Chinese Herbs From A Western Medicine Viewpoint

How a Harvard-trained doctor began to appreciate Traditional Chinese Medicine, TCM.

As a child growing up in China, I was always aware of Traditional Chinese Medicine (TCM). TCM is what we refer to as Eastern medicine, in contrast to the Western medicine we know from U.S. hospitals. I never understood much about TCM, only that it somehow involves herbs and that many Chinese people used it. The more I progressed in my medical training in major U.S. academic centers, the more distanced I felt from TCM. Why should I learn about something that lacks evidence, when there’s so much to know about for which there is good research?

 

Last fall, I went to China on a research trip. While my study is primarily on its Western medical system, I was so fascinated by what I learned of Eastern medicine that I spent many free evenings observing TCM practitioners. There is so much I didn’t know. As a discipline, TCM is far too complex for me to understand in my short observation, but there are some very important “lessons from the East” that are applicable to our Western medical practice:

 

#1. Listen—really listen. The first TCM practitioner I shadowed explained to me that to practice TCM is to “listen with your whole body”. Pay attention and use every sense you have, he said. I watched this doctor as he diagnosed a woman with new-onset cervical cancer and severe anemia the moment she walked into his exam room, and within two minutes, without blood tests or CTs, sent her to be admitted to a (Western) medical service. I’ve seen expert clinicians make remarkable diagnoses, but this was something else!

“How could you know what you had and that she needed to be admitted?” I asked.

“I smelled the cervical cancer,” he said. “I looked and saw the anemia. I heard her speak and I knew she could not care for herself at home.” (I followed her records in the hospital; he was right on all accounts.)

 

#2. Focus on the  diagnosis. I watched another TCM doctor patiently explain to a young woman with long-standing abdominal pain why painkillers were not the answer.

“Why should we treat you for something if we don’t know what it is?” he said. “Let’s find out the diagnosis first.” What an important lesson for us—to always begin the diagnosis.

 

#3. Treat the whole person. “A big difference between our two practices,” said one TCM doctor, “Is that Western medicine treats people as organs. Eastern medicine treats people as a whole.” Indeed, I watched her inquire about family, diet, and life stressors. She counseled on issues of family planning, food safety, and managing debt. She even helped patients who needed advice on caring for the their elderly parents and choosing schools for their child. This is truly “whole person” care!

 

#4. Health is not just about disease, but also about wellness. There is a term in Chinese that does not have its exact equivalent in English. The closest translation is probably “tune-up to remain in balance”, but it doesn’t do the term justice, because it refers to maintaining and promoting wellness. Many choose to see a TCM doctor not because they are ill, but because they want to be well. They believe TCM helps them keep in balance. It’s an important lesson for doctors and patients alike to address wellness and prevention.

 

#5. Medicine is a life-long practice. Western medicine reveres the newest as the best; in contrast, patients revere old TCM doctors for their knowledge and experience. Practicing doctors do not rest on their laurels.

“This is a practice that has taken thousands of years to develop,” I was told. “That’s why you must keep learning throughout your life, and even then you will only learn just a small fraction.” Western medicine should be no different: not only are there new medical advances all the time, doctors need to continually improve their skills in the art of medicine.

 

#6. Evidence is in the eyes of the beholder. Evidence-based medicine was my mantra in Western medical training, so I was highly skeptical of the anecdotes I heard. But then I met so many patients who said that they were able to get relief from Eastern remedies while Western treatments failed them. Could there be a placebo effect? Sure. Is research important? Of course. But research is done on populations, and our treatment is of individuals. It has taken me a while to accept that I may not always be able to explain why—but that the care should be for the individual patient, not a population of patients.

“In a way, there is more evidence for our type of medicine than for yours,” a TCM teacher told me. “We have four thousand years of experience—that must count for something!”

