Michael Tierra

Michael Tierra


I really like when I can use a standard protocol for a disease and receive consistently good results. This is especially true when it is a condition such as rheumatoid arthritis, an autoimmune condition. Specifically, “autoimmune disease” refers to a condition where the body mistakes its own tissues for foreign invaders such as bacteria and viruses and creates antibodies to seek out and destroy those specific tissues. In the case of rheumatoid arthritis, the body attacks its own synovial tissues within the joints.

Besides being an autoimmune disease, rheumatoid arthritis differs from the more common osteoarthritis in terms of cause. Where rheumatoid arthritis is characterized by redness, swelling and eventual crippled joints and may affect all tissues of the body including soft tissues, osteoarthritis is caused by wear and tear of the joints that occurs in most animals as a somewhat normal course of aging.

At the onset RA might first affect the small joints of the fingers and toes with symptoms of warm, redness, stiffness, and swelling in these joints.  Eventually this can spread to larger joints including hips, shoulders and knees with occasional periods of remission. RA can damage the joints within three to six months of onset and individuals with RA may be unable to work after 10 years. Furthermore, it can affect other tissues including theheart, lungs, vascular system, eyes, skin and blood. All of these further complicate diagnosis. Western medicine has no cure for RA.

There is a standard blood test for used to diagnose rheumatoid arthritis.[1] Personally, I don’t refer to the RA factor blood test in my practice to treat a condition such as RA because traditional herbal medicine doesn’t require such a test. Furthermore, sometimes such tests applied to incurable diseases such as RA deepen a commitment in the patient’s mind to having a condition which from the body-mind perspective only makes rallying the complete healing forces of the body more difficult. Additionally, the RA factor test is unreliable; it can test positive in normal people and negative if there are other autoimmune conditions active in your body such as Sjogren’s disease, lupus, and viral hepatitis. Finally, I have treated many people who tested positive for RA successfully, provided the condition is not so advanced as to exhibit severe bone degeneration with twisted, crippled joints. In all cases, significant pain relief can be consistently achieved with the adoption of an anti-inflammatory diet and nature’s wonderful healing herbs.

It is estimated that approximately 41 out of 100,000 are diagnosed with RA per year and 1.3 million American have been diagnosed with it. The risk is somewhat higher for women and begins earlier in life than for men. Heart attack and stroke risk increases as much as 60% one year after diagnosis, people with RA are more liable to infections, and twice as likely to suffer from depression.

Drugs used to relieve symptoms are among the worst in terms of short- and long-term adverse effects. Drugs used in the treatment of RA include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), which are the mildest pharmaceutical treatment option. They range from aspirin to many others including ibuprofen. These help to reduce inflammation but do not halt the progression of the disease.
  • The next in line are corticosteroids, which quickly reduce inflammation and are supposed to be limited to short-term usage.
  • The next group of drugs are classified as disease-modifying antirheumatic drugs (DMARDs) which work to slow down the progression of RA and biologic DMARDs which are often used in combination to increase the efficacy of DMARDs.

Conventional medicine is beginning to acknowledge that dietary changes, lifestyle changes and herbs can relieve RA symptoms. My own clinical experience concurs with this.

There are few serious diseases that I can say seem to respond to a basic treatment protocol. However, so many patients who have come to me diagnosed with RA and osteoarthritis have responded positively to essentially the same basic protocol, which I share with you below.

Adopt an anti-inflammatory diet which consists of eliminating all refined white sugar, refined flour products, dairy, alcohol, and coffee. For some this may include gluten as well as other possible allergenic foods. Instead one should adopt a fiber-rich diet of organic fruits and vegetables, animal products such as naturally and organically raised animal foods, free-range chicken and eggs.

For many this may mean beginning with a special healing diet of kicharee, based on a combination of rice (white or brown), split yellow mungs beans, spices such as turmeric, cumin coriander and ghee.

Omega-3 fatty acids are well known to reduce inflammation throughout the body and are extremely beneficial for the treatment of RA. Various brands are of good quality including Nordic Naturals, Life Extension, Dr. Mercola’s krill oil, Carlsen’s, and Kirkland’s. I suggest a daily dose of 1000 to 1600 milligrams daily.

Alpha Lipoic Acid (ALA) is a powerful detoxifying antioxidant with special affinity for the liver and kidneys. ALA assists in converting glucose into energy, improves insulin sensitivity which asserts blood sugar control and is even known to reduce neuropathy in diabetics. It also naturally increases glutathione, the most powerful antioxidant that is produced naturally by our body. There are many fine products on the market, including Source Naturals time-released capsules available in 100, 300 and 600 mg doses, NOW Alpha Lipoic Acid, Pure Encapsulations Metabolic Xtra, and Vitacost. Take 200-600 mg daily.

A single daily good quality multivitamin should be taken for a few months to remedy any vitamin deficiencies. I use Source Natural’s Life Force Vitamins, but there are many other good quality multivitamins on the market. I usually like anything that Now brand produces. Rainbow Light also has a fine multivitamin.

Herbal formulas:

The single most effective formula I have used with consistent beneficial results is the TCM formula known as Angelica and Loranthes Combination (Du Huo Ji Sheng Tang). The brand I most commonly rely on is Active Herbs formulation called JointsJoy. It is available in easy to swallow pilules or tablets. This consists of a highly concentrated 5:1 herbal formula of 14 herbs, minimal fillers and binders made in a GMP-certified kitchen and imported in accordance with U.S. FDA guidelines. The recommended dose is 6 tablets taken two or three times daily with warm water. Because an RA patient might be taking this supplement for several months, I recommend purchasing a case of 12bottles at a time.

Another formula that is particularly effective when arthritis flares up in cold, damp weather is Feng Shi Xiao Tong Pian which in Active herbs brand is conveniently called ArthritEZ.

In addition, I recommend two capsules of Planetary Herbals’ Triphala complex which assists in normal detoxification, digestion and elimination. Triphala is a basic formula that can be used for all conditions as well as general health and wellness.

Planetary Herbals’ Flex Ability (Shu Jin San) is a Chinese formula consisting of 10 herbs. It treats arthralgia, both osteo- and rheumatoid arthritis, neuralgia, neuritis, numbness and pain in the legs, hemiplegia, chronic B vitamin deficiency, and paresthesia.  It is famous for increasing flexibility and works more on the muscles and tendons. It is available in liquid extract and tablet form. Take two tablets three times daily.

The above three formulas can be taken concurrently or on alternate weeks. 

Finally, every herbal anti-inflammatory protocol should include turmeric (with other herbs as appropriate for the patient's constitution). I use Planetary’s Full Spectrum Turmeric extract at a dose of 30 to 40 drops three times daily.

Other optional herbs and supplements that can be included are MSM (methylsulfonylmethane) and Planetary’s Guggul-Cholest.

One should get moderate daily exercise; a vigorous walk or swim are excellent options. Yoga stretches, besides making for more flexibility and limberness, also work on activating the deep hormonal systems of the body – be careful to not overdo yoga when beginning as it can result in sprains and strains which may limit further exercise at least for a while. Remember, a personal exercise routine is not a competition. Any exercise can be overdone. All one needs is about a half hour daily.

