After spending a ton of money with a few Traditional Chinese Medicine (TCM) consultants and not getting very far I decided to consult with some heavy weight, prominent online guy. Half a year ago I purchased an online consultation with Dr. Joel from drshen.com. I figured he has a huge herbal store and may steer me in the right direction.
After I shared with him all my symptoms he asked a few additional questions that I was happy to answer:
Q. Do you still have dream disturbed sleep?
A. No disturbing dreams any more. Just very light and interrupted sleep, usually waking around 1am or earlier if I eat anything past 6pm. Late meals affect me a lot so I usually try not to dine or even snack past 6pm.
Q. Does stress effect your digestion?
A. Somewhat, but it has to be lots of stress. Although I get this heat in my stomach from any tension, it’s as if it was two hot columns inside my abdomen.
Q. Aside from your appendix surgery, have you ever been hospitalized for any other reason?
Q. Have you ever had a venomous insect or tick bite in the past?
A. Yes. Right before I left CA I had a tick bite and a big rash around it. MD at Palo Alto Medical gave me an antibiotic and said I it would take care if it was infectious in any way. Recent blood test showed I did have Lyme’s antibodies, but the infection is no longer “active.” This raised a lot of suspicions because some of my neurological symptoms could be related to Lyme’s, even though I never developed any more serious symptoms that normally come with Lyme’s. Recently, I also checked for H Pylori and blood showed lots of antibodies but stool test showed up as negative.
Q. Do you have a bowel movement every day?
Q. Do you have hot flashes during the day as well as at night?
Q. Does the ‘heat’ in your abdomen stay in a fixed location, or does it move up or down?
A. I think it’s pretty fixed, if anything sometimes I feel it more on the left, sometimes more on the right.
Q. Do you still take the ‘Restore the Jing’ formula? If so, how much?
A. No, I only used one bag of it, one teaspoon in AM, one in PM. I felt the difference when I was totally exhausted but not much more later, it didn’t help with sleep.
Q. You say your libido is low; On average, over the years, how many times in a week might you have had an orgasm?
A. OK, I’m moderating this answer on my blog and won’t include here in case my colleagues are reading. 🙂
Q. Has this changed recently? Is the volume of ejaculate unchanged?
A. Also moderated but if you’re curious then e-mail me.
Q. While sitting and at rest, can you feel your pulse at your wrist below your thumb?
Q. Is the beat regular, or do you notice skipped beats?
Q. Can you feel it 1) with slight pressure, 2) with some pressure, 3) with deep pressure, 4) can’t feel it.
Q. How many beats in 15 seconds?
A. 17 or 18
Q. If you look at your tongue in daylight, does it appear 1) purplish, 2) reddish, 3) pinkish, 4) pale? (see examples below) Or you can attach a photo taken in daylight.
A. I think it is towards the pink side, but more pale with some coating all over it.
Q. Do you notice feeling hot or cold when others don’t?
A. I think so, especially the rainy days and when I get very little sleep.
Q. Do you have a noticeable preference for hot or cold beverages?
A. Definitely warm.
After an evaluation of the above, he sees two distinct possibilities and not being entirely sure which diagnosis is most correct, but he suggested that we begin with the first. If we’re successful there’s no need to pursue the second, which is much more complicated and could take far longer.
1) Liver Invading the Stomach resulting in Stomach Fire and Stagnation, plus Kidney YANG and JING deficiency leading to weakness in the lower back and cooling of the ‘Fire Gate’.
2) GU Syndrome. Relating to a tick (of other venomous bite) subsequently effecting the nervous system.
As to what could be causing this Liver Invading the Stomach pattern he couldn’t say for sure as he doesn’t know me very well. He said it could be physical and/or mental, but it’s usually some stress or habit coupled with one’s unique constitution.
