, including eczema. Associated with topical steroid withdrawal and multiple food and environmental allergies. This happened to coincide with a huge growth in patients interest in alternative treatments and the creation of a integrative medicine center at NIH at that time.

Amanda Whitehouse, PhD 5:42

And that is news to me. I didn't know that during COVID you went back for an MPH, a Master's in Public Health as well. On top of all your other accolades and qualifications.

Xiu-Min Li, MD 5:53

I think it's very well needed.

Amanda Whitehouse, PhD 5:56

Clearly the context of the time in which you did it paints the picture for why we need more, more people who are already so excellent like you getting extra expertise in that area too. You're amazing. I don't know how you do all that you do.

Xiu-Min Li, MD 6:09

Thank you.

Amanda Whitehouse, PhD 6:10

You are talking about being sent those, “I give up” patients and that's how I found you, those patients with the topical steroid withdrawal in some of the social media groups that I was in and parents were showing the before and after photos of what their children's skin had looked like before and after they found you. I was hoping you could tell us about how you approach that, how you overlap the traditional Chinese medicine approaches and Western approaches in getting that work started with those eczema patients that your colleagues started pushing off onto you.

Xiu-Min Li, MD 6:44

Thank you. So I, I think it boils down to the fact that we know TCM works. So our job is to find out why it works how to make the work better. One way of looking at was suggested by my friend Dr. Scott Sicherer. Perhaps you know him too.

Amanda Whitehouse, PhD 7:08

Yes

Xiu-Min Li, MD 7:08

He said that Western medicine involves targeting a single molecule on a single other molecule. Whereas TCM targets multiple molecules with multiple other molecules. Thus, TCM can simultaneously have multiple properties, allowing it to treat both pathology and the symptoms, ensuring that TCM has a respectable place in western science and practice is hard work. I teach immunology at a graduate school and a medical school and continually update my immune knowledge. I also lead a group with the PhD students and medical school students and the residents doing research in the field, of food allergy and eczema, among other inflammatory disorders. I see Western and the TCM as the two great medical systems that can be harmonized. Both recognize external factors, for example, such as evidence, allergens, pathogens as triggers in susceptible individuals.

The main difference is the treatment approach for, for Western medicines we target. Pathogens avoidance, neutralize IDE antibodies will block T two receptors with a fast acting method such as biological steroids and immunosuppressants. The exception is, as you know, environmental allergy immunotherapy, which is slow, but a very effective long term. The weakness for most medicines is that once the treatment stops, there is a high chance of a relapse. Additionally, there is a concern of inhibiting good immune system, which weakens the ability to affect infectious disease.

In TCM, we focus on whole person to rebuild the balance and have most of the time a sustainable effect. My research with food allergy comes from hearing food allergy moms talking about their children's symptoms and making a connection with the symptoms of intestinal parasites, which were a problem for Chinese people for thousand of years. The immune mechanism for both conditions, IE food allergy and the parasitic infection turned out to be similar. An antibody called the IgE was involved. My research ever thinks has been derived from a classical formula called M1, although it is now refined to fractions of the original formula, and we continue this work to refine for the mostly effective safe therapies for food allergy. Thank you.

Amanda Whitehouse, PhD 10:49

So I would imagine that that would make it even more complex as you're trying to overlap these things with new patients coming in. I'm remembering, when my son came to you, and you were explaining, we don't want to stop using the medications that he's already on to manage. You have this slow integration of the two. So when a new patient finds themself on their way to you, how do you approach that on a patient to patient basis to identify what their individual needs are?

Xiu-Min Li, MD 11:16

So for food, allergy, the IGE is a reference, right? So when the patient come to me, nowadays there are lots of choices. Patient can do immunotherapy, and then they, sometime they have symptoms. They want to come to introduce TCM then to, to make their children or themself tolerate the immunotherapy better. So the, for food allergy. In addition to IgE, there is a good biomarker. We had a publication that called the Basal View Activation Test, right? So that method is you are not challenging the person you took the blood. And put in the tube. Then you add, for example, peanut protein at a different concentration. You look at the percentage of the cells that release histamine. This can be run by a very advanced equipment called flow cytometry. So this has been a very good marker.

We received that institutional review board approval, that's another project, we study biomarkers of multiple food allergy that, that was supported by a family fund. For the TSW or severe eczema, the biomarkers we have now also approved by IRB at two at minimal two levels. First is we do swab and then we look at the bacteria components. Second, we measure skin integrity. You know that that's transdermal water loss. It's a, a objective matter of skin integrity. And now we also have a new technology. You do not need to biopsy the skin. You use the strips and then you can get the surface skin, and then you can measure the genes called fliggarin, which is a very strong biomarker of a skin integrity. So in summary, there is a good biomarker to provide the objective matters, to understand the disease and also to monitor the progress because we have the IRB approval and also we have a family fund to support this. Now, we are able to make this available for the patient who are interested in receiving TCM for food allergy or eczema, we are able to monitor the progress. Thank you.

