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Balance (Heat)

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CLINICAL APPLICATIONS

 

  • [     Symptoms associated with menopause 
  • [     Hot flashes or night sweats
  • [     Mood swings, emotional instability and irritability
  • [     Related symptoms such as restless sleep, crying spells and disorientation

 

WESTERN THERAPEUTIC ACTIONS

 

  • [     Endocrine effect to balance female hormones and ease common symptoms associated with menopause 1,2,4,5,6
  • [     Antiperspirant function to stop sweating 3,7,8
  • [     Mild sedative action to settle the emotions and stabilize moods 1,2
  • [     Mild sedative action to treat insomnia and restless sleep 1,2,3

 

CHINESE THERAPEUTIC ACTIONS

 

  • [     Nourishes yin
  • [     Clears deficiency heat
  • [     Calms theshen(spirit)
  • [     Stops perspiration

 

DOSAGE

 

Take 3 to 4 capsules three times daily on an empty stomach with warm water. Take the last dose half an hour before bedtime if hot flashes, insomnia, restless sleep or night sweating are especially worse at night. For severe conditions gradually increase the dosage to 8 to 10 capsules three times daily until symptoms are controlled. After relief of symptoms, dosage can then be reduced to 3 to 4 capsules daily.

 

INGREDIENTS

 


Bai Shao(Radix Paeoniae Alba)

Bie Jia(Carapax Trionycis)

Chai Hu(Radix Bupleuri)

Da Zao(Fructus Jujubae)

Di Gu Pi(Cortex Lycii)

Fu Xiao Mai(Semen Tritici Aestivi Levis)

Gan Cao(Radix Glycyrrhizae)

Hu Huang Lian(Rhizoma Picrorhizae)

Mu Dan Pi(Cortex Moutan)

Qing Hao(Herba Artemisiae Annuae)

Sheng Di Huang(Radix Rehmanniae)

Xiao Mai(Fructus Tritici)

Ye Jiao Teng(Caulis Polygoni Multiflori)

Zhi Mu(Radix Anemarrhenae)


 

FORMULA EXPLANATION

 

The chief cause of imbalance in women during menopause is Kidney yin deficiency with deficiency heat. The treatment protocol to address the hot flashes, mood swings and night sweats is to clear the deficiency heat and nourish the yin. The patient may also have irritability and emotional instability because of Liver qi stagnation.

 

Xiao Mai(Fructus Tritici)nourishes the shen(spirit)of the Heart and treats excessive worrying or anxiety. Chai Hu(Radix Bupleuri)works with Xiao Mai(Fructus Tritici)to regulate nervousness, irritability, and mood swings by spreading the stagnant Liver qi. Qing Hao(Herba Artemisiae Annuae), Zhi Mu(Radix Anemarrhenae)and Mu Dan Pi(Cortex Moutan)reduce hot flashes and heat sensations by clearing deficiency heat. Bie Jia(Carapax Trionycis)and Sheng Di Huang(Radix Rehmanniae)nourish the Kidney jing(essence)and replenish vitality that is lost through normal aging. Fu Xiao Mai(Semen Tritici Aestivi Levis)stops abnormal perspiration. Ye Jiao Teng(Caulis Polygoni Multiflori)nourishes the Heart blood, pacifies nerves and treats insomnia and nervousness. Bai Shao(Radix Paeoniae Alba), Gan Cao(Radix Glycyrrhizae)and Da Zao(Fructus Jujubae), the three herbs that make up the formula Gan Mai Da Zao Tang(Licorice, Wheat, and Jujube Decoction), nourish the blood of the Heart and moisten internal organ dryness. Finally, Di Gu Pi(Cortex Lycii)and Hu Huang Lian(Rhizoma Picrorhizae)drain yin-deficient fire to control flare-ups of hot flashes.

 

In summary, Balance (Heat)is an excellent formula to address all imbalance associated with menopause.

 

SUPPLEMENTARY FORMULAS

 

  • [     To address the cause of menopause by tonifying the Kidney yin and reduce deficiency heat, add Nourish.
  • [     To only tonify Kidney yin and jing(essence), add Kidney Tonic (Yin).
  • [     For prevention and treatment of osteoporosis, add Osteo 8.
  • [     For emotional instability, irritability, and mood swings, combine with Calm.
  • [     For severe shen(spirit)disturbance with insomnia, combine with Calm (ES).
  • [     For menopause with stress, insomnia and fatigue, add Calm ZZZ.
  • [     For depression, add Shine.
  • [     For fibrocystic disorders of the female reproductive organs, use Resolve (Lower).
  • [     For benign breast tumors, mastitis and nodules, use Resolve (Upper).
  • [     For hair loss, combine with Polygonum 14.
  • [     For constipation, use Gentle Lax (Deficient).
  • [     For lack of libido, addVitality.
  • [     For poor memory and forgetfulness, use withEnhance Memory.
  • [     For hypertension, addGastrodia Complex.
  • [     For vaginitis, addV-Statin.
  • [     For thirst and dryness, addNourish (Fluids).

