Moringa Miracle Herb or Case of Consumer Beware

Recently I came across a book on African Herbs which contained numerous herbal moringa treemonographs.  The monograph that caught my eye was  on Morniga oleifera.  I was intrigued by Morniga’s popularity among breastfeeding mothers.  Moringa has followed the superfood path of being the latest and greatest remedy for everything under the sun.  In reading through the monograph, I found some support for these health claims but not for others.  Below is an example of how health claims are perpetuated and the importance of looking beyond the headlines.
Los Angeles Times – “Scientifically speaking, Moringa sounds like magic. It can rebuild weak bones, enrich anemic blood and enable a malnourished mother to nurse her starving baby. Doctors use it to treat diabetes in West Africa and high blood pressure in India …. And it’s not only good for you, it’s delicious.”

Indigenous to sub-Himalayan regions of Northern India and Pakistan, Moringa now has world wide distribution. All parts of the plant have numerous medicinal actions including antibacterial, anthelmintic, anti inflammatory, antibiotic and anti-hypertensive, to name a few.  The Moringa tree is know by different names throughout the world including “drumstick tree” or it’s common name of “horseradish tree”. In Ayurvedic medicine it is known as Shigru and Jacinto in Spain.

 

Moringa is considered a food and medicinal herb. Moringa oleifera grows in many  health claimscountries where malnutrition is widespread and has been used to increase vitamin and protein levels, providing a valuable source of antioxidants and vitamins.  The leaves are the most common part of the plant used in commerce.  When one searches the web there are numerous links to the health benefits of Moringa. A blog post by Wellness Mama on the super food claims of Moringa covered a important point:

Perhaps you’ve seen some of the health claims that gram-for-gram, Moringa has more protein than yogurt, more potassium than bananas, more calcium than milk and more Vitamin C than oranges.  While this is technically true, it is important to note the distinction that this is “gram for gram,” and not by volume. Since Moringa leaves are relatively lightweight, 100 grams of Moringa leaves would be substantially more volume than 100 grams of an orange.

Consider this: a medium size orange is approximately 130 grams, or 4.5 ounces. Now consider a leafy substance like Moringa leaves. For simplicity, we’ll use a similar leaf, Spinach, for comparison. The FDA estimates that 1 cup of raw spinach is about 30 grams. This means that to get the same “gram for gram” comparison, a person would have to eat 4+ cups of fresh spinach leaves to consume the same number of grams as one orange.  This comparison becomes even more glaring with some of the other nutrients. For instance, it is claimed that “gram for gram” this plant contains two times the protein of yogurt, but 100 grams of yogurt is only about 1/2 cup, while a person would have to consume 3+ cups (or six times as much by volume) fresh leaves to get to 100 grams.  Additionally, while it is a good natural source of the nutrients listed above, 1 cup of fresh Moringa leaves provides only 10-20% of the RDA for these nutrients listed above, so a person would have to consume a lot to obtain “superfood” levels of these nutrients. Most Moringa supplements are dried, not fresh, which reduces the amount of certain nutrients and concentrates others.

This points to the faulty logic used as the basis of advertising.  So although Moringa is full of vitamins and protein, it is important to look at the detail, this isn’t a case of comparing apples to apples.

 

bookBack to the monograph.  The monograph reported on traditional uses of Moringa.  According to the monograph Moringa leaves and seeds were used as food:

  • Soup is made from the leaves and is used to treat hypertension
  • Fresh leaves are eaten like spinach, the leaves are used for making sauces
  • Moringa pods are eaten as a vegetables
  • The leaves are used as a protection against malnutrition
  • Moringa leaves are a rich source of Vit. E, A and fatty acids
  • The fruits or seed pods, known as drumsticks, are a culinary vegetable commonly used in soups and curries
  • The flowers are featured in some recipes as well, although they need to be cooked slightly to neutralize toxicity.

The bark, leaves, and root of Moringa have also been used in traditional healing:

  • Leaves used as poultice aiding in wound healing
  • Leaves are used against nervous ailments
  • Juice from crushed bark, flowers, roots and leaves, mixed with honey is used for nervous disorders
  • Bark or leaf used for its antispasmodic properties
  • Root chewed against mouth ulcers
  • Root chewed to aid in digestion
  • Root pulp is poulticed against pulmonary diseases
  • Root decoction if drunk against epilepsy, hysteria, fever.
  • Lightly boiled leaves, bark or root pulp or pulverized root is applied to painful joints
  • Extract of bark or root for scurvy
  • The root and pounded flower are used on wounds
  • Infusion of root is used as gargle
  • Root poultice is a stimulant, used for some forms of paralysis and fever.
  • Juice extracted from crushed roots ear drop for ear infections
  • The leaf infusion contains oxytocin
  • Leaf pulp used as dressing against inflammation
  • Whole plant decoction used against viral hepatitis
  • Used as gargle for throat related infections
  • Seed oil is rubbed on joints.
  • Used as a traditional supplement for infants. One rounded soup spoon contains about 8 g of powder with 2.2 G protein.
  • During the 19th c. Plantations in the West Indies were exporting the oil. It is pleasant tasting edible oil which does not become rancid.
  • In one study the seeds of Moringa were used to purify water. (Gilpin et al., 1994)

Moringa is promoted as a galactagogue or milk stimulating herb by many commercial moringa plantsources.  In a review of literature on Moringa some cultures used it primarily for increasing protein levels during breastfeeding. The Philippines have documented use of its ability to augment breast milk production.  There is a survey of studies that does show it has a demonstrated  significant increase in milk produced 4-7 days after treatment. The caution is that the internet is filled with much misinformation about whether Moringa leaf should or should not be taken during pregnancy, at this point I would air on the side of safety.  The other parts of the plant should not be taken and can cause miscarriage or bleeding.

Cautions:  The leaves of the Moringa oleifera tree are generally considered to be safe and edible, but there is some controversy regarding the roots and stems pointing to potentially harmful effects, especially in women. These parts of the plant may not only act as a contraceptive (both temporary or permanent) but may also lead to miscarriage and other problems.  There is research showing a potentially immunosuppressive and cytotoxic effect of the seeds of the plant, and extracts or supplements that contain the roots, seeds and stems should be avoided for this reason until more research is done. Additionally, the leaves of the plant have been shown to have a mildly laxative effect and may cause digestive disturbances in some people. Supplementation of the seeds or one extract of the leaves (methanolic) at doses around 3-4 fold higher than the recommended dosages appears to be associated with genotoxicity and should be avoided; water extracts of the leaves do not appear to confer this risk.  Moringa oleifera has anticoagulant properties of unknown potency and biological significance.

