The menstrual cycle: a window into the female body

A rite of passage can ease a girl into womanhood

In traditional cultures, the women elders prepare younger ones for menstruation and the natural processes to which their bodies are going to be subjected. When the time of the first period comes, girls get introduced into womanhood with an important rite of passage which involves neither shame nor disgust, and that enables them to fully embrace their feminine bodies and quite possibly to never experience PMS, infertility, or menopausal syndrome. Some ancient peoples, such as the Celts,  held the belief that women had heightened psychic and healing abilities during menstruation.
In the West, there is instead little preparation for the events marking puberty and the coming of the first menstrual period, and there is little appreciation or respect for the real significance of these events in a woman’s life. As a result, Western women tend to lack a basic understanding of how female hormones work and how our life-style, our emotions, and the way we treat our bodies can affect our hormonal balance.

The ABC:

 Everything in the body works through a complex balancing mechanism. This mechanism depends on feedback sent by every tissue of the body via the blood and neuro-endocrine pathways to the brain and endocrine glands. Hormones are chemical messengers that trigger functions all over the body and that need to be at optimum levels in order for the whole system to function properly. When the maximum level of a hormone is reached, the feedback mechanism causes the producing gland to stop its release. When taking artificial hormones such as the contraceptive pill, the same feedback mechanism causes a reduction in the production of natural hormones, resulting in inadequate levels of the hormones once the pill is discontinued or, in the worst cases, in an inability of the body to produce its own.

The menstrual cycle can be divided into two major chunks: the follicular phase and the luteal phase.

Each phase has its own characteristics in terms of hormonal activity:

Menstrual phase	Hormonal levels	Characteristics
Follicular phase Day 1-when period comes- to 14- or to when ovulation occurs	Low levels of oestrogen and progesterone at beginning of cycle Pituitary hormones rise to stimulate  growth of a new eggs (follicles) Levels of oestrogen rise steadily to a peak before ovulation	Low hormones cause the period to start One egg ripens and produces oestrogen High oestrogen thickens uterine lining and produces “fertile  mucus” The egg is released- ovulation
Luteal phase Day 15 –or day following ovulation- to day 28 – or last day of cycle	Oestrogen levels fall Pituitary hormones fall Progesterone levels rise to a peak Oestrogen and Progesterone fall if pregnancy did not occur to begin new cycle	Progesterone stimulates the womb to produce nutrients in case of pregnancy Progesterone stops the production of pituitary hormones Low levels of hormones start cycle again

The TCM version:

The menstrual cycle reflects the balance of Yin and Yang

In TCM, what occurs during the first half of the menstrual cycle is regarded as a result of the growth of Yin which reaches its peak during ovulation to give rise to the growth of Yang during the second half of the cycle. This is a reflection of the Yin quality of oestrogen and the Yang quality of progesterone and is a good example of how our body reflects the constant dance of co-creation and equilibrium between Yin and Yang which is represented by the Yin-Yang symbol.

The organs mostly involved in this process are the Kidneys - which govern reproduction, and are the root of Yin and Yang- , the Liver - which make everything (hormones, blood, etc.) flow smoothly, and the Heart – which has a direct link with the Uterus to allow its opening and closing during menstruation and ovulation. The Spleen is also indirectly involved through its role in processing food and drink to produce sufficient Qi and Blood.

The balance of Yin and Yang and the health of four of the main organs of the body are thus reflected in the menstrual cycle. Any symptoms related to the hormonal changes are a reflection of lack of balance in our general health. Symptoms such as weakness and dull aches during the period or an absence of periods (amenorrhoea) may indicate a deficiency in the Kidney energy due to poor constitution, over-exercise or over-work; premenstrual symptoms may be caused by the blockage of the Liver or the Heart Qi from emotional stress or unexpressed emotions; very light periods or bleeding at other times during the cycle may indicate a deficiency in the Spleen Qi from poor diet; lack of ovulation may be due to emotional stress affecting the Heart, and so on.

This is not only relevant for fertility but for our general health. In an interesting analogy by the late Dr John Shen who was renowned as a master at diagnosing disease, he compares the way we treat our bodies to the way we treat our cars. He used to say that not only our cars are regularly checked, but they come with instructions and little lights that lit up every time we need more petrol or to top up the oil and water. Conversely our human bodies, which come with no such instructions or fault-finding devices, are not considered deserving of regular check-ups or even of much concern as to putting the right “fuel”, or correct amount of fluid into them.

I would say that I agree with everything Dr Shen said apart from the fact that women do have the little lights that lit up when something needs attention. This little light is our menstrual cycle.   We have the unique opportunity to check the state of the whole of our health every single month and address any issues there and then. Rather than regarding female hormones to be the producers of symptoms that need to be medicated, we need to regard any disruption of the menstrual cycle as a sign that something is wrong.

Suppressing our natural hormones or the symptoms surrounding the different stages of the menstrual cycle on a regular basis may mask deep issues that are actually affecting our health, and which can result in further imbalances and more severe symptoms.

Looking after your menstrual health:

Apart from following general guidelines for the maintenance of our health such as having a balanced diet and life-style that include enough rest and regular moderate exercise; it may be helpful to read some of my previous posts to understand how to look after the Kidneys, Liver, Heart and Spleen. 

Here are some general tips to maintain a healthy cycle:

• Unless absolutely necessary, avoid the use of artificial hormones such as the contraceptive pill. There are many other forms of contraception available that will not interfere with your cycle at such deep level. If it is not possible to do this, try to have regular “pill holidays” to allow your body to attempt to produce its own hormones.

