Feature Formula: Xiao Yao San for PMS

Xiao Yao San, or “Free and Easy Wanderer” as it is often translated in English, is a widely prescribed Chinese formula for treating menstrual disorders, depression, and digestive difficulties. Xiao Yao San has been in use for over 1000 years and includes a number of well-known Chinese herbs, including dang gui, or Angelica root. This versatile formula is extremely clinically effective in addressing a variety of menstrual difficulties, including PMS.

PMS, or pre-menstrual syndrome, is a cluster of symptoms that usually occur in the week leading up to a woman’s menstrual cycle. These symptoms can include: bloating, breast tension, irritability, depression, anxiety, constipation, loose stools, insomnia, cramps, and headaches.

For some women PMS symptoms appear right after ovulation, while other women don’t experience PMS until a day or two before the start of their period. There are also some women who don’t have PMS at all. (Yes, I swear those women exist!)

Let’s take a look at what creates PMS from a Chinese medicine perspective and how Xiao Yao San can help.

PMS in Chinese Medicine

The “ideal” menstrual period should come and go with no pain, no breast tenderness, no unholy desire to eat chocolate cake, and no “nothing fights” with your partner. But since we live in the real world, with its endless stressors, both physical and mental, many women brace themselves for PMS each month. Like clockwork, it seems we go haywire.

In reality, we do not go haywire.

Our bodies are beautifully attuned to the external world and are primed to carry life. What a miracle! But anyone who suffers through cramps, pre-menstrual depression, and loose stools every month might not exactly think a period is a miracle.

In Chinese medicine PMS symptoms have a physiological origin, meaning there are bodily explanations for why you don’t feel well. This should be a great relief to women who wonder if their pre-menstrual anxiety and agitation are all in their heads. While it’s true that PMS can create some really nasty mental states, Chinese medicine, and specifically Xiao Yao San, addresses the underlying physical imbalances that make us feel so uncomfortable.

Qi and Blood Stagnation

The natural outcome of PMS is that you eventually start to menstruate. Your period has an energy that must be released. Whether your pre-menstrual days are easy-going, like the Free and Easy Wanderer, or excruciating, is determined by how freely your qi and blood are flowing. When qi and blood are bound up, they wreck havoc.

Here’s an image I use to think of qi stagnation: imagine leaning your palms against a wall and pressing with all your body weight. The energy you’re expending leaning into this wall is magnificent, and yet, no matter how hard you try, you can’t move that wall. Instead, you become tired, agitated, and frustrated. That’s qi stagnation. It’s annoying, and somewhat painful, both to the body and the mind (not to mention the ego).

Now, imagine pounding your fists on that immovable wall. Really think about it! There you are, a vibrating ball of energy trying to get through a wall that will not yield, unless you smash into it with all your might. Smashing through that wall will hurt, but you’re totally determined to do it because you have to. That is blood stagnation, the cause of cramps, menstrual back pain, and clots.

Behind every cramp and clot are qi and blood stagnation, and the origin of this stagnation is lack of free flow. When our lives feel bound, we constrict. The same thing happens in our bodies. The same thing happens in our minds, too.

Ever notice how when someone tells you to chill out, or relax, or take it easy when you have PMS you want to scream? This is normal. PMS creates an uncomfortable tension between constriction and release that is ultimately relieved through starting your period, but before that happens, you’re still pressing and pounding on that wall. If you could relax, you would. But the truth is, you can’t, because until your body shifts from preparing for the period to actually having a period, your body is under pressure.

This is where Xiao Yao San comes in.

Xiao Yao San’s primary functions, in Chinese medicine terms, are to move qi and blood, support the Spleen (aka, your digestion), and build the blood. Let’s take a look at how Xiao Yao San supports the Spleen.  

Spleen Deficiency in Chinese Medicine

The term “spleen deficiency” is used a lot in Chinese medicine. The Spleen is the primary organ of digestion and has a similar function to the pancreas in Western medicine.

The Spleen is responsible for absorbing and distributing the nutritional aspects of our food and sending the waste materials on for elimination. When the Spleen is weak, our digestive function suffers. This can lead to gas, bloating, loose stools, constipation, weight gain, and a feeling of heaviness or lethargy. Sound familiar? Many women have irregular digestion around their periods, which is why you can’t really treat PMS if you don’t support the Spleen.

Especially as it relates to menstruation, a healthy Spleen is critical for making sufficient blood. When the Spleen is impaired, either through undernourishment (such as in crash dieting or eating disorders), or bogged down by low-quality food (think junk food, greasy meals, sugar, alcohol, and processed food) it cannot make high quality blood. For women who are menstruating, this is a problem.

High quality blood moves easily, doesn’t clot unnecessarily, and provides the proper nourishment for pregnancy. We have a good idea of the quality of our blood by seeing how it is shed in menstruation. This is a critical tool for determining our fertility, should we decide to become pregnant.

Blood Deficiency in Chinese Medicine

Chronic Spleen deficiency leads to internal blood deficiency. Blood deficiency can cause women to feel cold, experience headaches, dizziness, and brain fog, feel depressed or anxious, and have scant periods. This lack of sufficient blood can also add to menstrual cramping. Light, and especially erratic, periods are often a sign of fertility issues as well.

Moving backward from these symptoms, we can assume a woman has Spleen deficiency if she has blood deficiency. Similarly, if a woman loses a lot of blood, either through a heavy period or childbirth, it is imperative that she replenishes that blood by eating healthy food. This is one of the reasons why nutritional counseling is so important in cases of infertility. We want to be making the best blood possible for sustaining a pregnancy.

How to Use Xiao Yao San for PMS

Xiao Yao San can address PMS at any point in the menstrual cycle after the time of ovulation.

For most women ovulation occurs around 14 days after the first day of their last period. The onset of PMS symptoms can happen any time after ovulation. Sometimes it can be hard to pinpoint exactly when ovulation occurs, especially if your cycle is erratic. The average monthly cycle between periods is 28 days, but your period could fall anywhere from twenty-one to who-knows-how-long between menstrual cycle. Xiao Yao San can still help.

