Navigating the Holidays with a Special Diet

This blog post was originally written for Apothecary By Design – a premium quality specialty, retail and compounding pharmacy in Portland, Maine. http://www.apothecarybydesign.com/blog/

I remember when I was a kid going to my Aunt’s house for Thanksgiving, my mom would always show up with a box of special food for us with brown rice, special breads and other jars of rattling, unappealing looking things. I always felt slightly embarrassed, wishing we could just blend in with everyone else. Now, I am that person. I always travel with special bread, usually my brown rice pasta in case of dinner emergency, and other ingredients and snacks that I know I can eat.

Food allergies are on the rise world-wide. It is estimated that 15 million Americans have food allergies, and this potentially deadly condition affects 1 in 13 children. Another study found that 3 out of 4 children had a food reaction. Symptoms can range from an itchy mouth or runny nose, to asthma attacks, skin eruptions, behavioral changes, anaphylaxis and more.  The Center for Disease Control released a study in 2013 stating that food allergies increased 50% between 1997 and 2011. With these kinds of numbers being evidenced in clinical studies, it is likely that many of our readers will be figuring out how to manage this holiday’s season with at least one family member on a restricted diet. For more information on food allergies, please see the following links:

http://newsinhealth.nih.gov/issue/aug2012/capsule1

http://www.foodallergy.org/facts-and-stats

So, what is your plan for managing these holidays that are full of delicious foods that don’t work for you? The first step is to strategize. Complete restriction is unlikely for most of the population, and can lead to binge eating behaviors as a reflexive backlash. This is the “no-strategy” strategy that usually fails. Instead, make some educated choices, and make a plan. Some people can get away with small amounts of some allergenic foods, and can’t get away with others. So, making choices to suffer a little on some fronts so you can stay strong on others may be a safe plan. If you need to stay on a strictly narrow regime for health reasons, it will be more important than ever to plan ahead and bring tasty alternatives to the traditional choices so you have a meal you can enjoy as well.

For example: You really suffer when you eat gluten, but you can get away with eating dairy occasionally.

Thanksgiving Plan: Bring gluten free crackers for the crackers/cheese hour. Bring Imagine brand gluten free turkey gravy (not incredible but good enough.) Bake a gluten-free apple crisp. Plan on skipping the stuffing, but eating the mashed potatoes and dessert with ice cream.

Some families are willing to substitute key ingredients to make some elements of the meal safe for the whole family. For example, mashed potatoes could be made with Earth Balance margarine and an alternative (unsweetened) milk option to be dairy free. Again, a gluten free gravy could be used in addition to the traditional recipe, and a small amount of oven baked stuffing could be set aside for the vegetarians.

If you or a family member has an anaphylactic response to a particular food, it is best to inform all guests ahead of time. Make sure you have an epi pen available as well if you or your child has this kind of severe allergic reaction. There are some supplements that can help balance the overindulgence for mild to moderate food reactions . Gluten-ease was mentioned in our last newsletter as a simple occasional digestive support. This product contains high potency enzymes that ensure complete digestion of gluten, gliadin and casein proteins, reducing allergenic effect and potentially reducing symptom onset. This product is not recommended for celiac disease or people with severe gluten or dairy reactions.

Other products that help quiet an inflammatory food response are quercetin, bromelain, and nettles. These products can often be found combined together in products like D-Hist and D-Hist Jr by Ortho Molecular, and are best taken for 2-3 weeks before the food is introduced to minimize systemic inflammation.  Quercetin is not safe in pregnancy, but nettle tea is a safe, simple remedy that everyone can use. Carminative teas like peppermint, fennel, and ginger can also help ease digestion for everyone after a large meal.

 

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Nutrition, Herbal Medicine, Homeopathy

Naturopathic medicine is not a single kind of healing, but is an array of healing practices. I think of Naturopathic Medicine as a wheel, and what we do as the different spokes that make up the whole. These “spokes” are called modalities, and include acupuncture, counseling, herbal medicine, functional medicine, homeopathy, massage, minor surgery, nutrition and in some states/provinces, prescription medications and/or IV therapies. Naturopathic Medicine is diverse – each doctor chooses what areas to focus on.  Many N.D.’s choose one specific modality, like acupuncture, functional medicine, or homeopathy. Others, like myself, are eclectic and utilize many of the modalities, depending on the individual case.

