Weight Loss
Why Would You Have Anxiety & Diarrhea?
The question shouldn’t be why WOULD you have anxiety and diarrhea? The question should be why WOULDN’T you have anxiety and diarrhea?
The cause of loose stools can be over complicated and analyzed, replete with fancy biochemical terminology, citing the benefit or particular bacterial strains, such as Lactobacillus rhamnosus GG, Saccharomyces boulardii, and Bifidobacterium, but from a Chinese medical perspective it comes down to one of two fundamental pathologies, and/or a combination of the two.
Either we have too much unhealthy bacteria in the gut (“dampness”), putting excess strain on our stomach, causing excess poop—or not enough good bacteria (“dryness”), which leads to the production of more inflammation than nutrients and again, excess poop. Over time, one pathology inevitably engenders the other and we’ll almost literally poop our brains out, as the gut produces most of the body’s serotonin, which acts as a signaling molecule to the nervous system.
The modern coined “Gut-Brain Axis,” first outlined by Zhang Zhong Jing as “Tai Yin” system in his masterpiece, Discussions on Cold Damage 2,000 years ago—it stands to reason that we should feel some type of emotional dysregulation as the cause or result of chronic diarrhea.
Two of the best ways to manage this are, you guessed it! Diet and exercise!
Warm, cooked vegetables and moderate protein strengthen the microbiome and exercise unburdens it, specifically and especially strength training, as the muscles classically exist in a mutually interdependent dynamic of engenderment with the pancreas and stomach. Strong muscles can equal a strong gut (though there is such a thing as “too strong,” where a person’s weightlifting addiction over-burdens their organs’ fluid and bacterium reserve), or vice versa.
When lifestyle doesn’t seem to do the trick, Chinese medicine has a great deal to offer.
For a gut that is overburdened with damp, harmful bacteria, we offer herbal formulas that revolve around Poria Mushroom if there are accompanying heart palpitations or insomnia, Atractylodes if there are accompanying thirst or joint pain, Magnolia Bark and/or Bitter Tangerine for bloating and/or chest tightness, or Pinellia root if nausea, thirst, or dizziness.
For a gut apparently deprived of healthful bacteria we recommend eating more white rice, especially if the patient is prone to loose stool. Chinese herbs include licorice root if there is acid reflux or low blood pressure, ginseng if there is thirst or fatigue, wheat for anxiety and depression, or Gypsum Stone if the person feels over-heated, manic, and craves cold drinks.
When bodily fluids plummet, as in diarrhea (or excessive urination, excessive menstrual bleeding, excessive any form of loss) it gives rise to the Chinese metaphorical concept of “Wind,” that is too much heat and/or energy (Yang) rising to the head as a result of a lack of fluids (Yin) in the lower portion of the body. This “Wind” can manifest in any way, from unsettling symptoms of the gut, chest, head, or mind. Anxiety is a proclivity near and dear to me, and throughout my thirties (combined with organic maturity) Chinese medicine helped me enormously. Please reach out if you or anyone you know is dealing with this familiar pattern!
What (the HECK) Should We Eat?
It may seem ironic that the most foundational Chinese medical texts harp on diet and nutrition almost as moderate and infrequently as do modern western medical schools. Part of the reason is in ancient times they did not have to navigate the “paradox of choice” of today. They ate what was available and needn’t concern themselves with overindulgences such as refined sugars or heavy seasonings, as neither one yet existed.
How to eat was apparent and matter of fact. Cooked rice and whole grains were encouraged in moderation to support stomach fluids and absorption. Cooked vegetables were mandatory in every meal and animal protein was highly encouraged, however not in nearly the quantity non-vegetarians consume it in today.
How to translate this into modern lifestyles:
For BREAKFAST we recommend any form of porridge and/or eggs with cooked vegetables—preferably the latter. The former can be oatmeal with nuts and fruits or rice, quinoa, or millet congee, either with nuts and fruits or pickled vegetables. The latter can be a baked sweet potato with butter, roasted sweet potatoes with olive oil, roasted zucchini with olive oil, sauteed collard greens, steamed brocooli, roasted carrots with butter… truly anything that one finds delicious and practical for those busy weekday mornings.
For LUNCH we recommend leftovers or a soup or some kind of cooked meal with vegetables. Raw foods, such as salads or smoothies are ok in moderation for some, but raw foods are more difficult to digest. They tend to cause gas and bloating and inflammation in their wake.