If one has access and can afford it, a series of acupuncture treatments can be extremely beneficial, especially if the acupuncturist employs methods other than just needles such as moxibustion  (applying heat close to acupoints and areas on the body), gua sha (a relatively painless rubbing over specific areas), and cupping therapies. I feel confident that this protocol will absolutely relieve or cure most cases of early stage arthritic conditions of all kinds (before deformity has occurred) and relieve inflammation and pain generally in all cases.

If one wishes to set up a telephone consultation or an office visit with myself, Lesley or one of my associates call (831) 429-8066, East West Herb and Acupuncture Clinic 912 Center Street, Santa Cruz, California.






[1] Sjogren’s syndrome is characterized by dry eyes and dry mouth. It is also an autoimmune disease. In traditional herbal medicine Sjogren’s syndrome is a form of Yin Deficiency. I have also treated this condition successfully with a dietary and herbal protocol.

Kratom leaves


See Part 1 of my series on kratom here.

I work at a local free clinic alongside other students and colleagues dispensing healing advice, free herbs and acupuncture. One of our regular clients is a woman who had been famous for her constant irritability and violent outbursts of anger. One day, unkempt, dirty, toothless, friendless, homeless, “crabby Judy” as I lovingly dubbed her, appeared in her customary angry and fitful self (though less so than as in previous months, thanks to our steady work with her). This time, she complained of chronic migraine headache and pain throughout her body. I decided to try giving her a teaspoon of the more uplifting white-veined kratom and administered some acupuncture on a bench outside of our clinic area. When I came back to her a half hour or so later, she specifically commented how her headache was nearly gone, her pains were greatly relieved, and in her own words she described how she felt “somewhat more uplifted.” Having treated her several times before, I could easily differentiate the beneficial difference kratom had on her psyche.

A wise man once told me that the most important aim of a healer is to instill hope in their patients. It is difficult to do this if a patient experiences the same complaints and pain as when they first came. My experience treating Judy that morning inspired hope in both of us; not that all of her life problems could be resolved but that with the help of a near-miraculous herb, kratom, we could each part with a sense of hope because she felt better.

I’m sure if you cut through the confusion and hype, you will see that kratom is not a cure-all, but many suffering people would find it useful.

Clinical Classification and Uses of Kratom

Mitragyna speciosa (Kratom)

Family: Rubiaceae (same family as coffee)

Energy and flavors: Warm and stimulating in small amounts; cool and sedating in large doses. Bitter.

Organs and channels affected: Liver, Lung, Heart, Large intestine

Chemical constituents: Over 40 alkaloids, especially mitragynine and 7-hydroxymitragynine. These are both opioid receptor cell agonists, occupying all but one of the opium receptor sites in the body. This is considered the reason that it can be used as an alternative to opioid drugs with none or few adverse side effects.  

Properties and actions: TCM: Relieves pain, Calms Shen, astringes Lung Qi, astringes the Large Intestine. Western: Analgesic, sedative, anti-anxiety, mild anti-depressive, anti-inflammatory, anti-diarrheal. Ayurvedic: pro-vata dominant because of its cooling and drying properties; anti-pitta because it is cooling; anti-kapha mainly because of its bitter flavor.

Uses and Indications:

  1. Pain
  2. Opiate withdrawal
  3. Alcohol withdrawal
  4. Speed-type drug withdrawal
  5. PTSD
  6. Anxiety
  7. Depression
  8. Insomnia
  9. Inflammation
  10. Diarrhea
  11. Cough

Note: Of the many indications described above, I have had particularly good results from individuals who suffer from PTSD with related severe bouts of anxiety and depression.

Dosage: Of the powder, 3 to 9 grams once to three times daily. Dosing is highly variable depending on the individual, the severity of the condition to be treated, the strain and strength of the kratom powder.

A widely published dosage recommendation is as follows:

  • 2 - 4 grams= mild stimulating effects (a teaspoon of powder is three grams)
  • 4 - 6 grams= medium effects (Stimulant or Sedative effects / Analgesic Effects)
  • 6 - 8 grams= strong effects (Sedative / Analgesic Effects; Too strong for most people)
  • 8 grams or Higher= very strong effects (Sedative / Analgesic Effects; NOT RECOMMENDED)

Note: The dosages above are not per-day doses but a dose taken at one time, once, twice or three times a day.

Always begin with the low to medium dose, usually about a teaspoonful. Its pain-relieving effects last anywhere from 4 to 6 hours. The dose can be repeated, increased or decreased as needed with the general rule that one should take as low of a dose necessary. The dose can be increased gradually based on and as needed basis according to the above dosage guidelines.

To reiterate: only take the minimum dose necessary. (I don’t recommend using it recreationally – it is actually just not that much fun!)

The Three Predominant Strains of Kratom Are Classified as Follows:


Green-veined “maeng da


Considered the most sedative and pain relieving

Medium potency, most useful clinically

More stimulating, rather than sedating and pain relieving

All three strains share the same basic properties with various strengths and potencies as described above.

Since the powder is the form most commonly used, I usually recommend ingesting a teaspoon of the powder and quickly washing it down with water. Because the properties of kratom are based on its alkaloids, it is most powerfully absorbed when it is taken with a little apple cider vinegar mixed in water or lemon juice. Some people have trouble tolerating its bitter flavor; to offset this, some take kratom mixed with chocolate milk or chocolate.

Can You Build up a Tolerance to Kratom?

Though I have not witnessed this personally, some who need to use concentrated high doses for severe problems may find themselves building up a tolerance. This can lead to increased dependency. If possible, use it on an as-needed basis and to refrain from taking it every third day or so. If after using kratom for a while, you find yourself craving it, stop using it altogether for several days.

Much like caffeine withdrawal experienced by coffee quitters, after stopping kratom, some people may experience a few days of mild discomfort, which range from headaches, jittery feelings, nausea, etc. These symptoms are relieved as kratom is cleared from the system.  (see https://www.kratomscience.com/dosage-conversion-chart/)

Contraindications, Possible Adverse Reactions and Adulteration Issues

Kratom is generally safe and its effects are similar to the effects of Kava (Piper methysticum) in its anti-anxiety and calming effects. It is much stronger than kava for pain. Use with caution for symptoms associated with Yin Deficiency such as night sweats, dryness, constipation, unusual thirst, and itchiness. However, if it is still needed for its pain-relieving, anxiety-dispelling, and opiate-withdrawal properties, it would be best to take it with a Yin tonic. These are herbs with tonic, demulcent properties that help balance the drying effects of kratom, such as mai men dong (Ophiopogon japonica tuber) and/or marshmallow root.

Because it is sold as a recreational drug, some distributors have taken to spiking their kratom powder with substances to intensify its effects. Some kratom products (see Krypton Kratom) were found to be spiked with the opioid tramadol that is addictive. Deaths and severe reactions were associated with these adulterated products. Avoid this at all costs; find a reliable source of pure, unadulterated kratom. In general, avoid buying kratom from outlets specializing in dispensing cannabis and other intoxicating substances for private use. The exception to this may be the various “kava bars” which have sprung up around the country.  These bars sell mild psychoactive herbal drinks which are consumed in a public setting.

Is Kratom Addictive?