I advise women to start taking Xiao Yao San as soon as they have their first symptom of PMS. For many women, breast tenderness comes first. Other women notice digestive issues early. Some women become depressed, anxious, or can’t sleep. Pay attention to the symptoms you experience and see if there is a pattern. Each month you’ll become better at knowing when to start taking Xiao Yao San for PMS.

If your period runs like clockwork, and you know you’ll begin feeling lousy three days before you start menstruating, plan on starting Xiao Yao San a couple of days before those symptoms come on. Every woman is different, and this formula is safe and effective for many different types of PMS.

Xiao Yao San can also be modified to make it more cooling, more blood building, etc. Pills are an easy way to take this formula, but some women need a more specialized formula, which requires a customization of raw herbs or herbal powders. Ask your acupuncturist or Chinese herbalist what the best form of Xiao Yao San is for your particular type of PMS.

This versatile formula is one of my favorites. I’ve seen many women go from having PMS every month to barely noticing when their period is on the horizon. I love how gentle it is at working with a very complex (and irritating!) set of symptoms. If you have PMS, definitely talk with your practitioner about trying Xiao Yao San.

For additional information on using this formula in a clinical setting, see Memorial Sloan Kettering Cancer Center’s About Herbs listing for Xiao Yao San

Congee: The Ultimate Comfort Food

bowl of congee

I didn’t grow up eating congee, the ultimate comfort food, but since learning about it in Chinese medicine school, I have grown to adore it.

Since many Americans aren’t familiar with the wonders of congee, or rice porridge, I thought it would be helpful to give you my recipe, plus a few good reasons to add this ultimate comfort food to your diet.

What is Congee?

Congee, or jook, as it is sometimes known, is a slow-cooked porridge made from rice or millet and water or broth.

There are as many ways to prepare congee as there are people who eat it. A number of East Asian cultures, including China, Korea, and Japan, have variations on congee. This easy-to-digest soup is usually fed to the very young, the very old, and people who are ill.

But you don’t need to be sick to eat congee! In fact, congee is a nutritious addition to most anyone’s diet, especially people with low energy, stomach ailments, loose stools, or low appetite. (For more tips on diet, see 10 Ways to Improve Your Digestion with Chinese Medicine.) When made with brown rice or millet, rather than white rice, it provides steady energy over many hours, especially if served with some form of protein.

I personally eat congee because it is easy on my stomach, provides consistent energy, and marries well with vegetables, eggs, and chicken.

During the cold months of the year, I alternate congee with oatmeal for my morning meal. A warm bowl of silky-soft grains is the perfect stick-to-your-ribs breakfast on a snowy morning. What’s better, it can be made in advance and paired with a few basics from the pantry and refrigerator.

So how can one simple food provide enough versatility to be eaten every day?  

How to Make Congee, the Ultimate Comfort Food

Chinese versions of congee are usually made with white rice. While white rice is definitely easy to digest, I opt for brown rice instead. Brown rice is lower on the glycemic index than white rice, which means it turns into sugar much slower in your system. Rather than spiking your blood sugar, brown rice congee provides slow, steady energy over a longer period of time.

Brown rice congee also has more fiber, which aids in both firming loose stools, through adding bulk to the stool, and moistening the digestive tract in cases of constipation. Congee’s high liquid to grain ratio is the perfect combination of solid food and nourishing broth. It satiates our desire for both calories and water, leading to a lasting sense of being full.

I make my congee with a combination of chicken bone broth (either store-bought or homemade, depending on how much time I have) and water. Some congee broths are made with pork or beef, while other cooks favor water alone. The real key to an excellent congee is slow-cooking the grains until they fall apart, creating a silky, shiny, thick porridge that holds up to the addition of proteins, vegetables, and condiments.

The backbone of congee is the luxuriously soft grain: easy to digest, deeply satisfying, and highly versatile.

Congee Mix-and-Match

Congee is a savory food that pairs well with vegetables, tamari, sesame oil, and eggs. It is also delicious mixed with chicken or pork, though vegetarian versions are just as exciting. Once you’ve mastered the broth and the grain, anything goes.

Leftovers are also great in congee. (Think cooked vegetables or last night’s protein.) I’ve even been known to throw leftover congee into other foods, such as chicken soup, as a thickener. (Use caution though. This can go wrong. The worst idea I ever had for combining leftovers: chili and congee. Don’t do it!)

My recipe for congee is just a launching pad for your own creations. Have fun discovering a new food requiring little more than a bit of time and a lot of curiosity.

Brown Rice Congee

1 cup brown rice (short grain, long grain, or basmati)

4 cups bone broth (optional; if making vegetarian version, use 8 cups of water rather than 4)

4 cups water

2 Tbsp. Better Than Bouillon chicken bouillon (optional)

2 cloves garlic, grated (optional)

1 inch of ginger, grated (optional)

Combine rice, broth, water, and bouillon in a slow cooker. Cook on low overnight, approximately 8-10 hours. I do not add salt to the congee at this stage, as I may add additional bouillon when I reheat it, or I may use tamari, both of which are quite salty.

If you do not have a slow cooker, bring rice and liquid to a boil, adding bouillon once it has reached boiling. Turn the heat down to a very low simmer, placing a lid on the pot. Stir the grains every 15 minutes to prevent sticking to the bottom of the pan. Cook for 2.5 hours or until grains are broken and soft and the congee is silky and somewhat pearly in color.

Once the congee is cooked, you will have quite a bit to eat over several days. To reheat congee, simply mix some of the porridge, which will be thick, with water or additional bone broth and/or bouillon until it reaches the consistency of soup. You can also add in cooked meat, such as shredded chicken, while the soup is reheating.

To up the nutritional content, throw a handful of baby kale into the congee once it’s hot (the greens will soften in the warmth of the congee without becoming soggy and overcooked).