 

There is so much I have not covered about TCM. Its practices vary regionally, and no doubt, there are more and less capable practitioners (as there are in Western medicine). More research into TCM methods will be important. However, regardless of whether we Western doctors want to prescribe TCM treatments, we should recognize there is much to learn from Eastern medicine, including what it means to be a physician to really care for our patients. Upon my return from China, I, for one, have a new found appreciation for Eastern medical practice and a renewed understanding of holistic medical care.

Herb & Vitamin Fillers – is there a recommended dose?

pill questions markLabels on most herbal products in the US provide little to no information regarding  the amount of fillers ie. starch, otherwise known as excipients.  Excipients are  inactive substance used as a carrier or any ingredient that is added to adjust the intended dosage. Often excipients are used to  achieve a uniform  5 to 1 herb ratio.  (Basically a diluents).  Excipients are also used to improve administration such as making capsules or  pressed pills.

Currently, there is no technology to make capsules or pressed supplements without using these fillers. Current FDA labeling requirements for dietary supplements do not require the manufacturer  to list the amount of excipients. This leaves room  for lots of speculation and ambiguity regarding the strength of the products.  How much product in the bottle is filler and how much is vitamins and/or herbal extract? There is no set answer for this question simply depends on the manufacturer  and many are not disclosing this information on their labels.  

Gel-Caps and individual packet herbs are the only modalities which do not need to contain excipients.  There are over 750 additives (includes excipients) which  have been approved  by the Food and Drug  Administration (FDA) for  our food & supplement products. Excipients  toxicity and safety has been a controversial subject for more than a decade. Some research suggests excipients destroy immunity by bursting T-Cells and block nutrient uptake. This topic is too broad to discuss here.   I mention this, only to bring awareness that the issue exists. 

There are compelling reasons for these theories and  further  research is clearly warranted.  There is simply too much we don’t  know about  how excipients interact in our bodies. Excipients usage in Chinese herbal products ranges anywhere from 35% to 50% of a 100 gram bottle of extract, the same percentages apply for capsule herb products.  Dextrin is a common excipients along with non-GMO potato starch or  corn starch (corn is the most genetically altered food).  Again, the amount of excipient  used is  not currently required on product labels. Advantages of adding excipients are they extend the shelf life of Chinese herb products. Chinese Herb tea pills were traditional made without  an excipient.

The natural clumping of  the herbs was beneficial in this delivery system.  Unfortunately the shelf life is very short. Remember herbs are natural products and without preservatives they do turn rancid when exposed to air.  One side effect of adding excipients has turned into a benefit  for  people who prefer  to swallow their herb granules by  placing granules  on their tongue and swallowing with water. The use of  excipients makes this easier by reducing the natural stickiness of  the herbs.

Flower Medicine on the Forefront of Liver Cancer Treatment

Ye Ju Hua Wild Chrysanthemum Flower Chinese HerbNatural products like Chinese herbs have become increasingly important for new pharmaceutical discoveries. Chinese Herbs and other phyto-medicinals  are being widely studied particularly for cancer treatments. Currently more than 60% of cancer drugs are of plant origin.  New research on the Chinese herb called Ye Ju Hua or Wild Chrysanthemum flower shows anticancer activities and could be a valuable resource in the fight against cancer.

The flowers of Chrysanthemum indicum (Chrysanthemi Indici Flos), is a traditional Chinese herb widely used throughout China and Asia which this study suggests could be a promising novel treatment for liver and other cancers. Hepatocellular carcinoma (HCC) is known as a common and aggressive malignant cancer worldwide.  In China, HCC accounts for 90% of primary liver cancer, which is the second most common cause of death. Chemotherapy plays an important role in the treatment of cancer, but it is limited to a significant extent by its toxicities and side effects. One possible way to increase the potency of anticancer drugs and to decrease side effects is to develop traditional medicines, especially from medicinal plants.
 