• Avoid the use of tampons which block the menstrual flow and are often associated with symptoms such as pain and clotting of menstrual blood.

• PMS is mostly a consequence of emotional or physical stress. Acupuncture and Chinese herbs are very effective for severe PMS. There are specific points to soothe pain and to calm the emotions, and excellent herbal formulae that can energetically “decompress” the system so that tension is released. TCM treatment can also help the mind and body to relax and enable us to tackle the actual causes of stress. Other forms of healing and regular meditation can also be of great help especially one week before the period is due.

• Avoid stimulants such as alcohol, drugs and coffee. This is particularly important in the last week of the cycle as the Qi is gathering momentum to enable menstruation to happen. Stimulants at this time will block the Qi which can result in menstrual cramps and emotional instability. Coffee can also cause severe cramping in those who already experience pain so it is best avoided during the period.

• Many authors see menstruation as a cleansing event where women can discard both physical and mental toxicity. Make sure you have enough rest during your period and make time for relaxation and quiet contemplation to make the most of the opportunity to cleanse your body and mind.

• Nourish your Blood after every period. According to TCM, women lose both Blood and Qi during the period. In order to balance this loss we need to put a special emphasis on nourishing the Blood. This can be done by consuming mainly good quality protein and iron-rich foods from day 4 to 8 of the period. Women who are vegan or who experience heavy periods may benefit from using specific Chinese herbal remedies to support the Blood or other natural Iron supplements after every period.

In addition to this, specific symptoms such as those of severe/recurrent PMS, dysmenorrhoea (painful periods), amenorrhoea (absence of periods), menorrhagia (excessive bleeding), endometriosis, infertility, anaemia, etc., can be treated by Acupuncture and Chinese herbal medicine both of which can be used to regulate the menstrual cycle by harmonising the Qi, Blood and the organs involved in it.

The divine feminine

The menstrual cycle is part of our being women, the more we attune ourselves to its natural rhythm, the more we will be in touch with our whole bodies and with our real selves. This may help us access our real feminine powers, and our ability to create beauty, to create and preserve life, to heal and to bring love into the world.

The "holistic" or CAM approach

CAM stands for "complementary and alternative medicine". This probably brings to mind myriads of therapies, conflicting information, theories that sound frankly absurd to anybody sensible, not enough evidence.  So what is it that makes us even consider to go “alternative”? and why are there millions of people* in the UK choosing to pay for all sorts of CAM treatments even when they have access to free health care?

There are many reasons why people end up visiting a CAM clinic.  Some people just believe that addressing health problems without drugs or chemicals is more effective. But it is not just a question of belief, many of the people I have treated with Acupuncture and Chinese herbs did not actually “believe” that they would feel better as a result of these interventions. They either came out of curiosity because they had heard from someone else that it could help, or out of desperation after exhausting the options that conventional medicine could offer them. This is not to say that any form of complementary medicine is better than conventional medicine. The disciplines are just different and have strengths and weaknesses that often “complement” each other: Conventional medicine is at its best saving lives from extreme life-threatening conditions and injuries, but it is not so effective at understanding or treating chronic conditions such as M.E or chronic pain. Some CAM disciplines with well-established clinical knowledge such as Chinese Medicine can improve the quality of life of those suffering from chronic illness, while they may not be the wisest choice in life-threatening situations.  A more enlightened society could easily put this to good use to everyone’s advantage. Unfortunately, although things have moved on a lot in the last 10 years and we can now find therapies such as Acupuncture and Massage in a limited number of NHS clinics, we are still entangled in a pointless “either-or” situation. 

The best of two worlds would benefit everybody

In an ideal world, we would be working together for the benefit of all those suffering from any type of illness and for the prevention of disease through the CAM holistic approach that sees every aspect of each person as an important part of the whole. The body-mind-spirit terminology still sounds like a hippy concept to many, but is in fact more relevant now than it has ever been. Working at physical (symptomatic), ecological, psychological and emotional levels, is fast becoming the best way to treat illness as we slowly come to realise that there are no “wonder” drugs that can take away all our symptoms, and that our life-style and environment affect our health in ways that cannot be resolved without us making deep changes. 

The holistic philosophy behind CAM therapies not only presents a different way of looking at health and illness, but allows us to take an active role in the management of our symptoms and the maintenance of our health. Many people find this empowering as they move from feeling totally dependent on health providers to having more control over their own health.

So what does a holistic health approach have to offer?  

1. You are not regarded as a symptom or a collection of symptoms: Traditional Chinese Medicine for example, has a solid theoretical framework that helps a practitioner make associations between seemingly unlinked symptoms in order to understand the origin of the problem. Thus, a headache is not just something that is happening in your head but could be caused -amongst other things- by a deficiency of your Blood due to heavy periods, a weakness in the Kidney from over-work, an imbalance in your Liver coming from stress or unexpressed emotions, blockage in the channels that run through the back or neck from heavy physical work, or the beginning of a common cold. This “mapping” of how a symptom develops looks at how your constitution, life-style, environment and relationships are affecting you to cause headaches, and is actually more important than the symptom itself.  As a result, you are not expected to have treatment every time you experience a headache for the rest of your life. On the contrary, correct treatment should not only relieve the symptom but it should ultimately aim to resolve whatever is causing it. Some of this may be down to you making suitable changes to your life-style.

This is very much in contrast with the conventional medicine approach, where treatment is purely symptomatic. Although this is highly effective in the short-term, it generally does not work for chronic conditions. When you just address the symptom without looking at causes or contributing factors, even the most powerful medication will eventually be rendered useless as the body creates tolerance to it. Most people taking medication long-term end up on the highest possible dosage which inevitably puts the body under toxic strain (the inactive parts of drugs are nasty chemicals after all) and can result in the development of side-effects that usually means taking new drugs to relieve them. 

