Thursday, August 23, 2012

Tongue Chronicles: Are We All Yin Deficient?

Yin.  I didn't even know what that was until a week ago.  Now, it's got me thinking.  Here's the story.

As many of my dear friends and readers know, I have had endocrine issues for years, starting with obesity at age 9, transforming into gestational diabetes during my first pregnancy in 2007.  The saga continued in March 2010, when I was diagnosed as "pre-diabetic" by my MD, following an oral glucose tolerance test and HbA1c.  I was put on metformin and monitored, but with no healthy diet changes yet made, my numbers did not change much.  

Fast forward to January 2011.  I started LCHF, and noticed dramatic improvements to my health and well-being.  Among those improvements was a change in my HbA1c and daily blood glucose readings for the better.  

Fast forward to the present day, and labs from my last two PCP and endocrinologist appointments have come back with a "normal" HbA1c.  I give all of the credit to LCHF.  Carb restriction is the way to go, without a doubt.  There is no better diet to help control your blood glucose.

However, for many of us who have a history of metabolic and endocrine disorders (Diabetes, Obesity, PCOS, anyone!?), diet is not enough to get your glucose down to where it needs to be.  This has certainly been true for me.

I take blood glucose readings pretty regularly with my glucometer, at home.  While adherence to a LCHF diet has improved my glucose readings tremendously throughout the day, I am still getting high glucose readings in the morning.  This is frustrating and confusing, because I fast during the night when I sleep, and so why in the heck would my fasting glucose at 7 a.m. be the highest of the day??!!  

I tinkered around with the timing of dinner, and found that earlier dining and no snacks aftert 7 p.m. helped to get my fasting glucose down from 139 to 117, on average.  That's still too high for me.  I am a young woman who is interested in having more children, and the American College of Obstetrics recommends that fasting glucose be below 100.  

There are a lot of theories, including the Dawn phenomenon and the Somogyi effect, to help explain why fasting blood glucose is so high in some people.  The Dawn phenomenon essentially posits that counterregulatory hormones (growth hormone, cortisol and catecholamines) cause the glucose level to rise overnight. For people with diabetes who do not have enough circulating insulin to keep this increase of glucose under control, the end result is a high glucose reading in the morning.  The Somogyi effect can be called "rebound hyperglycemia", and essentially posits that diabetics become hypoglycemic during the overnight period, and the body seeks to protect itself by releasing hormones that create glucose, in response to dangerously low levels of blood glucose.  One way to determine if either of these things are happening to you is to test your blood glucose at 2 a.m.!  That sound great!  Not.

So, I drew this conclusion: fixing my diet is not enough to get my blood glucose completely in control.  There is more going on than meets the eye, and it has everything to do with unresolved hormonal issues. 

I have made an appointment with my endocrinologist, and will see him tomorrow.  He will undoubtedly prescribe me some form of long-acting insulin to take before bed, to keep me low for the morning.  I can do this.  I have done it before.  I will do it now, if need be.

imageI ALSO started seeing an acupuncturist (is that the right word?), for the first time, last Monday.  He took one look at my tongue and diagnosed me with a chronic yin deficiency.  Apparently, I have a cracked tongue (not a split tongue, thank you very much), and TCM (Traditional Chinese Medicine) dictates that a cracked tongue indicates yin deficiency, you know.  Here are some creepy photos of yin-deficient tongues for your enjoyment.  

Here are some of the apparent symptoms of yin deficiency:

  • Afternoon mild fever
  • Night sweating
  • Five Centers Heat
  • Scanty, dark urine
  • Dry stools, no pain
  • Thirsty, with no desire to drink, or just in small sips
  • Dry mouth and throat at night
  • Mentally restless but tired, vague anxiety, fidgety
  • Defensive
  • Frequent waking during night
  • Red line inside eyelid
  • Mild red, painless spots
  • Overextended
  • Red cheeks;
  • Tongue is red with little coating, peeled, and possibly cracked
  • Rapid pulse.
I have several of these symptoms.  Interestingly enough, I happen to have mild, red, painless spots - my dermatologist calls them guttate psoriasis.  


This is Rehmannia.
Pretty, but unpalatable.
So, the acupuncturist is treating my yin deficiency with acupuncture (which doesn't hurt) and vile Chinese herbs.  "Herbs" is a very benign word, and cannot begin to conjure up how disgusting the prescription really is.  Called "Rehmannia 6", though they typically carry this in capsule form, the office was out this week, and I had to take the powdered version, ten tiny spoonfuls each day.  It is like eating lemon-scented sand.  Just as gross as you can imagine. There is literally no way to prevent myself from gagging.  Ugh.  

But, how do I feel?  

The answer: Pretty good.  

This Chinese medical treatment is definitely having a diuretic effect on me, which is good because I was feeling kind of bloated.  I feel less thirsty, and my water output is up.    My fasting glucose readings haven't changed much, though I did just have a 114 reading on Wednesday, which is the lowest I've seen in a while.  

Here's the skinny on TCM: for those of us who are used to Western medicine, TCM sounds a little crazy.  Yin is substance, yang is energy.  Yin is damp, yang is hot.  I need more yin-derived dampness to tamp down my normal levels of hot yang...  Odd, and a little dirty?  Just me?  Okay.

Sound a little wacky to you?  Think again.  

Check out this 2003 article from the journal Endocrinology (link is to the full free .pdf version).  On page 3752, there is a diagram which depicts leptin and ghrelin as yin and yang, respectively.  When in balance, yin/leptin and yang/ghrelin "maintain an appropriate and tight regulation of body weight and food intake".  When out of balance, obesity, anorexia and cachexia result.  

I'm giving TCM a chance.  What about you?

I'm pretty sure that I'm not going to post pictures of my tongue.  Let's keep it classy, world wide web!

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