Acupuncture, counseling and massage are not as applicable for self care; however, nutrition, herbal medicine, and homeopathy are very important ways that people can take care of themselves. There is only so much help that Dr. Google can offer. If general information basics are not resolving the issue, or you have complex health concerns with multiple medications involved, having a licensed ND assist you in recovery is going to be the most effective and safest utilization of natural medicines.

NUTRITION is the philosophy of using food as medicine. Nutrition can be used therapeutically to treat specific conditions – such as eating beets and dandelion leaves for liver cleansing, or cabbage juice for ulcers. The foods that we eat in 2013 are very different from what our grandparents were eating. The soils are stripped of minerals (or toxic like on Munjoy Hill, ) many foods are genetically modified, and the preparation and processing of foods radically alters nutritional values. Supplementation is generally included with nutrition as it is often necessary, given today’s food choices, to supplement some nutrients that are no longer found in food.

HERBAL MEDICINE is an excellent way to treat the whole family. In theory, it is similar to using pharmaceuticals – specific components within each herb cause specific actions in the mind, body and spirit. Herbs can have a powerful action or a gentle action. Generally, the best herbs for self care are simple, common and safe for everyone in the family. If there are any specific contraindications such as interactions with medication, I would be sure to mention those.  The general dose for herbal medicine for an adult is 1 teaspoon of tincture (alcohol extract) in a small amount of water, 3 times a day. Teas are drank hot 2-3 times a day or as needed. Children’s dosage can be determined as follows:

Patients weight in lb divided by 150 = percent of dose

ie) 70 lb child / 150 = 0.46 so child gets slightly less that ½ adult dose.

If is 1 tsp 3 x a day for adult, give ½ tsp 3 times a day to child.

Herbs are generally best taken on an empty stomach, to maximize absorption.

HOMEOPATHY is a very complex system of medicine that gently supports the body’s ability to heal itself through the use of “remedies” and the philosophy that “like treats (or cures) like.”  The specific remedy chosen is one, which, if given to a healthy person, would elicit the very symptoms of an illness. Therefore, the remedy is known to cure that illness. Homeopathic treatment can be a profound journey of self-discovery as old wounds are healed and our true potential is illuminated. Explaining the mechanism of homeopathic medicine is difficult as it operates on the quantum level rather than the commonly understood Newtonian mechanism of action.  Symptoms are seen as effective reflections of compensation on the  mental, physical, and emotional levels. For example, when a warning light comes on in your car,  we investigate what was wrong with the engine, not just disconnect the light! Seen as warning lights, symptoms are the body’s way of showing the outside world that something is wrong or not working properly. The constellation of symptoms points the Homeopathic Doctor to understand the bigger picture overall, and which remedy is indicated to effectively treat the underlying condition. A Naturopath practicing Homeopathy gives a homeopathic remedy to stimulate the body’s defense systems to complete the healing process. This is the concept of the vital force: the body is always trying to move towards health.  This medicine is an extremely safe and effective method of eliminating disease.

 

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Beauty Medicine: VariLite

I had a VariLite laser treatment this week at the Cosmetic Enhancement Center of New England to treat my facial veins. And as I lay twiddling my toes and breathing thru the mild burn, I mused on how long I have had the purple and red lines and from whence they came…. Nose veins and rosacea run in my family, as does fair skin that burns easily. I started getting my redness as soon as I hit the ski slopes with my Dad, and continued to insidiously develop them throughout my twenties. As my eyes watered and Dr. Ollila erased my venous congestion, I thought about how Chinese Medicine correlates the areas being treated with the stomach and large intestine, and my own struggles with digestion. And I promised myself that because I have the good fortune to be able to eliminate these physical signs of my own genetic faults and dietary excess, I will do what I can to prevent this same congestion, stagnation and dis-ease from developing again.

8949_7Traditional Chinese Medicine maps the body with meridians or channels that carry the energy of each organ along the arms and legs. Many of the meridians also run on the face. Areas of physical imbalance in specific areas reflect deeper organ health issues. In my case, the large intestine area at the side of the nose was an obvious place of congestion, reflecting a chronic issue of constipation that was finally resolved in my thirties when I identified and removed food allergies.