A truly holistic approach would use conventional drugs only when appropriate, and use alternatives in the form of diet, body work, acupuncture or herbal remedies when the side-effects of the drugs are worse than the symptom they are trying to help.

2.  A symptom is more than a symptom: Rather than some annoying occurrence that does not let you get on with your day, in holistic health a symptom is regarded as a “messenger” that gives access to what is happening much deeper in the body.  In fact, the real role of a holistic health practitioner is not just to relief symptoms but to show you the complex interconnectivity between your body, your environment, your mind, relationships, and emotions. This is where the root of all chronic illnesses lies. 

Acknowledging that what we do, and how we do it, has an effect on our health is perhaps the single most important thing that we can learn in order to manage and prevent illness.

Taking control for your health is not easy but it sets you free!

3.The power is yours: Going “alternative” or “holistic” does not in itself rule out using conventional medicine. What it does do, is take the responsibility for your health away from doctors, therapists, and practitioners, and put it back in your hands, where it should have always been. You can have your power back but, as always, power entails responsibility. It may be that you are not ready for that, you may want to stick to the old way and expect your symptoms to be taken away, and even be prepared to put up with them as long as you don’t have to change anything. This is a perfectly valid position, as long as you are taking a conscious stand.

Those who want to go the whole way are not necessarily in for an easy ride either. Going “holistic” is definitely not for the faint-hearted. You will be required to acknowledge that what you daily put into your mouth, how you treat yourself and others, your views on the world, and your relationships can all affect you and those around you. Not only that, but you will also have to DO something about it! Once you know these things there is no escaping them.  

There is no need for all of us to go to dark places

It is indeed hard work, but I can say from experience that it is worth-while. If I look back 17 years or so, I see myself as a terrified and broken young woman banking on the doctor to take away severe symptoms that simply would not go away, even with the strongest medication. It was a painful process to realise that it was down to me, not to the doctor or anybody else, to become healthy again. Those difficult years were the price I paid for getting to be in control of my health and of my life. I can honestly say that I feel enormously grateful for everything, even for the pain, but I do not think it has to be that way for everyone. There is no need for all of us to go to dark places, or suffer from terrible illnesses and fear, knowing that there is a choice. We can benefit from other people's experience and knowledge to become more conscious and responsible for ourselves before we lose our health or touch bottom in other ways.

This is of course not the answer to everything. We can never control every aspect of our lives, and pain, ill-health, and confusion will always be part of our human experience. The difference is that taking responsibility for our actions and thoughts, and acknowledging that everything we do and think has consequences for ourselves and others, can give us strength to accept whatever life brings us with an openness to experience it fully, no matter how unpleasant it may be. In my opinion, this is a risk worth taking!

Reference:  

*Website:http://business.wales.gov.uk/FS4BWales_files/syn0441__Complmentary_Therepies.pdf in 2008 this market study found that 6 million people a year were accessing complementary therapies in the UK.

The organs in Chinese Medicine: The Heart and Pericardium

This is the fifth and final post on the series of the main TCM organs: the Liver, Kidneys, Spleen, and Lungs have been covered in previous posts. The Heart (Xin) and Pericardium or Heart protector (Xin-Bao) are the organs of the Fire element and are clinically treated as a unit although in theory they are two separate organs. I will be sharing some ideas about the two Fire organs, symptoms of imbalance and how to maintain their health. I have already discussed the Heart to some extent in a previous post on the meaning of the Heart in TCM.

According to TCM, the Heart is the Emperor amongst the organs and, as such, it needs to be protected from being directly attacked by pathogenic factors. The Pericardium or Heart protector is in charge of performing this task, and is regarded as an organ in itself which possesses its own energy channel. However, in clinical practice there are no functional distinctions between the Pericardium and the Heart and because of that they will be discussed as one in this article.

Just as its Western counterpart, the TCM Heart is in charge of pumping Blood through the Blood vessels and maintaining a steady pulse, as well as flexible, free-flowing Blood vessels. 

Through the Heart we see beauty and connect with the world

Perhaps more important for clinical practice is the fact that the Heart is considered to be the seat of our consciousness, which influences our mental acuity, short-term memory, and our sleep. The Heart can be regarded as the centre of our human experience representing the fusion of the mind, body and spirit which makes us regard it as our true self, prompting us to "follow our Heart". All this happens through the Mind-Spirit (Shen) - the spirit of the Heart - which is responsible for the harmony and integration of all the other spirits that correspond to each of the main organs: the Corporeal and Ethereal souls, the Will, and the Intellect. Through the Shen, the Heart is also in charge of our ability to feel and to appropriately communicate and connect with the world outside, including our experiences and relationships.

The paired organ of the Heart is the Small Intestine which is in charge of filtering out impurities from our food, thoughts, and emotions, and to retain the purest nourishment to be used by the Heart and other organs.

The TCM functions of the Heart are:

• Governs Blood and controls the Blood vessels 
• Opens into the tongue 
• Manifests in the complexion 
• Houses the Mind and Spirit

Apart from being in charge of circulating the Blood through the Blood vessels, the Heart plays a role in the actual making of the Blood. An adequate supply of “Heart Blood” is necessary to nourish and soothe the mind and emotions so that we are sharp in our thinking, emotionally balanced, and able to relax and attain restorative sleep at night.

The health of the Heart is reflected in a healthy complexion and in the integrity of the tongue muscle. This includes not only the general appearance of the tongue, but also its responsiveness and ability to form the words properly.

