This year winter begins with the solstice, which is the shortest day and longest night of the year. In Oriental Medicine (OM), winter is the season associated with the water element and is yin in nature (dark, cold, moist and still). Just as nature is sleeping and resting in anticipation of warmer days, the season urges us to rest, conserve and replenish our energies until the coming spring. The change in season may bring about abundant allergies, while colds and flus take advantage of the stresses only the end of the year can bring. The emotion associated with the water element is fear and it contains the spirit of will power. An imbalanced water element may present as fearful, which depletes vital energies. Just as water provides fluidity for movement and lubricates every joint, the water element’s spirit guides us to smoothly overcome fear and difficulties.
By supporting positive qualities, the most stressful time of the year can be the most joyous time of the year. To make the most of this winter, enrich Kidney essence (jing) or constitution and maintain your immune system (wei qi) by following these lifestyle changes until spring.
1. Go to bed early and wake up later, stay warm and expend minimal amounts of energy.
2. Avoid raw or cold foods as they tend to cool the body further. Do consume warm foods such as soups, lamb, pork, chicken, peanuts, beans, walnuts (hu tao ren), Chinese dates (da zao), longan fruit (long yan rou), cinnamon (gui zhi), ginger (sheng jiang) and garlic (da suan).
3. Wear warmer clothing to protection your yin qi, but do not make your home or workplace so warm that your body does not adapt to the outside environment.
4. Continue to exercise to keep your pulse and qi strong, but do not exercise to the point of exhaustion.
5. As reinforcement of your lifestyle, acupuncture and Tuina relieve stress and improves digestion. Applied to specific areas such as the abdomen or Stomach 36 (Zu san li area on the lower leg), they also boosts immunity by increasing white blood cell counts.
By adopting an OM lifestyle, embracing the change of season and nostalgia for the year gone by, we can fuel the energies to create new memories in the coming year.
To see how athletes can optimize their success in winter, see Journey Inward for Outward Movement.
Irritable Bowel Syndrome (IBS), also known as spastic colitis, is the most frequent gastrointestinal (GI) disorder and accounts of 30 -50% of all referrals to gastroenterologists. In 10-20% of European and American populations it starts in late teens to early twenties occurring more often in women.
IBS is not classified as a disease, but as a syndrome. It is considered a functional GI disorder characterized by a variable combination of chronic and recurrent intestinal symptoms that are not explained by structural or biochemical abnormalities.
Symptoms may occur alone or in combination: abdominal pain or discomfort with altered bowel function; abnormal frequency of bowel movements (BM); typically diarrhea, constipation or both; flatulence, bloating, loss of appetite, nausea, increased mucous production, painful BMs. Cramping, intermittent, lower abdominal pain does not usually occur at night nor interfere with sleep and most symptoms are commonly relieved by defecation.
Additional non-bowel symptoms may include heartburn, chest pain, headaches, fatigue, muscle pain, urologic dysfunction and gynecological symptoms, and often coincide with chronic fatigue syndrome. There is a Mind-Gut interaction where anxiety and/or depression frequently accompany IBS symptoms in varying degrees.
The cause of IBS is not clear. It is felt to be a “dysregulation” of intestinal motor and sensory functions of central nervous system (CNS) origin – thus the psychogenic component. The gut produces 95% of serotonin in the body. If the gut is not functioning optimally this affects mood, thought processes and clarity of mind. There is strong evidence for disruption of balance between non-pathogenic flora and the immune system, while GI infections treated by antibiotics result in a higher chance of acquiring IBS.
Diagnosis follows the Rome III Criteria, which includes abdominal pain for at least three days per month for three months and is characterized by two out of the three following symptoms: pain relieved with a BM; change in frequency of BM; and change in the consistency of BM.
Other causes should be ruled out such as lactose intolerance, drug-induced diarrhea, parasites, food sensitivity (may depend on combination) and food allergies.
Medications include the possible use of tricyclic antidepressants and symptomatic treatment for spasms, constipation and diarrhea. Antibiotics are often improperly prescribed because diarrhea is confused with infection. This leads to other gut problems such as poor gut flora.