Chrysanthemum   has a long history of use in Traditional Chinese Medicine to treat vertigo, hypertensive symptoms and several infectious diseases such as pneumonia, colitis, stomatitis and carbuncles.   A series of recent studies have demonstrated that Chrysanthemum possesses antimicrobial, anti-inflammatory, immunomodulator, and neuroprotective effects.  Recently, much attention has been devoted to the anticancer activity of Chrysanthemum on human cancer cells, however, its anticancer mechanism of action is still not clear and needs further investigation. The inhibition of tumor cell growth without toxicity in normal cells has attracted considerable attention in cancer therapy.  

Clinical studies have shown Chrysanthemum  can be used in combination with other chemotherapeutic agents and other Chinese herbs.  One study  found that patients with metastatic breast cancer postoperatively receiving Chrysanthemum as one of the main components, in combination with other traditional Chinese medicines, had a 5-year overall survival rate of 70% and a complete response rate of 60%, and in combination with chemotherapeutic agents, had a 5-year overall survival rate of 77% and a complete remission rate of 80%, without adverse effects.  Another study demonstrated that Chrysanthemum  in combination with traditional Chinese herbs, achieved a response rate of 67% in advanced stage esophageal carcinoma patients. 

Plant-pharmacology used in Traditional Chinese Medicine (TCM) continues to be an important source of discovery and development of novel therapeutic agents for cancer treatments.
 
 
Zong-Fang Li, Zhi-Dong Wang, Shu Zhang, Xian-Ming Xia, Department of General Surgery, The Second Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China. Chen Huang, Key Laboratory of Environment and Genes Related to Diseases of the Education Ministry, School of Medicine, Xi’an Jiaotong University, Xi’an710061, Shaanxi Province, China
Supported by Grants From the National Natural Science Foundation of China, No. 30672766 and Science and Technology Developing Foundation of Shaanxi Province, China, No. 2006 K16-G4 (1)
Published online: September 28, 2009
Peer reviewer: Dr. Yukihiro Shimizu, Kyoto Katsura Hospital, 17 Yamada-Hirao, Nishikyo, Kyoto 615-8256, Japan

Ginger to Maintain Your Health

ginger[1]

Ginger is a common recommendation in my clinic. Ginger is wonderful for digestive disorders and it is anti-inflammatory. "Drink Ginger tea" is one of the most common suggestions I make.

Don’t underestimate ginger just because it isn’t the fancy favorite of TV Chefs. Ginger root is a common herb used in Traditional Chinese Medicine (the Chinese name is Sheng Jiang). Ginger is also used as a spice for cooking, particularly in Asian food.

Here are some great ideas from an article by Jennifer Dubowsky, L.Ac. originally posted Dec. 2008 about the benefits of ginger.

Ginger’s rhizome (the underground stem) is highly spicy and widely touted to aid digestion. That is why ginger tea is very popular. In addition to a lovely flavor, it is anti inflammatory and eases digestion. Consider drinking ginger tea (try Traditional Medicinals) after meals. Another benefit from ginger is its ability to combat nausea from various causes including morning sickness, motion sickness, chemotherapy,and food contamination. Many people use ginger to treat coughs, influenza, and colds. I also recommend it to my patients to improve fertility and ease PMS symptoms.

It is interesting to note, too, that ginger has been employed in Chinese herbal medicine for thousands of years due to its numerous beneficial properties. Called Sheng-jiang in the Chinese pharmacopoeia, ginger used alone as a single herb is considered to alleviate nausea, dispel pathogens by inducing sweating, expel cold, as well as stop coughing and reduce excess phlegm in the lungs. In Chinese herbal medicine, Sheng-jiang, or fresh ginger, is considered to have very different properties than Gan-jiang, or dried ginger. Gan-jiang is useful for "cold" pain of the stomach and abdomen, diarrhea due to "cold" in the abdomen, cough, and rheumatism, among other uses. Dried ginger has also been shown to inhibit vomiting.