Possible symptoms of Heart imbalance:

Heart Function	Possible symptoms of imbalance
Governs Blood and controls the Blood vessels	Weak, irregular, intermittent pulse Chest pain/tightness Broken blood vessels Palpitations, or irregular heart beat Cold hands Depression, anxiety, insomnia
Opens into the tongue	Tongue ulcers Inflammation/pain in tongue muscle Speech impediments Inability to articulate thoughts into words
Manifests in the complexion	Pale/red/purple complexion Lack of lustre on the complexion Blushing
Houses the Mind and Spirit	Memory loss (particularly short-term memory) Lack of mental acuity Personality disturbances Insomnia/Dream-disturbed sleep/Nightmares Inappropriate or tactless behaviour/speech (e.g. Laughing or crying for no reason) Awkwardness or anxiety around people Inability to look others in the eye Inability to feel/appreciate experiences- feeling “numb”

Treating the Heart with Acupuncture and Chinese herbal medicine:

In clinical practice, Acupuncture points on the Heart and the Pericardium channels are often used to treat physical symptoms located in the chest and diaphragm and for disturbances in sleep, as well as lack of emotional and mental stability.  Acupuncture also combines well with conventional medicine for the treatment of heart disease as it can improve circulation and relieve pain. 

When symptoms are due to insufficient Heart Blood, a combination of diet and Chinese herbal remedies are more likely to provide the deep changes necessary to relief symptoms completely. Chinese herbal formulae that combine ingredients that nourish the Blood and calm the Heart such as Tian Wang Bu Xin Wan (Emperor of Heaven’s pills to tonify the Heart), are often used to treat Heart imbalances resulting in insomnia, anxiety, forgetfulness, and palpitations. It needs to be noted that these symptoms may be caused by imbalances in other organs so correct diagnosis and accessing prescribed remedies from an approved supplier through a qualified TCM herbalist are essential.

How to look after your Heart energy:

- Nourish your Blood: Maintaining a healthy Blood will in turn nourish the Heart, as they have a reciprocal relationship. In TCM this means a steady supply of protein and of naturally dark and rich foods. The adequate supply of protein is determined by your metabolism and by the amount of activity that you perform. The more energy you burn (particularly in the form of sweat), the more Blood you are using and the more protein you will need. Extra-nourishment is needed if you are a breast-feeding mother, experience any kind of bleeding including heavy periods, have a chronic illness, or are recovering from an acute disease.

Conversely, too much cardio exercise and exposing yourself to excessive heat will have a detrimental effect both on the quality of the Blood and the health of your Heart. If you have ever spent a summer holiday somewhere really hot, you may have noticed feeling “wobbly” or irrationally short-fused after lying in the sun for too long. This is the direct effect of over-heating your Fire organ. Excessively spicy and pungent foods also heat up the Heart and make the Blood “evaporate”, so avoiding an excess of spices is also important here. For general views on a healthy TCM diet click here.

Foods that particularly benefit the Heart and the Blood include:

• Protein: Small amounts of good-quality chicken, beef or lamb can supply enough nutrition to the Heart Blood. Eggs are also good sources of nourishment. If you are a vegetarian or vegan you need to consume some form of protein with every meal. Nuts, seeds, beans and pulses and natural soya products (not processed ones such as soya mince) can all provide good nourishment for the Blood. 
• Naturally dark foods: Dark green leafy vegetables such as curly kale, spinach, dark cabbages, black soya beans, kidney beans, aduki beans, watercress and nettles are all considered in TCM to be specially nourishing to the Blood, and are "coincidentally" rich in iron. 
  
• Naturally sweet and dark foods Beetroot, grapes, molasses, dates, figs, and unsulfured apricots are also iron rich and excellent Blood nourishers. Note that consuming excessive amounts of sweet foods can have a detrimental effect on the digestive energy of the Spleen!

Laughing with your whole being opens the Heart

- Enjoy yourself: Joy is the emotion that is closest to the Heart. Lack of joy –or an excess of it like the one experienced through euphoria-inducing drugs – can have a detrimental effect on the Heart. As the Heart is the centre of our emotions, nourishing ourselves emotionally is just as important as nutrition to maintain a healthy Heart. The Heart needs to be joyful and vibrant without excess. Regularly laughing, singing and/or dancing in such a way that you feel care-free and light, is likely to open your Heart and allow you to experience the joy of life.

Healthy relationships, not just romantic ones but with family and friends, also nourish the Heart. Spending time with friends and family, feeling close to them and sharing unique moments over food or activities, are all necessary to maintain our mental and emotional balance. In the UK, many of us spend too much of our lives fretting about often un-important things and sacrificing the quality of our relationships to our work. We may even end up resenting those people who place demands on our time outside work and, in the case of our family, dutifully agree to spend time in their presence – but not WITH them -once or twice per year. This lack of connection and joy in relationships is becoming endemic in the West and has a definite impact on the rates of Heart disease in societies where people have become more isolated. For more on this click here.

- Find love in unexpected places: More than just the romantic love we tend to associate with the Heart, this is the emotion that makes us feel elated and part of something beautiful and wholesome. Seeing the beauty of the world, either through those we hold dear, or through the beauty found in nature, art, or the perfection of a baby not only opens our Heart but nourishes us at many levels making us feel joy and gratitude. Find out what triggers this feeling in you, visit it often and allow your inner light to shine and lit up every aspect of your life.

Kindness benefits both the giver and the receiver

Compassion is an extension of the love we feel for others, which enables us to share the pain experienced by other living beings, and makes us want to take it away. Becoming aware of the needs of others and performing any acts of kindness that are within our power- whether a smile, a kind word, or more practical help- , will not only nurture our Heart energy but that of the recipients of our compassionate love.