The stomach area near my mouth also had faint signs of congestion and stagnation. This area is less of an obvious problem for me – I have a so called “iron stomach.” On the other hand, I do worry. And the stomach is one of our primary organs that is effected by stress, anxiety and rumination. From a mind-body perspective, it makes sense that my stomach area would show signs of strain after years of academia, life’s lessons,  and all the personal stresses that happen. Removing the veins will not remove the underlying strain I put on myself, but I can (and will)  do more to improve my stress management and coping skills to prevent them from resurfacing.

Beauty medicine is a valuable component of modern medicine. With healthy living, exercise and great nutrition, many people’s biological age is younger than their chronological age.  Cosmetic treatments allow us to defy our years and erase the physical evidence of our earlier mistakes. However, it is important to delve deeper and work beyond the superficial level. I am grateful for the opportunity to diminish the signs of aging and look as young as I feel inside. I am also more aware now that I am older (and wiser) to include nutrition strategies like daily fiber ( raw vegetables, ground flax seeds) and probiotics to maintain long term large intestine health.  (For some people,  deeper digestive issues will need to be resolve before a simple maintenance regime is enough.) Stress insists on wreaking its havoc on my face, so I can find better ways to metabolize stress or wear the consequences!  And, of course I will also be aware of the critical damage that sun, wind and cold can have on the sensitive visage – only mad dogs and Englishmen go out in the noon day sun!

If you are interested in beauty medicine, contact The Cosmetic Enhancement Center of New England at http://www.cecofne.com/.

To find out more about how Integrative Medicine can complement your treatments for long term effects and internal wellness  call 207-774-1356 to book an appointment today.

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Dr. Wrights website: www.thewrightdoctor.com

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Naturopathic Trans Health 101

** This is a handout from PTHC June 2013 – Please email me at thewrightnd@gmail.com with your experiences using natural medicines in transition! **

Naturopathic Medicine is: licensed in the state of Maine and many other states and Canadian provinces. We provide primary care using medical and alternative medicine. Naturopathic philosophy is based on the premise your body knows how to heal itself, and medicines from nature can help you overcome obstacles to health.

Naturopathic Doctors tools are: Botanical Medicine, Homeopathy, Nutrition, Lifestyle Counseling, Stress Management. Some ND’s also provide hands-on treatments (Chiropractic, Massage, CranioSacral Therapy,) Prescription medication (thyroid and female hormones, antibiotics, some Lyme medications, topical products),  Acupuncture, Traditional Chinese Medicine and IV Therapies.

FOUNDATIONAL NATUROPATHIC SUPPORT – FOR ALL GENDERS

  • Green tea 1-2 cups daily– anti-cancer, antioxidant, immune system support
  • Adrenal support – adrenals are a major source of hormone production when the gonads are taken out of the picture as is evidenced in menopause and andropause. B5, vit C, Siberian ginseng, Ashwaganda, Rhodiola, Licorice.
  • Probiotics – the digestive tract is the seat of our vitality and overall health.
  • Cruciferous vegetables, fresh ground flax seeds, green tea, sprouts all enhance excess (endogenous and environmental) estrogen elimination – important for every body!

GENERAL TRANSMALE SUPPORT

–       Support adrenals with herbs known to increase testosterone production.

–       Testosterone metabolizes into Dihydrotestosterone (DHT) – a biologically active metabolite of testosterone 30x more potent because of its increased affinity for T receptors. DHT is known to promote hair loss. This conversion can be modulated with SAW PALMETTO – stops the conversion of T –> DHT. PLus ZINC 10-30mg daily.

–       Nettle Tea – decreases bound T/ increases free (active) T, lymphatic support.

–       Reservage Keratin Booster  – prevention of baldness.

GENERAL TRANSWOMAN SUPPORT

–       Breast health! Reduce methylxanthine chemicals found in coffee, black tea, caffeine, and chocolate. At least monthly breast massage for lymphatic health using herbal oils.

–       Aerobic exercise.

–       Freshly ground flax seeds help the body eliminate excess estrogen – add to smoothies or yogurt with fresh fruit and maple syrup. Cancer prevention.

–       What is a phytoestrogen? Plant compounds that bind to estrogen receptors throughout the body.  Soy Isoflavones, Alfalfa (Medicago Sativa), Burdock (Arctium Lappa), Dong Quai (Angelica Sinensis), Evening Primrose, Pau D’arco (Tabebuia Avellanedae), Red Clover (Trifolium Pretense), Saw Palmetto (Serenoa Repens.)