Amanda Whitehouse, PhD 14:03

Can you tell people who aren't familiar with it a little bit about in research, and then with your patients clinically, what does that actually look like when they start receiving the TCM interventions? What might an example of a protocol for a patient's treatment look like?

Xiu-Min Li, MD 14:20

For the regular clinical trial. And the practice based, the research, it is different, right? For the clinical trials. It's a double blender place, placebo controller trial, everybody get the same thing. Will not get treated. But for the practice based study we, we have opportunity to modify the protocol based on patient's needs. So you can modify the protocol that's called the Real World Practice Based Study. So just for the patient who doesn't know this procedure is. Will be if a patient interest to come for the TCM treatment. This a combination with your couple other questions is that. We do need to make sure the patient is in a good situation. For example, they need to get the copy of CB, C and then to look at their liver kidney function. So therefore they will be in a very good situation to start the TCM If they have allergies, they already know, they work with their local allergist that they can get the copy of IGE testing that will also be used that as a baseline.

So what we can do is that we have a IRB approved the protocol, so we can add, as I mentioned, that if they have a food allergy. And they are interested in understanding additional biomarkers and monitor the progress. We can add the basophil activation test. If they have eczema, we can offer the skin swap and then the the skin transdermal measurement called Toro and also do a strip. At further inflammatory and skin integrity markers.

Amanda Whitehouse, PhD 16:31

Yes. And then, I know this too well and my son remembers it vividly. What might someone's daily regimen look like in terms of actually receiving the treatments that you're giving them? I don't know if people understand how the patients actually are treated with traditional Chinese medicine.

Xiu-Min Li, MD 16:46

Okay, so let, let's take eczema as an example. When the individual start this protocol, depending on the age, right? If for babies or young children, normally I do not give them internal because very difficult for the baby to take the tea because normally the traditional Chinese medicine tea is very bitter. That does not taste very good. Then. They will use herbal bath and the creams, so how to monitor the progress. I also set up. The milestones, as I said, unlike the conventional treatment like steroids, immune suppressant, or biologicals, normally you see the results very fast for skin, right? But for the TCM, you need a time months, then you can reach the milestones.

I use three milestones. The first is to heal the skin, right? So second is stable the skin and start to help. To improve their immune system. The third milestone is once the skin's good, I can start to taper the traditional Chinese medicine. So the people do not need to be on the protocol forever. That's the general protocol.

Amanda Whitehouse, PhD 18:09

Okay, I see. So it depends on the child's age, obviously, but some combination of the baths, the herbal creams, and then if they're older and they can consume it, then they might be drinking an actual tea. The herbal tea, my son. We mixed it into smoothies. I remember all three at my house.

Xiu-Min Li, MD 18:26

Yes, you, you are right if the old children or adults, so they can take a pill capsules, right? That's a additional regimen to help because you know that, for example, eczema, although that's external condition, but related to internally immune disorders, right, right. So I think the internal regimen is helpful too.

Amanda Whitehouse, PhD 18:51

I see. Thank you. You mentioned that when people are having more of an eczema or a skin issue and for food allergy, you've developed your own formulas. The one that I know of is FAHF-2. So can you tell me what that formula is, a little bit about what you have found with it so far and how that's addressing or modulating the immune system.

Xiu-Min Li, MD 19:10

Okay. So we call food allergy herbal formula 2, right? So then that formula was wrapped from a traditional formulation called wumei wan that used to treat the parasite infections. We test this formulation in, in the lab. It's very promising. And then in the trial also showed the promising results particular in the immune cells, but the drawback was that the regimen 10 capsules at each meal. Causes lots of medicinal fatigue, right? So subject does not want to continue to take them. So we have a poor adherence. So, although the blood work was encouraging, they could not meet the requirement yet. We had to since then continue to advance the product and now we have a more advanced product that also later on we talk about the single compound border.

Amanda Whitehouse, PhD 20:18

Okay. And is that the direction you're moving in? As I've been following your work, I've been reading about this focus on berberine.