 

NUTRITION

 

  • [     Encourage a diet with a high content of raw foods, fruits and vegetables to stabilize blood sugar. Wild yam is very helpful to nourish yin and reduce menopause symptoms.
  • [     Discourage dairy products and red meats, as they promote hot flashes.
  • [     Avoid alcohol, sugar, spicy foods, and caffeine as they trigger hot flashes and aggravate mood swings.
  • [     Increase the intake of soy products such as tofu, soymilk and soy nuts. Soy products regulate the estrogen levels and are beneficial for menopause.
  • [     Take Gou Qi Zi(Fructus Lycii)on a daily basis (mix with cereal or trail mix) to nourish Kidney yin.
  • [     Gan Mai Da Zao Tang(Licorice, Wheat, and Jujube Decoction)can be used as tea on a daily basis.

 

The Tao of Nutrition by Ni and McNease

  • [     Menopause
  • §        Recommendations: black beans, sesame seeds, soybeans, walnuts, lycium berries, mulberries, yams, licorice, lotus seeds, and chrysanthemum flowers.
  • §        Avoid stress, tension, and all stimulants.
  • [     For more information, please refer to The Tao of Nutritionby Dr. Maoshing Ni and Cathy McNease.

 


LIFESTYLE INSTRUCTIONS

 

  • [     Avoid stress, tension and anxiety as much as possible.
  • [     Avoid cigarette smoking or exposure to second-hand smoke, as they may dry yin and body fluids.
  • [     Natural progesterone cream can be applied every 15 minutes to help relieve hot flashes.
  • [     Vaginal dryness can be alleviated with sitz-baths, application of natural progesterone cream, aloe-vera gel or KY jelly.

 

CLINICAL NOTES

 

  • [     Balance (Heat)andNourishare two of the most commonly used formulas for menopause.
  • Balance (Heat)is stronger to clear deficiency heat, and relieve symptoms such as hot flashes and emotional disturbance.
  • Nourishis more effective to tonify the underlying Kidney yin deficiency, and alleviate conditions such as thirst, dryness, and atrophy of genitourinary tissues.
  • [     Balance (Heat)andNourishare both safe formulas that can be used throughout the entire menopause period.

 

ACUPUNCTURE POINTS

 

Traditional Points:

  • [     Taixi(KI 3) and Taichong(LR 3).
  • [     Shenmen(HT 7), Sanyinjiao(SP 6), Xinshu(BL 15),Ganshu(BL 18), Pishu(BL 20), Feishu(BL 13), Shenshu(BL 23), Taixi(KI 3), and Yinlingquan(SP 9).

 

Balance Method by Dr. Richard Tan:

  • [     Left side: Zusanli(ST 36)and Lieque(LU 7).
  • [     Right side: Hegu(LI 4), Yinlingquan(SP 9), Lougu(SP 7)or ah shipoints nearby, and Sanyinjiao(SP 6).
  • [     Left and right side can be alternated from treatment to treatment.
  • [     For additional information on the Balance Method, please refer to Dr. Tan's Strategy of Twelve Magical Pointsby Dr. Richard Tan.

 

Ear Points:

  • [     Uterus, Ovary, Endocrine, Sympathetic, and Subcortex.
  • §        Add Shenmenand Heart for emotional disorders.
  • §        Add Heart and Small Intestine for palpitations and irregular heartbeat.
  • §        Add Sympathetic, Cheeks and Lung for flushed cheeks, excess perspiration.

 

Auricular Acupuncture by Li-Chun Huang:

  • [     Menopause
  • §        Main points: Uterus, Endocrine, Ovary, Gonadotropin, Pituitary, Sympathetic, Anxious
  • §        Supplementary points: Kidney, Liver, Heart
  • [     For additional information on the location and explanation of these points, please refer to Auricular Treatment Formula and Prescriptionsby Dr. Li-Chun Huang.