For DINNER a homecooked meal of whole foods. Not everyone has time every night to cook, and I am no exception to that, but we encourage everyone do their best to prioritize metabolic health, say over a clean house or even a clean kitchen, google some recipes you like, and just do it! It’s all good: Steak, fish, chicken, pork, tofu, tempeh, beans, pasta once in a while… it’s all good! So long as it’s homemade and warm 🙂 Personally speaking, many of my own long-term chronic ailments forever abated in my early thirties after I started finally cooking for myself at home. The rest of them improved when I quit eating refined sugar.
Never in human history have sweets been as sweet as they’ve been in the U.S. in the past 50 years. I encourage all of my patients to find as best alternatives as possible for their cravings (coconut yogurt, any yogurts, almond butters, any nut butters, dark chocolates, some honey or maple syrup if necessary, hummus, anything but American junk!) and recondition their minds to making things like packaged candy that doesn’t expire relatively invisible to their eyes.
Needless to say, it also benefits metabolic health to not eat late at night, by the same token to not skip breakfast, not consume alcohol on most nights, and DO consume hot tea daily
This is not about shaming anyone. It’s about encouraging, educating, and empowering us to navigate an environment that is obviously not designed for long-term health.
Point Profile for Reflux: Stomach 36
The first acupuncture point whose name I learned and was able to identify while my (first) acupuncturist was needling me was “Stomach 36”—”Zu San Li,” or “Three Leg Mile,” in reference to its alleged ability to help the patient walk three additional miles, as all transportation at the time of its discovery was obviously by foot.
“Li,” in Chinese, may also be used as a homonym for “to rectify,” in reference to the energy the point provides, either to our internal physiologies or our kneecaps it resides just inches below. (Yes, this is the point that should feel like a brief surge of shin splint down your tibia)
In modern times we are not as concerned with the need to walk a few extra miles, but the physiological intent holds relevant. Located along the anterior tibial nerve, Stomach 36 can be used to improve energy by its mechanism of increasing blood flow to the stomach, when indicated. That is, if someone is lethargic because they had five drinks the night before and only slept five hours it’s not because their organs are lacking blood. They probably need a different acu-point combination (and a nap).
Besides GERD or acid reflux, Stomach 36 is useful for treating numerous pathologies, including but not limited to diarrhea, bloating, pain of the abdomen, vomiting, belching, also conditions of the throat, chest, and lungs because of the gastrointestinal microbiome’s connection to the respiratory microbiome; finally anxiety, depression, and dizziness, because of the gut brain connection. This 2023 NCBI study concluded its ability to increase the length and mean basal pressure of the lower esophageal sphincter, of which both mechanisms reduce reflux.
According to Peter Deadman’s Manual of Acupuncture, “the great Han dynasty physician (and weren’t all great physicians from the Han??), Hua Tou, is said to have valued the use of ‘ST-36’ to treat the ‘five taxations’ and the ‘seven injuries.’”
The 5 Taxations:
- Excessive use of the eyes injures the blood (even before cell phones—imagine now!)
- Excessive lying down injures the qi (i.e. hypersomnia begets more hypersomnia)
- Excessive sitting injures the flesh (i.e. lack of exercise saps our energy)
- Excessive standing injures the bones (poor security guards)
- Excessive walking injures the sinews (any other New Yorkers remarkably inflexible?!)
Because everything starts and circulates out from the gut, if I had to choose one point to needle on every patient for the rest of my career it would be Zu San Li, Stomach 36. With appropriate metabolic fluids, we can optimize our production of nutrients, which in turn reaches all other systems of the body. Basic science.
Acid Reflux
There is a concept in Chinese medicine called “Counterflow qi,” which is in reference to when bodily gases or fluids move in the opposite direction from how they are intended. In the digestive process everything is supposed to move down. Don’t get me wrong—not too quickly—but down nonetheless. Any symptom of movement to the contrary is evidence of metabolic dysfunction.
Belching and burping are generally not perturbing to most of their sufferers, possibly apart from the occasional social embarrassment for loved ones. Nevertheless, they are indicative of some degree of weakness and/or inadequacy of vital substances failing to fully process something in the gut.