–       Organic non-GMO soy 1-3 times week if tolerated.

–       HRT Companion by Vitanica** Great prevention product for long term use.

–       Reduce systemic inflammation for optimal long-term health – estrogen is protective for heart and bone health, but it can also be inflammatory. How to reduce inflammation? (CRP, homocysteine measures on bloodwork.)

SEXUAL TONIC HERB REVIEW– from The Male Herbal by James Green

Ashwaganda – WITHANIA SOMNIFERA Withanaloid chemicals resemble steroids biochemically. They are classified as an adaptogens to enhance libido and restore fertility and sexual potency.

PANAX QUINQUEFOLIUM – American ginseng.  PANAX GINSENG – Asian Ginseng. All ginsengs provide ginsenoside compounds that effect hormonal balance. Their overall chemistry supports strong sexual function through tonifying activity. They can also increase nitrous oxide levels, improving blood flow where needed. Panax ginseng is classically only used for men as it is too Yang for women’s health unless specifically prescribed.

Horny Goat Weed – EPIDEMIUM SAGITTATUM, EPIDEMIUM GRANDIFLORUM Exhibits moderate androgen-like effect.  Contains flavonoid ICARIIN which is a cGMP-specific PDE-5 inhibitor (like Cialis, Viagra and Levitra)

Muira Puama  – PTCHOPETALUM OLACOIDES Increases circulation, nervous system tonic, improves sexual weakness and diminished sexual desire in all genders.

Maca – LEPIDIUM MEYENII, L. PERUVIANUM ** Nutritive tonic for all genders. Simulates ovarian and erectile functions. **  – Could restore fertility for FTM’s who decide to want to conceive after testosterone use.

Gokshura  – TRIBULUS TERRESTRIS ** Prostate and urinary system tonic. Contains saponin, a steroidal plant chemical to improve libido with impotence. Improves sexual desire, fantasy life and sexual self-confidence. May prolong duration of intercourse before ejaculation. Increases endogenous LH levels. May stimulate endogenous testosterone production in men and women.  ** May also stimulate ovarian or testicular action in ways that are not desired. Use with caution.

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Mediterranean Adventure II

We were concerned that traveling Gluten Free would be tough. And not even just gluten free – I can’t eat potato or corn, and my sweetheart can’t have rice. So, we were both headed abroad knowing that food choices could be tough. We had the good fortune of staying with family, so for most of the journey we had a kitchen and fridge to stock with staples we could rely on. For me – mostly eggs, rice cakes, delicious olive paste, incredible fresh green olives. For my sweetheart – she had the bonus of finding gluten free bread, plus corn cakes, jam, and yogurt. Then we  shared fruit, veggies and local cheeses. She brought her own corn pasta, and I had no trouble finding rice pasta as needed in the local “Veritas” (organic) market for family dinners. We even found quinoa! Local markets and/or supermarkets also had lovely fresh meats, fish and produce for family dinners. We both brought some snack bars (Kits Organics for her and Luna Protein for me) as well as trail mixes. Of course, there were also lots of delicious treats we could both have. Europe has an impressive array of yogurts, puddings, and other cold delights in small jars. (Less ice cream though, in the freezer sections.)

Overall, food turned out to be less of a problem than we feared. When going out, my sweetheart was invariably able to get “patatas bravas,” a local dish of fried potato with a yummy spicy mayonnaise. Tapas (or pinxtos as they are called in San Sebastian) were harder for me to navigate, so often I just didn’t. Dinners out were easier – I could almost always find some delicious fish or chicken and vegetable options in the Menu del Dia – a 10-15 Euro daily menu with 3 courses and wine and coffee included. As my sweetheart is more sensitive to gluten and cant get away with any exposure, she usually stuck to Ensalada Mixta (salad, tuna, olives, and hardboiled eggs) with a potato side dish. All in all, it worked out well. We weren’t able to sample the breadth of Spanish gourmet cuisine, but we still had some flavorful dishes and local delicacies.