I’m sure that any herb that is a potent pain reliever, antidepressant, anti-anxiety agent and has a long-time reputation responsible for helping thousands of people throughout the world overcome addiction to far more dangerous drugs and alcohol, has itself the potential to be addictive to some. This is especially true since kratom is also widely used and abused recreationally. Kratom is controversial because some choose to abuse it by taking high doses (over 10 to 15 grams or more of the powder one or more times daily); these people are bound to develop a dependency or addiction to it. I once knew a man who regularly drank 15 cups of coffee each day. He, like many others who use coffee on a regular basis, or the highly caffeinated so-called “power drinks” widely sold throughout the country would have difficulty withdrawing from these substances.

While caution from overuse of any substance should be implemented, in the words of one of the many thousands who have found benefit from kratom said in a letter on drugabuse.com: “Making a substance illegal because there's potential for a fraction of the population to have trouble with it does not seem to me to be a logical approach.”

I’m mainly an advocate for the responsible clinical use of kratom as an effective non-addictive alternative to other psychoactive drugs with well-known adverse health effects. Even those who claim that it is addictive will say that it is mild compared to highly addictive drugs such as opiates, alcohol, speed, etc.

The opiate drug oxycontin was created because its pain-relieving effects are longer-lasting that morphine and other opiates. The company who first brought it to market in the 1990s, Purdue Pharmaceuticals, convinced and enticed hospitals and doctors to use it even for mild or moderate pain conditions. As a result, it was widely prescribed even to children and that was the beginning of the present opioid epidemic.

With kratom, we have an herb that has offered hope for thousands to help wean themselves off of these deadly drugs, but even so, some government agencies want to suppress it. Even if one were to concede that there can be some problems with people abusing kratom, those problems have no comparison to the already existing problem of opioid addiction.

Making Kratom Tincture

Kratom is widely sold as leaf powder. Powders have a limited shelf life (about 3-4 months for full potency), and ingestion can be challenging because of its flavor. Making a tincture assures potency for many years, and are convenient to take because the drops can be diluted in water or another liquid to mask the flavor.

The downside of kratom tincture is that it is alcohol-based and therefore not suitable for individuals who have a history of alcohol addiction. Also, it is too easy to consume more than is needed when it is a liquid as opposed to the limitation of taking it as leaf powder. With both of these considerations in mind, the following tincture recipe is given from KratomGuides.com.


  • 1 quart vodka or diluted ethanol measuring 40 to 50% alcohol
  • 8 oz. (about 227 grams) of pure high quality Kratom leaf powder
  • About ½ ounce apple cider or white wine vinegar (which aids in the assimilation of the important kratom alkaloids)

Combine these ingredients in a wide-mouthed jar. Shake or stir daily for at least two weeks (although an extract made in this way could be used after a day or two).

When completed, carefully strain through fine mesh cloth. Bottle in 2- or 4-oz. amber dropper bottles at this point or allow to stand in a clear glass container for a day or so to allow any powder particulates remaining to settle to the bottom. Carefully decant the pure extract and bottle for use.

This is approximately a one to four ounce tincture, meaning that 1 part of the tincture is equal to 4 parts of the powder. One may have to experiment with the tincture dose but on average one might start with a dose of 30 to 60 drops which is approximately a half to one teaspoon.

Feel free to experiment with flavoring agents to make it more palatable. The most common is pure anise or fennel seed oil. One may only need a few drops to flavor. (Use caution when using pure essential oils for flavoring; consult a qualified practitioner and use food-grade oils from a reputable company. –M.T.)

2017 Reputable Sources for Kratom Leaf Powder

1.      BuyKratom.us – www.buykratom.us
This is the company I’ve been purchasing my Kratom from. I find them to be reliable, good quality and reasonably priced

2.      http://kratomguides.com/recommends/kratom-spot/

3.      http://kratomguides.com/recommends/pure-kratom/

4.      http://www.phytoextractum.com/?referrer=REF327161478868859

Read more about these companies at KratomGuides.com


Matt Wright, the general manager at Low Tide Kava Bar in Gulfport, Florida, described some of the signs held by demonstrators at a pro-Kratom rally held in Washington D.C. last year: “In support of keeping kratom legal there was a sign that read, ‘Death statistics of other illegal drugs from 2014: Heroin: 11,000; Cocaine: 5,000; Alcohol: 88,000; Opioid Pain Relievers: 20,000; Kratom: 0.’ There were also numerous other signs saying ‘Kratom Saves Lives,’ ‘Plants Not Pills,’ ‘Farm Not Pharma,’ and one heart-wrenching sign held by a young boy who appeared to be between 6 and 9 reading ‘Kratom Saved My Mom.’

This says it all.

Please at least go to https://www.americankratom.org/petition and sign the petition to the DEA to keep kratom legal.



Mitragyna speciosa by Uomo vitruviano

As of the beginning of August 2017, the National Institutes of Health (NIH) published notice of the state of the opioid epidemic in America. They estimated that of the 91.8 million people who were prescribed opiate pain killers, 2 million are addicted with an average of 142 dying from overdose daily. This means that every three weeks the same number of Americans die from opioids as died in 9/11.

Up to now, opioids and related compounds all derived from the poppy (Papaver somniferum) are the most reliable pain-relieving drugs since the American Civil war. Unfortunately, there is a price to pay when these drugs are too heavily used. That price is addiction, accompanied with the need to obtain more and stronger drugs to achieve similar pain relief. The problem for the addict is compounded, for as the drugs wear off there is even more intense pain and mental discomfort that acts as a disincentive to detoxification. Yet, another genre of pain-relieving drugs sold as over-the-counter anti-inflammatories includes acetaminophen, which are known to cause liver damage.

Most doctors agree that there is a need for another drug or substance to relieve pain; a few doctors even encourage their suffering and addicted patients to try the pain-relieving herb Mitragyna speciosa, commonly known as kratom. Herbalists, acupuncturists and naturopaths, however, have been overly wary of promoting yet another fad in the form of an herb that they have not heard of before. In the case of kratom, it is known to be widely used as a recreational drug and it has been the object of legal scrutiny. Its clinical value yet to be appreciated. 

The medicinal properties of all herbs were first discovered through trial and error. Kratom is no different. It has been used for thousands of years by natives of southeastern Asian islands for various health purposes, among them pain relief. Eventually, millions of individuals in America and Europe and throughout the world, seeking yet another drug with which to get ‘high,’ tried kratom. Kratom in normal low to medium dose is feeble compared to other drugs like cannabis but since the late 1800’s people have increasingly used it to withdraw from opiate and alcohol addiction and to relieve pain. On this note, consider how long it has taken for cannabis, once vilified as a dangerous recreational drug, to be found in recent years to offer potent health and medicinal benefits.

I’m a strong advocate for the use of kratom clinically and have had considerable personal experience using kratom leaf powder for the relief of chronic, intractable pain. In fact, I can’t think of any herb other than opioid drugs derived from poppies that provides such immediate pain relief and overall sense of well-being. 

How does kratom relieve pain?

There are more than 40 compounds in kratom leaves, including 25 alkaloids besides mitragynine which is the most abundant, occupying 1.2-2.1% of the total. Mitragynine is believed to be principally responsible for its pain-killing effects. Mitragynine is considered the main psychoactive constituent and functions as an opioid agonist, meaning that it has a special affinity for the opioid receptors in the brain.