Xiu-Min Li, MD 20:25

Yes. So we, since then we wanted to increase the ease of clinical use. So we start to isolate, identify the compounds. We identify the two compounds. Berberine is most potent, but Berberine has issues. Although in the lab, very effective, it does not have a bioavailability when you do in vivo after you ingest. That does not show the effect. So we start with the support by NIH grant and the private foundation support, we were able to make a natural nano- formulation. This formulation is using nanoparticle to capture the berberine to prevent the degradation in the GI tract. This will be administered in the form of a syrup. So the, this new formulation showed the very effective results and can basically bring down the antigen specific IgE, including peanut, the tree nut, all food allergies. And very importantly, this is in the models stage, after we stop the treatment, the IGE remained very low and no rebound regardless how many times you challenge the experimental model. So this new formulation now, we also received NIH grant. We working very hard trying to move forward to get it ready for the patient. That we expect will generally permanently reduce the production of a pathological IgE to to safer level. Without affecting the rest of our immune system, we, we already generate a strong evidence to support this vision.

Amanda Whitehouse, PhD 22:32

So that sounds like that would be something, potentially helpful to anyone with allergic disease if it's addressing the IgE, which underlies all of the allergic diseases. Does it have potential for everyone, not just food allergies?

Xiu-Min Li, MD 22:44

That's a very good question. IgE is a major pathological mechanisms for food allergy, asthma, environmental, so that, that's right. So this new formulation, nano formulation of bone will help food allergy, multiple food allergy, as well as possibly other allergic conditions. And the interestingly, berberine has been shown to have anti cancer effect. Therefore, we hope that our syrup will have a beneficial of label uses.

Amanda Whitehouse, PhD 23:20

Are there any safety concerns or things that you have to monitor that would be specific to using herbal therapies in patients?

Xiu-Min Li, MD 23:28

So it depends on the definition. If you use the herbal therapy as a dietary supplement, the current FDA does not regulate the efficacy, but for the safety, it's the same. You have to ensure the safety of your herbal therapy used for your patients. So for the product, we have to make sure the product meet the FDA's regulation. The product will have to be made in the GMP facility compliant product, specifically that will be pesticide, residue, microbials, and heavy metals. Right. The purity of your product need to meet the standard safety. There are several levels of safety checkpoints.

One, product quality control. All product must meet us FDA's standards for the control of heavy metals, microbial and pesticide residue. Two, patients will provide a copy of their routine labs, including C, B, C and CMP lab, it, et cetera, and make sure they do not have internal issues before the TCM protocol. If they have an allergy and then elevated the IgE in the past they should get. The lab updated too. And they will work with their primary and specialize the healthcare providers to follow up on this test. So we know it's safe, we believe it is safe, but we need to see the evidence to make sure it is indeed safe. So normally that will be good to redo this lab to make sure everything. Is in a safe range. The, the good timeframe will be every six month.

Amanda Whitehouse, PhD 25:36

It sounds like quite a process. Are there other barriers or challenges to using TCM, either for the patient or for you as the practitioner?

Xiu-Min Li, MD 25:44

Yeah. So then the challenges it's number one is that the protocol, what I have of taking eczema as a example, the patient has to do that tea that's a lot of effort. The second challenge is not only the time and the effort is the cost, right? Because the TCM now is not approved by the FDA. Therefore it's not covered by the insurance. So patient have to pay from their pocket of money. That's a big effort. Although overall, the cost, it's much, much less it expensive than the biologicals. But because this come from the personal fund that it is a challenge. That's why we work very hard, we are making progress, and then would like to get FDA's approval for botanical medicine, therefore, so insurance can cover the cost in the future.

Amanda Whitehouse, PhD 26:52

I know it's a long process. Do you anticipate this being something that would be available to people soon, or do you still have quite a road ahead in terms of actually getting this to be something that could be approved and available more widely?

Xiu-Min Li, MD 27:06

That's a very wonderful question. So depends the product. For the food allergy product I think that need to go through the double blend placebo control. The standard trial that we do have a plan, minimal five years or even longer. But some of the product can be used, as a dietary supplement available. But at the higher level, more potent, the efficacy will be stronger. For eczema because there's a lot different regimens.

I feel that the real world evidence based study will be a better option for the eczema patients. So it's hard for them to be on the placebo treatment when their condition very severe, right? So, FDA several years ago also issued a new mechanism allowing real world evidence based study. That's my target. So I think with that mechanism available, we should have a shorter process to get approval.

Amanda Whitehouse, PhD 28:27

That's exciting. And in the meantime, I don't think you have a huge practice because you're so busy with your research, but people can work with you individually as a clinician if they would like to. Is that correct? Are you still taking patients?

Xiu-Min Li, MD 28:41

Yeah, I still take a patient that I have a practice at Westchester Medical Center ENT department. The Practice Program is a Center for Integrative Medicine center for Integrative Health and the acupuncture.

Amanda Whitehouse, PhD 28:58

And how do people get in touch with you then, if they want to? Is there a website for that?

Xiu-Min Li, MD 29:04

The patient can contact the, my office at the number 914- 257- 3754. I just read it one more time. They can also email me. I will forward their request to my office. I do receive each day lots of requests. That is xiumin_li@nymc.edu.