A Japanese study brought ginger into the experimental lab. The study, led by Dr. Hiroshi Ochiai at the Department of Human Science, Faculty of Medicine, Toyama Medical and Pharaceutical University, Japan, was published in The American Journal of Chinese Medicine, 2006:34(1):157-69, and reported in the Chinese Medical Times, concludes that they were able to inhibit the growth of influenza virus using ginger extract.
For more articles by  Jennifer Dubowsky, a licensed acupuncturist in downtown Chicago, check out:  http://acupuncturechicago.blogspot.com/

A High Price for Deer Antler and for Chinese Medicine

Chinese herbal medicine

A family trip to Alaska, a lot of time in a van and unexpected lessons on deer antler aka Lu Rong. 

On a family trip to Alaska, we quickly learned Alaska is too big for road trips. However, we did see the most incredible scenery and enjoyed some off the beaten path family activities.  An ingrained family tradition. As the planner of the trip, I decide the family must pay a visit to a reindeer farm just north of Anchorage. Our teens had their i-pods and they are accustom to my crazy ideas of fun, so off we went on the 5 hour round trip drive.  Admittedly, I had an ulterior motive, I wanted to learn about Lu Rong, deer antlers, from a true source, and this was a golden opportunity I couldn’t miss.

In Chinese Medicine, the deer antler also known as Lu Rong is a prized and highly sought after commodity.  Deer antler has been used for hundreds of years for health and  longevity and is considered a yang tonic in Chinese Herbal Medicine.  Reindeer antlers our one source of antlers  however much more commonly used is the smaller breed of Red Deer.  Today the most expensive deer antler is harvested in New Zealand  but Alaska is also a source and prices range anywhere from $100.00 for a 100 gram bottle of  granules to $500.00,  quality can vary widely. I admit, a small ulterior motive, I was investigating whether  importing deer antler might become part of my herb business.

Chinese medicine antlers

Wow, I had no idea the antlers were so sensitive.  In fact, males who commonly fight each other will not touch one another while their antlers are in velvet, a growth stage named for the velvet like fur on the antlers. There is a tremendous amount of blood flow to the antlers which supports this growth and there is a correlation between the head being the most Yang part of the body, the antlers growing from the top of the head  and deer antlers categorized  as a yang tonic. Eskimos have used deer antler soup for it’s internal warming (yang) properties for as long as anyone can document.

 

We arrived at the reindeer farm which was operated by a family (and some hired help), mainly for the purposes of selling reindeer meat. The tourist business is a summer sideline. We paid a small entrance fee and along with two other families with young children were given instructions before we were allowed to enter the main pen and hand feed the reindeer some supplied food. I knew that deer are very skittish, nervous animals by nature and easily startled, but what else I learned was surprising. The number one rule was no touching the antlers of any animal that is “in velvet”.  The reason was simple. The antlers are extremely sensitive when they are growing and just touching the velvety soft exterior, especially at the tips, could freak out the animal and be dangerous for us. We could pet the deer anywhere else exception being, the antlers.

What else I learned; deer antlers, whether reindeer or red deer are not so easy to harvest.  It would seem harmless to saw them off once they are essentially dead and have no more blood flow.  The antlers die naturally every year and either fall off or are broken when the deer fight.  But, deer antlers are harvested when there is still blood flow to them, best when the tips are still rounded which means they are still growing.  Our guides explained they would never harvest antlers while in velvet because it would be like cutting off one of your fingers.  The antler is truly an limb extension of the animal. If  just touching an antler can make the deer skittish what do you thinking cutting off an antler would do to the deer?  Extremely painful to say the least.

This was the moment I decided no matter how much can be earned from deer antlers I could never be part of that industry. If the antlers were used once they are naturally shed by the animals, that would be different.  But by the time the antlers are naturally falling off they are dead, no blood flow no nerve endings. No medicinal value.

