We all learned some basic nutrition when we were in OM school; we learned which foods caused dampness, and how to treat heat and cold with foods. All of this fit perfectly into our studies and made sense at the time.Then we graduated. We began to see that OM nutrition didn't mesh so well with our patients. It wasn't that it was inaccurate, but the nutrition studies for OM were developed during a time when people ate completely differently. For instance, they ate more vegetables and less carbohydrates, and they exercised much more. They also didn't have access to the same foods all year long, and therefore rotated their diets according to the seasons. Their food was also grown in rich soil without pesticides and preservatives.
What we see now in our patients are modern diseases, stemming from modern ways of eating and a lack of nutrition that is impacting your effectiveness as a practitioner. You can treat these modern diseases - hypoglycemia, insulin-resistance, diabetes, food intolerances, adrenal fatigue, hormonal imbalances - but when the patient is malnourished (which is much more often than you can imagine), the treatment time is much slower.
For example, kidney deficiency is very closely related to adrenal fatigue in Western medicine. We prescribe herbs and acupuncture, and perhaps some lifestyle changes such as meditation. However, did you know that one of the major causes of adrenal fatigue is blood sugar imbalance, which is impacted not just by what the person is eating, but how frequently/infrequently they are eating? When the practitioners in my practice started prescribing specific nutritional supplements and Chinese herbs to support the adrenals, and prescribed a specific style of eating, we saw a dramatic improvement in our patients' kidney deficiency. Furthermore, their improvement continued even when they stopped taking herbs. Why? Because we had given them nutrition that actually restored their kidneys/adrenals, as well as the tools to help manage it at home.
But why should you be talking about nutrition? Because your patients are already talking about nutrition, even if you aren't. They're reading about it, seeing segments on TV, talking to their friends and looking desperately for some magic pill to help them feel better. They're taking some drugstore multi-vitamin, which is not only synthetic, but has approximately the correct amount of bioavailable nutrition for a gerbil. They've probably already been asking you questions about supplements - what to take, is this effective, what will help this condition. You might be having a hard time answering some of these questions because we didn't learn any of this in TCM school. Your information about modern nutrition is often coming from the same sources as theirs, and while you might know whether or not some of the supplements they're taking are helpful, you don't really know how or why.
The ability to build qi and blood is directly related to the nutritional health of a patient. Herbs can improve the body's function with what nutrition it has. While that can be effective, the molecular building blocks for blood and tissue (amino acids, vitamin complexes, essential fats) comes from what we eat. You may have some people who eat their vegetables or know enough to eat organic vegetables. However, did you know that vegetables harvested these days are as much as 40 percent less nutritious than they were 50 years ago, even organic ones? Did you know that omega-3s used to be widely found in meats, but because most animals are no longer grass-fed, they are sadly deficient, and then so are we? Or that besides vegetables, the most nutrient-dense food that exists is organ meats?
Even if patients ate perfectly, they would oftentimes still be deficient, and that's where having some understanding of nutrition and supplementation will help. Patients love nutrition; they know they're deficient and don't eat well, and they are already interested in taking supplements. Having an understanding of nutrition, combined with your background in herbs, will allow you to help correct them if they are self-prescribing. Since you may be the only doctor they're seeing, you will be able to see interactions between drugs, herbs and supplements. If you start prescribing nutritional supplements that make a difference the patient can clearly see, you will not only have very high patient compliance, but those patients will return again and again for more supplements. They don't do that nearly as often for herbal prescriptions. In our practice, we have a full Chinese herbal pharmacy, yet at least half of what we prescribe is nutritional supplements. Why?
One example is Steve, who gave up a professional football career because he had such bad leg cramps that even the doctors couldn't figure it out. He was still suffering, 20 years later. I prescribed a nutritional supplement that didn't just have the minerals he needed (since he was already taking a mineral supplement) but also had in it the catalyst to transport the minerals into his tissues. He came back a week later, nearly in tears, saying that it had worked immediately and he had already called his doctor to say that it was the first relief he had in two decades.
Another example is Karen, who had terrible PMS and depression. She was so miserable that I chose to prescribe nutrition instead of herbs because our experience has shown that this sometimes works faster. I prescribed a supplement that was a concentration of cruciferous vegetables, which helped to block the excess estrogen in her system causing her symptoms. Within two days, she was profoundly improved. While we are working on getting her system to remove the excess estrogen in the meantime, she still takes the cruciferous concentrate because it makes her feel so much better so quickly.
Western nutrition is the language your patients speak. If you can also speak that language and prescribe supplements that make a difference, your patients will improve much more rapidly and you will be much more effective as an OM practitioner.
Click here for previous articles by Marlene Merritt, DOM, LAc, ACN.