Important drug contraindications:  Some medications are changed and broken down by the liver. Moringa might decrease how quickly the liver breaks down some medications. Taking moringa along with some medications that are broken down by the liver can increase the effects and side effects of some medications.

  • Levothyroxine-Interaction Rating: Moderate.  Be cautious with this combination.  Levothyroxine is used for low thyroid function. Moringa might decrease how much levothyroxine your body absorbs. Taking moringa along with levothyroxine might decrease the effectiveness of levothyroxine.
  • Moringa might lower blood sugar. Diabetes medications are also used to lower blood sugar. Taking moringa along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
  • Moringa might lower blood pressure. It has the potential to add to blood pressure lowering effects of antihypertensive drugs.
  • There is research showing a potentially immunosuppressive and cytotoxic effect of the seeds of the plant, and extracts or supplements that contain the roots, seeds and stems should be avoided for this reason until more research is done.

This points to my initial concern about the over marketing of an herb, where it becomes almost impossible to filter through the numerous web pages to find reality.  As the global use of herbal medicinal products continues to grow and many more new products are introduced into the market, public health issues, and concerns surrounding their safety are important.  I am not in the camp of over regulation at all, but I do feel that for the most part consumers are not doing the level of research needed, or looking to clinical herbalists, who for the most part are trained to dig deep for efficacy and contraindications.

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Tinnitus-Ringing in the Ear, Treatment Options From Many Traditions

The Western allopathic approach to tinnitus is dramatically different from either Western Herbalism or Traditional Chinese Medicine in addressing this condition.

Western Allopathic Medicine: Tinnitus is the perception of sound when no actualindex3 external noise is present. Tinnitus is a non-auditory, internal sound that can be intermittent or continuous, in one or both ears, and either a low or high-pitch sound. The sounds of tinnitus have been described as whistling, chirping, clicking, screeching, hissing, static, roaring, buzzing, pulsing, whooshing, or musical. The volume of the sound can fluctuate and is often most noticeable at night or during periods of quiet. Tinnitus is often accompanied by a certain degree of hearing loss.

Tinnitus can be either an acute or temporary condition, or a chronic health malady. Millions of Americans experience tinnitus, often to a debilitating degree, making it one of the most common health conditions in the country. The U.S. Centers for Disease Control estimates that nearly 15% of the general public, over 50 million Americans, experience some form of tinnitus. Roughly 20 million people struggle with burdensome chronic tinnitus, while 2 million have extreme and debilitating cases.

In general, there are two types of tinnitus:

  • Subjective Tinnitus: Head or ear noises that are perceivable only to the specific patient. Subjective tinnitus is usually traceable to auditory and neurological reactions to hearing loss, but can also be caused by an array of other catalysts. More than 99% of all tinnitus reported tinnitus cases are of the subjective variety.
  • Objective Tinnitus: Head or ear noises that are audible to other people, as well as the patient. These sounds are usually produced by internal functions in the flow of blood or muscular-skeletal systems. It is often more like the sound of a heartbeat or pulsating. This type of tinnitus is very rare, representing less than 1% of total tinnitus cases.

index2Some medications such as aspirin, ibuprofen, certain antibiotics, and diuretics can be “ototoxic” or cause damage to the inner ear, resulting in tinnitus.

Other possible causes of tinnitus are:

  • Head and neck injuries
  • Loud noises,
  • Ear infections
  • A foreign object, or earwax touching the eardrum
  • Eustachian tube (middle ear) problems
  • TMJ disorders
  • Stiffening of the middle ear bones
  • Cardiovascular disease
  • Diabetes
  • Traumatic brain injury

There are also potential risk factors including the following:

  • Noise exposure from work, headphones, concerts, explosives
  • Smoking
  • Gender – men are affected more than women
  • Hearing loss
  • Age – older individuals have a higher likelihood of developing tinnitus

There is currently no scientifically valid cure for most types of tinnitus. There is, however, remedies that focus on diverting attention, addressing the emotional impact, and or cognitive therapy.

Western Herbalism: Tinnitus can serve as an important marker pointing to other potential health issues, since it a symptom and not a disease. Whatever the cause it tends to worsen in times of tension, stress and or muscle spasms. Stimulates like caffeine or nicotine, which increases vasoconstriction, can exasperate it. Furthermore, it can be caused by damaged fine hair cells of the inner ear. Although this cannot be reversed there might we some reduction felt in using some of the suggestions below. Stress reduction can often be helpful. Some herbs have been used to address tinnitus including black cohosh (Cimicifuga racemosa), goldenseal (Hydrastis canadensis) and more recently ginkgo (Ginkgo biloba).

Traditional Chinese Medicine (TCM): In TCM we know that the images6kidney qi communicates with the ears and that as we age or because of various states of health this can affect our qi, therefore the kidneys are often identified as root causes of tinnitus.

In approaching treatment of tinnitus, it is important to distinguish between an acute or sudden occurrence or a long-term tinnitus that gets worse over time or comes and goes. Furthermore, it is important to determine whether it is an excess-type or a deficiency-type of tinnitus. A key to this determination is that an excess type of tinnitus is often experienced in only one ear, while a deficiency based tinnitus tends to develop in both ears. The deficiency type usually gets better during the day and gets worse at night. A combination of deficiency and excess syndromes is possible, especially in persons with other illnesses or with tinnitus that has persisted for several years.

The following is a description of excess and deficiency patterns that might be able to better pinpoint treatment principles to be used.

Excess type #1, Hyperactive liver and gallbladder fire:

  • Sudden onset
  • Continual sound
  • Excess symptoms (a headache, flushed face, irritability)
  • Excessive anger, fright
  • Excessive use of alcohol

TCM formula: Long dan Xie Gan Tang (Gentiana Comb) with the addition of moutan, ligustrum, for persistent liver fire weakening the Kidney water.

