Herbal Medicine
Caffeine: How, When, and What to Drink
If I had to choose my two personal, favorite vices they would easily be caffeine and alcohol, the latter of which I take mostly in great moderation of course, out of respect for how poisonous it can be to the body. My teacher, Suzanne, often stresses to us that it is important to give the body some time to recover after drinking, inadvertently refuting the notion that 1-2 glasses every day is unacceptable.
As for caffeine, I used to be a “one a day” guy, that is until my baby was born, having since graduated to two a day. I drink an organic half-caf from Purity Coffee shortly after waking, followed by some kind of tea shortly after breakfast.
Functional neurology recommends waiting at least 60 minutes after waking to have your first cup of caffeine, as up until that time the cortisol hormone is still rising and should not be over-stimulated, lest we are more likely to “crash” later on. Chinese Medicine goes a step further (doesn’t it always?) and recommends waiting at least until 7am, as the hours between 5-7am correspond to the “qi” of the large intestine, which is obviously vulnerable to coffee. I say take this information and do your best as it relates to your present lifestyle and struggles.
On days where I have red meat, pork, and/or alcohol the night before I drink green tea, as the green tea leaf has a more cooling effect on the microbiome, regardless of whether taken cold or hot (in fact cold green tea, from a Chinese Medical perspective is highly inadvisable, as few stomachs would benefit from pouring “cold cold” all over it). Other days, which make up the majority, I have black tea, preferably Pu-Erh for its naturally fermented pro-biotics and subsequent healthy warming effect on the gut. Other black teas are fine too, but as with anything consumable in America, it is highly recommended to find a good quality product.
Supermarket tea brands are comprised mostly of dust swept from tea manufacturing plant floors—not real tea leaves—thus will not yield much health benefits at all. It makes me sad and frustrated when I see so many people trying to do the right thing, buying green or black teas or vegetables at the supermarket, knowing they are not being rewarded for their efforts, frankly as a result of capitalism.
If you insist on consuming cold foods for breakfast, such as fruit and or yogurt, it is especially important to have it with black tea and minimize green tea and coffee, the latter of which also ultimately has a “cooling effect” on the stomach, evidenced in how it purges and softens stool.
As sleep is a huge priority for me, I stop drinking all caffeine by 11am. I know conventional medicine recommends 12pm, though I’ve never understood the science behind this beyond its relatively arbitrary marking as the start of “afternoon.” 11am, on the other hand, corresponds with the heart channel in Chinese Medicine’s circadian rhythm, which corresponds with our psycho-emotional health and central nervous system. This makes 11am-1pm an ideal time to reduce hyperactivity in the upper portion of our bodies through things like exercise, as opposed to pouring more stimulation into it with caffeine. Stopping caffeine by 11am also allots us the recommended 12 hours to flush it out of our systems by 11pm, which is the latest advisable bedtime, as per the same circadian rhythm and the body’s natural melatonin secretion.
If you are overly sensitive to caffeine, we generally see it as symptomatic of fluid deficiency in the upper portion of the body, namely the central nervous system, that generally requires herbal medicine and red meat to replenish. If you are overly insensitive to caffeine—people who can drink it right before bed and still get a good night’s sleep—we see it as an excess of pathogenic fluids in the upper portion of the body. This generally requires herbal medicine and avoidance of “damp-causing foods,” such as sugars, gluten, and dairy.
Can It Be All Stress?
“It’s just stress,” is a diagnostic platitude commonly heard by patients when relaying either to friends or their doctor about some odd or non-immediately fatal symptom that lacks any conventional, empirical treatment.
It would be an over-simplification to label this stock response as wholly or always dismissive—in my opinion it is more often a result of the listeners’ lack of knowledge of physiological nuances, disease spectrums, and of course the entire internal paradigm of Chinese Medicine.