Most people who take a sufficient amount of kratom internally will experience pain relief in less than a half hour.  Kratom is usually taken as a powder. Dosage is variable depending on the strength of the kratom, the severity of the condition for which it is intended, and the size of the person who takes it. Further, kratom is known to have both stimulant and sedating properties. Stimulant properties are associated with lower doses and sedation with higher doses. I will describe dosage guidelines next week, but clinically the goal is to use as low an effective dose as possible. Discounting whether it will act as either a stimulant like coffee to which it is related or a sedative like opium, I recommend beginning with a teaspoon (about 3 grams) of the powder swallowed and chased down with water once or twice a day. Regardless of its sedative or stimulant properties in an individual, kratom will relieve pain.

It’s taken me some time to complete this article because I first wanted to scour and interview patients, stores and others who have recommended or used kratom with great benefit to themselves and others. I took it myself for a minor shoulder sprain and was amazed at how benign it seemed; I had no adverse reactions, no disorientation, no grogginess, and my pain was relieved within 30 minutes. Even several hours later when the effects of kratom surely would have subsided, I realized that the pain did not come back. I know it doesn’t work for everyone that way but my experience suggested that the alkaloids in kratom were not only analgesic but anti-inflammatory as well.

Since then I have recommended kratom to several patients suffering severe chronic pain and depression. Their respective pain and discomfort was well managed and with no adverse reaction.


Cases 1 and 2 are from my own clinical experience. Case 3 was reported to me.

  1. A woman in her mid-70s had advanced osteoporosis of the spine that caused constant pain making it difficult for her to sleep at night. Acupuncture and carefully prescribed herbal treatments were of limited benefit. Realizing how important sleep is for healing, I decided to try kratom. That night she took only one teaspoon of green-veined maeng da kratom. She gratefully reported that it was the first night she could get 6 continuous hours of uninterrupted sleep.
  2. Another patient was a woman diagnosed with rheumatoid arthritis. She had severe and constant pains in all of her joints especially her fingers. Again the pain inhibited her ability to relax and get much needed sleep. At first she was suspicious of taking any substance to relieve pain. Perhaps she vaguely heard that kratom was being used as a recreational drug and she might get hooked. While she was still in my clinic, I was able to convince her to take a teaspoon of the powdered leaf followed by a glass of water. She predictably objected to the taste but I heard from her the next day that she had such tremendous relief from the single dose, but she was trepidatious of taking it daily. I convinced her that she should not be afraid to use as much as she needed. It turned out that she only needed to take one or two teaspoons of kratom for a week, during which time diet changes and deeper-acting herbs I gave her helped eliminate her pain completely, and she had no further need for kratom.
  3. It was personally reported to me by a saleswoman working at a local store specializing in selling cannabis and other psychoactive herbs that she has dozens of clients who purchase kratom strictly for its pain-relieving therapeutic value. According this saleswoman, these are people who have tried everything; many were already heavily drugged and addicted to doctor-prescribed opiates. Among the many cases she mentioned, the one that seemed most amazing to me was a woman with cystic fibrosis who had for a long time been on several different prescribed pain-killing opioid drugs and a number of different antidepressants. With great determination, she wanted to “get her life back” and decided to use kratom to wean herself off of all her drugs. (I don’t know what dose she needed to take, but generally speaking, the more severe the condition, the higher the dose of kratom.) Years later, this woman, still with cystic fibrosis, is able to completely manage her pain with red-veined kratom. Red-veined is the variety that has stronger sedative and pain-killing properties.

Interviewing other patients and practitioners, I learned how kratom is the only thing some have found to manage the pain associated with chronic fatigue syndrome, fibromyalgia and Lyme disease.

Not Just for Pain

Kratom also relieves depression, and unlike opiates, it can promote a sense of mental clarity with no grogginess when used in the above described doses. Further, as an alternative to antidepressants, kratom does not interfere with selective serotonin reuptake inhibitor drugs (SSRIs or antidepressants) so they can be used concurrently. By so doing, many have been able to withdraw from antidepressants by gradually replacing them with kratom. However, I strongly caution against this without the advice and guidance of their medical doctor.

Kratom and Opioid Addiction

One of the most important uses of kratom is to ease physical and psychological pain associated with opiates, including morphine and heroin and alcohol addiction. The use of kratom for opium addiction was first employed in Thailand around the end of the 1800s at a time when opium was proliferating throughout China and eventually spread to the islands of Indonesia and Thailand. It was so effective for that purpose that the Thai government made kratom illegal. The reason was not that it was harmful to the people or addicting but because the government was being denied a then important part of its revenue based on the taxes levied on the sale of opium. To this day, kratom is illegal in its native habitat where people had been using it medicinally for centuries. However, with the rise in heroin and alcohol addiction, there is a movement to get the government to rescind its kratom ban.

Legal Issues

How effective kratom has and continues to be for pain relief and drug addiction was shown when the US Drug Enforcement Administration (DEA) on August 30, 2016, proposed to place kratom into a Schedule I category of Controlled Substances. This is the same category in which the most addictive drugs such as heroin and methamphetamine are classified: completely illegal. This met with a widespread groundswell of protests, mostly by people who were using it for pain management or opioid withdrawal. Approximately 140,000 protesters signed an online petition and were able to enlist 51 members of the US House of Representatives with nine senators on their side in protest of the DEAs proposed ruling. As a result, the DEA temporarily withdrew its notice of intent and for the last year it has been inviting public comment. See the document Assessment of Kratom under the CSA Eight Factors and Scheduling Recommendation submitted to the DEA here.

At present, kratom is legal in all but six states (Alabama, Arkansas, Indiana, Tennessee, Vermont, and Wisconsin). Kratom is also illegal for use by the US military.  It could still be banned and we would lose access to one of the most valuable herbs in the world. According to the American Kratom Association, currently 26,000 Americans have asked President Trump to keep kratom legal. Over 1,000 doctors, scientists and law officers told the DEA they don’t want a kratom ban. In fact there have been no deaths reported from pure kratom. Unfortunately, some companies decided to spike their kratom with an illegal opioid called tramadol. The resultant product called “kryptom” did result in some deaths and is now banned from sale.

The risk of dying from pure kratom overdose (whatever that may be) is nil. In fact high dosage of kratom is self-limiting as people who do so experience temporary gastric discomfort, nausea, and vomiting.

I’ve never personally seen or heard of kratom addiction and to the extent that it may exist it is quite rare. Individuals can form a dependency, which some may describe as ‘addiction’ but this is described as mild and comparable to withdrawal from coffee.

At present, these are the facts:

  • 100 million Americans suffer from chronic pain;
  • Of these, 21 million are also dealing with substance abuse;
  • Of these, 2 million abuse prescription pain drugs.
  • Drug overdose, which has gone up 4 times, has become the leading cause of accidental death.

Why would the federal government or states rush to ban an opioid replacement that’s hundreds of times less deadly than synthetic opioids?

I recommend visiting some of the online kratom support sites such as the American Kratom Association to read more about kratom’s history, biochemistry and the many anecdotal cases attesting to the positive effects of kratom for pain control and opioid and alcohol addiction. If you visit the AKA link above, be sure to sign the petition to keep kratom legal. In my estimation, it is one of the most important medicinal herbs for pain management other than opium.