Excess type #2, Phlegm Fire Syndrome

  • Intermittent ringing in the ears
  • Feeling of blocked ears
  • Chest stuffiness
  • Excess phlegm
  • Dizziness
  • Blockage manifesting as difficult urination or constipation

TCM formula: Wen Dan Tang (Bamboo and Hoelen Comb)

  • with the addition of pear, haliotis, uncaria (liver)
  • with lapis, scute, rhubarb and aquilaria (blockage of chest, constipation)
  • with dampness (Ban Zia Bai Zhu Tian Ma Tang)

Diet: avoid fat or spicy food

Deficiency type #1, Deficient Kidney Jing

  • Gradual worsening ringing
  • Dizziness
  • Backache
  • Deficient heat symptoms

TCM formula: Liu Wei Di Huang Wan (Rehmannia Six Formula) and schizandra.

TCM formula Er Long Zuo Ci Wan (Tinnitus Left Supporting Pills)

Deficiency type #2, Sinking Spleen Qi (yang def.)

  • Intermittently occurring tinnitus that is relieved through rest and reduced stress
  • Low energy
  • Poor appetite
  • Loose stools

TCM formula: Yi Qi Chong Ming Tang (Ginseng, Astragalus and Pueraria Comb.)

Lifestyle: stress reduction, adequate kidney and spleen building dietimages5

Ear Massage: There are several sites that have detailed directions for addressing tinnitus through massage:

The bottom line is that the early intervention is necessary for long-term success. If you are experiencing any of the symptoms outlined in any of the treatment options, seek the advice of a Physician or Clinical Herbalist (http://www.americanherbalistsguild.com/herbalists-and-chapters-near-you)

Sources:

Davis, Kathleen FNP. 2016. Tinnitus: Causes, Symptoms, and Treatment. The University of Illinois-Chicago, School of Medicine. Available from

http://www.medicalnewstoday.com/articles/156286.php

Flaws, B Sionneau P. 2001. The Treatment of Modern Western Medical Disease with Chinese Medicine. Blue Poppy Press. p. 55-56.

Hoffmann, D. 2003. Medical Herbalism. Healing Arts Press. P372-373.

Dharmananda, S. Ph. D. 1998. Treatment of Tinnitus, Vertigo, and Meniere’s disease with Chinese herbs. Institute for Traditional Medicine. Available from http://www.itmonline.org/arts/tinmen.htm

 

 

Herbal Tinctures: Getting or Giving the Right Dose

tincturesHerbal tinctures are the backbone of Western herbalism.  Generally, herbal tinctures are made from herbs extracted with a combination of alcohol and water, although glycerine and vinegar can also be used.  They are widely available, economical to produce and use, compact enough to stock in considerable variety and have a good shelf life. They can be combined and are convenient to take.   Dried herbs start to loose their potency after 6 months yet tinctures can last up to 10 years or more.  As a primarily Traditional Chinese Medicine herbalist, I mostly rely on concentrated decoctions, but in some cases when I am working with aerial parts of  plants, or herbs that could benefit from the effects of alcohol, increasing circulation, tinctures are more appropriate.

This posting is based on tinctures made using the weight to volume method.

Understanding dosage rates are important in achieving therapeutic outcomes.  I find that if someone isn’t responding to an herbal formula then analyzing their dosages can be helpful.

As a starting point most commercially available herbal tinctures indicate the weight to volume ratio.  For example, if the label states that it is a 1:5 extraction, this indicates that 1 gram (weight) of herb is equivalent to 5 milliliters (volume) of liquid.

A tincture formula will state the herb and the ratio of herb (by weight) to solvent (by volume), and the % alcohol (ethanol) in water.

Having this information is crucial in understanding the amount of herb that you are recommending or taking per dose.  Furthermore, this information is required by law to appear on the label. along with the serving size suggestion, which we will discuss further on.

In trying to communicate dosage equivalencies I have developed the following chart based on weight to volume ratios.  The side column indicates the common ratios and the top row indicates the volume of tincture consumed (in milliliters).  For example, if you took 1 milliliter of liquid made at a ratio of 1:2 then you would be ingesting a half of a gram of herb.

Tincture Dosage Equivalencydosage ratioSuggested Use:  Different companies have different suggested dosage rates.   Some companies suggest taking a dropper full and others recommended taking a range of drops as a serving size, for example, 20-60 drops.  When a dropper full is suggested the amount consumed depends on the size of the bottle and dropper.  When the suggested dosage on the bottle indicates a number of drops per dose, the amount consumed depends on the viscosity of the liquid.  Since this can change from one company to the next the best we can do is to have an understanding of some equivalents  recognizing that this is an approximation:

  • 20 drops = 1 ml
  • Dropperful from a one-ounce bottle—30 drops
  • Dropperful from a two-ounce bottle—40 drops
  • 5 ml = 1 teaspoon
  • A one-ounce bottle holds approximately 30 ml, 6 teaspoons, 30 dropper full, and 1,000–1,200 drops.

For example if using the suggested serving of 40 drops, and 20 drops = 1 milliliter, then you are taking approximately 2 milliliters of a 1:5 tincture and getting approximately .4 grams of herb per dose.  Most commonly it is recommended to take the tincture two to three times a day, so using this same example you  would be consuming between .8 and 1.2 grams of herb per day. Knowing the actual amount of herb that is recommended on a daily basis will help with putting the this into context.  Below is a partial list of recommended daily dosage of some common herbs.

Examples of dosages of some common herbs*:

Herb Daily Dosage
Angelica archangelica 3-9 grams
Ashwagandha 3-12 grams
Astragalus 6-15 grams
Black Cohosh 3-9 grams
Burdock 3-10 grams
Codonopsis 9-30 grams
Dandelion 9-30 grams
Dang Gui 3-15 grams
Echinacea 3-9 grams
Grindelia 3-6 grams
Hawthorn Berry 6-12 grams
Lemon Balm ½-6 grams
Motherwort 10-30 grams
Oregon Grape Root 3-9 grams
Passion flower 3-9 grams
Skullcap 3-9 grams
St. Johns Wort 3-9 grams
Uva Ursi 3-6 grams
Valerian 3-6 grams

* Planetary Herbology, Michael Tierra

In some circles there has been a discussion that the use of alcohol potentizes the action of the herbs, therefore less herb is needed.  Furthermore, the synergistic action of herbal combinations or formulas also increases effectiveness requring less herb.  These are great discussions but I work with aspiring herbalists who are often confused as to how to determine or convert tinctures to actual grams of herbs.  I hope that this helps and would encourage you to take a moment to actually consider that you might not be taking enough herbs to be effective.