Lifestyle: Eliminate offending foods such as common allergens: wheat, dairy, corn and soy. Avoid gas-producing and diarrhea-producing foods: beans, fermentable carbs, sweeteners, hydrogenated fats, brussel sprouts, cabbage, cauliflower, raw onions, grapes, plums, raisins, coffee, garlic, red wine and beer. Increase dietary fiber from non-wheat plant sources for constipation and foods that promote healthy flora in the gut such as beet fiber.
TRADITIONAL CHINESE MEDICINE (TCM) cannot be simplified without losing its essence. It seeks to find and understand the cause. TCM’s advantage in treating functional disease is holism and emphasis on various exterior functional activities of the human body.
TCM can’t live without the Spleen (SP); biomedicine does not consider its importance. In TCM the SP and Stomach (ST) energetic systems are paired. Together they receive food, assimilate it and send it to the rest of the organs and the body to be further processed. The SP ascends energetically while the ST descends. SP dysfunction may result in diarrhea, while ST dysfunction may result in nausea or vomiting.
The Small Intestine (SI) separates pure substances from the un-pure. It has the ability to absorb and distribute nutrients. There are few specific SI syndromes and SI qi deficiency can result in chronic diarrhea. Most SI diseases are referred to as SP problems. The Large Intestine (LI) has the ability to eliminate waste and its dysfunction is constipation.
Causes of IBS in TCM include: irregular diet; emotional stress leading to qi stagnation and affecting the SP and ST; SP deficiency causing anxiety, depression and sleep disturbances; Qi, Blood, Yin or Yang deficiency after chronic disease or after delivery; or overuse of laxatives or purging supplements.
Differentiation follows the basic presentations such as diarrhea-predominant IBS, constipation-predominant IBS with abdominal pain and flatulence, abdominal pain-predominant and alternating between diarrhea and constipation. Subcategories go into further detail and include but are not limited to:
- Excess presenting with abdominal distension and/or pain, red face, scanty and/or red urine, dry smelly mouth; may occur in heavier kids with less BMs due to lack of exercise.
- Deficiency in older patients and weaker constitutions with diminished Yin essence from over-consumption of spicy food and irregular toilet habits. There may be weakness, no power to pass stool, might not be dry, may even be soft; sweaty, pale complexion, shortness of breath and/or fatigue. This is also common in women after giving birth due to blood loss.
- Cold, in chronic conditions and older patients. Stools may not be dry, but difficult to pass or the patient may have no power to pass stool and present with a sallow or pale complexion, cold in the four limbs and lower abdomen and an aversion to cold with clear urine.
Acupuncture and Herbs seek to alleviate symptoms, address the cause and restore balance to the entire person by being highly modifiable based on patient presentation. Some acupuncture points are near areas of discomfort while others are found on distal aspects of the body. Herbs are a way to safely treat the body internally.
Nutritional considerations follow an energetic standpoint that is synonymous with the TCM diagnosis. Foods are recommended that nourish and balance the body without aggravating the gut.
Both Western and Eastern medicine agree it is necessary to address the whole body to alleviate the IBS presentation. After being diagnosed it is imperative that consistent lifestyle changes are made to maintain and prevent reoccurrence of symptoms.
In spring, all creatures take advantage of energy that was stored during the fall and winter months. New growth can be seen moving upward and outward, both emotionally and physically, via the reappearance of plants and animals, as well as our own emerging perspectives on life.
Spring is the season linked to the Wood element, and the Liver and Gall Bladder organ system. The energetic Liver should be soothed, nourished or regulated. Its function according to Oriental Medicine (OM) is to circulate Qi (energy) upward and outward in the body as well as control the other organs. The Wood element is characterized by growth and wind, which tend to be found more often in the spring. Wind can strengthen the Liver, but too much can cause it to overact on the Stomach and Spleen. This can lead to a disharmony that may manifest as stomach upset and/or digestive disturbances, acid regurgitation, and possibly diarrhea. For those that may have overworked themselves the previous season, their immune systems may be compromised.