- Re-connect and realise that you are never alone: In order to connect with others we first need to deepen the relationship with ourselves. This can only be done by spending time alone in meditation or reflection, learning to be in the moment and experiencing life through our Hearts. 

Once we learn to open our Hearts we will be able to feel continuously connected with everything in the world, and we will never feel alone again.

At a deeper level, our Heart is nourished by our connection to the divine –whatever you may call it- through prayer, rituals, communal meditation, and healing.

On ME: some definitions, TCM views, and self-help ideas

It is M.E awareness week. M.E is a condition that causes a lot of suffering to many people and that is greatly misunderstood. Here is some of what I have learnt from the wonderful people I have met who have been diagnosed with this condition, and my attempt to make sense of it using TCM ideas.

 Myalgic encephalomyelitis (M.E.), also known as Chronic Fatigue Syndrome (CFS), is generally defined as a condition of unknown cause characterised by fatigue made worse by exercise, which can be accompanied by any of a myriad of symptoms which may be severe and disabling. In the UK, the prevalent school of thought regarding M.E is psychiatric, so the focus of research has long been the belief systems and fears that perpetuate the condition rather than the mechanisms by which the symptoms occur. This is partly because what actually causes M.E has not yet been understood. 

There are many different working definitions of M.E, all of which consist of a list of possible symptoms that serve as a guide to diagnosis. Studies (1) have found that definitions that regard prolonged fatigue as the most important symptom for diagnosis, such as the Oxford criteria used in the UK, can create confusion between M.E. and other conditions that can also cause fatigue such as cancer, depression, Parkinson’s disease, burn out, infections, etc. It is thus down to physicians to explore all possible causes of the fatigue before issuing an M.E diagnosis, but unfortunately this is not always done thoroughly enough. As a result, it is possible that in the UK many people may be diagnosed with M.E when they actually have something else; including some treatable conditions (there are documented cases of this including Lyme disease, post-traumatic stress disorder, depression, etc.).

Researchers throughout the world have attempted, and so far failed, to find a single neurological, immunological, endocrinological, and genetic cause of this condition (2). Nevertheless, up to 60% of cases are triggered by identified infections, and viral infections have been suspected for many years while more recently gut infections, including candidiasis have been regarded as possible triggers (3). There are comparatively many more people who get no identifiable infection but perhaps only a sudden fatigue with some fluey symptoms or just a mild cold/flu from which they never recover. Because immune tests are limited in their power (they can only find what they're looking for!), it is always possible that there has been an actual infection but one that wasn’t suspected, or from a bug that is not well-known. The important thing here is that in most cases the immune system seems to be struggling with something, whether a known organism or not. So it is the immune system, not the actual bug that needs to be the focus of the treatment. Many things could weaken the immune system to the point of it being unable to fight off an infection. It could be a question of weak constitution or a malnourished body from poor diet and poor life-style choices, a polluted environment, vaccinations, over-use of antibiotics, or severe and prolonged stress. 

Pollution, amongst other things, can weaken our immunity

M.E symptoms are not limited to the immune system but can manifest at a neurological and endocrine levels. This is due to the close relationship between these three systems which are sometimes regarded as one single entity called the neuroendocrine-immune axis (6).

TCM views of M.E

The TCM diagnosis of M.E may involve patterns such as Residual pathogenic factor, Latent heat, Lesser yang pattern, and Yin fire (4). Damp pathogens are also regarded as a significant primary cause of the disease (5), while it is thought that all CFS sufferers have underlying deficiency.

References to “Chronic fatigue syndromes” found in classical TCM texts do not reflect the current condition that presents neurological, immunological and endocrinological dysfunction; and which is most probably influenced by pollution, vaccinations, and other modern-day practices. This is where a combination of theoretical knowledge, clinical experience, and flexibility are needed for a TCM practitioner to be able to provide a suitable treatment for M.E. Because M.E. is a condition that is extremely complex and varies from one individual to the next, there cannot be a set treatment protocol. Instead, the condition needs to be understood in terms of the clinical history, constitutional traits, and presenting symptoms of each individual. Even after treating several people with M.E it may still be difficult to know how an individual will react to treatment until you get to know them well.

In my experience treating M.E. with Acupuncture and Chinese herbs, treatment needs to involve a combination of clearing pathogenic factors (you may call it a virus or a bug, nerve damage, etc. while in TCM it would be Heat, Damp, Qi/Blood stagnation and so on); and strengthening the vital energy and the immune system. This has to be done very carefully because if you clear too harshly the patient will become even more exhausted, while too much strengthening may result in the reinforcement of the pathogen and worsening of flu-like symptoms, night sweats, inability to relax etc. 

Acupuncture is most useful for pain, digestive problems, low energy, insomnia and dream-disturbed sleep, and emotional imbalances related to M.E. Chinese herbal medicine can work at at deeper level addressing the actual pathogen directly and can be more effective for stronger or long-term symptoms. As important as the treatment approach though, is to compassionately listen to -and work with- each individual, rather than follow any prejudices or pre-conceived ideas regarding M.E. Each M.E. sufferer is an expert in his/her own condition, and they hold the key to their own recovery. A trusting relationship with the practitioner and a commitment to work as a team are key to the healing process.

What you can do for yourself if you have M.E:

This is by no means a comprehensive list, just an attempt to summarise what I believe are the most important aspects to be addressed when you have not just M.E but any chronic condition:

Diet:  Diet is always a complex issue and there is no one diet that will fit everyone. This is especially relevant for those with M.E as food intolerances can be quite extreme in some cases. Generally speaking, I would recommend following the Chinese Medicine principles of diet by supporting digestive fire and consuming warming foods that have been thoroughly cooked. You can find some tips for healthy eating following these principles here, and an explanation of the TCM view of the digestive process here.