The mind is en vogue in the past generation, so much so that people jump at the opportunity to sound mentally acute even while being mentally lazy in its default citation as a scapegoat for everything, the way fat was in the 20th century or sugar is now. It makes them feel aware of the more mysterious, all while maintaining an orthodox adherence to conventional medicine’s present understanding of things. I picture people picturing themselves as if sipping a small cup of whiskey wearing Coke bottle glasses and a bowtie in their reply: “It’s (probably just stress),” then putting their cup back down and nodding their head as if they’d just cured HIV.
While no one could dispute that stress is an important variable in the etiology of most illnesses, it is also just that: One important variable. So why when we have curious symptoms that conventional medicine has no explanation or treatment for do they never say: “It’s just diet?” “It’s just your sleep hygiene?” Or: “It’s just your exercise routine that needs refinement or reduction, or simply needs to exist?”
Why when one person experiences incredible stress does it show up as digestive issues, while for another it does as insomnia, and another as hives all over their skin? “People are different,” idiots might shrug and say, which isn’t untrue, but is an egregious oversimplification. People are different, which means if we each consumed diets and partook in exercises suitable to our own individual constitutions, we’d likely be able to ward off the ill effects of short or even medium-term life stressors.
If stress causes you low back or neck pain we know there is “dampness trapped on the exterior layer of the body.” If stress causes stomach issues we know there are already stomach issues, since most or many people can endure stress without such symptoms. If stress causes headaches or migraines then there was likely already some dysregulation of cerebrovascular flow in particular neurological pathways
In this way stress can be invaluably informative, by tipping our internal scale and showing us where we are weak, where in our bodies we are retaining pathogenic fluids, so we can properly treat, instead of dismissing it. Because odd, inexplicable symptoms are never nothing. They are not “all in our minds” or insignificant. Instead, from a Chinese Medical perspective, sadly they are potential coming attractions—foreshadows of diagnoses to come.
I apologize if this sounds dark or ominous. My intention is the opposite, to offer optimism and agency to those of us who have been repeatedly implied to that we must resolve all of our internal turmoil in order to be free of a particular problem. While I am all for a daily practice of meditation, prayer, community, and anything else that reduces stress, we should be able to also rely on medical providers to step in with something more to offer during periods where our practice of psycho-emotional work and discipline just is not enough.
How to Design Meals like Medicinal Formulas
If food is medicine then creating each meal should be a bit like writing your own herbal formula. Whenever possible, it should be as agreeable as possible with our unique physiology, though this is admittedly challenging when cooking for a family where everyone has different body types. Nevertheless, one part of each meal should complement the other parts, either through synergistic benefit or offsetting its potentially detrimental qualities.
As a longstanding, traditional example, any time we get Thai or Mexican food, it is served with cucumber or radishes, respectively, which are there to mitigate the side effects of the spice.
Most foods are good, but almost all of them have “side effects.” Red meat nourishes the body’s blood, yin, and qi, but if it were an herb it would be a bit warm and damp. Too much red meat and/or red meat that is not harmonized by the remainder of the meal can create damp heat, or inflammation in the stomach and intestines. Then again too little red meat can cause a deficiency of blood, yin, and qi. Ideally red meat (and pork) would be consumed alongside steamed vegetables, then followed by hot green tea, either after the meal or the following morning (green tea at other times and/or for vegetarians is thought to have a bit too cooling, or vasoconstrictive effect on the microbiome—for them black teas are preferable).
Carbohydrates are settling for both the stomach and the mind—probably why they give us such immediately pleasure—but they are obviously stickier foods, “damper” foods, which are more difficult to digest. For this reason whenever possible, it is best to eat them warm and cooked, and alongside more acrid spices in the meal, such as basil, rosemary, ginger, garlic, or onion. While I am Jewish and from New York, and love a great tuna on a bagel, there is a remarkable difference in the physiological response to cold tuna on bread versus cooked pasta with garlic and oil, maybe vegetables and cannelini beans. Yum!