Top the congee with sesame seeds, a few drops of sesame oil, and a splash of tamari for added depth. And for truly yummy and amazing flavor, add one soft-boiled, or “jammy,” egg to the congee once it’s cooked.

To cook a “jammy” egg, bring an inch of water to a full boil, gently place one egg in the boiling water, cover with a lid, and allow it to cook for 8-9 minutes. Remove the egg, run it under cold water, peel, and serve right away.

Now that you’ve got the basics for congee, the ultimate comfort food, be sure to email me your favorite variations. As I said, there are as many ways to cook congee as there are cooks. Incorporating this nutritious dish into your diet is as easy as throwing water and rice in a slow cooker. The real art is in finding the additional goodies that make you want to eat it again and again.

Wildfire Season in Boulder: Hot, Hazy, and Unhealthy

wildfire smoke and mountains

I’d like to start this post by telling readers I am not an alarmist when it comes to environmental health. Although I believe in the importance of clean water, pure air, and organic food, I also believe our success as modern humans demands that we adapt to environmental circumstances that are less than ideal. Widespread pollution—both indoor and outdoor—are part of daily life. That being said, wildfire season in Boulder, Colorado, has become quite unhealthy.

Living in Boulder, we are lucky. We source our water from nearby reservoirs fed by mountain runoff. Much of the farming and agricultural practices in our county are designed to be eco-friendly—organic, minimally damaging to co-existing wildlife, and as water-wise as possible. The Boulder community has, overall, done a good job of envisioning an urban future where humans live in, and benefit from, a healthy circle of natural environmental wealth. 

Climate change is changing all of that—rapidly. All we have to do is look at the last two summers in Boulder.

I’ve lived in Boulder since 2003 and have witnessed a slow but steady shift toward a warming city on a warming planet. My husband, who works in landscaping, attended a presentation on climate change five years ago in which the speaker told her audience that soon, summers in Boulder would be like Albuquerque, New Mexico. Indeed, that prediction feels accurate.

This summer I began paying closer attention to my clients’ ailments in light of the high heat and smoky air conditions. Many times I would look out my office window at the obscured Flatirons and say, “Do you think any of this has to do with the haze?” Invariably, people would tilt their heads and say, “Maybe. I never thought of that.”

Now that we are adjusting to the “new normal” for summers in Colorado, I urge you to consider the impact our air quality is having on your health. Wildfire smoke, ground-level ozone, and air pollution can make anyone feel unwell—including relatively healthy people. Here is a list of conditions I saw this summer that show a direct relationship to air quality:

  • Headaches
  • Sinus issues
  • Asthma
  • Allergies
  • Fatigue
  • Insomnia

It’s not just air quality though; the intense heat is aggravating us as well.

Chinese medicine pays close attention to environmental factors when it comes to illness. Simply speaking, there is no human illness separate from the environment in which it appears. The world we inhabit becomes the world we internalize.

Heat, in particular, can challenge the body in ways you might not immediately recognize. Sure, it’s important to stay hydrated and avoid heat exhaustion in Colorado summers, but depending on your constitution, heat can cause many other health problems.

Here are a few issues that can be aggravated by months of 90-degree heat:

  • Menopausal hot flashes
  • Mouth sores
  • Stomach ulcers and GERD
  • Constipation
  • Allergies
  • Migraine headaches
  • Gout
  • Some forms of arthritis
  • Urinary tract infections

Clients with heat-sensitive constitutions will need to be extra vigilant in the years ahead during the wildfire season in Boulder, especially people who are not accustomed to hot, dry climates.

Although waiting the summer out in air-conditioning is an option, this will only help with the high heat, not with atmospheric dryness. For me personally, I found the dryness of our wildfire season in Boulder to be particularly irritating to my lungs and sinuses.

Chinese medicine offers many solutions for lessening the impact of our difficult summers. Acupuncture is an excellent remedy for hot conditions, including everything listed above. I recommend starting regular acupuncture treatment in May or June before things get really heated up and continuing a maintenance schedule through the summer.

Diet also plays a role in mitigating the impacts of environmental stress. Universal irritants—coffee, alcohol, sugar, and refined carbohydrates—will add to systemic inflammation, as will smoking cigarettes or marijuana. I advise eating cooling, moistening foods during this time as much as possible, including fruit, whole grains, and vegetables. Remember, the more fruits and vegetables you eat, the more moisture you’ll get in your diet.

Finally, Chinese herbs. The Chinese herbal pharmacopeia is teeming with herbs that clear heat, moisten the lungs, and expel phlegm. Unlike acupuncture, herbal medicines are taken every day, which is great for people who travel or have a busy summer season. If you can’t make it in for treatment, herbs are a good choice. I can always help you with an herbal formula that fits your constitution.

Summer 2022 will be here before we know it.

We should assume it will be as hot and hazy as the last two summers and prepare ourselves ahead of time. Just like fire and flood mitigation, preventative medicine is a way of anticipating future stressors and seeking solutions before we become ill.

If you’ve had a difficult time during wildfire season in Boulder, make a plan for next year that includes acupuncture and herbal medicine before the temperatures rise. The stronger you feel entering the season of smoke, haze, and high ozone days, the more likely you’ll be to enjoy the summer season again.

How to Quit Coffee

Artful cup of coffee

I love coffee. I have never wanted to know how to quit coffee. Since my days as a writer, before I became an acupuncturist, I’ve loved the scent, taste, and ritual of morning coffee. I drink my coffee black—so black that I’ve been told my coffee is more like stout than coffee.

Over the years I’ve quit coffee for short stretches, particularly in acupuncture school, when I began to think critically about how food impacts my health, but for most of my adult life, coffee has been a part of my morning routine.

Recently, I was talking to an acupuncturist friend, and I mentioned my morning coffee.

You still drink coffee?  

She said this as if coffee were something we had all given up years ago.

Yes! I love coffee!