Next week, I’ll post the clinical classification, uses, dosage, and preferred administrations of kratom, along with some reputable sources. (See Part 2 of my series on kratom here.)

Kratom may be enjoying a lot of press these days in light of current events, but the benefits of a whole world of herbs is diverse and mighty. Thinking of studying the art and science of herbalism at East West? Mention this kratom blog and receive an extra $100 off enrollment on our already low-priced sale of the herb course. Offer valid through August 18.



Could you ever imagine yourself as being ‘sugar deprived?’  Do you find yourself unable to sleep soundly throughout the night, getting up frequently to urinate, feeling exhausted the next day with frequent memory lapses – or what about instead of feeling a boost of energy from a reasonable aerobic workout, you find yourself dragging through the rest of the day?

You could be glucose (i.e., sugar) deprived and suffering from that denied hit of fast energy necessary to power your nervous system, heart, and muscles. This can affect not only your quality of life, but also your health.

Both the heart and the brain require a substantial amount of glucose (sugar) to function well. A constant pumping action of the heart means that it needs a steady supply of energy. Many runners who suddenly die of cardiac arrest at a comparatively young age could be because they ran out of fuel to keep their hearts working.

The primary metabolic substrate for the heart is fatty acids. However, up to 30% of myocardial ATP is generated by glucose and lactate, with smaller contributions from ketones and amino acids. Although glucose is not the primary metabolic substrate in the heart at rest, there are many circumstances in which it assumes greater importance such as during ischemia, increased workload, and pressure overload hypertrophy. The brain is so rich in nerve cells that it is the most energy-demanding organ, using half of all the sugar energy in the body.

Many know the wisdom of having at least a piece of fruit before beginning a strenuous workout. The same is also true when undergoing long hours of intense thought. The greatest demands for fuel mainly come from our muscles and nervous system, especially the brain. We know that glucose is one of the few substances that readily passes the blood-brain barrier (BBB) and like the heart, the brain works throughout the night, including during sleep. We need energy in the form of a steady supply of glucose to the brain to sleep soundly.  When it runs out of fuel (i.e., glucose), the result is insomnia, disturbed sleep, being unable to get back to sleep, and not feeling rested when awakening in the morning.

The liver is in charge of processing sugar into glucose through a process called glycogenesis, in which glucose is formed through the breakdown of glycogen (the stored form of sugar). Glycogenesis is what prevents us from experiencing hypoglycemia when we run out of fuel during the day. It is possible to run out of stored fuel (glucose) when we are asleep or if the liver is underfunctioning. Thus, a liver imbalance is one of the most common causes of insomnia and sleep disturbances.

Whole Sugar and Insomnia

Of course, by sugar or glucose, I’m not speaking of refined sugar which robs our body of nutrients and which is unfortunately present in practically everything and is added to foods to get us to want more. Refined sugar is a pro-inflammatory substance that many believe to be toxic and one of the primary causes of alcoholism and addictions generally. (Anyone who finds it difficult to control a sugar habit should consider using honey or sucanat, a commercially available brand of clean, evaporated sugar cane juice.  These sugars have real nutritional value when consumed in moderation.)

Refined white sugar is bad, but there are beneficial uses for whole, unrefined sources of sugar such as honey and pure unrefined evaporated sugar cane such as Indian jaggery which in Central and Latin America is called panela. This sugar has all the vitamins, minerals and enzymes from the whole sugar cane plant.

Honey is a well-known remedy for insomnia. Composed of equal parts glucose and fructose, it is the glucose that feeds our brain for the first have of the night and the fructose after it is converted to glucose in the liver that continues to supply fuel to our brain for the second half. It is recommended to try taking two tablespoons full of raw honey before retiring, alone or with tea or warm milk. Honey contains the amino acid tryptophan, which helps sleep and this, in turn, converts to serotonin, the happiness neurotransmitter which helps us to awaken refreshed.

Powdered herbs mixed with honey is one of the simplest and most efficient ways to take herbs and are used in traditional cultures throughout the world. I often recommend this way to take herbs. Unfortunately, the antisugar phobia applied to all sugar including honey and whole evaporated cane juice keep people from using herbs mixed with honey, called an 'electuary,' or in syrups.

Asian Fruits Before Bedtime

Certain ‘power fruits’, namely longan, goji berries and/or jujube dates can be taken before retiring are also extremely useful for insomnia and taken during the day, counteract sudden mood shifts and depression which often is accompanied by a drop of energy. I recommend you purchase a pound of these three dried power fruits.

Longan Berries

My favorite is longan berries (Dimocarpus longus pericarp; Chinese: Long yan ru). These are closely related to litchi fruit which probably has similar properties. They are commonly called ‘dragon eyes’ because of the dark pit in the center of the translucent fruit.

Longan berries have a long history of use for nourishing the blood, calming the spirit and helping to overcome insomnia. This is because they are high in readily available glucose which feeds the heart and quickly passes the blood-brain barrier to fuel the brain. I like to keep a bag of these handy and soak about 10 and taken them before retiring as an alternative to honey.

Goji Berries

Another Asian fruit that is fast growing in popularity in the West is goji berries (Lycium chinensis). Like longan berries, this fruit is a blood tonic, and is especially good for the eyes because besides its natural sugar content is loaded with beta carotene. They work almost as well longan berries as a treatment for insomnia. However, goji berries are also a fruit I give to my diabetes patients to snack on throughout the day. They not only tonify Qi and Blood but also help regulate fluctuations in blood sugar for people with type 2 diabetes.

Jujube Dates

Finally the last super fruit that helps satisfy the body’s need for bioavailable glucose is jujube date (Zizyphus spinose; Chinese: da zao). These are commonly used in Chinese herbal formulas. They are eaten as a fruit and are popular throughout China as a confection. Jujube dates especially nourish and tonify Qi but they are also a treatment for insomnia and depression.

One of the simplest and most effective antidepressant formulas commonly used clinically is called ‘Gan Mai Da Zao taken either as a tea or convenient pills (‘wan’ in Chinese products). It consists of only three simple botanicals: licorice, sprouted wheat, and jujube dates. Simple but safer and far more effective than many pharmaceutical antidepressants, this formula is taken three times daily to relieve anxiety, depression, insomnia, hot flashes in menopause, and manic depression. Many companies sell this formula. My current favorite is Active Herb which markets it under the apt name of “MooDelight.”

Dried Longan, Red dates, and Goji Berry Drink

Combine the following:

  • 15 dried longans
  • 30 dried red dates
  • a handful of goji berries
  • boil in 2 cups of water

Add honey to taste and have a cup twice daily, especially before retiring.

Oh, and one more perk many experience from taking longan berries or honey before retiring at night is less or no calls to the bathroom to disturb your sleep.

What's that sound? Why won't it go away?

Tinnitus, commonly known as "ringing in the ears" and the perception of sound where no external source of sound is present, is a surprisingly common affliction. You may not know that complementary medicine offers treatment options for this condition, including herbs. Furthermore, Traditional Chinese Medicine recognizes four different types of tinnitus with four different herbal formulas matched to each specific type. 

This month, I am pleased to feature a blog post by East West grad and teacher Holly Hutton, who outlines several herbal treatment options for tinnitus, along with diet and lifestyle suggestions. 