Spring allergens from grass and trees are blown through the air into our bodies. Theses allergens can affect a person, particularly if they are overstressed by life or emotionally overloaded. This, in turn, will weaken their digestive function and wei qi/immune system. An unbalanced Liver energy may result in mood swings, depression or irritability, and occasional outbursts of emotion.
To assist the Liver Qi to flow, incorporate activities that both enliven and relax the body. Exercise should be calm and fluid. Try breathing exercises, stretching, Qi gong, Tai Qi, light weights, and/or yoga. Joint support is important, as the tendons and ligaments are a manifestation of the Liver energies and is well covered by the aforementioned modalities. Rest and recovery, as for every season, are imperative to good health. In this season, going to bed somewhat later in the evening and waking up earlier are applicable.
Springtime foods should be sweet in flavor to nourish the spleen, with some pungentness (spicy) and warmth to help soothe and regulate the Liver’s functions, such as black sesame, quail or Chinese yams. Include some fresh greens like kale and spinach as well as young plants or sprouts. Foods that help soothe the Liver if it is out of balance include chive, onion, peppermint, beans, sea vegetables, vinegars, lime, & animal liver. Although sour flavored foods are good to have at this time, more is not necessarily better. Foods that clog the Liver, such as processed, sugary foods, excessively fatty and hydrogenated fats, are devoid of life and should be kept to a minimum. Other foods to avoid include salty, cold in temperature, excessive raw foods, or difficult to digest foods, accompanied by a decrease in calories to reduce the load placed on the Liver.
Acupuncture and Tuina should be utilized frequently to boost the immune system, alleviate sinus pressure & headaches associated with allergies, assist in digestion, moderate mood swings, and assist in recovery from exercise.
“In the spring and summer when food is plentiful and humans tend to become lazy and slothful, finger pressure is used to increase digestion, fire and restore vigor.” Qi Bo – Yellow Emperor’s Classic
By incorporating regular self care practices via mindfulness, nutrition, exercise, acupuncture and bodywork, one can best retain and improve their own health during this season of growth.
Read about the coming Summer
With the multitude of seasonal allergens to choose from, it’s no wonder that allergies tend to be a large topic of conversation.
Air born allergens include seasonal pollens such as cedar trees, grass, and weeds. As an added bonus year-round allergens such as molds, vehicle exhaust, dust mites, pet dander, and insect parts can be added to the list. Seasonal allergies can cause a great deal of discomfort with non-native plants and trees, temperature changes, and winds carrying pollen.
As far back as the 2nd century BC, Oriental medicine (OM) techniques such as acupuncture, herbs, and dietary recommendations have been used to provide relief from the environment and create balance in the body. Today we know that acupuncture can modulate levels of cytokines and anti-inflammatory mediators as well as regulate the immune system’s overall response when too weak or overly active.
In conventional medicine, allergies are an increased response to an antigen or substances that can enter the body and stimulate it to create antibodies called IgE which bind to allergens. Mast cells then release histamine which cause symptoms (heat, pain, swelling, redness, itchiness, etc).
It is important to note that air born allergens are a localized immune system (wei qi) blockage that tends to cause symptoms in the head such as itchy, watery eyes, sneezing, runny nose, post nasal drip, headaches, ear congestion, throat irritation and/or occasional body fatigue. While the common cold (gan mao) tends to include most of the head symptoms but will also carry on to body aches, chills, fever, and for some digestive disturbances.
In addition to these already uncomfortable symptoms, underlying factors can also contribute to this immune system burden (e.g. food sensitivities, chemical additives to foods, tobacco smoke, chemicals in the home or workplace, medications, or even hormonal fluctuations).
If left untreated or ignored, air born allergies can progress to more serious conditions such as:
- Allergic rhinitis is the body’s immune system over-responding to non-infectious particles in the air. Symptoms include the development of sinusitis, eustachian tube dysfunction, chronic otitis media, and anosmia (inability to smell).
- Sinusitis is inflammation or swelling of the sinuses and typically happens after having allergic rhinitis. This happens when sinuses become blocked and fill with mucous that can harbor bacteria, viruses, or mold causing an infection.