I felt she should have mercy on me the way I do all of my clients who eat too much sugar or can’t give up smoking. The problem is that we were also talking about a health issue I was having that is typically made much worse with coffee.

She was right. As much as I wanted to justify why I still wanted coffee, it was obvious that it was aggravating my health in a way I could no longer deny.

Coffee in Chinese Medicine

From the perspective of Chinese medicine, coffee contributes to a number of unwanted health conditions. Here are just a few:

  • Migraine headaches
  • Menstrual cramps
  • Uterine fibroids
  • Ovarian cysts
  • Acne
  • Irritable Bowel Syndrome
  • Hot flashes and night sweats
  • Anxiety
  • Insomnia
  • Hypertension
  • Chronic UTIs

Coffee—even decaf—is an irritant. Its energetic properties are hot and acidic. Your stomach and intestines bear the irritating intensity of coffee, but it’s your heart that has to work the most with that cup of java, especially if it’s caffeinated. Coffee also opens your pores, makes you sweat, and causes you to urinate, all of which contribute to chronic dehydration.

But it’s not just the coffee itself that is so bad for us; it’s the other stuff we put in it as well. For example, sugar.

Sugar is a highly inflammatory food. Whenever we ingest sugar, it triggers all the systems in our bodies that are already inflamed (think arthritic joints, any site where infection may be present, and the lining of your gut).

The combination of coffee and sugar first thing in the morning creates an amazing buzz, but that buzz comes with a price. It spikes your blood sugar while aggravating your liver. Over time this spike/crash cycle depletes the body of water, agitates the heart, and contributes to insulin resistance. It can also lead to hypertension, a condition millions of Americans are already diagnosed with.

The female reproductive system is particularly sensitive to coffee. Coffee worsens breast cysts and cycle-related breast tenderness, uterine fibroids, menopausal hot flashes, ovarian cysts, and PMS.

There are actually very few “medicinal” uses for coffee, although it has been shown to help with cognitive function in older adults. This makes sense. As we age our natural yang qi diminishes and coffee mimics the effects of yang qi, encouraging us to move and remain alert. But for younger and middle-aged people, especially women, coffee is really nothing but trouble, even if it tastes great.

So, after years of clinging to my one cup of coffee, I decided to give it up.  

Now I want to help you do it, too.

How to Quit Coffee: It’s Not as Hard as You Fear

Coffee does different things for different people. Like alcohol at Happy Hour, morning coffee is a ritual. Rituals mark special junctures in our days, weeks, and years. Honoring these turning points is important. Just because you’re giving up coffee does not mean you need to give up that delicious twenty minutes of snuggling your dog or talking with your partner. Keep all of that!

To start your conversion from coffee, take what you normally consume in one day—say, two mugs—and cut it in half for one week. After one week, cut that mug in half. Now you’re drinking a half-mug every morning. At the end of week two, switch to one mug (with one tea bag) of black or green tea, no more.

If you are a heavy coffee drinker (3-4 mugs a day), give yourself more time to cut down. For example, if you drink four mugs a day, cut that down to two the first week, one the second week, and a half-mug the third week.

As long as you’re diligent about cutting your consumption in half every week, it does not matter how long it takes. Eventually, you’ll be off coffee.

Why the Slow Withdrawal?

Why not just stop completely? Or switch to decaf?

Here’s why this method works better than all of those approaches: it gives your body time to adjust to the withdrawal.

For most people, coffee is a mild addiction. Your body is used to the rush it gives you and will probably be cranky when you withhold the goods. That feeling of being robbed will wreck havoc on your mind and body, making it much harder to quit. This gradual process will give you plenty of time to counteract withdrawal symptoms, including headaches, constipation, and fatigue, all of which usually trigger us to go back to drinking coffee.


Many people use coffee as a laxative, so reducing your consumption could reveal you have slow bowels. Two easy things you can do beginning the week before you start lowering your coffee intake is to up your fiber (think fruits, vegetables, and whole grains) and increase your water consumption—a lot.

Start your day by drinking a glass of warm water, and keep this going throughout the time you’re weaning off coffee. If you continue this habit once you’ve switched to tea, it will make an enormous difference in your elimination.

Constipation comes in a couple of different forms: hot and dry or slow and stagnant. Hot, dry constipation will improve greatly with additional water, fruits, and vegetables. Slow and stagnant bowels also benefit from these additions, but you should also up your exercise, especially walking. Walking aids the digestive tract in elimination through rhythmic movement and gravity. Sitting will make constipation worse, so make sure you’re getting your body moving.

Caffeine-withdrawal headaches

Caffeine-withdrawal headaches are rotten, but they can be lessened through drinking more water, getting additional exercise, and switching to black tea at the end of your coffee conversion, at least to start out.

But why not decaf coffee? Many people switch from caffeinated coffee to decaf and call it good, but I am not a fan of this approach. Decaf coffee is still coffee, which means the energetic qualities of heat, acidity, and irritation are still there. Also, decaf drinkers still tend to load their mugs with sugar. Not good!

Black tea is healthier than coffee and green tea is even better. Just make sure you don’t go over one mug a day when you are weaning off coffee. This will help your body adjust to having less caffeine. If you replace your one mug of coffee with three mugs of green tea, you won’t get past the caffeine-addiction withdrawal, especially the headache.

If your goal is to kick caffeine all together, keep your tea consumption in check.


Fatigue is a common side effect of getting off coffee, but I promise, this is short-lived.

Once you’ve transitioned from coffee, your energy will level out. The post-coffee crash will be gone, and your body will adjust to getting its energy from food, exercise, and sleep. You will feel better than you ever did on coffee. Just give it a little time, usually one to two weeks. 

Cutting caffeine altogether

Cutting caffeine entirely is the next step, although if you’re only drinking one mug of caffeinated tea a day, that is much better than one mug of coffee. Tea is easier on your gut than coffee. It creates less inflammation and is less addictive, but nonetheless, it is caffeinated, which can lead to insomnia, agitation, and excess sweating.

