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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Two Immortals- Help with Menopausal Symptoms and Hypertension

Er Xian Tang (Two Immortals Teapills)

TCM action: warm kidney yang, tonify kidney essence, and drain deficient fire

Last year one of my esteemed herbal teachers, Leslie Tierra, talked about the great results that she was getting treating women with Er Xian Tang who had yin deficiency with deficient fire. This peaked my interest and I started to look at the history and herbs that comprised the formula. In a nutshell, deficient fire is often seen in women who are experiencing pre and post menopausal symptoms which might include hot flashes, night sweats, facial and malar flushing, irritability, palpitations, insomnia, decreased sex drive and vaginal dryness to name a few.

The formula Er Xian Tang was developed in the 1960’s at a hospital affiliated with Shanghai College of Traditional Chinese Medicine. Er Xian Tang was designed as a treatment for cases of hypertension (Western terminology) where there was a combination of kidney yang deficiency and deficiency fire of the kidney, two seemingly contradictory conditions. Yang deficiency include signs of internal cold and weakness including coldness, lassitude, edema of the legs, loose stools, sterility or infertility, frequent urination, urinary incontinence, while the signs listed above indicate deficiency of Kidney fire.

A comparison of the role of the heart and kidney in allopathic and TCM can be helpful in understanding the intent of the formula. Er Xian Tang treats renal hypertension.   Renal hypertension from an allopathic perspective results impaired functioning of the kidneys, reduced urinary elimination and excessive renin (a protein and enzyme secreted by the kidneys) production. The heart sends a continuous supply of oxygenated blood around the body. The kidney filters the blood, extracting waste in the form of urine, and also helps regulate the water and salt levels to control blood pressure. When the heart is no longer pumping efficiently it becomes congested with blood, causing pressure to build up in the main vein connected to the kidneys and leading to congestion of blood in the kidneys. The kidneys suffer from the reduced supply of oxygenated blood. When the kidneys become impaired, the hormone system, which regulates blood pressure, goes into overdrive in an attempt to increase blood supply to the kidneys resulting in renal hypertension. This eventually damages the heart, which has to pump against higher pressure, in the arteries.

In TCM Er Xian Tang treats kidney yang deficiency and deficiency fire of the kidney. In TCM, according to the five elements theory, the Heart is categorized as yang and the Kidneys are considered yin. Normally, the Heart yang (fire) descends and joins with the Kidney-yang to warm and propels kidney-yin (water) to ascend to nourish heart yang (fire) to prevent it from hyperactive. Think of it as a continual loop with fire warming the kidneys, while water helps to contain heart fire. Or as Western medicine describes: the heart sends a continuous supply of oxygenated blood to organs including the kidneys that help to regulate water and salt levels to control blood pressure. In both systems the heart and the kidneys are closely related, with a mutually dependent function. If this functional relationship becomes abnormal in TCM it results in a condition termed “non-coordination between the heart and the kidney”.

This gets us back to yin deficiency with deficient fire. In Chinese medicine, the Heart and Kidney energies should work together. The Heart sends Fire down to warm the Kidneys: in return, the Kidneys send pure fluids up to nourish the Heart. In Heart and Kidney Yin deficiency with Deficient Heat the downward action or upward action is severely reduced. This leaves too much Yang (fire), due to lack of cooling Yin (water), hence deficient heat, resulting in night sweats, insomnia, and steaming bone syndrome. Normally you expect to see symptoms of deficiency fire of the kidney associated exclusively with yin deficiency, yet in this case, this type of fire is described as yang excess which arises from an imbalance of yin and yang (the deficient yin can not control the yang). When yin and yang are both deficient, one can experience symptoms of each deficiency, which may either flip back and forth between the two or manifest simultaneously.

Er Xian Tang, Two Immortals

Xian Mao-Curculigo, Golden Eye-Grass Rhizome

Tastes and Energies: spicy-hot,

Category: Tonify the Yang

Actions: Warm Kidney yang and tonify Kidney essence,

Contraindications: Yin Deficiency w/ Heat

Yin Yang Hou-Epimedium Leaf

Tastes and Energies: spicy, sweet, warm,

Category: Tonify the Yang

Actions: Warm Kidney yang and tonify Kidney essence, tonify Yin, harnesses Liver yang,

Contraindications: Yin deficiency w/ Heat

Ban Ji Tian-Morinda Root

Tastes and Energies: spicy, hot, toxic,

Category: Tonify the Yang

Actions: warm Kidney yang and tonify Kidney essence,

Contraindications: Yin deficiency w/ Heat amp heat

Huang Bai-Phellodendrum Bark, Amur Cork-Tree Bark

Tastes and Energies: bitter, cold

Category: Clear Heat Dry Dampness

Actions: nourish Kidney yin and drain fire from deficiency, used for steaming bone disorder, night sweats.

Contraindications: Spleen Qi Deficiency w/ Cold

Zhi Mu-Anemarrhena Rhizome

Tastes and Energies: bitter, sweet, cold

Category: Clear Heat, Drain Fire

Actions: nourish Kidney yin and drain fire from deficiency, nourish yin and moistens dryness, generates fluids and clears heat.

Contraindications: Spleen Qi Deficiency, diarrhea

Dang Gui-Angelica Sinensis Root

Tastes and Energies: sweet, spicy, warm

Category: Tonify the Blood

Actions: Moistens and nourishes the blood and regulates the penetrating and conception vessels. Invigorates blood, moistens the intestines, increases circulation

Contraindications: Spleen Qi Deficiency, dampness

Er Xian San cautions:  during pregnancy, during early states of acute illness, loose stools, diarrhea, poor appetite or chronic digestive weakness.