Related blog post:  https://herbalgoddessmedicinals.wordpress.com/category/herbal-preparations/

Up coming blog:  How to make tinctures using the weight to volume method.

 

 

Traditional Chinese Medicine: Erectile Dysfunction (ED) and alternatives to Viagra

I recently saw my first client with ED and spent time researching how Traditional Chinese Medicine (TCM) approaches working with this condition.  Erectile dysfunction (ED) or impotence occurs when a man has consistent and repeated problems sustaining an erection. Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It is also sometimes also referred to as impotence.   Several studies have looked at the prevalence of ED including one, the Massachusetts Male Aging Study, that reported that ED is increasingly prevalent with age. At age 40, approximately 40% of men are affected. The rate increases to nearly 70% in men aged 70 years.  Age was the variable most strongly associated with ED, although there are emotional and physiological reasons attributed including: diabetes, obesity, heart disease, high blood pressure and atherosclerosis, endocrine diseases, lifestyle, diet, neurological and nerve disorders, medications, drug abuse, anxiety and depression. Additionally men may have difficulty obtaining or maintaining erections after various forms of cancer treatment. Surgery and radiation therapy to the pelvic area, hormonal therapy, chemotherapy, and various medications may all significantly impact a man’s ability to obtain or maintain an erection. Viagra is the leading medication prescribed for ED, although as with all medications,  it is not without its associated side effects:

  • HeadacheUntitled1
  • Flushing in the face, neck, or chest
  • Upset stomach, indigestion
  • Abnormal vision
  • Nasal congestion
  • Back pain
  • Muscular pain or tenderness
  • Nausea

If considering options than Viagra, such as those explored below, it would be advised see a TCM trained specialist.

Traditional Chinese Medicine (TCM) considers that the strength or weakness of men’s sexual function is associated with the energy of certain internal organs, including the kidneys, liver and heart. The Kidneys are one of the major organs to support the body’s sexual function by storing essence (Jing), controlling human reproduction, growth and development. Essence or Jing rules the production of sperm. The heart plays an important role in erection and arousal. Kidney essence is classified as yin, while qi is yang, yet they depend on each other to maintain a dynamic balance, if out of balance it can result in ED/impotence. Excessive sexual activities and frequent masturbation can deplete the kidney essence.

The Ming Men (located on the middle of the lower back) is an essential part of traditional Chinese physiology. Called the “Gate of Life,” it holds the Genuine Yin and Yang of the body from which all substances and functions develop. The term Ming Men refers to one of the body’s two kidneys, where the male’s “essence” is stored. In Kidney Deficiency cases, warming the Ming Men and Kidney Yang are necessary to balance the body.

index4Men’s sexual function disorders have been strongly associated fast paced life styles. This state of chronic stress restricts the flow of the qi through the Liver channel which travels through the pubic area and reproductive organs. When the Liver is affected by stress and the Liver channel is blocked then qi cannot flow smoothly leading to sexual dysfunction and disorders.

The process by which the penis becomes erect is complex, involving not only the nerves, muscles, blood vessels, and other tissues in the penis itself, but also includes factors such as emotion, lifestyle and general health. During arousal nerve impulses are sent to nerves in and around the penis, which cause an increase of blood flow into that organ, causing it to become firm and erect. If there is insufficient blood the penis is unable to achieve erection.

The Heart plays a crucial role in erection, orgasm and ejaculation. In TCM the ability to have an erection and ejaculation depend on the communication between the heart and kidneys. The Heart-Qi needs to descend to communicate with Kidney-Qi. Vice versa, Kidney-Water needs to ascend towards the Heart and contain Heart-Fire, the coordination between the descending of Heart-Fire and ascending of Kidney-Water ensures a normal sexual cycle in men. During the excitement phase of sexual response the Minister Fire within the Kidneys is aroused and flows up towards the Pericardium and Heart: for this reason the person becomes flushed in the face (the complexion is a manifestation of the Heart) and the heart rate increases during sexual excitation. With orgasm and ejaculation, there is a downward movement of Qi, which releases the accumulated Minister Fire downwards: in order for this to occur normally the downward movement of Heart-Qi is crucial. If there is deficiency of Minister Fire within the Kidneys it will result in decreased libido and ED or impotence in men. If Heart-Qi and Heart-Blood are deficient or not descending to communicate with the Kidneys, there may be ED, impotence or premature ejaculation.

tongue blood stasisThere are several other common patterns in ED including blood stasis and damp heat. In cases of Blood Stasis, the flow of energy (called Qi) and Blood is blocked or obstructed in the lower abdomen preventing needed blood flow to create and maintain an erection. This condition often presents with signs of a tight and tender to palpitation lower abdominal area. Treatment will focus on breaking the stagnation in the lower abdomen, returning the proper flow of Blood though the affected area.

Another reason for ED or impotency is the presence of damp heat. Whenindex5 damp heat accumulates it acts creases stagnation or impedes the free flow of Qi. There are many causes of damp heat including unresolved health issues, unresolved low-level pathogens, and or excessive alcohol intake. Signs that point to the presence of damp heat include itching, pain, and swollen prostate, sweating in the genitals, heaviness and aching in the lower limbs, greasy yellow coating on tongue. Treatment includes clearing heat and nourishing any underlying deficiencies.

In determining treatment for ED it is important to utilize the four basic techniques of assessment: questioning, smelling/listening, palpitation and inspection. Furthermore the constitution of the client is taken into account at the same time as TCM pattern differentiation. The following is a summary of pattern differentiation taken from Giovanni Maciocia and Shen-Nong.com, as well as, several other authors.

