Insomnia and Chinese medicine

I'm currently treating an individual who has been suffering from insomnia and difficulty sleeping for over 20 years.  I thought it would be interesting to share this case as I know a good night's rest is something many people don't have enough of.  What I like about how Chinese medicine approaches this subject is that we not only address the branch (lack of sleep) but the underlying causes- this is important to individuals who have to take sleep aids.

32 year old female with insomnia and difficulty sleeping for over 20 years
- Experiences vivid dreams, heart palpitations upon waking with difficulty waking
- Menses are long, heavy with clotting and dysmenorrhea
- Diet is poor, patient wants to improve
- Difficult to sweat upon exertion
- Experiences depression and symptoms worsen with emotions
- Swollen, geographic tongue
- Slender build
- Low energy, better in evening

Vivid dreams, heart palpitations- Heart blood deficiency
Menstrual symptoms- excess bleeding compounding blood deficiency
Poor diet- contributes to Spleen qi deficiency which produces less qi and blood
Difficult to sweat- blood deficiency
Depression/emotions- Liver blood deficiency
Geographic tongue- yin deficiency

This illustrates how in Chinese medicine, when a patient presents with an issue, we address it holistically as everything is related.  Her diagnosis would most likely be "Insomnia due to Liver/Heart blood deficiency with underlying Spleen deficiency".

It's important to start with determining whether we're looking at either a deficiency or excess of yin or yang.  Yin is cooling, blood, nurturing while yang is excitement, energy and hot.  Her slender build, geographic tongue and energy increase in the evening point to a deficiency in yin; an excess of yang would present more as a fever- this is a yin deficiency as we are saying 'there isn't enough yin to nourish and balance the yang'.  We believe in TCM that females are ruled by blood as they bleed monthly, breast milk is made out of blood and are more yin in nature; it's easy to see why this is a difficult balance for females.  Diet is very important to building blood as well as regulating the cycle so that one isn't bleeding heavily.

When one goes to sleep at night, this is a yin time and the blood is said to return to the Liver (Jueyin channel) which is the deepest channel.  This allows for restoration and rebuilding.  Each organ in Chinese medicine is said to have a spirit- for the Liver, this is the Hun.  When there isn't enough blood returning to the Liver, the Hun is said to 'wander' as if it doesn't have a home.  The Heart is a similar scenario (Shen).  This is how Chinese medicine understands the pathodynamics of insomnia.

We treat the root and branch in these treatments.  We want the person to start to become more sedated through our point selection while at the same time encouraging the generation of blood.  This can take some time as blood building is a gradual process.  Through herbs and diet, this can be resolved though.

It's important to stress that there are many types of insomnia and that's the beauty of Chinese medicine- we don't treat every insomnia patient the same, we look at what is being presented.  There is a saying, "Same disease, different treatment; different disease, same treatment'.  If you are suffering with insomnia, acupuncture and herbs are a fantastic way to non invasively and naturally treat.  Find a reputable acupuncturist in your area if you are interested in treatment.

How Does Chinese Medicine Treat Seasonal Allergies?

Recently in our school clinic, we have had our typical group of allergy sufferers this time of year.  Their symptoms range from nasal congestion, watery eyes, postnasal drip to pressure headaches so bad their considering sinus surgery.  I cringe when I hear all of the decongestants they're taking as there are so many side effects such as appetite loss and even permanent loss of smell.  I'll briefly share what I know regarding the pathogenesis of seasonal allergies and how we treat it in Chinese medicine.

Most seasonal allergy sufferers have what we call weak 'wei qi' and are combating a wind-heat invasion.  You can think of wei qi as your immunity but we see it as the most yang of the qi energy that rises just above the hairs on your body and protects you from the Six Evils (wind, cold, damp, summer heat, dryness, heat).  What differentiates an allergy sufferer from a person suffering a cold or flu is that there are no signs of fever/chill, aversion to cold/wind and no body aches or fatigue; the majority of symptoms reside in the head.  Strong wei qi is produced by a properly functioning Spleen and healthy Lung.  This brings up the next subject: Prevention.

Chinese medicine is a preventative medicine.  They say a novice doctor heals you when you're sick, but an experienced doctor heals you before you become ill.  The Lung and Spleen organs are two of our most important organs to daily living.  Think about it- you have to breathe in air and you have to take in food; without these two, you will produce no postnatal qi.  The quality of food and the quality of air that we take in determines the functioning of our entire body.  The saying You are what you eat couldn't be more correct.  Often the people with seasonal allergies who I see that have the phlegm and nasal congestion also have a poor diet, this being because the Spleen has been damaged by poor diet and is no longer able to 'transform and transport' the nutrients necessary up to the Lung; instead, it sends the phlegm up to the Lung.  This is why we say the Lung is the 'container of phlegm'.    The second type of allergy sufferer I see is the person with weak wei qi due to a Lung deficiency either from smoking or childhood illnesses that damaged their lungs.  These patients normally have dry skin, dry cough and dry nasal cavities with postnasal drip.  This illustrates just one reason it's imperative to provide your body with the best and most nutritional food you can- because that nutrition is transformed into qi and sent to the Lung to act as a shield around your body.