Shifting to caffeine-free beverages is a great goal and one I encourage you to try once you’ve kicked coffee completely. There are a variety of coffee substitutes out there, including roasted dandelion, chicory root, and certain varieties of mushrooms. Or you may just decide to go with something totally different, like peppermint tea or a custom herbal blend.

Learning how to quit coffee is the hardest part. Go slowly and give yourself the time it takes to make the switch gradually. Your body will thank you, and you’ll find coffee has much less power over you than you imagined.

Coffee with blank journal

P.S.—Searching for photos of lattes, espresso, and steaming mugs of coffee for this post was brutal for me, the ex-coffee drinker. This delightful photo with a blank journal was nearly enough to send me down Coffee Lane. But I resisted! I wish you the best of luck in quitting coffee, too.

The Mystery of the Heart-Mind in Regulating Your Menstrual Cycle

Although we normally think of menstruation as a physiological function, the mind plays a role in the regularity and duration of our periods as well. Most menstruating women do not skip a cycle under normal, everyday stress. However, if you suffer a shock, such as losing a loved one, witnessing a distressing event, or going through a divorce, you may skip a period…or two.

The reason for this is both practical and mysterious.

Evolutionarily, we are primed for conception when the circumstances are optimal, meaning we stand a good chance of carrying a child to term. Intense emotional upset sends a signal of things being not okay for conception. And even if having a baby is far from our goal, our body can sometimes make that decision for us by preventing a regular, fertile cycle.

This is particularly difficult for women who live with trauma or ongoing circumstances of abuse. It can even become problematic for women who are under intense emotional strain, either from past or present circumstances, when they try to conceive. This is not meant to be dismissive in any way. It is not “all in your head,” as so many women have been told. In fact, it’s all in your heart.

The Brain Vs. the Heart-Mind

The Western concept of The Mind is situated in the brain. In our culture the brain is likened to a computer or a machine; it is an object that can be dissected to discover the truth of how it works. However, this concept of the mind “living” in the brain does not accurately reflect the way we process the world, nor does it account for many mysteries reflected in the body. It is only one perspective on consciousness, and incidentally, one that fits nicely into a mechanized interpretation of reality. However, most women I know, most people I know for that matter, do not operate like machines.

In Chinese medicine the brain works in service to the Kidney energy, which is basically our biological life-force energy. The Kidney energy is responsible for reproductive capacity and plays a big role in fertility (think of it as the genetic material you’d pass to your offspring). The brain is basically an expression of what we might see as the individual, a single biological entity in a world of things that aren’t us. Its role is to keep us, as individuals, alive and spread our DNA.

The traditional Chinese medicine concept of The Mind is that it is located in the Heart. This Heart-Mind is open, loving, and curious. Whereas the brain is mostly involved in self-protection and reproduction, the Heart-Mind is expansive. It connects us with others through affection, compassion, and joy.  There are many important and interesting implications of this for medicine, meditation, and yogic exercises, but for our purposes, it is important for initiating, nourishing, and sustaining the menses.

How crazy is that? Your Heart-Mind plays a significant role in your fertility.

Why is this? In Chinese medicine we say that the Heart engenders the blood, meaning it infuses it with spirit. Ample, high-quality blood is critical for a healthy period. But even more mysteriously, this relationship between the Heart and the uterus reflects how open, receptive, and nourished we feel.

The Mystery of the Heart-Mind: It’s all About Connection

Think of it this way: your brain can be taught a “life hack,” but your Heart cannot. The Heart understands things on a wordless level. You already know this, right? So does your uterus. The brain has one function: to keep us alive, and as an extension of the reproductive energy, to keep our DNA circulating in the gene pool. It’s great at that, but let’s be honest, do you feel warm and fuzzy and expansive when you think about your brain? Probably not.

Your reproductive organs are highly sensitive to emotional distress, including feelings of abandonment, trauma, and loneliness. Your cycle really can be interrupted by grief, fear, and worry. And no matter how hard you try to “wrap your mind around it” (or, make your brain figure it out), it’s impossible to correct your period through logic alone. Menstruation is a relational process.

The Heart-Mind actually has a very high function: it connects us to each other, which strengthens us individually to withstand pain, loss, and suffering. It enables us to feel joy, love, and pleasure. We become larger, and more resilient, because of our relationships with others. And, most importantly here, your biological body—your uterus, ovaries, fallopian tubes, all your female parts—recognize the power of these positive, loving relationships.

If your period is causing you difficulty, start with your relationships. I’m talking about all kinds of relationships: romantic, friendships, familial bonds, and your relationship to nature, including pets. Begin to think about ways you can connect to the people, animals, and landscapes in your life that make you feel loved. This can work miracles on your menstrual cycle, not to mention many other biological systems. We all need to feel connected to something outside ourselves. It gives us a sense of hope, which encourages fertility.

Women have a special opportunity to witness the power of the Heart-Mind through the menses. Focus on feeling connected first. Use your Heart-Mind as your guide and track changes to your cycle. Are your periods more regular, less painful? You were born with a great capacity to give and receive love. I encourage you to use this power of connection as medicine for your own wellbeing and witness all that it can heal.

10 Ways to Improve Your Digestion with Chinese Medicine


Many people are surprised to learn that Chinese medicine, including acupuncture and Chinese herbs, can treat numerous digestive complaints, including stomachache, acid reflux, constipation, loose stools, gas and bloating, and digestion-related abdominal pain. In fact, Chinese medicine has many ways to improve your digestion.

Healthy digestive function is important as it provides the energy necessary to fuel all your cells with glucose. The digestive system is also critical for detoxifying the body by providing an exit route for unwanted waste material. This is why poor digestion can quickly lead to other illnesses, including rashes, eczema, and psoriasis; fatigue; low immunity; depression; and insomnia.

