Tongue diagnosis in Acupuncture

When you visit an Acupuncturist for the first time, you will go through a huge amount of questions involving diet, stress factors, lifestyle choices, past medical history, etc, but one of the most astonishing things you will be asked to do is….stick out your tongue!

I wish I could record the expressions of amazement and puzzlement on the faces of people when I ask them to do this! Im frequently asked “why”? And then “what does that tell you”?

The answer is everything! The tongue in Chinese Medicine is one of the most important diagnostic tools we use. It can tell us everything about your state of health and indeed what organs of the body may be out of balance and requiring attention.
The root of the tongue corresponds to the kidneys, the middle of the tongue relates to Spleen and Stomach (digestion), the tip of the tongue indicates the Heart and Lung organs, and the sides give an idea of the state of the Liver and Gallbladder.
Here are some of the things we look for :Claudine Ivers tongue

Colour. A normal / healthy tongue body has a pale red / pink colour with a slight coating.

Red Tongue: This indicates Heat either excess or deficiency depending on the coating or absence of coating. Heat can come from Stress or Emotional problems and can result in Insomnia, IBS, etc.

Purple body. This can indicate Blood stasis, which is often a factor in Dysmennorhoea or Endometriosis and can manifest in severe Pain. A Bluish Purple body may indicate retention of Cold especially in the Uterus leading to another manifestation of Dysmenhorrea or Endometriosis. Application of Heat both externally and internally would be appropriate here in your Acupuncture treatment wheras in the Purple tongue body, movement of Stagnation/ Stasis and reduction of Heat is more appropriate.

Red tip. The tip of the tongue corresponds to the Heart, and the area just behind this relates to the Lung area. A red tip with a normal coating otherwise may indicate anxiety, insomnia, palpitations etc. A red Lung area may show symptoms of cold or flu, and may indicate Asthma or cough.

Red sides of the tongue. The sides correspond to the Liver and Gallbladder area in Chinese Medicine. These organs are mostly the organs which become unbalanced when the body is experiencing stress giving rise to a condition called Liver Qi Stagnation in TCM terms. Sometimes there may also be engorged blood vessels under the tongue with this condition also.Symptoms of Liver Qi Stagnation are irritability, migraine, insomnia, IBS, belching, headaches, hypochondrial pain, dysmennhorea, agitation.

Teeth marks. Teeth marks along the side of the tongue indicate a condition called Spleen Qi Deficiency. Most people in our modern world suffer some form of Spleen Qi Deficiency without experiencing ill effects. In general the symptoms of Spleen Qi Deficiency are tiredness, lassitude, loose stool, bloating, sometimes nausea and vomiting.

Coating. A healthy tongue has a light white coating. If this coating is absent, the underlying tongue is usually red, which will be very evident. A red tongue with little or no coating indicates something called Yin deficiency or Deficiency Heat. Deficiency Heat or Yin Deficiency is a symptom in Menopausal women, and will result in Irritability, Night sweats, feeling agitated, Insomnia, restlessness, palpitations etc.This condition definitely requires attention to diet and lifestyle to improve quality of life. Chinese Herbs work very well here to improve symptoms and regulate the body.

Thick white coating. This is usually indicative of Damp retention in the interior, and will give rise to symptoms of Bloating, maybe loose stool, Sluggish digestion, feeling tired and lethargic.

Yellow Coating. This again is Damp retention but it has now combined with Heat. This will give rise to symptoms of Heat, sweating, Pains in muscles or joints, perhaps constipation, maybe Migraine, certainly irritability and agitation.

Tongue thickness. A thick flabby tongue which is also very wet indicates excessive Damp in the interior and possibly Yang deficiency, causing mostly Digestive issues and tiredness, with a general lack of motivation.
A short thin tongue indicates Blood and Qi deficiency which can have all sorts of implications for Menstrual symptoms like Amennhorea, constipation, short menstrual cycle, tiredness, insomnia, arthritic pain etc.

And we can see all of that in the space of less than a minute! There are other things we look for also, but the above are the most important,and mostly co-incide with the verbal history given by the patient.

So when an Acupuncturist asks you to stick out your tongue, its not rude if you do! Its essential for the conversation of diagnosis and treatment.

Managing Menopause with Acupuncture and TCM

Menopause marks the stage in a womans life where her periods stop and she is no longer fertile or able to become pregnant. In Ireland and the UK, the average age for the Menopause is 52, but interestingly, in India, the average age can be 41 yrs old!

The Menopause is a normal part of life! It is a milestone, just like Puberty. It is NOT a disease or a condition, and every woman will experience this transition at some stage of her life. However, it is amazing how taboo the subject can be for so many women! I believe there is an element of denial for some women, maybe because it marks the loss of their youthful childbearing years and the transition to middle / old age.For some women who have never had children for whatever reason, it marks the definite reality that this can no longer happen, and I believe a lot of women experience subconcious loss and grief during this time and beyond.