I find it interesting how seasonal allergy symptoms are understood in their pathodynamic and will share a couple of examples:
Dry nose, eyes and skin- the Lung effuses wei qi throughout the entire body which is meant to warm and moisten the body.  The Lung is considered a canopy in Chinese medicine and it's said the nature of the Lung is warm and moist.  When you smoke, the Lung becomes dry or what we call 'yin deficient'.  Often, smokers will have a warm core but cold extremities- this is due to the wei qi not being strong enough to cover and warm the entire body
Nasal congestion, runny nose, watery eyes- most sources will explain this as a stagnation and obstruction of Lung qi- in other words, because the qi of the Lung is not strong enough to effuse the entire body with moisture, it is stuck around its orifice- the nose (we say the Lung opens to the nose).  The watery eyes can the wei qi attempting to expel the wind-heat invasion.

A good place to start in treating allergies is prevention.  When you're taking decongestants and antihistamines, you're treating the branch- the root resides often in a Lung and Spleen deficiency.  If your diet is consisting of refined or overly processed foods, no vegetables and high in sugar, dense breads and hard cheeses, you're going to continue to suffer with allergies.  Making the change to foods that are easy to digest, wholesome and nutritious is going to support your wei qi and heal your allergy symptoms.  Treating allergies starts before one has allergic symptoms- this is often in September that practitioners will have their patient take Bu Zhong Yi Qi Wan  to promote wei qi, drain damp and support digestion.  When approached in this manner, the symptoms when allergy season comes around are reduced and continue to reduce year by year.  When the person is in the midst of allergies, Bi Yan Pian is a formula that can help reduce symptoms.

See your local acupuncturist for help with your allergies and developing a plan to heal yourself and prevent them in the future.

Springtime in Chinese philosophy & medicine

It's Spring!  The winds are coursing and changing, temperatures are transforming and life is bursting and blossoming again.  It is the energy that compels seeds to open deep in the thawing ground, to push up and out with all their might toward the air, light, and warmth so they may grow and flourish.  The more I learn about Chinese medicine and philosophy, the more I am intrigued by the messages within our seasons and harmonious cycles within our universe.  I thought I would share what springtime means for us as human beings as well as share recipes/diet changes to make during this season.

Springtime Doyo
Let me begin by sharing an interesting concept that is based in Japanese culture called Doyo, which means 'end of seasons'.  Doyo is a special period of 18 days before the first day of each season; our most recent Doyo was the transition from Winter to Spring.  In America, the first day of a season is marked by the solstice or equinox while in many other culture, this is marked on the midpoints between them.  For example, in America, the first day of Autumn is September 22nd, while in Japan and other countries, it's August 7th.

The Doyo is a time of transitioning where many illnesses that may lie dormant or are unresolved can arise as the qi is strongly shifting.  I noticed this Spring Doyo that many people who have chronic illnesses had a flair up, a friend of mine who has been having a tumultuous pregnancy had to be admitted to the hospital because the baby was trying to come too early (excess qi in the universe), and a family member passed, unable to renew themselves this year.

In Chinese Acupuncture, we have special treatments that we use specifically during the transition within Doyo periods to prepare for the next season.  It is recommended to get these treatments between every season as it helps strengthen the body during these transitions and is a good time to speak with you Chinese medical doctor about what the next season symbolizes and how to live harmoniously within it.

Spring and the Wood Element
The element of Spring is Wood as the qi of this time is shooting up and expansive, much like the new growth you see in your garden and the buds covering the trees.  The organs associated with this time are Liver and Gallbladder which means that emotionally, this is a time when anger and frustration can arise do to an imbalance within these organs; kindness and forgiveness is experienced when there is balance.

The challenge of Springtime is 'Renewal and Birth'; it gives us a chance to explore our hopes for the future and envision how we want to live.  When Wood is balance, we clearly see what the next step is and feel excited and energized to plant the garden, begin a new job, or start a creative project that has been waiting to be born.

Wood Imbalance

• Inflexible, rigid, and stiff body or mental attitude (Wood Qi stagnation)
• May experience hormonal imbalance, shoulder or neck tension, headaches
• Quick to anger, frustration, negativity, or depression (Wood Qi stagnation/deficiency/excess)
• Timid and afraid to assert oneself (Wood Deficiency), or too push and domineering (Wood Excess)
• Struggles with indecision (Deficiency) or impulse decision-making (Excess)
• Symptoms become worse with stress, in the spring, or in windy conditions

Balanced Wood

• Flexible mental attitude and body, with strong tendons and easy movement
• Stable mood and energy, balanced hormones
• Sense of inner purpose; able to envision what comes next
• Adapts to change and moves forward in life
• Calmly makes plans and executes decisions after careful assessment of a situation
• Appears harmonious and in the flow of life, with little stress or tension

Food, Flavors and Herbs for Spring

Green, upward growing vegetables provide the Rising Yang Qi that begins to move during the Wood Phase.  Eating these foods- asparagus tops the list- adds a healthy dose of active energy to your body. Other foods that embody the Rising Yang Qi are clergy, boo toy, romaine lettuce, and all the leafy vegetables that grow toward the sun.  in addition to the upward reaching foods, spreading seeds have enormous quantities of qi for the purpose of pushing up into the light.  Add sprouts to your diet and you will take in that same vitality, along with a good dose of B vitamins and enzymes that facilitate digestion.