To be fair,  I am told  that many people who raise deer exclusively for their antlers as a Chinese medicinal, use a veterinarian to perform the sawing off operation.  Some say they tranquilize the animals and/or provide Novocain. Once the antlers are cut the deer’s head is wrapped in bandages and something is given to reduce the bleeding at the site. Antlers are always harvested when they are at the height of the growth stage. If you have ever seen slices of deer antler the highest grade are red in the middle, from the blood flow. Regardless, once I spent just a few minutes with these beautiful docile creatures, I knew I didn’t want any part of an industry initiating animal cruelty. Yang tonics are great strong medicine.  Chinese Herbal Medicine has plenty of  plant based yang tonics, no animal products would ever be part of Pacific Herbs.

The Coffee Bean and Chinese Medicine

Coffee as Chinese MedicineI’m a coffee drinker alas only in moderation.  Now, I’m re-thinking that moderation as I learn more about the benefits of the coffee bean. 

 

A cup of coffee is 2% caffeine and 98% other bioactive ingredients. To say the least, it is a complex beverage. People seem to forget that the coffee bean is an herb. Indeed, the coffee plant belongs to the Rubiaceae family, which is a source of several different Chinese herbs, including the gardenia fruit. The coffee beans medicinal effects have been well known since 1908, when the Indian Materia Medica was published.  

 

At the proper dosages, the coffee bean has the ability to improve health in several ways. Drinking coffee can increase cardiovascular health and lower the risk of colon cancer, gallstones, cirrhosis, and Parkinson’s disease A typical dosage for this type of herbal medicine is in the range of 6-18 grams per day, which translates to about 1-3 cups of coffee, depending on how many grams of ground beans are used. Roasting the coffee beans does not detract from the beneficial effects of this herb.

 

The primary active substances in the coffee bean are chlorogenic and caffeic  acids. These substances have been shown to have anti-depressant and anti-anxiety effects.  No wonder those local  Starbucks have  become our favorite pit stops.  Coffee also contains antioxidant phenols that can reduce the risk of cancer.

 

This blog idea was instigated by a study on the long-term coffee drinking on type 2 diabetes mellitus, it said “long-term coffee consumption is associated with a statistically significantly lower risk for type 2 diabetes,”  I added a study link at the bottom if you are interested. Coffee, just like any other potent herbal medicine, is not necessarily for everyone, as some people may be more sensitive to the effects of caffeine. But the coffee bean contains many beneficial vitamin ingredients including potassium, niacin and magnesium. 

 

Start your day with a freshly brewed cup of this herbal bean can have some wonderful health benefits. Enjoy, but don't use coffee for just for the caffiene and best use it in moderation.

Study Link
Am J Clin Nutr. 2001 Mar;73(3):532-8.Consumption of high doses of chlorogenic acid, present in coffee, or of black tea increases plasma total homocysteine concentrations in humans.  Olthof MR, Hollman PC, Zock PL, Katan MB.                   http://www.ncbi.nlm.nih.gov/pubmed/11237928

Stop Painful Menstrual Cramps with Chinese Herbs

herbs for pmsLately this is my favorite topic and formula to make in my herb granule pharmacy .. because  the calls I receive go something like this.  "I took it once & I'm off the couch and back to normal",  "I can't believe those herbs work",  "Why didn't you tell me before", "I didn't take a single motrin this month",  I could go on and on, but you get the idea.  So here's some information about the herbs in the PACHerbs PMS Relief Herb Pac & some interesting information on well conducted research on menstrual pain. 

Don't mask the pain with NSAID's  try an approach that's worked for centuries, Chinese Herbal Medicine.  An international nonprofit organization, known as the Cochrane Collaboration, studied the effectiveness of Chinese herbal medicine in relieving menstrual pain compared to western drugs.  Their conclusion:  “Chinese herbal medicine for primary dysmenorrhea roughly doubled pain relief and improvement in overall symptoms compared with conventional Western pharmaceuticals."