But not only do we go through the Menopause and all the physical symptoms this entails (Ill get to them later), but for 2 to 3 years prior to the final period, there is a gradual winding down time called Perimenopause, where the Oestrogen levels begin to taper off before the ovaries finally go into decline, which is ACTUAL Menopause.Experts say that the Menopause is diagnosed when a woman has not had a period for a whole year. Prior to this, falling Oestrogen levels will bring on irregular periods, sometimes heavy bleeding, and some night sweats.

So what are the symptoms of Menopause?

. Irregular Periods leading to no Periods.

. Loss of Fertility

. Vaginal Dryness. This can sometimes be very uncomfortable, especially during sex and is due to falling Oestrogen levels.

. Night Sweats. These for some women can be very severe, and may necessitate a change of night clothes. They may happen up to 5 times a night.

. Hot Flushes (Tropical moments)! These happen at any time during the day and may start with a slight heat in the face or neck, and may spread up or down the body. Sometimes this is accompanied by a visible redness in the face and some perspiration.

. Insomnia. This may be due to the night sweats.

. Moodiness or irritability. This may again be due to lack of sleep, or as mentioned above, an underlying inability to accept their life stage.

. Anxiety. This happens to quite a number of women, and is likened to an unexplained feeling of dread, even though there may be no actual reason for it.

. Palpitations. This goes with the anxiety / stress.

. Painful or achy joints. This is due to falling Oestrogen levels.

. Bloating, weight gain or change in bowel habit. Again Oestrogen is the culprit.

So…all in all while it is a normal milestone, for some women it can be a very uncomfortable one. Most symptoms can go on for 2 to 3 years after the cessation of the menstrual cycle.

So How can TCM help?

The first thing to say is that interestingly… most Asian women experience very few of the above symptoms during their menopause!
This is because they prepare for this transition early by addressing their diet and taking herbal prescriptions.

From a TCM perspective, Menopause is a natural decline in Kidney Qi and Essence. The Kidney in TCM is an essential part of our growth and development throughout our lives, and has a huge impact on our Puberty, Menstrual cycles, Fertility and ultimately our Menopause.Stress throughout our lives can impact the strength of our Kidney Qi, as can the natural phases of Menstruation and childbirth, until when we reach Menopause the effects become very noticable.

In Menopause, the component of our Kidney Qi which is most affected is our Kidney YIN. Yin in TCM is the energy which relates to fluidity, moisture, coolness, tranquility, night time and peaceful sleep, as opposed to YANG which is the very opposite,relating to Heat, Dryness, Action and Day time.

So with the decline in Oestrogen which is the hormone which keeps the vagina moist,the body temperature regulated and keeps evertyhing fluid, this corresponds to a decline in Kidney Yin Qi (energy), and thus needs to be supplemented.

So how do we do this?

The first thing is Diet and Lifestyle.

Avoid anything which increases the Yang. This includes Coffee, Alcohol, Spicy food, and Stressful situations. Include instead, Camomile tea, Peppermint tea, LOTS of water, Fish, Fresh fruit and Vegetables. Most women in Menopause need 200 to 400 fewer calories due to a slower metabolic rate, and increase exercise. Try Yoga or Meditation to aid relaxation.

Sleep in a cool room and wear loose clothing.

Include a supplement of Magnesium, as research has shown that this mineral can be lacking in Menopausal women, and it can help minimise Hot flushes and improve sleep. Also include a supplement of Sage to help with flushes, Omega 3 to improve concentration and help Cardiovascular health, and Vit B Complex to help with stress.

And now for the best part! Acupuncture and Chinese herbs!

Acupuncture can STOP sweating, can improve sleep and restore the balance of Yin and Yang in the body. Chinese herbs to increase Yin and calm the mind can naturally restore the equilibrium of the body. Chinese Herbs have been used for centuries to help women through this transitional phase of their lives.The first recorded Chinese Herbs were from around 200 AD where a Dr Zhong Zhang developed a range of prescriptions which he kept locked in a golden cabinet. But somehow they got out and they or variations of them are still in use today.These include Liu Wei Di Huang Wan, You Gui Wan, Jin Qi Shen Qi Wan…and others!

So the Menopause doesnt have to be a stressful minefield of uncomfortable changes. There is help and Acupuncture and TCM can help you move through this phase peacefully and with minimal stress.

Why not give me a call to discuss what it can help you with.

Mairead Fahy RGN Dip Ac and TCM L Ac Nanjing (China). Phone 0539483155 or 0876452409.