Traditional Chinese medicine and lipedema – Part 2

By Tatjana van der Krabben

A while back I wrote about my new attempts to work on my fatigue and winter circulation issues through Chinese medicine. In my case that includes acupuncture. Note: acupuncture is NOT recommended in lymphedema and this advice has been extrapolated to lipedema. I can only speak for myself and I personally do not experience adverse effects. Other elements of traditional Chinese medicine will also be addressed.

Of course I jumped the gun and tried to figure out my symptoms myself. I already figured out that spleen deficiency wasn’t all there was too it*. I was thinking adrenal fatigue. Or, as put in this context: kidney deficiency. Traditional Chinese medicine doesn’t differentiate between kidneys and adrenal glands as such. I thought I had it pegged: it explained fatigue, comes with symptoms like dizziness, tinnitus and back problems. With the body functions relying on heat from kidney qi, I figured there was my answer.

Although my present therapist being willing to look at other options than the ever blamed spleen, she rightfully did stick to her own path to diagnosis. It was a close call. She was almost inclined to go with kidney deficiency, but the truth is, I have more liver deficiency symptoms as it is. Turns out, even the hours of the day you are struck with fatigue and the exact location of your headaches are indicators of the source of the problem.

With more than 50% of the estrogen metabolism taking place in in the liver and with its other major job of processing toxins in mind, that’s not a crazy place to look for clues. Although…it’s technically not correct to copy and paste our Western idea of the liver onto the traditional Chinese one. When pointing at an organ’s name in this context, one best looks at the description: the whole of the described functions, thus labeled with an organ’s name, is telling you what it’s actually pointing at. I took the Wikipedia definition, because it’s quite readable and helps you see it in terms of functions, more conceptual: http://en.wikipedia.org/wiki/Liver_(Chinese_medicine).

The liver:
• governs 'unclogging and deflation' of qi and emotions. The free flow of qi in turn will ensure the free flow of blood, digestion, and water.
o the free flow of qi and blood is particular significant since traditional Chinese medicine stipulates that stagnation of that flow will cause pain.
o by association via its respective element each zàng organ is embracing a certain emotion. The free flow of these five (and other) emotions is thus linked to the unrestrained circulation of the qi of the zàng organs.
• 'stores' blood
• opens into the eyes
• governs the tendons
• reflects in the nails
• governs anger
• houses the hun (魂, "Ethereal Soul")

What is this ‘storing of blood’? In quite plain English, it’s to be understood as follows:

The liver stores the blood. The liver is considered a storage area for blood when blood is not being used for physical activity. These periods of rest contribute to the body's restorative processes. During exercise, the blood is released to nourish the tendons and muscles.

This function is also intimately associated with the menstrual cycle; the liver maintains an adequate blood supply and regulates the timing and comfort of menstruation. Any dysfunctions in the menstrual cycle are almost always treated through the regulation of liver blood, qi, or yin.

When liver qi is stagnant (a very common condition), a person experiences irritability, tightness in the chest, and, in a woman, symptoms of premenstrual syndrome. When liver blood is deficient, symptoms such as dry eyes and skin, pallor, and lack of menstruation can occur. (Source: http://health.howstuffworks.com/wellness/natural-medicine/chinese/yin-organs4.htm)

So, what rings bells? Circulation, reference to digestion and water circulation, mood swings, dry skin, bad nails and paleness and my dry eyes driving my MAD. I was prescribed artificial teardrops and was about to max out on my daily recommended dose when I turned to my therapist – that dry.

Treatment

Through acupuncture mostly energy enhancing points where selected to help boost my liver and counteract the fatigue. My circulation issues were addressed with a moxa lamp pointed at the abdomen. Nifty thing. Does more than make you feel all warm and toasty. It is said to alleviate pains, reduce inflammation, improve blood circulation and metabolism. Not a needle in sight for that one. The moxa lamp is also referred to as TDP lamp. It’s challenging to find information that is objective; most online information is linked to a site that is also selling them. This one is at least not linked to a web shop: http://www.livingwellpdx.com/TDP_Lamp.html. I still need to self-test a little, but I can say it goes beyond warming yourself in the moment. The effects tend to last. Also, with connective tissue massage (a whole other story) I get from my edema therapist, my abdomen where the lamp is pointed is the softest and suddenly requires the least attention. That’s interesting. So, I’ve ordered my own lamp and will use that for further self-testing. Hopefully it can also alleviate lipedema pain, or at least joint pains, but that’s a question mark at this point!

