Wednesday, September 25, 2013

Traditional Chinese medicine and lipedema – Part 1


By Tatjana van der Krabben
Every year, as it gets cooler, my circulation stagnates. My extremities get extremely cold and the skin on my feet becomes parched. Leaving the house and facing the elements becomes torture and by Christmas I’m dreaming of a…white sandy beach. To boost my circulation I see an acupuncturist. I’m aware of the controversy. It is NOT recommended in lymphedema and this advice has been extrapolated to lipedema. This is by no means a hint to have acupuncture. I can only speak for myself and I personally don't experience adverse effects. However, traditional Chinese medicine is more than acupuncture. I wanted to dig a little deeper to see what their take on things is.

Three separate therapists specialized in traditional Chinese medicine have listened to my lipedema symptoms and all independently blamed a ‘Yin’ constitution, spoke of ‘cold’ and ‘dampness’ and pointed at the spleen. So, first things first: what does that all mean?

Yin and Yang are sometimes described as opposites. That would be an incomplete perspective. They are seemingly contrary forces, interconnected and interdependent in the natural world. Just think opposites that belong together like dark and light. The symbol for Yin and Yang depicts a rather fluid concept where they both touch and complete each other. Yin stands for femininity and is associated with the passive side, negative principle in nature, the north or shady side of the hill. Yang is masculine and associated with the positive, active principle in nature and south or sunny side of the hill. This goes a wee bit against my feminist nature, but that’s how it goes.
My present condition has been described as ‘Yin’, the cold slope of the hill. The part where the sun doesn’t shine and it rains a lot. A cold, damp environment. Edema is being associated with this ‘dampness’. In traditional Chinese medicine the source of the edema is often the spleen.

In Healing with Whole Foods – Asian Traditions and Modern Nutrition by Paul Pitchford (2002) the symptoms of this dampness are described, as well as suggestions for counteracting the dampness.
Dampness creates signs of stagnation and sluggishness – the person is easily tired and feels heaviness in the body. If there is pain, it is fixed in one location. Condition of dampness include edema or watery accumulations in all or parts of the body; excess mucus, tumors, cysts, parasites, yeasts such as candida, fungi, excess body weight, and a thick and/or greasy tongue coating. Affects the functioning of the spleen-pancreas, and therefore weakens digestion.”

Different angle, namely traditional Chinese medicine, but it presents a familiar image. On the website of Ageless Herbs (http://agelessherbs.com/tcm/spleen-qi-deficiency/) the weight issue related to spleen deficiency is more spelled out and linked to insulin resistance:

“Insulin resistance is when glucose is rejected by cells as use as fuel, and then re-circulated to the liver to be stored as fat. The Spleen is pivotal in the ability of the body to utilize glucose for energy and building muscle and tissue on a cellular level. One can easily see how, in the face of insulin resistance, the body begins to store fat, regardless of diet; thus the cry of so many that they cannot lose weight regardless of how restrictive their diet is.”

Looking at this I can imagine why those following this orientation quickly pointed at the spleen en dampness to explain my current symptoms.

How to deal with this dampness and cold?
Below you find a list of things that doesn’t agree with dampness issues. From the traditional Chinese medicine perspective that is.

·         Dairy

·         Meat

·         Eggs

·         Tofu and other soy products

·         Pineapple

·         Salt

·         Concentrated sweeteners
Note: the lists vary! Several lists also comprised (refined) grains and sugar. This list was derived from the book by Paul Pitchford as mentioned above. They however all say ‘no’ to dairy and soy. And how about those sweeteners? Interesting theory they should add to the edema. We tend to look at it in terms of inflammation and thus causing the edema, but it’s also a digestion issue: the not lipese don’t necessarily get edema from that (and may be otherwise affected).
Pitchford recommends the following for dampness:

“Foods with dry dampness are often bitter and/or aromatic. Examples: lettuce, celery, turnip, kohlrabi, rye, amaranth, aduki bean, wild blue-green micro-alga, asparagus, white pepper alfalfa, pumpkin, vinegar, papaya, and bitter herbs: chaparral, pau d’arco, valerian, chamomile.”
For counteracting excess cold he recommends:

·         Work on fears and insecurities, become more active, avoid long hot baths, keep kidney area , legs and lower abdomen warm.

·         Use warming foods and methods of preparation. Don’t eat food below room temperature or very hot.

·         Use ginger root (preferably dried). Also use ginger, cinnamon bark or twigs, cloves, basil, rosemary, and/or angelica root.

·         Warming grains and seeds: oats, spelt, quinoa, sunflower seed, sesame seed, walnut, pine nut, chestnut, fennel, dill, anise, caraway, carob pod, cumin, sweet brown rice. Rice, corn, buckwheat and rye are acceptable here, as they have a neutral energy, but the other grains are cooling and should be used sparingly.

·         Warming vegetables and fruit: parsnip, parsley, mustard greens, winter squash, sweet potato, kale, onion, leek, chive, garlic, scallion, cherry, citrus peel and date.

·         Peppers and concentrated sweeteners are warming, but should be used moderately, because otherwise they are weakening with likely cooling results.

·         If the above remedies are not adequate moderate amounts of animal products may help. Butter is the only dairy product that creates warmth. Anchovy, mussel, trout, chicken, beef and lamb are some of the common warming foods.
The logic behind advice against cold foods and drinks is not difficult to understand. If you are already feeling cold and your body is somehow struggling to keep warm, the intake of cold items will demand even more of the heating capacity of your body. So, on board with traditional Chinese medicine or not, take a minute to think about it before you jump on the juicing and the raw food trend. It may not be for you, either because of the chilling factor or because it contains hidden sugar (fructose) with the extra fruit you are likely to throw into the blender as well.

When I first heard this about 10 years ago, I was annoyed and not particularly interested in taking this advice. I came from the food pyramid and 1000 calorie day plans. Salads were the only way I knew how to attempt to control my weight. I don’t argue it anymore. By now I’m miserable when I take cold food and drinks. I had to ditch the much celebrated hip, but unfortunately not so hot, veg smoothies. By day four I was in agony. I felt like I ate junk. You know that sickening, heavy feeling when you know you shouldn’t have taking something? Topped off by cramps an hour or so later to rub it in. I tried it again a few times, but had the same digestions problems all over. Less veg more fruit in the smoothie was my dumbest move in retrospect: the overload of fructose made my head spin on top of everything else.

I’m also feeling more attracted to the anti-cold remedies. Like a moth to a flame, really. In the dampness department the valerian was a fun surprise. To counteract stress I was recommended to take valerian. I noticed in the following weeks I dropped water weight. Four pounds so far. I had no idea it could do that, but found out through experience. Most of the other suggestions in camp dampness I find little appealing. Kohlrabi? Not since my mother stopped making me eat it! Asparagus? Well, only the green ones then. Lettuce and alfalfa? I can’t tolerate it until the temperatures are going up again.

Among the ‘body warmers’ you can spot a couple of familiar anti-inflammatories. Warming or anti-inflammatory or both: they all worked well for me. In fact, edema is decreasing still and despite the first few mornings with cold fog my feet are still toasty. I decided to be good and cut back on my intake of cayenne pepper capsules. Let’s see if less is truly more with that one.  

Conclusion: I did the acupuncture, but the progress is always temporary. The following session I’m always back to square one. I drag myself through winter. I experience less edema for sure, but I can’t seem to climb back on the ledge. I keep dangling. I’m not strained, more like running empty. Lately there’s finger pointing at adrenal fatigue. I pitched this with my acupuncturist and she took the bait. We are venturing beyond the spleen over the next few months. To be continued.