Primary Patterns:

Kidney Deficiency:

  • Weakness of Life-Gate Fire/Ming Men
  • Deficiency of Kidney Yang Deficiency
  • Deficiency of Kidney Yin Deficiency
  • Damage of the kidneys by fear

Damp Heat:

  • Downpour of Damp Heat into the Lower Burner
  • Damp Heat in Lower Burner
  • Damp Heat in Liver-Gallbladder Channel

Blood Deficiency/Stagnation:

  • Liver-Blood Deficiency
  • Heart and Gallbladder Qi Deficiency
  • Heart-Blood Deficiency
  • Damage of the heart and spleen
  • Blood Stasis

Qi:

  • Liver Qi Stagnation

Untitled2Weakness of Life-Gate Fire-The Gate of Life or Ming men is (located on the middle of the lower back) is an essential part of traditional Chinese physiology. Called the “Gate of Life,” it holds the Yin and Yang of the body from which all substances and functions develop. Along with the Yin-Yang theory, one of the most fundamental principles in Chinese medicine is that of the “Three Treasures.” The Three Treasures consist of jing (essence/potential energy), qi (energy/function), and shen (spirit or spirits). In terms of understanding the Ming Men the concepts of jing and qi are primary. Original Qi is stored in an energetic center called Ming Men. The relationship between the Kidney organ-system and Ming Men is defined by the relationship between the elements of Water and Fire, or Kidney and Heart as explained above. Strengthening Jing and the Life-Gate are often the first approach when working with ED/Impotency.

  • ED/Impotence
  • Seminal discharge, white/cold
  • Dizziness/vertigo
  • Tinnitus
  • Pale complexion,
  • Cold extremities
  • Listlessness of spirit
  • Weak aching lower back and legs
  • Frequent urination
  • Pale Tongue with white coating
  • Deep thready pulse

Formulas:

  • Wu Zi Yan Zong Wan (Five Ancestors Teapills)
  • Zan Yu Dan (Procreation Elixir)
  • Right-Restoring Pill combining with Procreation Elixir
  • Jin Suo Gu Jing Wan (Golden Lock Teapills) Kidney Yin and Yang deficiency with leakage of fluids creating instability at the Gate of Life.
  • Cong Rong Bu Shen Wan (Cistanches Tonify Kidney Pills)
  • Er Xian San (Two Immortals Teapills) regulates the chong and ren channels
  • Ge Jie Da Bu Wan (Gecko Tonic Teapills)

Deficiency of Kidney Yang symptoms: Yang is responsible for our physiological functions and energy. A deficiency of Kidney Yang is an internal condition results in cold and weakness, along with ED or impotence. A deficiency of Kidney Yang indicates a deficiency in the “Life Gate” or Ming Men. This coldness results in the lower libido, ED or Impotence. It is

  • ED/Impotence
  • frequent clear urination,
  • cold limbs,
  • dizziness,
  • tinnitus,
  • fatigue,
  • lower back weakness
  • Deep-Weak pulse
  • Pale tongue

Formulas:

  • You Gui San (Right side Replenishing teapills)
  • Wu Zi Yan Zong Wan (Five Ancestors Teapills)
  • Jin Gui Shen Qi San (Golden Book Teapills)
  • Ba Ji Yin Yang Teapills (Morinda Pills to Balance Yin and Yang)
  • Huan Shao Dan Wan (Return to Spring Teapills)
  • Ge Jie Dan Bu Wan (Gecko Tonic Teapills)

Deficiency of Yin Deficiency

  • ED/Impotence
  • Dizziness
  • Scanty urination
  • Night-sweating
  • Insomnia
  • Tinnitus
  • Floating-empty pulse
  • Red tongue w/o coating

Formulas:

  • Zuo Gui Wan (Return Left Pill)
  • Zhi Bai Di Huang Wan (Eight Flavor Rehmannia Teapills) with deficient heat
  • Liu Wei Di Huang San (Six Flavored Teapills)

Damage of the kidneys by fear-Fear can shock or injure the Kidney-Adrenals, along with leading to the disordered movement of qi.

  • ED/impotence
  • soft erection
  • timidity
  • tendency to doubt and suspicion
  • palpitations
  • susceptibility to fright
  • restless sleep
  • thin and slimy tongue coating, string-like
  • thready pulse.

Formula: Huan Shao Dan Wan (Return to Spring Teapills)

Downpour of Damp Heat into the Lower Burner

  • ED
  • Premature ejaculation
  • Sweatiness of the scrotum
  • Heavy aching lower limbs
  • Thirst
  • Bitter taste
  • Dark burning urine
  • Yellow slimy coating on Tongue
  • Pulse is Slippery and rapid

Formula: Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction

Damp Heat in Lower Burner

  • ED/Impotence
  • Difficult-painful urination
  • Deep yellow urine
  • Itching of genitals
  • Urethral discharge
  • Sticky-yellow coating on tongue, with red spots on root
  • Slippery pulse

Formula: Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction

Damp Heat in Liver-Gallbladder Channel

  • ED/Impotence,
  • Difficult-painful urination
  • Rash external genitalia
  • Irritability
  • Sticky-yellow coating on tongue, with red spots on root
  • Wiry pulse

Formula: Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction

Liver-Blood Deficiency

  • ED/Impotence
  • Dizziness
  • Blurred vision
  • Depressed mood
  • Insomnia
  • Pale tongue
  • Choppy pulse.

Formula:

  • Shao Yao Gan Cao Tang Jia Wei (Peony and Licorice Teapills)
  • Si Wu Tang (Dang Gui Four)

Heart and Gallbladder Qi Deficiency

  • ED/Impotence
  • Premature ejaculation
  • Depressed mood
  • Timidity, sighing
  • Insomnia
  • Palpitations
  • Easily startled
  • Pale tongue
  • Weak pulse

Formula: Da Bu Yuan Jian

Heart-Blood Deficiency

  • ED/Impotence
  • Palpitations
  • Dizziness
  • Depressed mood
  • Insomnia
  • Pale tongue
  • Choppy pulse

Formulas:

  • Gui Pi Tong (Ginseng and Longan Combination)
  • Si Wu Tang (Dang Gui Four)

 Damage of the heart and spleen

The Spleen is the source of Blood production along with ensuring its flow within the vessels. If the spleen is operating properly then it transports and transforms sufficient nutrients for plentiful heart blood. Vise versa, according to the five-element theory, the Heart is the mother of the Spleen. If there is deficiency of Heart Blood or Qi it impairs the function of the Spleen to transport and transform. This domino effect will impede the Spleens ability to transport sufficient nutrients to keep Blood flowing in the vessels (ability to achieve and maintain erection).