In addition you really should try to:

- Avoid all refined and processed foods especially inverted sugars, hydrogenated fats, and chemical additives such as preservatives and natural or artificial flavourings/colourings. As in M.E there is a constant battle going on at deep levels of the immune system, further exposing the body to the toxicity caused by substances the body cannot recognise can only make the situation worse.

- Stay clear of damp-forming foods. According to TCM, most cases of M.E have an element of Damp and Phlegm which are the pathogens that can be behind symptoms such as muzzy head, inability to think clearly, heaviness and aching in the body especially the limbs, and digestive sluggishness and food intolerances. If you suffer from these symptoms you may benefit from having a de-humidifier in the room you sleep in at all times (this is particularly relevant to our damp Bristol climate!) and from avoiding damp-forming foods such as: 

• All dairy products, especially the full fat versions. Goat and sheep milk products are not as bad but I would recommend non-GM soya products unless you are allergic to soya   
• Pork and rich meats 
• Peanuts, especially when roasted   
• Concentrated juices, especially orange and tomato: try home-made freshly squeezed ones instead, or just stick to water and herbal teas 
• Wheat and preferably all types of bread 
• Yeast   
• Beer   
• Bananas   
• Sugar and sweeteners. Good quality honey and molasses are good alternatives   
• Saturated fats   
• Too much raw, cold, sweet or rich food

Rest: Many people with M.E feel exhausted but cannot rest because they feel wired inside. This is a difficult symptom to deal with, but there are some things that can help:

• Avoid stimulants such as coffee, tea, alcohol, sugary drinks, coke, chocolate, and drugs. Stimulants do not give you energy, they draw from your deepest energy to give you a false and short-lasting boost only to leave you feeling more tired than before. 
• What you really need is to be able to access a truly relaxed state where your parasympathetic system can kick in so that true rest and energy recovery can occur. For this you need to make a habit of consuming calming herb teas such as camomile, passiflora, lime flowers, hops and lettuce leaves. I would not recommend valerian here as it is an energetically warming herb that in some cases can stimulate rather than calm. 
• Gentle massage, Reiki and Acupuncture can also induce this relaxed state so if you are unable to “switch off” by yourself it is worth trying one of these therapies so that your body and mind can learn how to do it.

Relaxation-inducing treatments can teach us how to "switch off"

Meditation: Any type of daily meditation for any length of time (a few minutes per day are definitely better than nothing!) will help you work on the all too familiar over-thinking that does not allow for proper rest or healing. In addition, meditation will help you be in the present, and even if you don’t like your present very much it can take you away from guilt, fear, and anger that will naturally spring up especially when you are going through a bad patch. These emotions are natural but not useful for the healing process so it is of paramount importance to find ways of feeling them without holding on to them. This is no easy task and may take a long time, but should be one of your goals for improving your health.

Avoid over-doing it: It is only natural that on "good days", when you suddenly seem to have a bit more energy you will want to do all those things that you have been unable to do for ages. This can however be counter-productive as it is common to be unaware of when to stop so you may easily go too far. Exhaustion and stress lower immune response and, as your immune system is already engaged dealing with something (known or not), this can either exacerbate your symptoms or leave you exposed to further infections. This will further stretch your immune system and can set you back days if not weeks. This is why it is so important to keep calm and rested!

Although positive thinking and affirmations can be of great benefit, it needs to be said that pushing yourself too hard will not help you feel any better. There is a fine line between overcoming your fears regarding activity and being unaware of the consequences of too much activity. Only trial and error will tell you what is right for you, and you may have to go through periods in which you went too far before you find out what works for you. It is all part of the process.

Love yourself in sickness and in health: Accepting that our mental and physical abilities are diminished indefinitely and that we are unable to perform jobs or tasks that we see as closely linked to our identity is a tough call, but it needs to be done. This, however, does not mean that you have to resign yourself to your situation: Acceptance is not the same as giving up. While being in denial and going against the tide are both exhausting and not conducive to healing, admitting that you are unwell, scared, and at a loss can instead be the first step towards making positive changes to improve your health.

 

Accepting ourselves as we are in the midst of illness can release some of the anger, frustration, and guilt that lock our energy in an emotional vicious circle. We can then use this energy for our recovery. Ask yourself this: can I really expect others to understand my suffering and accept me in my illness, when I am unable to do this for myself? Never forget that we are much more than our physical bodies and our creative power and loving energy can still represent a unique contribution to the world even if we cannot physically make or do things. 

Last but not least..

Any organ can be involved in TCM M.E pathology. I recommend you read my posts on the Liver, Kidneys, Spleen , and Heart to find out how it’s all linked together and how you can nourish and strengthen your whole body. 

Like all chronic conditions, M.E is multi-dimensional. Not only it affects the various systems of the body but it also has an impact at mental, emotional, and spiritual levels. In my view, working at these levels is necessary for true healing, although this is not necessarily done all at once but following each individual process. 

A person with M.E is confronted with a lot of fear especially about the future, and this is often fuelled by lack of understanding from everyone around. Loving care and compassion from friends and family is possibly more important than anything else for those who are experiencing M.E. They need to feel allowed to experience their symptoms without feeling judged and without guilt. This type of condition is becoming more prevalent in the developed world, so we all need to remember that we are not invincible and that one day it may be us on the receiving end.