- Both rhinitis and sinusitis can lead to less productivity at work and more doctor visits.
- Some people may exhibit increased allergy sensitivities. For example, people who have fibromyalgia are more aware and some pregnant women in their second trimester may experience increased allergic symptoms and hypersensitivity to their environment and medications.
Allopathic medications can help in acute conditions but tend to mask symptoms and come with a slew of side effects. Many patients turn to antihistamine relief at the first sign of allergies and are quickly prescribed antibiotics for nasal rhinitis.
Antihistamines are designed to treat allergies and relieve respiratory symptoms by blocking the effects of histamine, which is a not a natural process, as they affect ALL mucous membranes and can dry them out. Common antihistamines, such as Benadryl, tend to dry up body fluids (jin ye).
Other medication side effects include drowsiness, epistaxis (nose bleeds), and nasal dryness in addition to normal allergy symptoms. Steroids (oral, topical, inhaled) can reduce inflammation but foster overgrowth of yeast. Prolonged or inappropriate use of antibiotics can lead to immune deficiencies, digestive disturbances, and chronic fatigue.
The cause (pathogenic factors) of allergies is a relative idea. OM pays considerable attention to the symptoms of pathogenic factors (allergens), which are related to body constitution and lifestyle factors.
Food sensitivities or allergies, blood sugar fluctuations and stress can tax the energetic kidneys (adrenals) and create a cortisol imbalance. This depletion leads to inflammation in the body which may manifest as pain, tightness, fatigue, and water retention leading to poor digestion and lowered immunity.
Compromised digestion and immunity invite our external environment and seasonal allergens to easily allow for viral and bacterial infections to take hold.
Seasonal symptoms can be predictable:
- Fall – ragweed whose symptoms are characterized as Wind Dryness
- Winter – cedar, cedar fever is clearly Wind Heat
- Year round allergies have a Wind component
- Mold is considered Wind Dampness
Acupuncture Treatments help to moderate the body’s response to allergens and help create a healthy immune response. Although an appropriate diagnosis of a person’s presenting pattern is important, there are specific allergy points located in the ears and important points on the hand, feet, head & face. In addition to needles cupping, moxibustion and herbs play a strong role in improving the way you feel.
Herbal Treatments, which are easily modifiable, also support the immune response and continue to help as a daily therapy to complement acupuncture treatments.
A common Chinese formula, Jade Wind Screen Yu Ping Feng San, is helpful for year round allergy sufferers who tend to have a weakened immune response, characteristically tend to catch cold easily and are sick longer than normal. It can be administered two months before specific seasons as well as during.
For more acute allergies non-sedating antihistamine formulas such as Nose Inflammation Formula Bi Yan Pian, Magnolia Flower Powder Xin Yi San and Pe Me Kan Wan are very helpful. When made into a tea the steam can be inhaled from the cup to get an immediate effect before drinking
- If you have a seasonal allergy don’t wait until symptoms occur to start receiving acupuncture and herbal treatments. Starting treatments at least two months prior will prepare and support the immune system for the season to come.
- Check daily pollen counts before leaving your home.
- Whenever possible exercise *indoors in moderate temperatures. Also avoid haze and smog, weather changes and exhaust fumes from vehicles.
- All mucosal membranes are affected by eating foods that create an immune response. Avoid phlegm producing foods (sugar, dairy, wheat and soy which are also common food allergens)
- Avoid processed sugars – sugar decreases immune function and increases inflammation.
- Reduce your internal load: In your home and work spaces use non-toxic, low residue paint and household cleaners. When looking for body products buy aluminum free, low in chemical and perfume additives. Clean and dust often, and change out air filters regularly.
- HEPA filters in central air or free-standing filters are beneficial.
- Moderate emotional factors – crying, yelling and distress – all cause increases in cortisol, which in compromise immune function.
- An external natural approach is a nasal saline lavage, such as a netipot. It has minor decongestant benefits and improves mucociliary function in both allergic and non-allergic rhinitis. To avoid contamination from faucets, use distilled water and follow instructions that the product provides.
*Note: mold spores are found indoors too.
