Expert: Tamsen Staniford, L.Ac. - 3/23/2010

Question
Hi Tamsen. Some months ago I was having loose malodorous stools with some mucus. I always have heartburn. I also seem to coughing up phlegm am constantly fatigued and feel short of breath. I did some research on traditional chinese medicine and ibs and was leaning more towards a spleen deficiency.  But recently I've noticed a bitter taste in my mouth and I seem to get irritable rather quickly. This was leading me more in the direction of liver depression. I'm 52. I've had symptoms of premenopause for some time especially night sweats, depression, mood swings. i was seeing an acupunturist but my finances weren't good so I had to stop. I take eight flavor rehmannia which diminishes the hot flashes somewhat.My question? Is it possible to have spleen and liver problems both at the same time? If so, is there a patent remedy you could recommend. I also have herpes. Would it be o.k. to take the eight flavor with  long dan xie gan wan occasionally if I have an outbreak. I would so much appreciate any helpand guidance you could offer. Sasha P.S. I do seem sometimes to be constipated.

Answer
Sasha,

First of all I commend you for working to understand your condition through researching TCM, which can be both an elegant and confusing medical system!
Liver and Spleen (I capitalize them to differentiate them from the anatomical organs) pathologies are commonly seen together because the two systems have a very intimate relationship.  Spleen manufactures the qi and blood that the Liver stores and smoothly transports around the body.  When the Liver is deficient it will overtax the Spleen trying to get more qi and blood out of it which further weakens the Spleen system.  This is a simplified explanation of the downward spiral that can happen when the two systems are not in harmony.  The most common disease pattern of this type is actually known as Liver/Spleen (or Wood/Earth) disharmony.  One of the most common patterns seen in IBS is indeed Liver/Spleen disharmony.

Back to your condition, without seeing your tongue and looking at your pulse I can not recommend herbs for you to take.  However, I can say that it is okay to take the Long Dan Xie Gan Wan for outbreaks while taking the Zhi Bai Di Huang Wan, just don't take them at exactly the same time.  Leave a few hours in between each formula so they both work their best.

Although finances are tough, I would advise you to work out an affordable plan with your acupuncturist to check in every month or few months to make sure you are still on track and taking the right formulas.  That is also a good time to get what I call an acupuncture "tune-up" which is always beneficial, no matter how infrequent.  I like to do this for patients with tight finances or those who simply do not need to come in that often.  At the very least, ask your acupuncturist if they could do a quick discounted herbal consultation every now and then to keep you on the right track.  Even though you have been doing great research on your own, the trained professional will save you money and time in the long run by getting a more in depth and clear diagnosis to work with.  They will also be able to customize a formula for you that will work better than a patent teapill.  There are so many convenient options nowadays for taking customized formulas that you don't need to be worried about buying the ones your acupuncturist has on stock if you can't afford them.  Many herbal companies will take the prescription from your acupuncturist and ship you the formula in pill, powder or liquid form; and they all have different price schemes.  I'm sure your acupuncturist will gladly recommend a good company to you.

I wish you the best in health,
Tamsen Staniford, L.Ac.