References

1. Carruthers et al., 2003 “Myalgic encephalomyelitis/chronic fatigue syndrome: Clinical working case definition, diagnostic and treatment protocols”, Journal of Chronic Fatigue Syndrome, 11 (1), pp. 7- 115. 
2. Baker&Shaw, 2007 ‘Diagnosis and management of chronic fatigue syndrome or myalgic encephalomyelitis (or encephalopathy): summary of NICE guidance’, British Medical Journal, 335(446) 
3. Lakhan & Kirchegessner, 2010 ‘Gut inflammation in chronic fatigue syndrome’, Nutrition and Metabolism, 7(79) 
4. Maciocia, 2008 The practice of Chinese medicine: The treatment of diseases with acupuncture and Chinese herbs.  
5. Jiang & Franks, 1994 ‘Analysis of 50 cases of M.E. treated with Chinese herbs and acupuncture’, Journal of Chinese Medicine, 44, pp.13-20.
6. Petrovsy, 2001, "Towards a unified model of neuroendocrine-immune interaction", Immunology and Cell Biology, 79, pp. 350-35. Can be accessed online here

 

The organs in Chinese Medicine: The Lungs

This is the fourth post on the series on the main TCM organs. I have covered the Liver – which is in charge of circulating Qi throughout the body, the Kidneys – the root of life and source of our deepest energy, and the Spleen – the maker of Qi and Blood needed for day to day functioning of all the organ systems in the body. This week I will be sharing ideas about the Lungs, their functions, symptoms of imbalance, and ways to look after them.

The Lungs (Fei) in TCM

The TCM Lungs comprise not only the anatomical lungs but also the whole of the respiratory system, including the nasal passages and the vocal chords. The Lungs are considered the uppermost and most superficial organs of the body, and constitute both a connection and a barrier between the external environment and deeper aspects of the body. Because of this, they play a key role in the immune response to outside influences. 

The Lungs are the organs of the Metal element and are closely related to the skin and the Large Intestine, their paired organ. Their role is thus not limited to respiration but also to providing immunity and aiding the elimination of waste products and toxins through the respiratory system, the skin, and the bowels.   

According to TCM, the Lungs:

The Lungs keep us alive with oxygen

1. Govern Qi and respiration: Through both nasal and skin respiration, the Lungs are in charge of obtaining oxygen, or air Qi, which constitutes a basic catalyst for the making of Qi for the whole body. That the Lungs- rather than the Spleen- are the rulers of Qi reflects the fact that oxygen is in fact more essential than food or water to the survival of the human body. 

2. Control dispersing and descending: From their position as uppermost organs, the Lungs are in charge of distributing Qi and nourishing fluids throughout the body to provide resistance to invasions from external pathogens.  

The Lungs also regulate the Water passages and contribute to the metabolism of fluids and their subsequent distribution throughout the body. They also provide the descending energy that facilitates the excretion of waste products through the stools, urine, and sweat.

3. Rule the Exterior of the body: The Lungs provide a layer of Defensive Qi and fluids that lies under the skin protecting us from pathogenic factors that may come from the environment. In addition, they are in charge of the opening and closing of the pores allowing nourishment to be absorbed through the skin and waste products to be excreted through the pores in the form of sweat.

4. Open into the nose and manifest in the body hair: The nose is the first point of entry into the Respiratory system and its ability to fully breathe in the air and to identify all smells is considered a manifestation of the Lung energy.

The body hair, as part of the Exterior of the body which includes the skin and the pores, is thought to reflect the health of the Lungs. Healthy Lungs will provide sufficient energy for the regulating action of the body hair which, in conjunction with the pores, stops the body from cooling or heating excessively and helps prevent pathogens from entering through the skin.

  

5. House the Corporeal soul (Po): The Corporeal soul is regarded as the most tangible part of our spiritual aspect. This is the soul that ceases to exist when we die, and the one that connects us directly to the body and our physical experience. Our ability to engage with the world and to experience it through the senses is thus an expression of our Lung energy. The Corporeal soul also enables us to accept that everything in life is ephemeral and to allow renewal and change to take place in every aspect of our life.

Symptoms of Lung imbalance

As the Lungs are the first line of defence in the body, they are regarded as the “tender organs” and can be the first to be affected by strong environmental and emotional influences, particularly when the body is weak. Lack of balance in the Lungs can be reflected in lack of vitality, low immunity, symptoms along the respiratory system, and skin problems.

The protective role of the Lungs is also manifested at a mental and emotional level in our ability to establish boundaries and the sense of self-respect and self-worth that gives us the strength to face the world.

Sadness and grief can easily cause imbalances in the Lung energy and vice-versa. At the most superficial level, our attachment to what we love is dependent on our sensorial experience of it, which is the realm of the Corporeal soul. Loss has therefore a direct impact on this aspect of our beings and, by extension, on the Lungs.

Symptoms that can result from Lung imbalance include:

Lung function	Possible symptoms of imbalance
Govern Qi and respiration	Congestion and pain along the respiratory system Shortness of breath, cough, dyspnoea Lack of vitality, tiredness Weak voice
Control dispersing and descending	Water accumulation (oedema) especially in upper body or under the skin Thickening of fluids and accumulation of phlegm  Dryness in the skin or anywhere in the respiratory system Cough, breathlessness, oppression in the chest Constipation/ Urinary retention
Rule the Exterior of the body	Allergic reactions (particularly respiratory and dermatological) Low immunity, tendency to catch colds Dry, rough skin Sneezing Itching and skin rashes No sweating/spontaneous sweating
Open into the nose and manifest in the body hair	Blocked nasal passages, sinus problems Impaired sense of smell Nose-bleeds Impaired thermo-regulation Loss of body hair
House the Corporeal soul	Chronic sadness, depression Inability to “engage” or feel emotions Low self-esteem/feeling of self-worth Fear of change and extreme attachment to people, things or situations