  • Inability to achieve and/or maintain erection
  • Lassitude
  • Palpitations
  • Poor memory
  • Restless sleep
  • Poor appetite/eating habits
  • Colorless facial complexion
  • Thin and slimy tongue coating, pale tongue,
  • Fine or choppy pulse.

Formula:

  • Gui Pi Tong (Ginseng and Longan Combination)
  • Spleen-Restoring Decoction

Blood Stasis-Surgery, cancer, radiation and chemotherapy can potentially result in creating stagnation of blood to the perineum, which can impede the flow of blood and qi.

  • Prickling pain in testes
  • Pain or distention in chest and hypochondria
  • Stabbing pain
  • Dark complexion
  • Dry skin
  • Purplish dark tongue
  • Thready, uneven pulse

Formulas:

  • Xue Fu Zhu Yu Tang (Stasis in the Mansion of Blood Decoction)
  • Wen Jiang Tang Wan (Warm Cycle teapills)

Liver Qi Stagnation-Normal flow of liver qi ensures that all emotional processes are in harmony and blood is flowing sufficiently. If there is a stagnation of liver qi then this can result in the lack of nourishment to tendons including genitalia.

  • ED/impotence
  • Depression
  • Anxiety and irritability
  • Discomfort of the chest and stomach
  • Distension and oppression of the hypochondriac region
  • Poor appetite/eating habits
  • Loose stool
  • Thin tongue coating
  • String-like pulse.

Formula:

  • Xiao Yao San (Bupleurum and Dang Gui Formula
  • Jai wei xiao yao san (Bupleurum and Peony Formula) clears deficient heat
  • Chai Hu Shu (Disperse Vital Energy in Liver), for liver qi stagnation and Liver Blood Stasis

Traditional Formulas used for ED/Impotence:

Ge Jie Da Bu Wan (Gecko Tonic Teapills), Qi, Yang, Blood and Jing deficiency

Symptoms:

  • Weakness or pain in low back knees
  • Joint pain and stiffness
  • Difficulty walking
  • Weakness, fatigue, exhaustion, listlessness
  • Weak voice, pale face
  • Spontaneous sweating
  • Occasional chills and feverishness
  • Dizziness, vertigo, tinnitus, hearing loss
  • Forgetfulness, poor memory,
  • Frequent urination, nighttime urination
  • Edema,
  • Chronic diarrhea w/undigested food, abdominal distention, poor appetite
  • Cold limbs, cold intolerance
  • Decreased sex drive, impotence
  • Shortness of breath, wheezing, shallow breathing aggravated by exertion, shallow breathing aggravated by exertion, chronic persistent cough
  • Palpitation
  • Insomnia

Jin Suo Gu Jing Wan (Golden Lock Teapills), Kidney Yin and Yang Deficiency creating instability at the Gate of Life

Symptoms:

  • Chronic leakage of fluids, spermatorrhea, nocturnal emissions, premature ejaculation, impotence,
  • Urinary frequency, night urination, urinary dribbling or incontinence
  • Fatigue, weakness, listlessness
  • Excessive sweating
  • Weakness and rapid fatigue in muscles, sore and weak low back and limbs
  • Chronic watery diarrhea
  • Tinnitus

Wen Jiang Tang Wan (Warm Cycle teapills) * deficiency and cold in Chong and Ren channels causing blood stasis

Symptoms:

  • Five palms heat
  • Dry lips and mouth
  • Dry skin or hair
  • Fatigue, weak or cold limbs
  • Impotence
  • Pain in the testicles
  • Urinary incontinence

*primarily used for women in the category of warm the menses and dispel blood stasis, but can be used for spermatorrhea, erectile dysfunction, orchialgia, seminal insufficiency.

Supplementary herbs and formulas:

  • Wu Chi Pai Feng Wan (Black Chicken White Phoenix Pills)
  • Tonic wine: soak red deer antler, ginseng roots, lycii berry and schizandra in rise wine. Take 1 tsp 3 times a day, especially for winter.
  • Planetary Herbs: Damiana Male Potential
  • Ashwagandha
  • Shilajit
  • Damiana
  • Yohimbe
  • Ginseng

Moxibustion and Qi Gong: In cases of Kidney deficiency that require warming, moxibustion can also be performed at index6these acupuncture points. The moxibustion treatment involves the burning of a herb, Ai Ye-mugwort, to warm and circulate the energy in the local area, strengthening the Life Gate fire.

Qi Gong has specific movements to strengthen the Gate of Life (http://www.funwithqigong.com/2009/07/open-and-move-from-the-gate-of-life/)

References:

http://www.shen-nong.com/eng/exam/specialties_menimpotence.html

https://www.jcm.co.uk/liver-gallbladder-based-erectile-dysfunction-treatment-by-chinese-medicine-part-1.html

http://www.altmd.com/Articles/TCM-for-Erectile-Dysfunction

http://maciociaonline.blogspot.com/2013/06/the-treatment-of-male-problems-in.html

http://www.itmonline.org/5organs/kidney.htm

http://www.tcmtreatment.com/images/diseases/impotence.htm

http://www.theacupunctureclinic.co.nz/male-sexual-dysfunction-by-will-maclean/

Pao Zhi- Ancient Techniques applied to Western Herbs

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Honey Stir Fried Licorice Root

Pao Zhi is an ancient Chinese technique of altering the tastes, energies and directions of medicinal substances by processing. This transformational alchemical approach to preparation can increase herbs therapeutic effectiveness and applicability for individualized treatment. Albeit a simplistic view, I view it is akin to cooking, in which the very nature of food, is transformed for assimilation.

What about western herbs? I have used some of the very same processes described below with Western traditional herbs including honey stir-fried elecampane root to direct its energy to digestion, dry stir fried solomon seal with a salt solution to direct its energy towards the kidneys, cooking nettles with black bean juice to enhance its ability to nourish blood, and dry stir frying rice with angelica to reinforce it action on the spleen.