Go to Holly's post, "Tinnitus-Ringing in the Ear, Treatment Options From Many Traditions" for a clear elucidation of the complementary approach to this common condition.

Arthritis, joint and back pain is so prevalent throughout the world that there really is no point to describe how many sufferers there are. It is safe to say that if you are around the age of 55 or older you probably have some form of arthritis somewhere in your body.

From a Western medical perspective there are two broad forms of arthritis, osteoarthritis and rheumatoid arthritis.

Osteoarthritis is joint pain primarily caused by a gradual loss of protective cartilage. This can be caused by physical injury, mechanical stress or metabolic abnormality that can gradually break down the cartilage that cushions the ends of the bones from rubbing against each other. This is the most common type of arthritis.

Rheumatoid arthritis is the most severe type of inflammatory joint disease. It is an auto-immune condition where the body’s immune system attacks its own tissues, which in turn damages the joints and surrounding soft tissue. This is a chronic form of arthritis that leads to stiff, deformed joints of the hands, arms, legs and feet. It is the slowest and most difficult to treat.

Western medical treatment involves the use of non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen and steroid-based drugs such as corticosteroids and immune-suppressive drugs. All of these have long-term adverse side effects and some have short-term adverse effects such as stomach irritation, gastritis and ulcers.

Arthritis and Traditional Chinese Medicine (TCM)

TCM classifies both types of arthritis as “Bi syndrome” disease. Bi means for “blockage.” Thus in TCM all such pains are considered to be caused by some sort of blockage. What is blocked or what causes blockage in arthritis, and for that matter back pain, which is considered in the same category, gets us into some strange concepts and terms (from a Western physiological point of view).

The most common type of arthritic pain is caused and aggravated by coldness and dampness. No wonder that individuals with this type of arthritis complain that their symptoms are worse in cold, damp weather, but also by wind. Heat, a fourth TCM cause, occurs as resistance from the continued effects of Cold-Damp-Wind causing blockage.

Western rheumatology hypothesizes that one of the major reasons why cold and damp weather aggravates most people’s arthritic pains is because of changes in air pressure. Specifically, it is the change of barometric pressure which is the weight of the atmosphere that surrounds us. This pressure occurs when barometric pressure drops before bad weather sets in and cause the joints and cartilage of our joints to expand. This theory is given by Dr. David Borenstein, MD, FACP, FACR, a rheumatologist and clinical professor of medicine at George Washington University Medical Center and past president of the American College of Rheumatology. Still, many people claim that weather does not affect their arthritic pains.

The virtue of the Chinese description of “Bi Syndrome caused by Cold-Damp-Wind” is that it leads the herbalist to select the most appropriate herbs which are classified in TCM as treating Coldness, Dampness, Wind or Heat.  

Cold pattern arthritis (Cold Bi) is characterized by severe joint or muscle pain in a fixed location. It is relieved by the application of warmth.

Damp pattern arthritis (Damp Bi) exhibits symptoms of pain, soreness, swelling of the muscles and joints, and a feeling of heaviness and numbness in the limbs.

Unlike Cold Bi, Wind pattern arthritis (Wind Bi) is characterized by pains that move from place to place, or joint to joint. It is described as being aggravated and caused by exposure to wind.

Heat pattern arthritis (Hot Bi) is characterized by severe pain and joints that feel hot, and look red and swollen. This type of arthritis is relieved by applying cold to the affected areas.

Underlying physiological imbalances that predispose an individual to develop arthritic and lower back pains are described in TCM as coming from deficiencies of the Kidneys and Liver.

In TCM, the Kidneys include the adrenals so that any type of stress or fatigue, be it climatic, physical or emotional will cause the Kidney-adrenals to hyperfunction and react to regain homeostasis. The Liver’s job is to moderate the adrenal hormones caused by stress by breaking them down as necessary. The Liver also neutralizes toxins which cause internal stress.

This TCM Kidney-Liver organic function may be deficient due to congenital conditions or may gradually weaken with lifestyle abuse and age. Thus to achieve any enduring benefit from treatments, one would wisely add herbs to supplement and strengthen this vital internal TCM function.   

Traditional diagnostic methods based on symptomology, tongue, and pulse are employed to determine the most effective treatment approach. However, in the case of arthritis and lower back pain, there is one formula which is in a unique small class out of the possible thousands of TCM formulas that I consider to be the “best bet” or "use first, refine later" group of formulas. It is Du Huo Ji Sheng Tang (Du Huo Angelica and Loranthes Mistletoe (Taxillus) Decoction).  

How effective is it for these conditions? I would estimate that it will relieve joint pains at least 80% of the time.

It consists of the following:

  1. Angelica pubescentis (du huo) - 4.5 g. Traditionally this herb is used to disperse Wind-Cold-Dampness especially from the Lower Warmer (from the lower back down through the legs and knees). I would venture that these properties would also be found in Western Angelica archangelica root.
  1. Herba Asarum (wild ginger, xi xin) 1-3 g. This herb releases Exterior Wind-Cold, warms the Lungs, transforms Phlegm, and scours Wind-Dampness from the sinews and bones to stop pain. Chinese wild ginger, as well as North American Wild ginger in my opinion specifically, can be used to treat colds and induce diaphoresis. However, its unique property is that it also promotes internal circulation and dispels Wind, Cold and Damp to relieve pain. It is used because of its special effect to open both externally via sweating, but more important internally between the tissues and organs of the body. It is currently removed from commercial formulations because it contains Aristolochic acid which is thought to cause kidney damage. (http://www.niehs.nih.gov/health/materials/aristolochic_acids_508.pdf). To my mind, I think we should be aware of this potential danger but based on the lower dosage, and widespread use over millennia, I would use it for a short time especially in patients with severe arthritic pains that may not be relieved if this herb is left out of the formula. An acceptable, though not as powerful, substitute for this herb would simply be fresh ginger root.
  1. Saposhnikovia root (fang feng) 3-10 g. This is another root from the Apiaceae family, which includes Angelica archangelica, osha, and lovage.  It also expels Wind-Cold and Dampness and alleviates pain. It is especially effective for dispelling Wind.
  1. Radix Gentianae Macrophyllae (qin jiao) 9-10 g. This herb is a species of Chinese gentian root. Gentian root is bitter and in Western herbal practice is almost completely relegated to use as a bitter digestive herb. However, it seems to be neglected as an herb that is detoxifying and anti-inflammatory.  It is used in this formula because it expels Wind-Dampness and relaxes the ligaments. It may be that the Western gentians could be used similarly.
  1. Herba Taxilli (sang ji sheng, Chinese mulberry mistletoe) 4.5 to 30 g. This is a particularly useful herb for arthritic pain symptoms. It also expels Wind-Dampness, strengthens the ligaments and bones, tonifies the Liver and Kidney Yin, and nourishes the Blood. European mistletoe is commonly used today as a nervine, hypotensive, and as an anticancer herb. It was important to the Druids for many conditions including arthritis.
  1. Radix Dipsacus (xu duan, teasel root) 4.5 to 30 g. This specifically tonifies the Liver and Kidneys, and strengthens the lower back and bones. It is used for the weakness of the legs and knees and to mend bones. It also helps to prevent miscarriage. Western teasel root (D. fullonum or "Fuller's teasel) found growing both in Europe as well as North America is widely promoted because of its ability to relieve joint pains associated with Lyme disease for which it is indeed effective. However, In Scottish herbal medicine, it is also used to treat arthritis.  (http://www.herbalmedicine.org.uk/index.php?page=tim-entwistle)
  1. Eucommia bark (du zhong) 3-10 g. This is the bark of a species related to the rubber tree. It tonifies the Kidneys and Liver and strengthens the ligaments and bones. It also downregulates high blood pressure.
  1. Achyranthes bidentatae (niu xi)3-10 g. This herb invigorates Blood circulation to relieve pain and strengthen the bones and ligaments. It also benefits the joints and nourishes Liver and Kidney Yin.
  1. Cinnamon bark (rou gui or Chinese cinnamon) 1-6 g. This is Cinnamomum cassia distinct from "true cinnamon" known as Cinnamomum verum. It is this latter species that is widely used as a condiment in the West. It may share some of the properties of C. cassia which is a very hot herb used to Warm the Kidneys, strengthen Yang, strengthen Ming Men Fire, disperse deep Cold, warm and unblock the channels and vessels (blood circulation), and to open the lower back and alleviate pain.
  1. Angelica sinensis (dang gui) 9-10 g. This is another herb in the Apiaceae family and is used to promote blood circulation, disperse Cold and relieve pain.
  1. Chuan xiong ligusticum (Chinese lovage) 4.5 – 9 g. An Apiaceae family plant that is one of a number of herbs in this formula that promotes Blood circulation regulate the flow of energy, expel Wind-Cold and alleviate pain. It is reasonable to assume that Western lovage root and the various ligusticum species including North American osha could be used as a substitute.
  1. Unprocessed Rehmannia glutinosa (sheng di huang) 3-10 g. This is the premier TCM herb used to nourish Yin (fluids) and Blood. It tonifies TCM Kidneys and Liver, which are considered to contain the root of deficiency for lower back and arthritic pains. Unprocessed Rehmannia is more strongly antiinflammatory than the processed form which is considered to be more tonic.
  1. Rice wine-soaked Rehmannia glutinosa (shu di huang) 3-10 g. This herb has stronger Liver and Kidney tonic properties.
  1. Paeonia alba (bai shao, white peony root) 3-10 g. This herb nourishes Blood and relieves spasm and pain. It is one of a group of tonic herbs along with dang gui, Rehmannia, white peony root, ginseng or Codonopsis and honey-fried licorice that serve as tonics to treat underlying deficiencies associated with lower back and arthritic joint pains.
  1. Ginseng (Panax ginseng) or Codonopsis (dang shen) 9-30 g. (Use the greater amount for the latter.) These tonify Qi and generates body fluids. They are the supreme Qi or energy tonics used in TCM. The principle of this formula used to treat lower back and joint pains is called 'root and branch' therapy which combines herbs that tonify the underlying deficiency (root) so that the herbs that dispel Wind-Cold -Dampness which are Blood-moving and pain-relieving treat the primary (branch) symptoms. This important TCM formulation principle is unfortunately pretty much absent from Western drug treatments for these conditions which use strong antiinflammatory drugs to only relieve inflammation and pain but do nothing to treat underlying causes. (It is also absent from sensational commercial marketing of herbs such as turmeric root only for its anti-inflammatory properties.)
  1. Poria mushroom (fu ling) 4.5 – 12 g. This is used to promote urination, relieve dampness, strengthen the Spleen and harmonize the Middle Warmer (digestive organs). Traditional medicines generally agree that disease begins in the GI tract from dietary habits causing weak digestion. Thus, digestion, which might be considered 'the root of the root' of most diseases, are treated by herbs including Poria, ginseng or Codonopsis, and honey-fried licorice root.
  1. Honey-fried Glycyrrhizae praeparata (zhi gan cao) 3-6 g. This herb contributes to the Qi and digestive tonic properties but also harmonizes and relieves any of the harsh effects of the other herbs in the formula.

Modern Formulations of Du Huo Ji Sheng Tang

Active Herb’s version of this formula is called Jointsjoy.

Another version, Solitary Hermit, is manufactured and sold as part of the Plum Flower herb line.

A Planetary Herbal formulation based on this formula and widely used in my clinical practice is simply called Lower Back support.

Any of these three products can be used with more than relative efficacy to relieve and cure musculoskeletal pains of all kinds.


Gluten or dairy intolerant? You may not need to give up wheat and dairy, says Dr. John Douillard, DC, in his book Eat Wheat (Morgan James Publishing, 2017). Backed by years of clinical experience helping people who previously were unable to digest wheat and dairy, Dr. Douillard employs traditional thousands-of-years-old Ayurvedic principles backed by more than 600 scientific studies to develop the methods described in his book for gut health.

His conclusion? Most who claim to experience varied and myriad symptoms of discomfort as a result of eating dairy, wheat and other glutinous grains is the result of a toxic condition that has weakened their digestion.

Based on my own clinical experience, I agree that, with the exception of the less than 0.5 to 1% who actually have lactose intolerance and celiac disease (the latter being a serious conditions that can be medically diagnosed through simple clinical tests) should absolutely avoid consuming these foods. However, the rash of symptoms attributed to eating dairy and wheat ranging from simple bloating, heavy dull feeling and lethargy after eating, to a wide range of metabolic to mental and emotional conditions may do better if they view these as symptoms that may benefit from treatment rather than a primary handicap.

Thus I appreciate that this is not just another theoretical book but one that lists numerous cases of his patients who were suffering from various degrees of gluten and dairy sensitivities and intolerances and who, after undergoing recommended detoxification cleanses, reported that not only were they able to eat these foods again, but with better digestion and a more lasting improvement of health and well-being overall.

All systems of natural healing believe that the foundation to health is a healthy gut, meaning the ability to break down and assimilate vital nutrients and efficiently eliminate metabolic wastes. I agree with Douillard’s thesis that the underlying causes of gluten sensitivity-intolerance is a toxic, weak digestive system. In fact the symptoms associated with gluten sensitivity-intolerance are common to all traditional healing systems. The Western herbal tradition addresses this with the use of digestive bitters such as Angostura bitters commonly sold in liquor stores throughout the world and originally designed to relieve digestive problems by stimulating hydrochloric acid and biliary secretions. Then there is Traditional Chinese Medicine (TCM) with dietary and herbal treatment its most common diagnoses: Spleen Qi Deficiency, Liver-Spleen Qi Stagnation and diseases caused by Phlegm. Finally Dr. Douillard’s specialty, Ayurvedic medicine, has a wide range of treatment and herbs for specific digestive problems and the elimination of deep-seated toxins called ‘ama’ which is related to the TCM concept of invisible Phlegm, or the lymphatic system which according to Douillard is lodged in the fat cells.

In fact, Douillard describes how the most  recent research has discovered a direct connection of the lymphatic system between the GI tract and the brain.  This explains the Chinese description of schizophrenia and psychosis as “invisible Phlegm masking the brain” and the relationship between gluten sensitivity-intolerance and the brain in Dr. Perlmutter’s book, Grain Brain. However, merely eliminating gluten not only deprives us of the pleasure derived from these foods but also a wide range of associated vital nutrients they contain, including fiber, iron, zinc, folate, niacin, thiamine, riboflavin, calcium, Vitamin B12, and phosphorus.