In Oriental Medicine (OM) winter is the time to turn inward with meditative thoughts and conserve one’s energy. The winter’s energetic system is found in the Kidneys and manifests physically in the ears, lumbar spine and knees. Positive energy in this season reflects in a calm ability to handle stress with consistent focus and moderate energy throughout the day. Hearing can be more acute in the winter months, but the lower back and knees may experience more discomfort than in other times of the year. Some aspects of the Chinese medicine Kidney energetic can be seen in the biomedical kidney’s water metabolism, adrenal, reproductive and excretory functions . Through self-neglect or from prolonged stressors, people may find themselves anxious, irritable, fatigued and in some ways fearful or insecure. Since the cold slows the flow of blood and warmth to our extremities, activity should maintain continued circulation of the body’s fluids and proper joint relationships, as well as build our resources rather than deplete them.
Beneficial activities include Qi Gong, Tai Chi, low intensity movement or corrective exercises. Pre-workout exercises designed to warm the body up should be done for longer duration than in the hotter times of the year. Outdoor activities should be during the warmer, sunnier parts of the day and kept at a shorter length of time.
The weather can creep into the body and aggravate old injuries, arthritis and other aches and pains. This is especially true for outdoor athletes such as runners, bikers and hikers who spend a lot of time exposed to the elements as well as our aging populations and younger children. Pain patterns manifest in different ways.
- Wind: marked by a decrease in range of motion and pain that changes location.
- Cold: fixed stabbing pain with spasms that does not usually have inflammation, is aggravated by cold and relieved by warmth.
- Damp: fixed and intense pain with a feeling of heaviness, numb skin and muscles that wet conditions may aggravate.
- Heat: not so common in the winter; characterized by local inflammation and/or redness in the joints or extremities, and may be aggravated by heat.
The wind is a carrier of other pathogens such as cold and dampness. Adequate clothing or protection is imperative. The yang parts of the body where most external pathogens enter and cause problems, such as the back and nape, should be covered. Normally our immune system (wei qi) is ample protection but chronic exposure, poor food choices and weaker or overworked constitutions create susceptibility. Enjoy foods that nourish the Kidneys and warm the interior of the body. Choices should include nourishing soups, broths and stocks, moderate spices and congees or porridge.
- Foods that nourish the Kidneys: black beans, grapes, bone broth, eel, quail, walnuts (hu tao ren), black sesame (hei zhi ma), Chinese yam (shan yao), goji berries (gou qi zi), seaweeds: sargassum (hai zao), kelp (kun bu) or other varieties
- Warm foods: lamb, deer, beef, chicken
- Warm spices and herbs: mild peppers, cinnamon, cardamom, nutmeg, ginger (sheng jiang)
- Although salt guides to and nourishes the Kidneys, it is unnecessary to add copious amounts to our modern diets. Instead utilize seaweed, which is rich in iodine, and sea salts for cooking.
- Raw and cold foods make the body weaker by disrupting digestive processes. They include: iced drinks, ice cream, and excessive raw vegetables and fruits.
Overtraining or overworking in the winter will greatly affect your performance in the following season. Be aware of early signs and adjust your activities accordingly. Signs include – but are not limited to – a higher resting heart rate, decreased focus, mental fatigue, insomnia, mood swings, chronic muscle soreness, frequent injuries, delayed recovery, sensitive digestion, and/or unwanted weight loss or gain. Athletes and exercise enthusiasts who continue through the colder months of the year should follow these guidelines.
- Regular acupuncture and tui na treatments restore balance to the body and speed recovery.
- Warm up sufficiently. Include the use of a foam roller and dynamic stretching.
- Avoid prolonged static or deep stretching at the beginning of workouts as this will cool the body down further, increasing the chance of injury.
- Stay hydrated and maintain adequate nutrition. The body sweats less in the cold and relies more on exhalation and urination to expel water and waste, which creates the illusion of hydration.
- Rest and be aware of signs of over-training.
By conserving energy, exercising moderately and eating well you can enjoy the season and ready yourself for a smooth transition and expansion into Spring.
For other articles on winter, see Oriental Medicine Winter.