An individual herb can be used in different ways depending on what part of the plant is used; where as, with the process of pao zhi one can transform the energy, flavor and action of the same part of the plant. In Traditional Chinese Medicine (TCM) the preparation of herbs is an integral aspect of the therapeutic strategy. Pao Zhi is a vast subject and this article is only the tip of the iceberg. I have included some references at the end of the article for further exploration.

There are a multitude of reasons why herbs are subjected to processing including the removal of debris, reduction of toxicity, reduction of odors and flavors, to reinforce or modify energetic properties, prolong storage and most importantly, to increase assimilation. This image represents a visual overview of Pao Zhi techniques and the types of products that are produced. The following is a partial list of methods of Pao Zhi preparation and pinyin names, which are reflected in the naming of Chinese Herbs:

  • Sheng: uncooked without heat or cooking.
  • Shu: prepared with heat or cooking
  • Shui Zhi (w/ water): multiple rinsing and washing, moistening and soaking
  • Shui Fei, using water in the process of pulverizing. Used to eliminate salts, toxicity, refine minerals, and soften for cutting.
  • Huo Zhi (w/ fire): Stir-frying, calcination, roasting, baking and blast frying. Stir-frying might be done with or without the addition of various substances including honey, vinegar, rise, wheat brand, etc. that alter the energetic action of the herb.
  • Sometimes a combination all or any of the above including steaming, boiling, distilling and dipped into water after calcinated.
  • Fermentation and sprouting or germination is also used as a method of transforming herbs.
  • Many of the herbs that are toxic such as Fu Zi (aconitum carmichaeli) or Ban Xia (Rhizoma Pinelliae ternatae) involve successive transformational processes to make them safe for use.  This is a video that shows the traditional preparation of Fu Zi.

One of the most common methods of transformation is through the use of stir-frying with either one or several substances to change the energy/action of the herb. The following examples illustrates how Pao Zhi can effect flavor, actions and corresponding organs:

  • Stir-frying with rice, with its sweet flavor and neutral energy helps to eliminate dampness andSlide10 supplements the spleen and qi. Directions: a pan is preheated and rice is added and stir-fried until it starts to smell, the herbs are added, and cooked until both are brown, then the herbs are separated out. An example of this is with Dang Shen (Codonopsis).
  • Honey has a sweet flavor and cool energy but when heated it becomes warming. Directions: combine a small amount of honey and dilute with water until fairly runny. This is tossed with the herbs until they are coated. The herbs are stir-fried in a dry pan over low heat until the honey is no longer sticky. This process alters the herbs actions to reinforce the supplementation of the spleen and qi by increasing their moistening and tonification properties. Examples: Dang Shen (codonopsis), Gan Cao (licorice) and Huang Qi (astragalus).
  • Salt has a cold energy and enhances downward action directing the energetic actions of theSlide09 herbs to the kidneys, supplements yin, addresses empty fire blazing, promotes softening of nodules and stimulates diuretic action. Directions: Mix salt and water for a 2% solution or 2 grams of salt in 100 millilitres of solution. Toss the herbs with the salt solution until well coated and then stir-fried over low heat until dry. An example of this process is with Zhi Mu (Anemarrhenae) and Huang Bai (Phellodendrum), for use in yin deficiency with empty fire blazing.
  • Vinegar (rice) has a warm energy. It also has a sour and bitter flavor directing its action towards the liver. Directions: take 15 parts vinegar to 100 parts water then soak the herb thoroughly, followed up by stir-frying it over a low fire until a golden color.   Examples are Chai Hu (Bupleurum) and Qing Pi (citrus peel).
  • Wine is acidic and sweet flavored. It is also heating and helps to increase circulation or quickening of the blood in the network vessels. Directions: using 20-50 parts of wine to 100 parts of herb, the herb is tossed with the wine, and then stir-fried over low heat until yellow. Examples are Dang Gui (angelica sinensis) and Chuan Xiong (ligusticum wallachii)

An excellent example of this is to look at the different methods for preparing Di Huang (Rehmannia glutinosa, Chinese foxglove) to obtain different energies, tastes and actions.

  • Xian Di Huang, (raw fresh root) is sweet and bitter with a cold energy. It clears heat, cools the blood engenders fluids and stops thirst.
  • Di Huang Zhi, (raw fresh juice) is sweet and slightly bitter with a cold energy. It clears heat and stops bleeding.
  • Sheng Di Huang, (dry uncooked) is sweet and slightly bitter with a cool energy. It enriches yin and clears heat.
  • Chao Shen Di Huang, (dry stir-fried till scorched) is sweet and slightly bitter. It has a cool to neutral energy.   It enriches yin and nourishes the blood.
  • Sheng Di Huang Tan, (dry stir-fried till carbonized) is sweet, bitter and slightly astringent. It has a cool to neutral energy.
  • Shu Di Huang**(steaming in rice wine). It is sweet and slightly warming. It supplements yin, supplements the blood, supplements the essence, and supplements the kidneys.
  • Chao Shu Di Huang, (steaming in rice wine and stir-fried till scorched). It is sweet flavored and warm energy. It nourishes the blood, nourishes the constructive qi, and enriches yin.
  • Shu Di Huang Tan, (steaming in rice wind and stir-fried till carbonized). It is sweet flavored and slightly astringent. It is warm energetically. It supplements the blood and stops bleeding.
  • ** David Wolf and Mountain Rose Herbs prepared rehmannia is manufactured, by boiling the root in a mixture of yellow wine and black bean infusion until the liquids have been boiled away and the roots are black. The roots are then dried in the sun.

Slide15You can see that by using different processes one can change the energy of the herb from cold to warm and the flavor from sweet to astringent. By understanding the needs of the individual client, one can further amend prepared Shu Di Huang by using ginger juice (dampness), cardamom (or chen pi (citrus peel) for spleen vacuity and qi stagnation when stir frying.

The following link is a study on the chemical comparisons of dried rehmannia root and prepared rehmannia root (steamed). The report’s results show characteristic changes in the content of major monosaccharides and oligosaccharides as the dried root is converted in the steaming process of the prepared root, indicating a possible special role for fructose, stachyose and rehmaionoside in the differing therapeutic effects of dried and prepared rehmannia. http://www.sciencedirect.com/science/article/pii/S2211383512001499

Further Reference:

  • Sionneau, Philippe. An Introduction to the use of Processed Chinese Medicinals. Blue Poppy Press, 1995.