Amanda Whitehouse, PhD 29:39

Okay, thank you. I will share that. I'll put it in the notes for everyone with the correct spelling for your email address. And just in case people who are listening don't know, you're based in the New York City area right.

Xiu-Min Li, MD 29:51

Yes, I'm based in New York or West Westchester.

Amanda Whitehouse, PhD 29:54

Okay. And so, I try to keep an eye on the chatter that is out there, and there are some people out there claiming to do TCM for food allergies. Can you talk about people who might say they're doing similar work and what people should know about if they're interested in working with you versus just going out and looking for someone who claims to do TCM for food allergy?

Xiu-Min Li, MD 30:15

That, that's wonderful question. In recent years my practice I, I, I attract. A quite number of allergists, the pediatricians interest that I also give a talk in national Allergy Conference. I run couple for workshops because some pediatricians allergists, it's very willing to learn my protocol. So therefore I have several pediatricians allergists that we're still in the process. They want to learn how to help their patients. So sometime if I have a patient from other area, they want to have, the pediatricians or allergies, they're very supportive. As I mentioned, that traditional Chinese medicine still not mainstream of medicine yet, right? Newer medical school students, they work with me. They have a better standing understanding, but not everybody has a good understanding about traditional Chinese medicine for this group of conditions. So sometime the patients will not have a easy time to convince their pediatricians were allergies. So I start to build this network when the patient need it, I can refer the patient to, the pediatrician or allergies, that we have a good collaboration. I think it's very, very helpful.

Amanda Whitehouse, PhD 31:48

That's exciting. I'm glad because you can only do so much. You're one person and I'm amazed at all of the things that you already fit into your schedule, so that'd be great if it that network can grow. Yeah. So if you could send one message to patients who are struggling with severe eczema, severe food allergies, what would you say to them?

Xiu-Min Li, MD 32:09

This is a very good question, Amanda. Thank you for asking this question. First, I have a deep sympathy for the patient and the family who are affected by those conditions that negatively affect their quality of life. I also want to say that there are promising results for eczema, including severe eczema related or not related to TSW. We also have several pipelines of products that fundamentally normalize IgE and reset the immune system and may provide a possible cure. We work on NIH grant and the other findings and the collaborations to accelerate this project. I'm very grateful for the families who have been so generous to support my research, which is a strong motivation for me to move this project faster. Thank you.

Amanda Whitehouse, PhD 33:22

Yeah, so thank you for all of your hard work. I've shared on the podcast how our path took us different directions. We were so thankful to get started with you and I continue to follow your work and will be. I will be fingers and toes crossed and following every word that you're putting out for potentially a cure down the road, which is really exciting to all of us to hear. Thank you so much for that hope.

Xiu-Min Li, MD 33:43

Thank you, Amanda.

Amanda Whitehouse, PhD 33:45

And thank you for taking the time to join us when your schedule is so busy. I really appreciate it.

Xiu-Min Li, MD 33:50

Talking to you is very inspiring. I really appreciate the opportunity. I hope everything is good with you. Thank you, Amanda.

Amanda Whitehouse, PhD 33:59

As we wrap up, here are three action steps you can take to continue learning after today's episode.

Number one. If you're interested in learning more about how traditional Chinese medicine is being studied in the context of allergic disease, I encourage you to take some time to look through Dr. Li's research. She has spent so much time bringing rigorous scientific methods to the study of these traditional therapies, and it is truly fascinating. I'm going to put links to her body of research and some of her books in the show notes.

Second, if you are interested in working individually with Dr. Li, you can call her office directly at (914) 257-3754. You can also contact her by email. It's Xiu-Min Li xiumin_li@nymc.edu. That'll be in the show notes as well.

And third, if you are navigating all of these options and trying to make sense of the many different approaches that exist, you can check out my workbook from Fear to Freedom. It was written specifically to help patients and families understand the different treatment paths, the social emotional effects of them, how to navigate those, and have informed conversations collaboratively with their medical team.

One more quick note. If you prefer watching or reading, instead of listening, you have options. You can find the video versions of the podcast on YouTube, and if you're a reader, you can find the full transcripts on the podcast or on the blog at my website, the food allergy psychologist.com. Thank you for listening, sharing, leaving me ratings and reviews, and helping the show to grow to reach so many more people than I ever imagined it would. I truly appreciate it and I will be back next week.

The content of this podcast is for informational and educational purposes only, and is not a substitute for professional medical or mental health advice, diagnosis, or treatment. If you have any questions about your own medical experience or mental health needs, please consult a professional. I'm Dr. Amanda Whitehouse. Thanks for joining me. And until we chat again, remember don't feed the fear.