The sour flavor dynamically influences the Liver Network: its astringent contracting action releases stagnation from the Liver and moves qi upward.  Sourness also assists in the digestion of fatty foods and proteins.  This is a yin flavor, so you should not overdo it in the Rising Yang Qi season.  For example, you can safely drink lemon water in the morning to balance the burgeoning Yang Qi, but doing it every day may cause too much contraction.  

Wood Balancing Dietary/Emotional Advice

• Drink fresh lemon juice in water first thing in the morning.  (Sour is the flavor of wood)
• Add raw veggies and cooked greens to the daily diet
• Eat lightly, with fewer heavy meats and fats
• Cut down all preservatives, refined foods, sweets and anything that is slow to digest (heavy meats, hard cheeses, raw salad, dense bread)
• Exercise at least for times a week
• Avoid sugar, alcohol, and caffeine
• Practice taking a step back and gaining perspective before reacting to frustration

Foods that Relax the liver and move the qi

• asparagus
• bupleurum
• cabbage
• lemon, basil
• black pepper
• cayenne
• celery
• coconut milk
• dill
• garlic
• ginger
• safflower oil

We've now covered important energetic information to better prepare you this Spring and allow you to live more harmoniously and healthfully.  If you have recipes you'd like to share or any questions/comments, please feel free to leave them below.  Thank you! Collin

1. Qigong Through the Seasons, Davis, Ronald H. Singing Dragon 2015

2. Rhythms of Change, Suanders, Mary. Hidden Needle Press 2014

Why I decided to kick caffeine...

It's been about a week since I've stopped drinking black tea and I thought I would share the changes that I've noticed since then and talk about the effects caffeine has on our health.  I notice that a lot of the people I treat have a fondness for caffeinated beverages and I feel that it is an aspect of our health that we should consider, especially for our long term health.

This is not my first time taking a break from caffeine- for years I've been an avid black and green tea drinker and prior to that a coffee/espresso consumer.  When I used to drink coffee or espresso, I would normally experience a unilateral headache, jitters and dizziness which lead me to switch to teas.  The effects tea had on me were less severe unless I had two or more 8 oz. cups of tea.

In 8 oz. of coffee, there is on average 100 mg of caffeine while 8 oz. of tea has an average of 50 mg. (1)  Caffeine works by stimulating the adrenal glands which sit above your kidneys and release adrenaline meant for fight-or-flight situations.  The consumption of caffeine is stimulating this reaction from your adrenal glands in non-fight-or-flight situations and can lead to adrenal fatigue. Signs of adrenal fatigue are (2):

• Feelings of exhaustion for no reason
• Trouble getting out of bed in the morning even with a proper amount of sleep
• Feeling most energetic around 6pm, tired again between 9-10pm and then energize from11pm to 1am
• craving for salty and sweet snacks
• Loss of concentration and memory loss
• A decreased ability to handle stress
• Trouble bouncing back after being sick
• Reduced sex drive
• A Sensitivity to cold

Since I've stopped drinking tea, my sleep has been incredibly deep and I feel renewed when I wake up.  My emotions are more even; I laugh more and there is less fear of interaction. It is also better for your skin.  In his bestselling books, The Perricone Prescription and The Wrinkle Cure, Dr. Nicholas Perricone encourages people to quit coffee to prevent skin aging.  His patients have shown him the consequences of elevated cortisol levels on skin aging and wrinkling- dehydration and a decrease in collage and elastin production.  High caffeine consumption in women is also being linked to breast cancer and early menopause. 

I recommend moderate water consumption throughout the day; the rule of half your bodyweight in ounces has worked well for me.  Supplements like Reishi mushroom and Cordyceps fungi are adaptogenic and incredibly good for you.  When energy is low, deep breathing exercises are beneficial and if you can take a nap, you should.  Naps are great for you.

If you suffer from anxiety, difficulty sleeping, poor memory or fluctuations in energy, I would recommend considering decreasing the amount of caffeine you consume or discontinuing consumption completely and seeing how you feel.  Remember the delicate balance your body tries to regulate with your hormones and assist it in reaching homeostasis by not adding more chemicals.

If you have any questions or comments, feel free to leave them below.  Thank you! Collin  

1.  http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/in-depth/caffeine/art-20049372
2.  http://drjessechappus.com/7-ways-to-naturally-reverse-adrenal-fatigue/