You are What You Eat Part II: Integrative Protocols
In the previous installment of this article I discussed important ideas concerning gastrointestinal health and foundational ideas from TCM, which can provide key insights into creating effective protocols for healing the gut. In this second part I will discuss ways to integrate Western herbs and supplements into TCM protocols to support the healing process. I will also cover some basic ideas which are crucial for setting the stage for healing an irritated gastrointestinal tract.
One of the most important ideas I mentioned in the last article was the identification and avoidance of food sensitivities / allergies. This issue cannot be overemphasized when addressing chronic gastrointestinal issues. Clinicians must have patients critically examine food diaries and must explain to the patient how these sensitivities/allergies contribute many symptoms not typically identified with gastrointestinal in nature.
Symptoms such as chronic fatigue, headaches, joint pain, chronic UTI's, rashes, and depression can all be traced to gastrointestinal irritation. Therefore it is incumbent upon the clinician to assist in the education of patients as to the importance of evaluating and eliminating food sensitivities/allergies. The withdrawal from the identified irritants must be complete and often permanent. This is a complex subject that is beyond the scope of this short article but must be mentioned in any discussion addressing gastrointestinal health.
The supplement vitamin D3 is a crucial factor, it has a small intestine brush border barrier function and therefore the clinician should always have the patient obtain a blood test to evaluate the status of blood levels of vitamin D3. Vitamin D3 deficiency weakens the barrier of the small intestine and weakens innate immunity. Therefore any level of D3 deficiency will contribute to gut irritation and exaggerates the systemic effects of food sensitivities/allergies. As this is a basic blood test and supplementation is economical, clinicians should always make this a standard evaluation when dealing with gastrointestinal complaints.
Other basic nutrients which contribute to the healing and nutrition of the gut lining from the lumen of the small intestine are Zinc, Vitamin C and Vitamin A (retinol). These along with D3 are very cost effective and while simple provide crucial substrates for healing the lumen of the small intestine and can prevent systemic complications of food sensitivities / allergies and speed healing while the patient is undergoing other healing modalities. The amino acid Glutamine is also an important nutrient for healing the small intestine and can easily be used in a tasteless powder form. Higher doses of Glutamine are needed to effective stimulate healing and are most often dosed at 10 grams TID between meals. If a patient if following a high protein diet, buffalo and venison provide extremely high levels of glutamine and can be substituted for beef, poultry etc.
The most important herbal categories to focus upon when using Western herbs in healing the gut are: demulcents, carminatives and bitters depending upon the pattern differentiation of the patient. Herbs which have direct wound healing properties are also important and three of the most important in this respect are aloe vera ( juice or gel), calendula and plantain. Calendula and plantain can easily be delivered in a powder form orally and mixed with aloe vera juice or applesauce. Other effective herbs for healing an irritated inflamed gut are chamomile, yarrow, slippery elm, and marshmallow.
These medicinals can easily be combined in a tea form for administration and dosed liberally. If patient compliance is low due to taste of herbs capsule forms can be used as well. Another herb which can be used in high does is the TCM medicinal Huang Qi or astragalus. This herb can easily be added to soups or taken in a tea form and is particularly warranted when patients are suffering from chronic fatigue and or loose stools. If a patient is presenting with a pattern of Damp Heat, the use of small amounts of herbal bitters can be highly effective. Once the Damp Heat signs are reduced and the tongue reflects significant change from Damp Heat signs, the clinician should remove the bitters formula. It is crucial that the patient taste the bitters so the clinician must explain this to the patient to improve efficacy and compliance. It is also important for the clinician to choose a bitters formula which does NOT use stimulant laxatives as this can irritate the gut and contribute to Spleen Qi vacuity as well.
These basic foundational ideas for using supplements and western medicinals along with TCM protocols can be a highly effective way of quickening the healing process of chronic gastrointestinal challenges.
It is important for the TCM clinician to understand that Western herbs and nutritional supplements should be used to compliment a professionally administered TCM diagnostic protocol and not replace poor clinical judgment. The clinician should have a clear reason for choosing each and every herb administered to the patient and should be able to explain how the respective herb is working via the diagnostic rubric of TCM pattern differentiation.