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Fertility after radiation, chemo & tamoxifen

Dr. Nieters,
I am an acupuncturist in Seoul and I have a patient who is trying to get pregnant. Do you have recommendations for dietary, supplement, or any other thing to aid in this process?  She was also wondering about her body temperature, as she runs a little cold and several people here have told her that if her body is cold it is hard to get pregnant. She is 36 yrs old.  she was diagnosed with stage 2 breast cancer in 2005 and underwent lumpectomy, chemo and radiation. She took tamoxifen for 5 yrs, which she completed last year. She has high cholesterol 260 currently. ldl was 179 and hdl was 66. She is not taking statins.  She takes a multivitamin, folic acid 800 ug, and kirkland fish oil 1 capsule daily.
Thanks John!

– Seoul Acupuncturist

Dear Seoul Acupuncturist,
That is a very long list of very difficult issues.  Fertility rates drop very dramatically after radiation and chemo.  The tamoxifen is the bigger problem though.  The tamoxifen basically destroys the kidney yin, and somewhat the jing reserves ,with it’s interference with the estrogen system.  The chong and ren will also be affected.

She has to rebuild her ovarian reserves and re-establish the qi and blood to the uterus which has been severely malnourished from the Tamoxifen on top of the chemo insult..
She needs a lot of kidney yin building supplements as well as blood movers to re-establish lower jiao balance.

She must do a BBT (basal body temp chart to see if she is ovulating properly (proper length of follicular and luteal stages)  also to see if she is maintaining a 12 day temperature peak.
With the cold temperature and other problems the minimal testing would be TSH and day 21 progesterone levels.  Lots more that should be done, but those are the minimum.  The “high” cholesterol is a positive.  The cholesterol is the precursor for her diminished hormone levels.

1. TSH and Progesterone tests
2. Daily moxa at Ren 4 and at Stomach 36.  Also will need it at appropriate spleen, liver, kidney points by diagnosis.
3. Herbs to fit the diagnosis.  Think something strong like Wen Jing tang (if chong channel deficiency with cold), Ren Shen yang ying tang, Shi Quan Da bu Tang, Fu Zi li zhong tang (if more middle jiao cold), Ren Shen Dang Shao San, etc.
4. BBT chart – need a clear sharp temp increase days 13-15.  12 day flat temperature peak.  Sharp drop from peak to menses.  Have sex (not you; her) on the day the temp before the peak (need to estimate from the prior month).  2nd best day is 2 days pre peak.  3rd best day is the day of the peak.
5. Good quality fish oil (not kirkland) at 3-4 grams per day.
6. Chi Nei Tsan abdominal massage

Be Happy!

– Dr. John Nieters, L.Ac. DAOM

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