Salads. Oh boy, do westerners love salad. Frankly, if you tend to any digestive problems whatsoever, raw foods should be avoided as much as possible, but if you must:
Consume salad more in summer—less in winter—and always alongside some cooked protein and/or ginger tea. The acridity of the ginger should help to warm the stomach to digest the raw foods. The protein should provide warmth, plus some much needed calories, or “qi and yin.”
Cooked vegetables, allergies notwithstanding, are probably the only perfect food that wholly lack side effects, which is probably why they are also the one food that nearly every paradigm of medicine agrees upon. If you don’t consume cooked vegetables daily you are on a dangerous path, in my opinion. They are nearly always harmless and beneficial… yet still ultimately inadequate, as we can only imagine the metabolic fatigue and inevitable illnesses to come were someone to consume exclusively vegetables.
Food is a gentle medicinal. It will neither heal nor destroy us quickly on its own, however it will always do one or the other over time. I’ve seen firsthand, in myself, loved ones, and patients eradicate chronic symptoms by pursuing a more Eastern diet, though it took many months—in my case years! People should not get discouraged by eating well for a particular interim and not feeling dramatically better. Instead, pay attention to whether you feel worse (always a possibility), meanwhile recognizing that without internal medicine, diet alone may take a long time to cure disease. It is up to us to continue to better understand the nature of each food, so that we can wisely design the perfect “herbal formula” three times a day until the end of time.
Pictured above is an imperfect, but still great meal: Breaded chicken cutlet, sauteed spinach, and roasted acorn squash with roasted apples, cinnamon, and maple syrup. What is “imperfect” about it? First, fruit should be consumed at least 15 minutes apart from other foods so as to avoid creating its notoriously mucus-like congestion in the microbiome. Also, “natural” or not, let’s be honest: maple syrup is sugar; and chicken is healthier without breadcrumbs. On the other hand, breadcrumbs make up a very small amount of the meal, the apples are at least cooked, hence easier to digest, and the leafy greens with garlic should help to optimally process the meat and sugars.
Breakfast Idea: Eastern Nutrition
Patients often ask me what they should eat for breakfast. Most Americans are conditioned to either skip breakfast, have something simple and unhealthy like a bagel or toast, or something “healthy” like yogurt or smoothies. While the latter might check off as such within the context of a scientific laboratory, obviously Eastern Medicines hold that uncooked foods are more difficult to digest, thereby ultimately providing us with less nutrients, in spite of having maybe started with more on the grocery shelf.
While going through Chinese Medical school my own microbiome was a minor disaster, and one of my teachers who was treating me at the time requested I eat sweet potatoes (with my eggs) for breakfast.
“You want me to eat Thanksgiving for breakfast?” I asked. He laughed and asked if I’d ever had eggs with hash browns or french fries. Of course I had, countless times.
He rhetorically asked me what the difference was —if I chopped sweet potatoes in the same way as hash browns, even adding onions to my liking. For years to follow sweet potatoes became my daily breakfast. And many of my health issues gradually improved during that time.
I became perpetually more educated in health and self-care, also about food itself. I learned that sweet potatoes are not in season for the majority of the year, which means during those periods they are, a) not as much what my body needs, and b) likely lacking in their maximum nutrients. From yams it was an easy transition to exploring other vegetables as side dishes with breakfast, which I realized was a good way to get in some daily recommended portions of greens from the start.
For many years now my breakfast has been eggs with a cooked, in-season vegetable, and would struggle to imagine starting the day any other way. In the Winter we eat a variety of root vegetables—whether roasted potatoes, carrots, radishes, or turnips—in Summer it’s more leafy greens. As for the ongoing, raging egg debate, now reignited by many functional medicine docs, all I can say is I’ve eaten eggs every single day for decades. I don’t doubt some peoples’ allergies to them, in which case they should surely avoid until that allergy is rectified. For the rest of us eggs provide invaluable nutrients in a very light, easily metabolized way. In Chinese Medicine they are said to nourish the blood, so much so that the yolk is even an ingredient in the herbal formula, “Huang Lian E Jiao Tang,” which is used to clear inflammatory heat that exists as a result of healthy systemic fluid deficiency. This “blood” benefit is probably why eggs are so highly recommended by many holistic fertility doctors.