Since I have sensitivities to many substances, he suggested to start with a low dose of this custom formula:
CHAI HU . . . 15% (Bupleurum)
CHUAN LIAN ZI . . . 15% (Sichuan Chinaberry)
ZHI KE . . . 10% (Bitter Orange)
YAN HU SUO . . . 10% (Corydalis)
SHAN ZA . . . 10% (Hawthorne)
DU ZHONG . . . 10% (Eucommia Bark)
HE SHOU WU . . . 10% (To-Fi root)
BAU JI TAN . . . 10% (???)
HUANG LIAN . . . 5% (Coptis root)
ROU GUI . . . 5% (Cinammon root)
The course of treatment is 3 months. The dose is normally 8-10 grams per day, but he suggested I begin with 4 grams a day and gradually increase the dose. “Dissolve 2 grams of powder in any amount of liquid, and drink twice a day, take it first thing in the morning and later at night before bedtime. It works best when taken on an empty stomach.”
To be honest, I was very skeptical when I received this diagnosis. I was just starting to seriously study my condition from TCM perspective and the whole “liver invading stomach and cooling of fire gate” concept just seemed bizarre and too difficult to grasp. Plus, it was kind of hard and expensive to have this custom formula shipped to Lithuania so at that moment I just set this advice aside and kept experimenting with other herbal formulas.
As time went on all my signs stubbornly kept pointing to liver stagnation and adrenal fatigue. Then months later yet another TCM guy suggested to try Xiao Yao San formula, aka Bupleurum & Peony or ‘Easy Wanderer’ as it was known for back in the day. It worked magic for me and I bought several bottles right away. My liver was flowing, digestion moving, appetite returned. In fact it was working too well as I lost any little weight I had left on me. Then, out of nowhere, those pesky chills came back from 9am-11:30am that were preventing me from sleeping. I had to stop the formula as it became unbearable.
So I kept searching and wondering… what in the world could be causing those inner chills. I kind of narrowed it down to my liver. Then looked up the liver channel and learned that there can be cold stagnation in the liver channel and one reason for that is low kidney yang. Bang! Back to adrenals and thyroid issues.
So I decided to go back to Dr. Joel’s advice and study the formula better as I was getting good at navigating around herbs. So I learn that this is basically a Chai Hu Xiang Fu Tang (Bupleurum and Cyperus formula) with modifications to warm the adrenals, aka kidney yang or ‘fire gate.’ God, I was ready to kick my own ass. Why didn’t I try this half a year ago?
‘Liver invading the stomach’ pattern basically means chronic stress induced digestion issues and ‘low kidney yang and jing’ is adrenal fatigue. Bupleurum and Cyperus formula removes liver stagnation and harmonizes the stomach and this seems like exactly what I could use right now. The way to avoid those chills is to warm the ‘fire gate’ with yang promoting herbs like Eucommia and Cinammon.
So this is what I’m going to try now but instead of going through a cumbersome process of getting a custom formula I’ll just combine Bupleurum and Cyperus with a modified Rehmannia Eight to achieve the effect. This only leaves me without Coptis and Bau Ji Tang (which I couldn’t even find a reference of online) because I already have Hawthorne and Corydalis as separate herbs. If I feel this is the right combo then I’ll order the exact custom formula that Dr. Joel had suggested. If that also doesn’t work then here comes the GU Syndrome which is awfully exotic and exciting.
One piece of valuable advice that kind of stuck with me over the time was when Dr. Joel said that he was very uncomfortable mixing Chinese herbs with other supplements, as this practice negates the experience gained from thousands of years of study and refinement. Then he said what I feared but was plain obvious: “It’s understandable that you are trying many different things to solve these issues, but I believe you are trying too many different supplements and reaching conclusions about them without proper consideration. Compared to TCM, there is little history of using them, and virtually no history of using them in combination with each other or with Chinese medicine. For this reason, I encourage you to refrain from taking most other supplements while taking the medicines that I recommend.”
This advice grew on me and I now do not take any other supplements but Chinese herbal formulas, some magnesium and Cod Liver Oil.
Over to you: does this fit with any of your experiences and have you seen this pattern before? Would be very grateful for any insights.