 

MODERN RESEARCH

 

Balance (Heat)is formulated based on a classical Chinese formula. It is designed specifically for female imbalances and disorders such as menopausal syndrome with hot flashes, irritability, insomnia, and mood swings.[1],[2]

 

Zhi Mu(Radix Anemarrhenae)and Mu Dan Pi(Cortex Moutan)are used to regulate body temperature. Sheng Di Huang(Radix Rehmanniae)and Gan Cao(Radix Glycyrrhizae)regulate endocrine functions. Ye Jiao Teng(Caulis Polygoni Multiflori)treats insomnia. Fu Xiao Mai(Semen Tritici Aestivi Levis)and Xiao Mai(Fructus Tritici)stop perspiration.[3]Furthermore, Gan Cao(Radix Glycyrrhizae)has been used to treat adrenocorticoid insufficiency.[4],[5],[6]

 

It was demonstrated in one study of 21 patients that Qing Hao(Herba Artemisiae Annuae)reduced fever in 100% of the patients after having taken the herbs continuously for 7 days.[7]Another study showed Qing Hao(Herba Artemisiae Annuae)to effectively reduce body temperature in 126 patients with high fever with a success rate of approximately 68%.[8]

 

PHARMACEUTICAL DRUGS & CHINESE MEDICINE: A COMPARATIVE ANALYSIS

 

As life expectancy continues to increase, women are expected to spend more and more of their life in post-menopause years. Therefore, it is becoming increasingly important to ensure a smooth transition during the menopause years.

 

Western Medical Approach: Hormone replacement therapy (HRT) was long considered the standard treatment for menopause and related conditions. However, there is no longer a consensus as to when and how to use these drugs. While these drugs may alleviate hot flashes, they significantly increase the risk of breast cancer, ovarian cancer, uterine cancer, and have a number of significant side effects. For most physicians and patients, the risks are simply far greater than the potential benefits. The bottom line is – synthetic hormones can never replace endogenous hormones. Therefore, no matter how or when they are prescribed, the potential for adverse reactions is always present.

 

Traditional Chinese Medicine Approach: TCM offers a gentle yet effective way to address menopause and related conditions. Chinese herbs have demonstrated via numerous in vivoand in vitrostudy to have marked effect to alleviate hot flashes, vasomotor instability, loss of bone mass, and other conditions associated with menopause. Most importantly, they are much gentler and safer on the body.

 

Summation: Menopause is simply a transition in the journey of life. It is a not a disease, and therefore, should not be treated with synthetic drugs that pose significantly higher risks of cancer and other side effects. Herbs should be considered the primary option, and not the secondary alternative, as they are safe and natural, and more than sufficient to address almost all cases of menopause.

 

CASE STUDIES

 

M.K., a 50-year-old female, presented with a hot and flushed face, and very mild sweat one week before her menstrual cycle. Due to the sweating, she was unable to wear nylon or silk clothes. Blood pressure was 120/80 mmHg and her heart rate was 82 beats per minute. The pulse was thready and weak in the Kidney yin positions. The TCM diagnosis was Kidney yin deficiency with deficiency heat. Balance (Heat)was prescribed at 8 capsules twice daily. Symptoms resolved quickly after taking the herbs. She was then instructed to reduce the dosage to 4 capsules twice daily. Dietary changes were also made. Patient felt extremely grateful to the practitioner for prescribing the formula.

                                                                                               M.H., West Palm Beach, Florida

 

 

A 62-year-old saleslady initially presented with neck pain resulting from a car accident. She also had symptoms of night sweats and dry skin. The patient complained of feeling frustrated and had been gaining weight. Besides having smoked 1½ packs of cigarettes a day her whole life, the patient had been diagnosed with hypothyroid and was on 100 mcg of levothyroxin (Synthroid) per day. Her tongue was dusky red with a thick coat. Her pulse was choppy and rapid. The TCM diagnosis included Liver qi stagnation, Kidney yin and yang deficiency, and qi and blood stagnation. After 2 weeks of taking Balance (Heat), the patient commented, “I feel much better overall and I definitely sleep better and am less irritable.”

F.A., Calabasas, California

 

C.B. was a 56-year-old female who suffered from weight gain, right-side sciatic pain, insomnia, hot flashes and night sweats. She exhibited rapid, thin and thready pulse with peeled and cracked tongue. The practitioner diagnosed her with Kidney yin and blood deficiency with deficiency heat and blood stagnation. Neuro Plusand Balance (Heat)were prescribed. The patient reported the sciatic pain went away completely. Night sweats and hot flashes were reduced, and therefore, insomnia was no longer an issue.

 

                                                                                                                                                                                                                                               S.C., Santa Monica, California

 

A 44-year-old female nurse presented with irritability and approximately 60 hot flashes per day. Her tongue body was red with no coating and the pulse was slippery and rapid. The practitioner diagnosed this as Kidney and Liver yin deficiency. Because of the severity of her condition, she was given a higher dose of a modified Balance (Heat)formula. The formula contained Balance (Heat)along with 15 grams of Gui Ban(Plastrum Testudinis)and 9 grams of Qing Hao(Herba Artemisiae Annuae). The prescribed dosage was 6 capsules at 3 times a day. After taking Balance (Heat), the frequency of hot flashes reduced dramatically, from 60 per day to 2 to 3 per week!