EGGS AND “ZUCCH” (as my daughter calls it)
- Pre-heat oven to 375
- Slice squash however you like it, leave all of the slices on the cutting board, and lightly sprinkle them with salt. Let them rest for about 10 minutes (or longer) so that their excess water gets sweated out, then pat them dry.
- Add to pan with olive oil, sprinkle with salt, pepper, and whatever seasonings you like.
- Cook for 15-20 minutes, turning them over once in the middle to roast both sides
- Once almost finished cook your eggs to your liking.
- Drizzle a nice olive oil on top of them once plated
Thirst, Sweat, & Urine: What is Normal?
In contrast to the requisite ruling out of red flags by most nurses in conventional medical settings, the reason Chinese Medical practitioners ask about almost every system in your body is because we are diagnosing based on complete patterns—not just symptoms.
For example, if someone comes in for acid reflux, we cannot know their prescriptions until we know how often they urinate or poop, what each one is like, whether they experience headaches or dizziness, which part of the head they get their headaches in, how is their appetite, how thirsty they are during the day versus in the evening, etc. etc. This is because we are one of the only true forms of holistic medicine.
So, what is normal?
A normal amount of urination is approximately 6 times a day (yes, this includes waking at night). Much less than that and you are likely either retaining, or not drinking enough water in the first place. More than 6 indicates either a weakness in the urogenital microbiome, or excessive inflammation in the urogenital microbiome, which over time can lead to local weakness by putting strain on it. The remainder of the intake questions will determine which of the two is the case.
People should sweat, but not excessively so. Chinese Medicine is critical of HIIT or marathon training, hot yoga, and sauna therapy in most cases. While these might all feel great in the short-term and/or be proven to offer certain isolated benefits in the short-term, we believe they ultimately deplete the body’s healthy metabolic fluids. On the other hand, never sweating (exercising) at all is obviously just as harmful.
While some people barely break a sweat even when they exercise, others are drenched by the time they finish their morning commute, especially triggered by certain climates or seasons. The former can either indicate body fluid depletion or a malfunction of the immunological “qi.” The latter can either indicate inflammation, fluid retention, or also a malfunction of the immunological “qi.” This is where diagnoses and prescriptions get tricky.
Many western doctors have now begun to recognize the health benefits of the Chinese herb, astragalus, which on one hand is great. On the other hand, their recognition by way of empirical studies poses the challenge of having no comprehension of Chinese Medicine. If you give astragalus to the former example of a “cold-body person” with a simple immunological malfunction they will feel amazing and sing your praises. If you give it to someone with both immunological malfunction AND fluid deficiency it will do almost nothing. Worse, if you give it to a “hot-body person” with inflammation and fluid retention they will feel much worse.
Finally, it is normal to be thirsty, for 6-9 cups of water per day. A lack of thirst tells us there is fluid retention in the microbiome, signaling to the brain that it’s got plenty of liquid down here—no need to hydrate! This is dangerous, and better to fake it ‘til you make it in acquiring thirst. On the other pole are those who are ravenously or insatiably thirsty, which informs us of inflammatory heat in either their respiratory microbiome, gastrointestinal microbiome, or both, drying out their fluids. As always, the most complicated patterns are those who are generally unthirsty followed by sudden bouts of desperate thirst. This is a combination pattern that requires more thought, trial, and error.
I hope this was interesting and informative. One of western medicine’s shortcomings is its reliance on tests and labs to determine whether we are healthy or normal. While these are undeniably valuable, they tell only part of the story, which is why so many diseases get caught too late. Chinese Medicine is more brilliant in its neurotic recognition of pathologies in any abnormality, any imbalance, as something to rectify before it spirals into disease.