As a Naturopathic Doctor, I was constantly assessing the Mediterranean Diet and to see how the classic reputation of the region matched the real fare. As I suspected, there was plenty of bread, cheese, sugar, and packaged foods available as in the Standard American Diet (SAD.) There were a few noticeable differences though that may account for some of Europe’s lower body weights and improved life expectancy. First, there was no bacon. Yes, “bacin” was on some menus, but it was peameal-style bacon, pan-fried and not the true “bacon” of North American fame. Second, beef was rare to see on a menu or in the supermarkets, and was quite expensive. This made sense as we drove across the country, as there were very few cows. European terrain is not made for grazing the way Texas is.

Finally, and perhaps most impressive to me was the rest stops for food along highways. Each one was set up like a classy buffet restaurant, complete with chefs behind the food casing presenting grilled vegetables, roasted chicken, and a wide arrays of sandwiches, jambon, fruit and cheese choices. There were mini bottles of wine and cans of beer at every register, as if instead of being on a roadtrip one was intentionally stopping at that location for a meal. And stop everyone did, even for coffee. The American in me was shocked that people were literally getting perfect little iced espressos and walking to sit down and drink it before they got back on the road. We are such a to go culture! The contrast was very strong, and was I think the best illustration of the differences between our SAD diet culture and that of the Mediterranean. They sit down and savor a meal, a coffee, and a moment in time. It’s a lifestyle, a way of thinking, and a paradigm. We eat on the go, “para llavales”. We Rush, wolfing down food, eating mindlessly as we multitask and gulping down our beverages while we push on ahead. And we pack on the pounds and generate chronic disease as we go along, coercing our nervous systems into simultaneously digesting and running at the same time.

I am still filtering through layers of impressions, photos and reflecting on the whole experience of world travel. I highly recommend Spain to anyone – Barcelona is the second most popular tourist destination in the world, and well worth the hype. Traveling gluten free was not a problem; we were able to find great local resources and food options, especially for a food adventurist. For those who can eat gluten, there is an incredible world of tapas out there just waiting your arrival! But do yourself a favor – eat like you have all the time in the world.

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Mediterranean Adventures

We are traveling in Barcelona and parts of Northern Spain for two weeks ~  visiting ex-pat family and having a European vacation while Spring comes to the Northern US. As many Americans have often commented while traveling in Europe, the difference in body weight here is remarkable. Simply put, very few people are overweight. And, despite the smoking, wine consumption and late nights, it is known that Europeans live longer than Americans on average. So what is the big difference? Eating patterns, Diet, and Lifestyle.

By Diet, I do not mean calorie restriction, portion control or eating plans. I mean, a style of food intake linked to cultural patterning and local food options. The Mediterranean Diet has been a source of scientific study for several decades because European countries centered around the Mediterranean Sea have statistically lower levels of heart disease, diabetes, and other chronic diseases. It is a nutrition pattern that includes a foundation of olive oil, fruit, vegetables, fish, seafood, whole grains, pasta and potatoes. This is complemented by smaller amounts of eggs, dairy and chicken. Red meat and sweets are eaten occasionally. It is also a practical nutritional plan – meat is expensive, tomatoes and olives are not! The “Mediterranean Diet Pyramid” is a famous illustrated depiction of the basic concepts. (See Resources below for a great downloadable version.)

We noticed a few real differences right away.

1. There is no To Go – people sit to eat their food and drink their coffee.

2. There is no half and half or cream for coffee. There are no Grande or Venti coffee options. A coffee is a small cup of strong brew with or without steamed milk and sugar.

3.  The cities are made for walking and biking! With bike lanes and mazes of small windy alleys and wide picturesque boulevards the cities inspire pedestrian activity.

We haven’t quite adjusted to the concept of siesta time yet. In fact, between jet lag and our American ways, we have almost invariably set out right as the shops roll down their doors and the streets close up for the afternoon 2-5pm rest. This is our goal for the trip – to learn the fine art of Siesta. What an ultimate luxury!

US life expectancy links https://www.wsws.org/en/articles/2013/01/11/life-j11.html and http://www.economist.com/blogs/buttonwood/2013/01/life-expectancy

Mediterranean Diet Research: http://jama.jamanetwork.com/article.aspx?articleid=199485

http://www.mayoclinic.com/health/mediterranean-diet/CL00011

Practical Resources: http://oldwayspt.org/resources/heritage-pyramids/mediterranean-pyramid/overview

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Nutrition to Strengthen Liver Yin

     Modern culture is Yang obsessed. We go-go-go, we seek sun, we burn the candle at both ends, we exercise vigorously, and we love stimulants. It is a rare bird that has enough quiet, meditative alone time, in a dim or dark environment. This is the Yin state – nourishing, moistening, dark, and quiet – Yin builds what Yang wears down.