 

K.S., Encinitas, California

A 49-year-old female social worker presented with stress, anxiety, dizziness and irregular menses. The patient reported occasional irritability, hot flashes, night sweats and painful menses. Dry eyes and muscle cramps were also present. The patient was diagnosed with Kidney and Liver yin deficiency with Liver qi stagnation. With Balance (Heat)and Calm (ES), the patient experienced a reduction of hot flashes and had less irritability, stress, anxiety and dizziness. She also stated that she slept much better and that her menses were not as painful. The practitioner concluded that the combination of Balance (Heat)and Calm (ES)was quite effective in treating the patient’s condition.

D.W., Raton, New Mexico

               

M.M., a 41-year-old female, presented with “adrenaline-rush” sensations, characterized by heat flushes to her face, associated with mood swings and anxiety. Her tongue was red and purple, and her face was red. The Western diagnosis was stress-related anxiety attack; the TCM diagnosis was Liver stagnation and yin deficiency. After beginning herbal therapy with Calm,two capsules three times daily, and Balance (Heat),two capsules, three times daily, the patient stated that her affect and personality became calmer. Furthermore, she reported “feeling good,” with increased energy levels and sound sleep.

                                                                                               C.L., Chino Hills, California

 

 

J.D., a 48-year-old post-menopausal female, complained of severe hot flashes. She stated that even during cooler temperatures at night, she needed to cool down by constantly using a hand-held battery-operated fan directed at her face. However, she did not complain of insomnia, mood swings, or palpitations. She confessed that, as a nurse, she was leery of trying herbal treatment. However, she had already tried hormone replacement therapy and OTC supplements with no success, and finally decided to try herbs. Balance (Heat)was prescribed, at three capsules, three times daily. During a follow-up visit two weeks later, the patient stated that the hot flashes were completely resolved.

                                                                                               C.L., Chino Hills, California

 

 

A 51-year-old female nuclear medicine technician presented with hot flashes, night sweats and insomnia. The practitioner diagnosed her with Kidney yin and Heart yin deficiency with deficiency heat signs. Before the patient’s treatment, she had irregular periods for 1½ year. During treatment, no periods occurred for 6 months. The practitioner had tried Liu Wei Di Huang Wan(Rehmannia Six Formula) with minimal results. Next, she tried Zhi Bai DiHuang Wan(Anemarrhena Phellodendron and Rehmannia Formula) and the hot flashes were reduced from 10-12 episodes to 4 episodes per day. The practitioner then switched to Balance (Heat)at 6 capsules twice a day. Within 1 week the hot flashes and night sweats were gone. Tian Wan Bu Xin Dan(Ginseng and Zizyphus Formula) was also supplemented, which in turn helped her to sleep better. Balance (Heat)proved to be very effective for clearing heat.

R.M., San Rafael, California

 

A 50-year-old female interior designer presented with peri-menopausal symptoms of hot flashes, night sweats, insomnia, and emotional fragility. The patient still had residual hot flashes despite correct dosing with hormone replacement therapy. With this clinical picture, the practitioner diagnosed this case as yin deficiency with deficiency heat. Balance (Heat)was prescribed at 3 capsules in the afternoon and 3 capsules before bedtime. Abatement of all residual heat symptoms occurred within one day. The practitioner found that Balance (Heat)was an excellent augment to the hormone replacement therapy.

 

C.W., San Diego, California

 



[1]Bensky, D. et al. Chinese Herbal Medicine Formulas & Strategies. Eastland Press. 1990

[2]Yeung, HC. Handbook of Chinese Herbal Formulas. Institute of Chinese Medicine. 1996

[3]Bensky, D. et al. Chinese Herbal Medicine Materia Medica. Eastland Press. 1993

[4]Bradley, P. (ed). British Herbal Compendium Vol. 1. Dorset, England: British Herbal Medicine Association. 1992

[5]Newall, CA. L.A. Anderson and J.D. Phillipson. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press. 1996

[6]Snow, JM. Monograph – Glycyrrhiza glabra L. (Leguminaceae). The Protocol Journal of Botanical MedicineVol. 1, No.3. 1996

[7]Li, Kao Guo. et al. Effectiveness of artemisia (qing hao) in reducing fever. Chinese Herbology. 6:16. 1985

[8]Zhu, CH. Effectiveness of artemisia (qing hao) as injectables in reducing fever. Hubei Journal of Traditional Chinese Medicine. 2:17. 1983