So what are the hallmarks of a “healthy” digestive system? To begin with, we should have a good appetite, and when we eat, we should feel energized from our food. The ability to eat without acid regurgitation, bloating, belching, or gas are other signs of a well-functioning digestive system. Finally, regular elimination of a formed stool shows that your body has made good use of the food you’ve consumed.

So how does digestion “go wrong?”

  • We eat the wrong foods at the wrong times
  • We eat foods that are too rich, sweet, salty, or sour because they taste good
  • We eat processed foods that the body does not recognize as nutritious; these foods make us feel full but don’t provide nourishment
  • Emotional stress impairs the digestive function…and often our thinking around food!

We are often so confused about what to eat that we rarely think about how to eat. Thankfully, Chinese medicine has a lot to say about this.

Here are 10 ways to dramatically improve your digestion by changing the way you eat.

Choose warm, cooked foods

You’ve probably heard of digestive fire, right? Digestive fire is basically your metabolism, or how your body uses the food you’ve eaten to fuel your cells.

Cold foods, like ice cream, cool down the digestive fire, causing your metabolism to become sluggish. Similarly, raw food, like salad, compromises the digestive fire. How? Your body draws heat away from the organs of digestion to “cook” the food you’ve ingested before it passes through the digestive tract.

If you are low in energy already, these foods will increase your fatigue, lower your immunity, cause you to gain weight, and could even give you loose stools. If you suspect your digestive fire is weakened, switch to eating warm, cooked foods right away.

Not sure if you have weak digestive fire? Place your hand on your abdomen. Often patients with weak digestion will have an abdomen that is cold to the touch. If this is you, assist your metabolism by placing a heating pad on your abdomen, sitting in a warm bath, or soaking your feet in warm water…after you’ve switched to warm, cooked foods.

Eat a good breakfast

The digestive system is at its peak during the morning hours. Why? Because we need a full meal in the morning to function throughout the day after sleeping through the night. Eating a good breakfast will kick-start your digestive system, giving it something to do when it’s primed for action.

Similarly, your digestion is at its weakest in the evening and throughout the night, except for the liver, which is at its peak while we are asleep, detoxifying the body for the next day. We’ll look at that a bit later.

So what if you aren’t hungry in the morning? Eat something light. Soup is an excellent breakfast food and is eaten throughout Asia as a morning meal. I almost always recommend protein, too, such as eggs, to give your breakfast staying power and eliminate the need for a mid-morning snack.

Avoid iced beverages

Just as with cold foods, cold beverages constrict the stomach, making digestion slower. This includes drinks that come straight from the refrigerator and those served over ice.

But what about during the summer, especially on those ninety-degree days? Chinese medicine always acknowledges the role of environment in health. So although it is easier for your body to handle cold beverages in the summer, don’t overdo it. It is always better to have drinks at room temperature, or warmer, whenever possible, and palatable.

Incorporate exercise daily, especially walking

Exercise encourages gravitational movement in the digestive tract. Walking is particularly effective in gently supporting this downward motion.  Also, the rhythmic breathing of exercise massages the large intestine through the fluctuation of the diaphragm. Not only will your body use food more effectively when you exercise, your organs will be less stressed.  

Light exercise is particularly important if you are constipated. Mild constipation can often be relieved through gentle abdominal workouts, such as yoga. While walking facilitates gravitational movement downward, the twists and turns of yoga massage the internal organs and stimulate elimination. If you suffer from constipation, add a little yoga to your routine, especially movements that involve squeezing, twisting, and stretching your torso.

Eat dinner before 6 p.m.

The stomach is at its weakest from 7-9 p.m. at night and doesn’t regain full power until 7 a.m. the next morning. Eating too late can cause food to sit in your stomach and intestines, creating gas, bloating, heartburn, and even insomnia. Many patients find their sleeplessness is directly related to when they eat their final meal of the day.

To optimize your digestion, and ensure a good night’s sleep, aim to eat your last meal before 6 p.m. If you must eat late, try to make dinner a light affair. A small amount of protein, vegetables, and a complex carb will fill you up and reduce the possibility of having a late-night sugar crash.

Limit Universal Irritants, including sugar, alcohol, caffeine, and processed foods

Sugar is a highly refined form of energy that puts unnecessary pressure on the body. It increases phlegm and mucus production and irritates the lining of the blood vessels by forcing excess insulin into your bloodstream. Refined sugar should always be minimized. Even in ancient China, doctors recognized the life threatening danger of diabetes.

Another “sugary” food is alcohol. Alcohol is energetically hot and damp; too much of it irritates the digestive tract and puts stress on the liver, the organ of detoxification. Ever notice it’s difficult to sleep through the night if you’ve had too much to drink? There are a couple of reasons for this. One, the stomach gets hot and irritated from alcohol. Its close proximity to the heart causes you to feel restless due to that excess heat. Second, the liver is working on overdrive to clear your system of alcohol during its peak hours, making sleep all the more difficult.

Caffeine impacts the heart and circulatory system; a little bit goes a long way. How do you know if you’ve had too much caffeine? Watch for shaking, sweating, insomnia, and heart palpitations. This applies to coffee, chocolate, tea, and mate.

Processed foods, including GMO foods, contain ingredients that have been synthesized to make new foods or prolong the shelf life of perishable food. However, the more processing a food has gone through, the less vitality it contains. Chinese medicine encourages eating food with adequate qi, not foods devoid of life energy. Before ingesting a food, ask yourself how long ago that food was cooked, picked, etc. Whenever possible, choose foods that are minimally processed and close to their original condition.

Address emotional stressors

Digestion is also an emotional process. Remember the nervous system responses Fight, Flight, or Freeze VS. Rest and Digest? Digestion requires rest. As a mentor once explained to me: rest allows the blood to flow toward the digestive system and away from other parts of the body, such as the brain.

You may have heard the phrases “I can’t stomach it anymore,” or “Let me chew on it.” There is an undeniable relationship between thinking and the organs of digestion. Common digestive ailments caused by stress include stomachaches, IBS, diarrhea, constipation, gas, and bloating. Poor digestion is also directly related to low immunity, weight gain, and depression.