Vomiting is the extreme version of this, but the principle is the same. Somewhere in between is acid reflux, or “GERD” (gastro-espophageal reflux disease), which usually manifests as symptoms ranging from a burning sensation in the gut, chest, or throat, to a trapped feeling “below the heart,” as Classical Chinese texts would say. Patients experience this anywhere from once or a few times a week if they “eat something wrong,” to incessantly in every waking moment, understandably prompting them to somehow medicate, one way or another.
What causes this? Frankly, metabolic weakness and/or a lack of functional organ fluids, both of which can be caused by all the usual suspects: poor diet, stress, genetic predispositions, and long-term use of pharmaceutical medications.
Ironically, the drugs most commonly prescribed by conventional medicine for GERD, proton pump inhibitors, work by blocking stomach acid, thereby causing more physiological dryness, aggravating the root cause of the condition while muting its branch. This might be okay for a little while for those suffering from “excess patterns,” where the GERD truly is caused by excessive acid—but for those whose symptoms are due more to weakness, such medications will most likely yield a short leash.
Chinese medicine first attempts to distinguish the pattern—which kind of reflux are you? Then we treat accordingly, using acupuncture points and herbal formulas to calm the metabolic organs by imbuing them with more strength, mucosal fluids, and blood, and over time proper directionality of gases and fluids should follow suit.
In the meantime, it is advisable to eat foods that are easy to digest, such as sweet potatoes, steamed vegetables, eggs, fish, tofu, white rice, and/or pasta. Obviously, avoid as much as possible spicy foods and alcohol, refined sugar, dairy, and raw, uncooked foods. (Deep) breathing can be helpful for its inherent function to descend, as can massaging the stomach with both palms of your hands in 36 clockwise circles around the belly button. Empirical symptom management en route to unearthing the root cause of your unique pattern include DGL licorice pills if your pattern is one of weakness, or mint tea if you produce too much acid.
Mitigating the Side Effects Of Holiday Indulging
As all of our stomachs, intestines, livers, and pancreases quiver in fear, anticipating the overindulgences to come in the next six weeks, there are steps we can take to mitigate their onslaught of abuse, first and foremost of which is to potentially be mindful to not over-abuse—an unrealistic request for enough of us! So, what OTHER MEASURES can we take?
- Strength training: By making good use of the excess proteins and calories we can getbigger and badder musculature, and since the muscles draw upon the pancreas and stomach for tonification, strength-training provides the additional benefit of putting less burden on these organs, enabling them to better deal with the burden of parties.
- Hot tea: Booze if you must leading up to, during, and even after the meal, but bookmark your gluttony with hot tea—either Pu-Erh, which contains naturally occurring pro-biotics, or whichever flavor floats the boat. Hot tea will dilate and relax the blood vessels of your enteric nervous system (belly) which aids in digestion by breaking down the inevitable accumulations of gravy, yams, and butter.
- Breakfast! Some people make the mistake of skipping breakfast (or even lunch) the morning of Thanksgiving to “make room” for the feast to come. This is an error, as skipping breakfast actually sacrifices some of the gut’s enzymes and beneficial acids, which can make digesting the feast more difficult. Fine if you want to go small, but have something, preferably, oatmeal, millet congee, or eggs and vegetables.
- Stress management: The holidays bring at least one challenging individual into our homes, so in the words of my daughter’s favorite song: “Let it go.” Ignore if possible, just for the day, and re-address if you must the next time you speak to them.
- CHINESE HERBS! Last but not least, YOU GUESSED IT! Commonly used ingredients include hawthorn berry, which can lower cholestrol, magnolia bark if you’re the type who feels gassy and stuffiness in the chest, tangerine peel if you feel too low on appetite to get properly gluttonous, obviously ginger and licorice, the latter if you tend to GERD, also barley sprouts or medicated leaven, which are great for food stagnation.
If you’d like a brief consultation to determine what is the best gluttony-support formulation for your body type and indulgence to come, please don’t hesitate. If not for my own gout disease and general health awareness, I myself would have the inclination to over-indulge frequently, regardless of holiday season.
A brief expression of gratitude. I realize that Chinese medicine is inconvenient. It’s expensive, it tastes bad or it hurts for a moment, it takes time out of the day, etc. etc. I am grateful to all of my patients for trusting me, relying upon me, and staying the course, often through the trial-and-error process that in my opinion real medicine should look like. Happy Thanksgiving!