Blood Nourishing Tonic- East meets West

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Anemia and Blood Nourishing Tonic

Blood is a vital substance according to Traditional Chinese Medicine (TCM). In fact in The Book of Leviticus it states, “the life of a creature is in the blood”. In Western medicine, blood is defined as a bodily fluid that delivers necessary substances, such as nutrients and oxygen, to the cells and transports metabolic waste products away. According to the Oxford English Dictionary, the word “blood” dates to the oldest English, circa 1000 AD. The word is derived from Middle English, which is derived from the Old English word blôd. Throughout history and cultures, blood has held both medical and mystical importance. In the Greek and Roman Humoural system, blood was associated with air, springtime and a sanguine personality. They believed it to be produced by the liver. Blood became the basis for one of the oldest medical techniques “bloodletting”. In fact an interesting fact was the bloodletting or “bleeding” a patient to health was modeled on the process of menstruation. Hippocrates believed that menstruation functioned to “purge women of bad humors”.

Qi-300x300As we turn towards the East in TCM, blood has a different meaning. In TCM, blood is itself a form of Qi. Although difficult to translate the word “Qi”, I think of it as a all encompassing life force or energy. In fact, in TCM they consider blood inseparable from Qi itself. It is believed that blood is nourished from the distillation of the nutrients that we take into our body (food Qi). Given this outlook, one can start to see the interrelationship between the importance of eating well and the health of your blood. For instance, think of cholesterol, and the relationship between food and the buildup of plaque in our blood. Although this blog post isn’t about our digestion, you can see now important a well running digestive system is to blood health.

Deficient blood is often an underlying and missed issue in many conditions, especially those related to inflammation and circulation. In TCM “blood deficiency” include low blood pressure, various forms of ischemia, cold fingers and toes (including Raynaud’s syndrome,images both primary and secondary), and fatigue (high blood pressure for other reasons may also be present). Other slightly less common symptoms include thinning hair, heart palpitations, dizziness upon standing (postural hypotension) or vertigo (especially if there is hypoglycemia), falling asleep of arms, restless legs, frequent infections, menstrual cramps, headaches of various sorts, slow healing, low sex drive, sinus issues, ringing in the ears, nails that break easily or grow slowly, and low blood sugar. Fertility can also be affected, as the uterus requires adequate blood. Pregnancy is another time that requires an adequate supply of healthy blood. Our joints, ligaments and connective tissue are also sensitive to blood deficiency, since they get the least amount of blood. Sometimes blood deficiency does not present as full-blown anemia, but is still an underlying condition. There are some medical issues that blood deficiency is either directly related or an outcome of another condition.

Since food is considered our first medicine, I will outline some foods that help to nourish your our blood and then talk about one herbal remedy that is also useful. To nourish blood one has to increase the digestive absorption of the food that is eaten and add specific food to generate healthy blood. I will cover increasing absorption of nutrients in another blog post. indexThe nutrients most need to build blood are iron, folic acid and B12. Adequate protein is also crucial. In order to absorb iron we need to have adequate levels of copper, B and C vitamins. Greens, greens and more greens, as long as it isn’t mostly spinach are a great source of iron, along with legumes, grains, nuts and seeds. Algae and seaweeds are also excellent sources, although use sparely, since they are a super food or super concentrated. The Japanese made a blood builder out of pounded sweet rice and mugwort, or for a Western version you can use nettles. When blood deficiency is severe, protein from animal sources might be chosen. Dark grapes, blackberries, huckleberries, raspberries are also great. Actually one of the best sources of iron is organic animal liver, but honestly most people can’t get it down, and prefer it as a desiccated pill. When one builds blood naturally there is less inclination for constipation, a consequence of taking it in tablet form.

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Rumex crispus (yellow dock)

I have been experimenting with making a self-stable blood nourishing syrup. My primary target is pregnant woman, so using herbs that are designated, as safe during pregnancy is vital. There are many Chinese herbs that are great blood nourishers, including dang gui (angelica sinensis), rehmannia root, and peony root, not all safe during pregnancy. Since I am all about a bioregionalism approach I have primarily relied upon what grows in my garden. The base of my syrup is blackstrap molasses, an iron rich food source. I grow medicinal herbs so used yellow dock root (Rumex crispus) as my main ingredient. Although a pain to dig up and process, I find it is more medicinally active than in the dried form. I also included rose hips to potentize its effectiveness with Vit. C.  I also added orange peel for its carminative properties and cinnamon for its ability to enhance circulation. This recipe makes 2 quarts, so divide it depending on how much you want to make. When making syrups, I tend to cook them over several days to extract as much medicinal goodness as possible.

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After 3 days of cooking

 Anemia and Blood Nourishing Tonic*

1/2 cup of rose hips

1-cup dandelion root

1-cup of alfalfa leaf

3-cups yellow dock root

1-cup nettle leaf

1 cup raspberry leaf

2 T. kelp powder

1-Tablespoon of orange peel

1 cinnamon stick

2- qts of blackstrap molasses

Combine the blackstrap molasses and herbs in a large saucepan. Bring to a boil, then reduce, heat and simmer on low for one hour, let sit overnight, repeat for 3 days. Or you can use a crock-pot set to the lowest setting. Strain and bottle
For adults who are blood deficient, 1 tablespoon 3 t.i.d is recommended, if using as a tonic, 1 Tablespoon a day is adequate.
For children, 1-3 teaspoons daily is sufficient.

*Recipe is based on dried herbs.

 

Diaphoretics

Diaphoretics are herbs that promote perspiration and are best used to remove external pernicious influences such as wind, cold and dampness for example, colds, fevers, headache, stiff neck, flue like conditions. Contradictions are if someone is already perspiring heavily. Western herbology recognizes two classes of diaphoretics 1) stimulating/warming- increasing blood flow and 2) relaxing/cooling-relaxing pores. The major difference between the two is that warming diaphoretics are used to stimulate circulation and produce sweating, while relaxing diaphoretics help to break surface tension allowing perspiration. Knowing which one to use is the herbalists task.