The organs of digestion can also be damaged through food and drink choices made during times of stress. (Think of how many times you’ve “stuffed” your feelings with food.) Stress eating, emotional eating, bingeing, under-eating, and chronic overeating always have an emotional link—and a negative impact on your health.

If you suspect emotional upset is contributing to your digestive issues, get mental health support as well. Focusing solely on what you eat will only eliminate a portion of the discomfort. And since how we deal with stress tends to become habitual, symptoms like stomachaches and bowel issues will inevitably come up again when the stress is on.

Prioritize sleep

Detoxification occurs at night when the liver, the mighty powerhouse of the digestive system, is at its peak. Aim to get to bed no later than 11 p.m. when detoxification begins. The liver works through the night and continues to detox until the wee hours of the morning, ending around 3 a.m.

Eating heavy meals at dinner and over-imbibing will aggravate the liver during its detox cycle. While drinking alcohol may help you fall asleep, it almost always causes us to wake during the middle of the night. This is because the liver is working doubletime to clear the system of alcohol. This is not good rest!

To get a real night’s sleep, hit the pillow before 11 p.m., avoid too much alcohol, and eat a lighter dinner, preferably finishing your meal early in the evening.

Avoid overuse of unnecessary supplements and medications

Any medication or supplement you ingest must pass through your digestive tract. Some have a strong impact on the stomach, others on the liver or kidneys. 

If you are not sure if a supplement is helping you, consider stopping it. Herbal medicines, though stronger than food, are biologically closer to food than synthetically derived supplements, making them a bit easier to digest. Above all, allow your digestive function to be your guide. If a supplement or herb gives you chronic gas, diarrhea, or constipation, it is not helping you heal, no matter what its touted claim.

The same is true of medications. All medications, including over the counter meds, should be monitored by your doctor, but be sure to tell your doctor if you see negative changes in our bowel habits, experience abdominal pain, or see changes in your urination. Your doctor may recommend a different medication altogether or change the dosage.

Eat fresh, whole foods that are in season

Finally, what to eat!

Chinese medicine supports eating animal protein for adequate nutrition. If you don’t eat meat all of the time, consider eating it when you are weak, fatigued, overcoming an illness, or during the winter when your immune system is at its lowest due to cold weather.

Grains can be life-giving; experiment with what works with your body. China, where acupuncture originated, is a rice culture. We rarely see prohibitions on eating grains in Chinese dietary theory. As with all foods though, some people will exhibit more inflammation when eating grains, especially in excess. Patients who are diabetic, or pre-diabetic, should be especially careful with grains.

Fruits can be eaten in moderation, but remember, fruit is fructose and will act like sugar in your system. As with most approaches to diet, vegetables are wonderful. They keep your stools regular and provide lots of energy, minerals, and vitamins. Raw vegetables are best eaten during the summer months (remember to protect your digestive fire), but cooked vegetables should be a part of your diet year-round.

Digestive health is challenging for many modern Americans. If you suffer from digestive complaints, you are not alone.

Much of the food we consume is aggressively marketed to us. Whether it’s a new superfood, a fad diet with “ancient” roots, or a “gotta-have” convenience product, much of the sanity we need to navigate the world of food goes out the window once we become hungry, stressed, or sleep deprived. However, negative digestive symptoms are a clear sign that something is wrong, and no amount of advertising can change how we feel in our gut.

My goal is to help clients become a little less obsessed with what to eat and more open to exploring how to eat. I encourage you to listen to your “gut instinct” when it comes to food. This sense of curiosity can bring a change in habit, which is the very best way to develop a healthy relationship with food and keep your digestion working smoothly for life.

Aches, Pains, Sprains, and Strains: Acupuncture for Back Pain

senior man with back pain

Do you know the #1 reason why patients visit an acupuncturist? Pain. Specifically, back pain.

Low back pain affects 80% of adults in the U.S. This includes everything from minor sprains and strains to degenerative disc disease and sciatica. If you are over 70 years old, spinal discomfort can become a daily problem.

So what can acupuncture do for back pain? A lot.

Acupuncture is excellent at relaxing tight muscles around the spine. It can offer significant pain relief, even if the issue is structural, such as in the case of scoliosis. In fact, I often see patients after conventional medical intervention to help them manage lingering pain that is not controlled through other forms of treatment. 

In situations of severe back pain, such as in the case of fusions, traumatic injury, and chronic degeneration, I focus on providing systemic pain control. Because acupuncture encourages the body to release its own endorphins, this form of treatment is excellent for patients who are looking for a drug-free alternative to medication.

Here’s another bit of good news: the Centers for Medicare and Medicaid Services is covering acupuncture services used in research on the efficacy of acupuncture in the treatment of chronic low back pain. It’s a good first step. If CMS sees the potential of acupuncture in addressing this wide-spread condition, the next move could be Medicare coverage. Our profession is very excited about this possibility. You can read more about this project from our national professional certification commission, NCCAOM.

If back pain is causing you daily discomfort, consider acupuncture. During your first treatment we’ll discuss your condition, as well as any Western medical diagnoses from your doctor. Then I will develop a treatment plan based on your specific condition, which will work with your medical, exercise, and physical therapy programs. 

Want to learn a few more specifics about low back pain? See the National Institutes of Health Low Back Pain Fact Sheet for details.

Know someone who suffers from back pain? Have them call me at (720) 668-6638 to discuss possible treatment options. Most back pain sufferers see changes after just a few sessions of acupuncture, which is always a welcome relief.  

Autumn Immune Boost

autumn leaves

After a long, hot summer, we have finally reached the cool months of autumn, my favorite time of year. The first part of the fall season is the best time of year for an autumn immune boost.

In Chinese medicine, fall is associated with the respiratory system. As the days grow colder and the air turns dry, the lungs must work harder to defend the body against airborne pathogenic influences. Although ancient Chinese medical doctors had no concept of germ theory, acupuncturists and herbalists have long understood the importance of protecting the lungs during this vulnerable time of year.