When my toes get that purplish-grey look, like death not quite warmed over, additional needles are used to make the circulation take that extra jump all the way towards the toes. I also went from 1000mg of cayenne pepper to 500mg, because although cayenne is warming, too much could have the opposite effect according to traditional Chinese medicine. Funny thing is, it’s working.

Last but not least two tiny magnets are taped to the top of the instep of my feet. That’s a type of acupressure – skin is not punctured – to boost circulation all the way down to my feet. They usually last a couple of days. They either fall off or begin to irritate a little. The little magnets prolong the effect of the treatment.

In the past, when focusing on circulation and the spleen, I would experience a brief pick me up after each treatment. Its fleeting effect kept me dangling in the same spot, not bringing me definitive improvement. The shift of focus to the liver has brought progress, possibly supported by a mild fall and winter so far. Although I feel it’s safe to say this is going somewhere. Any and all temperatures below about 15o C (59o F) affect me and not in a good way. We’ve had plenty of that already, including my worst combo: cold dampness. Yikes!

Currently, we’re looking at a way to take things up a notch and aim for further improvement, but also to enable the body into self-support. For that, my therapist again gave me her copy of Healing with Whole Foods – Asian Traditions and Modern Nutrition by Paul Pitchford (2002). I found the following, paraphrased:

To address insufficient yin of the liver, mung beans, mung sprouts, chlorophyll-rich foods, cucumber, tofu and millet are recommended, as well as fresh cold-pressed flax oil and extracted oils of borage, evening primrose and black currant seeds. In this context seaweed, watercress and plum improve water metabolism. Also, taking sufficient liquids in general is helpful. Improving the kidney yin function is always beneficial in cases of liver yin deficiency; aloe vera gel is among the best kidney yin herbal tonics for building liver yin.

When the liver blood is deficient, this is a yin aspect that needs to be addressed separately. It can be built up with blood tonics such as spirulina and other chlorophyll-rich foods, dark grapes, blackberries, huckleberries, raspberries and blackstrap molasses. Helpful herbs include dang gui root (Angelica sinensis), prepared rehmannia root (Rehmannia glutinosa), peony root and yellow dock root (Rumex crispus). The three Chinese herbs dang gui, rehmannia and peony can be used singly, but are more effective when taken together in equal parts.

Frankly, I’ve only started looking into these additional remedies. Berries like raspberries are currently out of season in these parts and I tend to watch my fruit sugar intake these days, although I love them. I want to look into cold-pressed flax oil, since that comes recommended for numerous things. I started out with a chlorophyll-rich supplement: chlorella. Why chlorella? For a very simple reason: when checking out spirulina, I saw chlorella too and it was much cheaper. When going through supplements and herbs like I do, all coming out of pocket, I do watch that aspect, too! The other thing I intend to do is have a seaweed salad more often. I finally found dried seaweed without green dye to make chuka wakame, so I can happily indulge myself. Yum!

At the same time I stopped taking Rhodiola, that was initially recommended to me to help defy the fatigue. After I started taking that, I found it was more so recommended for adrenal fatigue. It did little for me; only more confirmation for me I need to go with the liver issues as pointed out by my therapist**. The chlorella started working within days. All in all I now experience less headaches, slightly less dry eyes, I sleep like a baby and feel slightly less drained. My toe nails are also less brittle, but that already followed from the initial acupuncture treatments. Best part: it’s end of December and my feet DON’T kill me for a change, despite the cold. All baby steps, but greatly welcomed.
It’s a long road. The dry eyes have been bothering me for about 15 years and this bad, where medication is required, for about 2 years now. That should give a clue how long this has been undermining my health and how much we do on will power and not much else. Sounds familiar, ladies?

* http://blog.lipese.com/2013/09/traditional-chinese-medicine-and.html
** This blog describes a part of my personal journey towards improved health. I don’t endorse acupuncture or unsupervised administering of herbs and/or supplements. Liver deficiency was a diagnosis based on my individual symptoms. Deficiency and fatigue are generally linked to lipedema, but causes are individual.

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.