David and/or Andrew 19-year-old girl with high creatinine (1.07), protein of 7.9, EGFR of 77, Calcium 10.8. Doesn't drink enough water. Overuse of ibuprofen. Urinalysis results pending. Normal BP, normal blood glucose. No indication of autoimmune kidney disease. Suspecting she "blew out her beans" (Her Dr's words, not mine!) using too much ibuprofen for menstrual pain. I think this is probably very common, as this is the 2nd case like this I've seen this past week, meaning Ibuprofen overuse due to menstrual/female issues affecting the kidneys. Unfortunately, there are many Dr.'s sending patients down this path. I'm not really sure what to ask here. Obviously, I'm looking at treating her female issues based on her individual symptom pattern, etc., but I would like to know your thought process regarding helping to restore her kidney function. I have a general idea what you are going to say, but I would like to know how you go about treating kidneys specifically injured by NSAID overuse. Thank you! Jami

I don’t know if this is what you think I will say or not, but for the dysmenorrhea, what does the pain feel like ? Herbs I tend to use for menstrual pain include Cyperus, Jamaica Dogwood, Corydalis, Black Haw (or Cramp bark), possibly Horse Chestnut, Sweet Melilot, Silk Tassel, Tree Peony, etc but which ones depend on the nature of the pain. No more Ibuprofen. For the Kidneys, I use Kidney trophorestoratives such as Nettle seed, Cordyceps, Astragalus, Pellitory of the Wall, or Dan Shen. Her creatinine is only slightly elevated, her calcium is the high end of normal, total protein is normal , but above optimal and her eGFR is definitely low for her age (I would expect above 100 for a 19 year old). Also increase water as dehydration can also cause elevated creatinine and total protein.

David, I had no idea what you would say regarding the dysmenorrhea, especially since clearly, I didn't give you enough information! No unusually heavy bleeding or clotting. Blood is normal color. Her tongue does indicate yin deficiency with heat. Thick, yellow coat in the center and lower jiao. Fairly normal looking coat in other areas of the tongue. Kidney yin, and stomach/spleen deficiencies. Sublingual veins indicate some blood stagnation, but I looked at her tongue 2 days before her cycle started. Liver qi stagnation lines are present. She describes her pain as burning and stabbing. With the addition of this information, I really would like to know what you would recommend. She has been having heat symptoms in her digestive tract. Some slight furring in the center area of the tongue. Nausea, rebellious qi/ burping, and tends towards constipation. Blood allergy panel (for what it is worth) shows allergies to most grains. She is reducing/removing these. She has removed Ibuprofen from her diet. She is attempting to increase hydration. For her kidneys, would H&A Kidney support formula be useful for her? I just scoured through my Materia Medica sheets/herbal therapeutic indications on each of these herbs in this formula, and they seem to fit her profile, but I am only making a very limited educated guess here! Would it be appropriate to add in Dan Shen as well to move out her damp heat, or would this further drive her yin deficiency and add to her heat symptoms? Thank you, David, for being so patient with me. This course of study is teaching me a huge lesson in patience! I have so many questions all of the time, but honestly...I don't feel like I know enough to ask an intelligent one!

For burning pain I use Tiger Lily (Lilium lancifolium), it is also indicated for yin deficiency H & A used to make it but it was discontinued for lack of sales, I do not know if anyone else has it, for stabbing pain Sweet Melilot. Bitters like Artichoke leaf are cooling, stimulate digestion and relieve nausea and rebellious qi, Wild Yam might be useful here as well . Yes, I suspect H&A's Kidney Support would be useful for her. Would it be appropriate to add in Dan Shen as well to move out her damp heat, or would this further drive her yin deficiency and add to her heat symptoms? No, it should be fine, you are combining it with Nettle seed, Astragalus and Cordyceps, all of which are yin tonics. No matter how much any of us know, it is a fraction of what there is to know, patience is a good trait to develop and just keep an open mind and keep learning.

David, Thank you, David. There is one thing that I do know...I don't know much! I guess it's a start, feeble as it may be. The only keeping me going right now is the vision of you smoking up your house stir frying cattail pollen;) I have purchased H&A's Original Bitters formula for her based on her energetics. Upon further blood allergy testing, it is clear she has leaky gut. How do bitters fit into this picture? She has a lot of histamine going on in there! I would appreciate your thoughts and recommendations. I started her on an Ion gut supplement (humic acid) to tighten up those junctions before each meal, and she started taking a methylated B complex with added thiamine as well, as her bloodwork is indicating deficiencies in these areas contributing to deficient stomach acid. I will recommend Kidney Support and add Dan Shen. Do you have a recommendation on how much to add if I start with a 4oz bottle of Kidney Support? Or just give her the recommended full dosage of Dan Shen on top of the Kidney Support compound? I know she would be more apt to comply if she had one combined tincture to take:) Thank you for the pain recommendations. I will look into these herbs. Jami

The only keeping me going right now is the vision of you smoking up your house stir frying cattail pollen;) Yes, that was an experience for sure I do not think humid acid really works for leaky gut (not in my experience), I use Turmeric, Calendula, Plantain leaf, Cat’s Claw, Licorice, Gotu Kola, etc for loss of intestinal epithelial barrier function. For excess histamine with mast cell degranulation I use - amla, eyebright, rose hips, blueberry, turmeric, gotu kola, etc Get a 2 oz bottle of Dan Shen and add 15-20 gtt (0.75-1 ml) to each 5 ml of Kidney support .

David, Thank you:)