Let’s look at a few simple ways to support your respiratory health during the autumn season.

Bundle up

In Chinese medicine environmental cold can enter the body through the pores in the skin, weakening the lungs and creating opportunities for illness to take root. The best way to prevent cold damage is to bundle up against the elements. Scarves, gloves, warm socks, hats, and extra layers go a long way in preventing illness during cold weather. Be especially conscious of covering your neck and the backs of your shoulders. Also, don’t forget to be careful around drafts from air ducts or fans, which mimic the forced quality of a cold wind.

Eat well

Immunity is directly linked to digestive health. In fact, in acupuncture, the lung is closely connected with the large intestine, stomach, and spleen organs. If you feel you’re catching a bug, avoid refined sugar completely. Sugar taxes your immune system, feeds bacteria and viruses, and compromises your ability to fight infection should you catch something. During the autumn months, stick with warm, cooked foods, and avoid ice-cold beverages. Don’t skimp on water though; staying hydrated with room-temperature drinks will keep you healthy year-round.

Sleep deeply

Sleep is essential for fighting infection, repairing achy joints and muscles, and calming the mind. In fact, most healing is conducted while we are asleep. Now that the weather is turning cold, many people find sleeping is easier than during the summer. Adequate rest will give you an autumn immune boost much more than taking supplements. Take advantage of the longer, cooler nights and allow your body the simple medicine of sleep.

When it comes to immunity, there are no true substitutes for proper nutrition, hydration, and sleep. That being said, if your respiratory system is habitually prone to catching colds and flus, now is the time for an autumn immnune boost with herbs and acupuncture.

Acupuncture for Hospice and Palliative Care

This spring I completed training to become a Certified Hospice and Palliative Care Acupuncturist. My goal of providing comprehensive acupuncture services to older adults includes end-of-life care for patients approaching death and those who choose to forego ongoing medical intervention. Acupuncture for hospice and palliative care is an effective way of easing anxiety, fear, and emotional distress surrounding long-term illness, as well as the dying process. By calming the mind, acupuncture helps patients preserve their energy for connecting with loved ones, engaging in spiritual practice, and approaching their final days with a sense of peace.

This work also assists in managing pain, helps patients sleep, increases appetite, and boosts mental clarity. Because it is so versatile, it can be administered to clients in hospital beds or wheelchairs at home or in skilled nursing facilities. It is a truly remarkable support that can even be offered simultaneously to family and primary caregivers, strengthening the wellbeing of all involved.

If you have questions about how acupuncture can help ease the dying process for yourself or a loved one, please reach out. It is an honor for me to be a part of your support network now and in the future.

Acupuncture for Hot Flashes

hot flash

Now that it’s summer in Boulder, let’s talk about those overwhelming hot flashes you’ve been having and how acupuncture and Chinese herbs can help.

Many women suffer from hot flashes related to menopause. For some women, these temperature fluctuations let up quickly after menstruation officially stops. Other women live with hot flashes and night sweats for years after menopause. This condition is, in many cases, treatable with Chinese medicine.

Unfortunately, Western medication for hot flashes is often anti-depressants. Since many patients don’t want to be on mood-altering medications, women are left with few options for managing this uncomfortable symptom. Acupuncture and Chinese herbs, on the other hand, really work to cool you down, regulate your hormones, and help you sleep. In fact, Chinese medicine has been used to help women through menopause for centuries.

Let’s look at what a course of treatment could include.

Warm, Hot, or Raging?

Hot flashes—and their nighttime counterpart, night sweats—usually begin as mild episodes of discomfort in perimenopause. During this time, the period becomes irregular. Blood flow may change, and you may experience a shift in frequency, duration of your period, or premenstrual symptoms. The perimenopausal transition can last for a number of years, and hot flashes and night sweats may start well before a woman is officially in menopause.

Menopause occurs once a woman has naturally gone twelve months without having a period or has had her ovaries removed. This hormonal shift can instigate stronger hot flashes and night sweating, although all women are different. For some women, hot flashes are never a problem; others report living with this condition for years after menopause.

The first question I ask hot flash sufferers is how frequently their episodes occur. Once a day? Twelve times a day? Only at night…but all night? Frequency is important to determine, as it will help us chart whether your treatment is working.

Next I want to know how hot a patient feels. Just uncomfortably warm? Briefly hot, but then chilled to the bone? Or are you soaking your sheets at night? Severity of the episodes is also an important point. This will steer me toward whether I recommend acupuncture, Chinese herbs, or both.

Finally, how long a patient has suffered from hot flashes is critical. Is it a new symptom, or have you had them for years? Typically, newer symptoms are easier to treat, whereas older problems take more time to unravel.

Acupuncture, Herbs, or Both?

Patients with mild hot flashes—often women in perimenopause—can usually expect great results with acupuncture alone. I recommend weekly treatments with sessions spaced further apart once symptoms significantly diminish. During that time I will have you track how often you have hot flashes and their severity.

If your hot flashes and night sweats are not managed by acupuncture alone, we should consider a customized Chinese herbal formula. Taking Chinese herbs every day is like getting a daily treatment. For women with strong symptoms, or for those who don’t want acupuncture, herbs are a promising solution.

Finally, some patients benefit most by using both acupuncture and herbs. Women who have had hot flashes a long time, or who have hot flashes with a complex overall health picture, should consider using both.

In all cases, the most important thing to remember is this: come in early. The longer the problem lingers, the harder it can be to treat. That being said, even if you’ve had symptoms for years, Chinese medicine may really be able to help. Most patients can expect changes in the first few sessions.

As one patient shared, “…following just a few treatments with Norah, my hot flashes are now what I would consider ‘micro-flashes’ and are few and far between.” (For more details see Testimonials.)

If hot flashes and night sweats are causing you to dread the summer months in Boulder, call us today to talk about acupuncture and herbal treatment options.