The intriguing aspect of Er Xian Tang is that it contains herbs that are contraindicated (not used) in cases of yin deficiency with deficient fire. It contains hot natured herbs, Xian Mao, Yin Yang Hou, and Ban Ji Tian, which tonify yang but can also increase fire. The formula also contains Huang Bai and Zhi Mu that are bitter and drying, which may damage yin. Huang Bai and Zhi Mu are considered a traditional Dui Yao, or herbs that are often used together to reinforce and complement each other. Together they clear heat, enrich yin and drain deficient fire. Huang Bai is bitter, cold, consolidates yin, drains deficient fire, while Zhi Mu, is sweet, cold, enriches yin, moistens dryness, and supplements the kidneys. Dang Gui builds blood, increases red cell proliferation, normalizes heart contractions and dilates coronary blood vessels increasing peripheral blood flow. Huang Bai and Zhi Mu are cold energetically and help to balance the spicy and heating energies of Xian Mao, Yin Yang Hou, and Ban Ji Tian.

Er Xian Tang serves as an example of evolving TCM formulation, where a new formulations are being utilized to address modern disharmonies by combining strongly warming yang tonics with cold, fire-purging herbs. In this case and the studies that have been conducted the formula appears to be effective for hypertension and for some other applications, such as menopausal syndrome and male infertility.

Additional notes:

Xian Mao and Yin Yang Huo are used to tonify the kidney and according to the Taoist’s aid in prolonging life. The name “Two Immortals” references the use of the word Xian.   Xian Mao was named in the Bencao Gangmu (by Li Shizhen; 1596) as one of the herbs believed to contribute to immortality. Xian Ling Pi (Epimedium, now know as Yin Yang Huo) alludes to the immortals’ intelligent nature, boosts the qi and strengthens the will. Around 100 B.C., a poem about attaining immortality, the ode Yuan Yu (Journey to Remoteness, or Roaming the Universe) was written. It depicts the transition to immortality:

Having heard the precious teaching, I departed,

And swiftly prepared to start on my journey.

I met the feathered ones at Cinnabar Hill,

I tarried in the ancient Land of Deathlessness.

In the morning, I washed my hair in the Hot Springs of Sunrise,

In the evening, I dried myself where the suns perch.

I sipped the subtle potion of the Flying Springs

And held in my bosom the radiant metallous jade.

My pallid countenance flushed with brilliant color,

Purified, my Jing began to grow stronger,

My corporeal parts dissolved to a soft suppleness,

And my spirit grew lissome and eager for movement.

 

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

 

 

Beet Kvass-A Russian Beverage Probiotic Tonic

beetsBeet kvass is extremely easy make and is a great “first” for those who have never fermented anything before.  Not only is it  delicious, but beets provide a unique source of phytonutrients called betalains. Betanin and vulgaxanthin are the two best-studied betalains from beets, and both have been shown to provide antioxidant, anti-inflammatory, and detoxification support.

We have all heard that fermented foods are important for our digestion. The reason why is that the fermentation process fosters the growth of beneficial  microorganisms. These microorganisms create compounds such as lactic acid bacteria that “predigest” the food, making them easier for our gut to absorb nutrients. beet probiotics-chart

Because the gut is the largest component of your immune system, introducing friendly bacteria into your digestive system, may also help keep illness away. Evidence suggests that the status of our gut health can affect inflammation, allergies and autoimmune disorders in the body.  The healthy bacteria that is produced through the fermentation process are currently being researched and point to a whole host of benefits, including a direct link to reduced bouts of digestive complaints. One of the organisms, lactobacillus plantarum has been linked to reduced inflammatory bowel, small bowel bacterial overgrowth in children, and reduced problems for sufferers of irritable bowel syndrome. Another product of fermentation is the friendly bacteria, Lactobacillus acidophilus, which has shown, in animal studies, to prevent polyps, adenomas, and colon cancer.  Needless to say – all of us could benefit from a daily intake of probiotics.

That is where beet kvass comes in.  I recently made my first batch of beets 2beet kvass and was instantly hooked.  It is delicious and so simple to make that anyone, anywhere can make this beverage, without the intimidation that often accompanies making sauerkraut,  and other fermented foods.  Some sites suggested the addition of a starter culture, but mine was fine, just using salt.  My motto is keep it simple.

So here it goes:  Take a few organic beets (3 large beets), cubing them into small pieces, placing them in a mason jar, adding 1 tablespoon salt, filling the jar (I used a half-gallon mason jar) with filtered water and screwing on a lid. Presto it is done.  You then just put it somewhere warm to ferment for 2-7 days.  Even better, you can make a second batch using the same beets.  Just drain off the juice from the first batch beet kvassleaving just a bit of the liquid in the jar along with the same beets and fill it back up with filtered water.  Set it aside to ferment again.  The first batch I let ferment for 1 week and the second batch I let ferment for 2 weeks.  Note:  I checked the jars every other day and would  unscrew the top and put it back on to release the gas.  I follow the same procedure with my other fermented foods.  If there isn’t any gas build up, then either move into a warmer place or let it sit longer.

You can get creative with your beet kvass by adding other items to your  including spices like ginger, caraway seeds, and other items like dried fruits, berries, let your imagination run wild.  As an herbalist I am going to start including medicinal herbs into the process starting with Hawthorne berries and other digestive enhancing herbs.  The sky is the limit.