Here are a few common Chinese herbs used for painful menstrual cramps, ( All our in our formula plus more)

1. Dong Gui (Chinese Angelica  or Angelica Sinensis) Also known as the "female ginseng," it is commonly used to regulate the menstrual cycle and relieve menstrual cramps.  It also helps to relieve menopausal symptoms, reduce PMS and anemia and to re-establish a menstrual cycle after cessation of birth control pills.  It is commonly sold as a single herb tea, bagged or loose.  It is considered a king herb or premier herb in Chinese gynecological disease because of its ability to harmonize the blood in Chinese medicine.  Dong Gui is also considered antispasmodic.  The coumarin chemicals present in this herb may help dilate blood vessels and relax the smooth muscles of the uterus, thus relieving menstrual cramping.

2. Chuan Xiong (Chuanxiong  Rhizoma) This herb is also a key medicinal herb for treating pain.  It improves blood circulation and promotes the flow of "qi" or vital energy.  Chinese women, dating back to the Song Dynasty, used to take this Chinese herb in the form of soup.  The soup is called a Four Substance Decoction and includes three other herbs:  angelica, red peony and Chinese foxglove.  The soup and tea are still used today as a blood tonic to relieve PMS, stop menstrual pain and improve overall health, especially after giving birth.

3. Bai Shao (White Peony Root) White Peony Root nourishes the blood and improves circulation.  It is also used for a wide variety of gynecological problems.  The peony root is considered a   liver tonic in Chinese medicine.  By strengthening the liver, it helps to increase the efficiency of protein and fat metabolism, thus inhibiting the excessive synthesis of prostaglandins that may cause an over-active uterus and endometrial pain.

4. Yi Mu Cao (Chinese Motherwort) Leaves from this herb are used to treat menstrual problems.  They have been shown to improve blood circulation and clear blood clots that occur in menstrual disorders and after childbirth.  The leaves also promote diuresis and relieve edema.  Studies on the alkaloid leonurine showed that this substance stimulates the uterus of rabbits, cats, dogs and guinea pigs.2

5. Yan Hu Suo (Corydalis Rhizome) There are two main functions of this Chinese herb:  to strengthen blood circulation and to relieve pain.  In conjunction with chuan xiong it is known to help both body aches and headaches.  Corydalis is related to the opium poppy.  Although only 1% in strength compared to opium, it is a very effective pain reliever.  The active chemical constituent di- tetrahydropalmatine (THP) is a neuroactive alkaloid with analgesic action that relieves cramping pain. Formulas or groups of Chinese herbs are more beneficial than single herb remedies because the herbs work synergistically for conditions such as menstrual cramps.  The Cochran study also stated that:  “The herbal remedies were also significantly better at relieving painful cramps and other symptoms than acupuncture or a hot water bottle, with overall promising finding.  Chinese herbs overall, whether standardized or tailored, yielded better pain relief than conventional pharmaceutical therapies.” Chinese herbal medicine can be a bit intimidating when you don’t know anything about these herbs, and the five herbs above are only a few of the herbs beneficial for menstrual cramps in the Chinese herbal encyclopedias.  Asian pharmacies sell prescriptions of herbal teas and pills daily, and Asian cultures have used herbs successfully for hundreds of years. 

By replacing NSAIDs with Chinese herbs, women receive an additional benefit of avoiding the nasty NSAID3 side effects such as upset stomach, heartburn, ulcers and rashes, and liver damage, to name a few.  Women don’t need to suffer month after month.  You can use Chinese herb supplements to be pain free and PMS symptom free all month long.

Check the research for yourself: Primary source: Cochrane Database of Systematic Reviews Source; Zhu X, et al "Chinese herbal medicine for primary dysmenorrhoea" Cochrane Database of Systematic Reviews 2007;3: CD005288.

  1. Chinese Medicine Program at the University of Western Sydney.1 (fourth issue for 2007 of The Cochrane Library)

2.  Yin, J. Modern Research and Clinical Application of Chinese  Materia Medica (2) pp 218-219 Beijing: Chinese  Medical Classic Press.

NSAID are Non-Sterodial Anti-Inflammatory Drugs.  Generics and name brands include:  ibuprofen, Advil, Motrin, naproxen sodium, Aleve, aspirin, Bayer, Bufferin, acetaminophen, and Tylenol.