Every organ of the body has a Yin and a Yang aspect. Some organs (Spleen, Liver, Heart, and Lung for example) are naturally more Yin in Nature. Other organs (Stomach, Gall Bladder, Small Intestine and Large Intestine for example) are more Yang in nature. These “natures” were determined by the functions each organ enact as well as more energetic attributes. Supporting the natural state of each organ will optimize health, and promote healthy functioning.

      Much is said about detoxifying the Liver, and reducing its Yang (brought on by alcohol, drugs and stimulants) but what happens when you actually have deficient Liver Yin that needs to be nourished?  Stripping an already deficient organ will create further disharmony that will eventually manifest as pathology.

      A diagnosis of Liver Yin deficiency means that this aspect of the Liver organ network is compromised. The Liver not only detoxifies, it has many other (building) jobs including cholesterol metabolism, vitamin storage, bile production, and blood reservoir. Blood is a Yin substance (all fluids are yin) and many B12 and iron anemias can be diagnosed early on as a Liver Yin deficiency by a trained Acupuncturist. Thin brittle nails, anemia, sallow skin, easy bruising, hair loss, blurred vision, tinnitus, dizziness, infertility  and some tremors  are all associated with a Liver Yin deficiency diagnosis.

Nutrition is one of the best ways to support and recover Liver Yin. A diet that is nutrient rich and nourishing is essential, as is sitting down to relax while you eat and chewing thoroughly to savor flavors. The diet should also include plenty of fluids, especially in the form of soups. Meals consist of 40% easily digested complex carbohydrates like whole grains and starchy root vegetables. Another 40% of the diet is cooked vegetables. Proteins comprise 10-20% of the diet, with a focus on high quality organic or grass fed sources. Healthy fats fill the other remaining 5-10%.

Below is a list of recommended foods to nourish Liver Yin. Do not limit your nutritional intake to only these foods. Instead follow the guidelines above of the optimum ratios of carbohydrates, vegetables and proteins, and add the recommended foods from the list below within your meals. Where ever possible choose organically grown foods to avoid genetically modified ingredients.

Foods to Nourish Liver Yin Deficiency

 Zucchini, squash, potatoes, sweet potatoes, string beans, beets,

Mushrooms including wood ears & tremella,

Tomatoes, spinach, carrots, parsley,

Molasses

Apples, banana, mulberries, mango, coconut, peaches, lychee fruit, melons,

Grapes, raisins, cherries, plums

Olive oil, flaxseed oil, almond oil

Vegemite, kelp, spirulina, wheatgrass

 Oats, rice, millet, barley

Adzuki beans, black beans, mung beans

Organic cow, goat and sheep yogurt

Tempeh, tofu, miso

Nuts & seeds, black sesame seeds (great as a condiment!)

Eggs

Pork, chicken, Chinese black boned chicken, duck

Mackerel, sardines, oysters, mussels, clams

Cuttlefish, squid, perch, eel

Foods to Restrict or Avoid

Chilies, cinnamon, garlic, ginger, onions, shallots, leeks, basil, cloves, wasabi

Coffee, black tea

Vinegar, pickles

Lamb, shrimp, veal

Citrus fruits

Cigarettes, alcohol

Recreational stimulants

Activities that build whole-body Yin nourishment are also encouraged while working specifically on Liver Yin. Rest more. Read. Spend some quiet, alone contemplative time in a cool, dark room with a candle lit (taking a bath is a nice way to do this.) Exercises like Tai Chi and Yoga are more Yin building than Yang in nature. Drink warm water and lemon. Get extra sleep. Breathe.

References:

Clinical Handbook Of Internal Medicine, Vol. 2. MacLean & Lyttleton. University of Western Sydney: Australia. 2002.

Chinese Dietary Therapy. Liu, J. Churchill Livingston: Edinburgh. 1995.

The Healing Cuisine of China. Zhao & Ellis. Healing Arts Press: Vermont. 1998.

An interesting theoretical write up: http://www.indiadivine.org/audarya/ayurveda-health-wellbeing/997986-liver-yin-deficiency-patterns-derived-patterns.html

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