How to look after your Lung energy

- Breathe in… More than any other organ, the Lungs are concerned with the present, with living in the moment. The act of breathing represents the link between us and the world from the moment we are born, right up to our “last breath”. Ensuring an adequate intake of air and correct breathing will help us maintain this connection with the world alive, and healthy. All that is needed is to practise deep breathing and to access fresh air:

   

• Here is a very simple exercise: Try inhaling really slowly first expanding your abdomen allowing it to fill with air, then expanding your chest to its maximum capacity without straining yourself. Stop for a few seconds and then start exhaling slowly allowing your chest to come back to its normal position and emptying your abdomen by contracting it gently. Stop for a few seconds and repeat for up to 5 minutes. Doing this on a daily basis can improve your Lung energy and your ability to live in the now. Deep breathing not only aids the oxygenation of every cell but returns us to the present moment where all the frustrations and resentments from the past do not exist, and where all the anxiety and fear about the future are irrelevant. Through deep breathing we discover that there is only NOW to be experienced. It is no wonder that deep breathing is used as the gateway into mindfulness and awareness in many meditative practices.

• In our busy lives, we overlook the fact that accessing fresh air is as important as having clean water and food on our plates. Visiting the countryside or a nearby park at least twice per week can go a long way at nourishing our body and soul. Using the breathing technique described above outside in the fresh air will make it even more powerful.  

Discarding what is no longer needed allows for renewal

·     -  Cleanse yourself: The Lungs are the organs of both elimination and protection, and the effectiveness each of these functions is in effect linked with the other. Just as hygiene is directly associated with fewer risks to our immunity, keeping a “clean” environment inside can help the Lung energy produce the protective energy that we need to fight disease. Clearing out physical and energetic waste also makes room for clarity and renewal. These are ways in which we can cleanse ourselves:

• Encourage your bowels to empty on a daily basis: Irregular bowel movements can both be a symptom and a cause of Lung imbalances. Lack of elimination of waste products can produce a toxic build-up in the body which may in turn make the immune system – the protective energy dependent on the Lungs - work harder trying to keep this toxicity from creating illness. Ensuring a balanced diet both in terms of quality and quantity is necessary for proper elimination. An adequate intake of fluids and fibre is also essential as is avoiding excessive amounts of red meat as well as fatty, sugary, and chemically-laden foods. For more on how to balance your diet click here. When constipation is chronic or recurrent, either Acupuncture or Chinese Herbal Medicine can be used to help restore regular bowel movements.

• Stay away from chemical additives and preservatives: Anything that your body does not recognise as usable is regarded as a waste product. This applies not only to the food that we eat but also to the air we breathe and anything that comes in contact with our skin. An excess of waste products in the system may impair efficient elimination through the bowels, urine and skin which can result in a build-up of toxicity and a subsequent burden on the immune system. Our ability to fight disease may then become compromised and we can end up perennially ill, or our immune system may become overly sensitive resulting in allergies to food and air-born particles.

•  Let go of pre-conceived ideas and prejudices that serve no purpose in your life: Just as we need to de-clutter our environment and our inner space, clearing out mental waste such as culturally acquired ideas that hold no truth but which stop us from engaging with people and situations is important for good health and the renewal of our energy. 

·        - Seize the moment: The Lung energy fuels our ability to be in the moment and is nourished by our enjoyment of the present. As children, we tended to inhabit our bodies powerfully and to experience each moment fully. As we grow up, many of us lose this ability so as adults staying in the moment needs to be achieved through deep breathing and accessing a grounding calm that allows us to engage with what is happening now. Activities that help us “be in the body” as opposed to trapped inside the mind such as Tai Chi, Qi Gong or Yoga can also provide us with tools that help us achieve this.

   

     - Detach yourself: The Lungs have the ability to constantly renew our energy through a combination of elimination of what is no longer needed and a continuous intake of potentially new energy. This implies an ability to recognise what needs to be discarded and a willingness to allow it to go. Understanding that everything in life – things, ideas, situations, people - is transient enables us to go smoothly from one stage of life to the next. When we are reluctant to accept this reality, we may remain in grief and pain until we make room for new things to come.

Chinese Medicine treatment for Lung imbalances

Because the Lungs are superficial and particularly susceptible to change, Lung imbalances can quickly respond to Acupuncture treatment. Acupuncture points to strengthen the energy of the Lung and Spleen are often combined for lack of vitality and respiratory problems rooted in weakness of the Lung energy. Points on the Large intestine and Lung channels can also be used to bring relief from the symptoms of common cold, flu, and allergies. Ear acupuncture can be particularly helpful for allergies as there are points that have antihistamine, and anti-allergic effects. 

Many classical Chinese herbal formulae are designed to deal with respiratory symptoms resulting from chronic Lung imbalances. Some of these formulae can provide enough support to the body so that the immune system can be boosted and symptoms such as recurrent infections or allergies can improve.Other formulae can encourage the body to provide moisture to the Lungs or to break down and expel phlegm that may be blocking the air passages.

When Lung imbalances are treated, a diet that helps balance the distribution of fluids throughout the body is necessary. In cases where too much phlegm has accumulated, dairy and wheat products should be avoided. Where there is dryness in the Lungs, skin or air passages, a diet that provides enough moisture needs to be put in place. Appropriate dietary and life-style advice should be offered to you along Chinese Medicine treatment in order to support the effectiveness of treatment and prevent future recurrence of symptoms.