With approximately 21% of the population currently adopting a gluten-free diet and a $9 billion gluten-free food industry (in 2014) to support it, there has been little interest in finding a deeper cause or cure. In fact, Douillard exemplifies how the condition he calls "toxicity impaired digestion" (TID) is best treated with traditional medicine, diet and herbs. 

His approach is to eliminate all processed and refined food from the diet, engage in periodic cleanses which he describes and are freely available on his website www.Lifespa.com, and adopt a seasonal approach to foods based on regional availability which is described in his book and his previous book, The Four Seasons Diet, also based on traditional Ayurvedic dietetics.

On a recent vacation in Kauai, my wife, Lesley and I underwent Douillard’s four-day cleanse based on taking increasing spoonfuls of ghee first thing each morning and eat no other fat throughout the rest of the day; and the traditional Ayurvedic healing food kichari, consisting of split yellow mung beans and white rice, with traditional healing spices of turmeric, coriander and cumin prepared without ghee, three times each day. In addition warm water is sipped every 10 or 15 minutes and certain Ayurvedic herbs such as triphala for eliminating metabolic waste were taken.

The fast was remarkably easy to follow and adhere to and there was little hunger for other foods. You can download the details of Dr. Douillard’s short cleanse or even embark on his 28-day cleanse. There are three levels of foods to use besides the basic kichari and ghee, which is the foundation. One is to add vegetables and fruit to the regime and another, especially for those with low blood sugar, to add white meat such as chicken.

The most unusual and a key component of the diet was the morning intake of ghee – pure butter fat. Ghee is considered one of the most healing foods in Ayurvedic and Tibetan medicine. Like all fat, it satisfies hunger but uniquely it cleanses and heals the walls of the intestines, stimulates the production of new bile for the liver and gall bladder, strongly strengthens the immune system, and encourages eliimination of old “ama” -- difficult to discharge, toxin-laden fat from the body – literally consuming good fat to eliminate bad.

We both felt significant benefit from this short cleanse and it did seem to ‘reset’ our digestive systems. We look forward to repeating the cleanse.

For many, reintroducing grains and dairy back into the diet may have to be a gradual process, beginning with yogurt, cheese or ‘scalded’ organic whole milk; with glutinous grains such as wheat, and occasional small servings of whole grains.

Douillard's point, in short, is that sensitivity-intolerance to these foods is not the cause but a symptom of deeper digestive imbalance, which if left untreated can be a precursor to more serious diseases later in life.  

Dr. John Douillard is the author of six books, numerous articles on natural health and fitness and the creator of Lifespa.com a respected source for Ayurvedic health and wellness.

In my previous blog on treating H. pylori-induced stomach inflammation with herbs, I touch briefly on a fundamental difference between conventional and complementary medicine: namely, that conventional medicine prefers to identify an isolated pathogen or discrete named diagnosis which it aims to treat singularly; whereas complementary or traditional medicine relies on signs and symptoms, within the unique individual and their personal conformation, and how these elements fit into a time-tested model of healing.

Being an herbalist means learning to think like a herbalist, which apart from a special knowledge of the therapeutic properties of plants also means to not overly focus on the symptoms of a disease but also the particular unique physiological ‘terrain’ from which the disease and its symptoms arise. With Chinese medicine, this means treating ‘root (cause) and branch (symptom) based on principles of yin and yang. In Ayurveda, it means differentiating the individual’s underlying prakriti (doshic or humoral imbalance) from the vikruti (doshic disease imbalance).

There are several layers of healing. One is to disguise the symptom, another is to deal with the microbiological cause of the symptoms. Still another is to treat the “cause of the cause” which is the imbalances in the body that predispose one to develop such things as infections (like H. pylori overgrowth). Still another cause beyond these physical ones are the psycho-spiritual reasons one develops a disease.

Relief or “cure” can be achieved at any of these levels. The first treatment principle should be to relieve the symptoms, which is the most superficial level of healing; second, treat the “cause of the cause” being the most physiologically beneficial level overall: and then attention must be paid to the third, psycho-spiritual level, which is the most profound.

Only masking the symptoms, which is the usual approach in Western medicine such as when antibiotics and anti-inflammatory drugs such as cortisone are given, is fraught with possibly damaging side effects. This is why many people seek the herbalist or acupuncturist for the second and third levels of healing. Every healer has some facility to work on each of these levels but the herbalist and acupuncturist uniquely specialize on second “cause-of-cause” level.

The third, psycho-spiritual level may either be all encompassing or may provide other levels of relief beyond the physical.

Addressing all three of these levels, with respect to the individual patient’s particular physiology, history of illness and mental or emotional disposition, is the definition of “wholistic” healing to which most herbalists and traditional practitioners aspire. It is an approach which, in my opinion, is most likely to bring about the sort of transformation that leads to deep and lasting healing.

Recently, a colleague sent me the following question:

A friend in Canada tested positive for H. pylori bacteria. Of course, the Western doctor he goes to wanted to start heavy antibiotic treatment. Plus, he said he would need to be on some 'pill' for the rest of his life! He is refusing until he can seek out alternative answers to this. He is 70 yrs. old, does not have a hiatal hernia, just a bit of indigestion at times.

What is Helicobacter pylori?

Helicobacter pylori is a common bacterium that many have with or without any noticeable symptoms. Recently a study found that Otzi, the 5,300-year-old ice-mummy, was also infected with H. pylori. Today it is estimated that it is present in about half the population.

H. pylori is known to produce an enzyme, urease, that allows the bacteria to live in harsh acidic environments such as the stomach. Urease reacts with urea to form ammonia which can neutralize enough of the stomach acid to allow organisms to survive in tissues for years. It is highly contagious and is transmitted through saliva, fecal contamination in food or water, and poor hygienic practices in general. As stated, the good news is that most people do not exhibit any symptoms. However, if enough of the stomach acid is neutralized, it can be a factor behind many acute gastrointestinal problems such as gastritis and GI tract ulcers.

The Herbal Approach to GI Inflammation

I’ve been involved with the study and practice of herbal medicine since 1968. In all of that time, I focused on treating the patient more than the disease. This is because my model, traditional herbalism, does not focus on treating specific pathogens associated with a disease, but the whole disease complex itself.

In other words, a Western herbalist may treat gastrointestinal symptoms caused by H. pylori with herbs not specifically targeted to eradicating the bacterium, but with herbs that reliably treat ulcers, abdominal and acid reflux. An Ayurvedic herbalist might treat these conditions as a humoral imbalance of excess pitta. A traditional Chinese herbalist would treat it based on Eight Principles and pattern analysis. In all three models, there is no particular advantage in testing and discovering that the inflammation is caused by H. pylori.

Today, many complementary health practitioners seeking to impress their patients too often resort to describing their diseases based on a Western medical model. The problem is that herbs are more food-like than drugs, exerting a broader function on restoring homeostasis and health. Still, many herbs do have specific tropisms or indications. For the patient described above, look to herbs that treat symptoms of ulcers, acid reflux, belching, bloating, nausea, vomiting, and abdominal pain as symptoms of gastritis. All of these conditions are effectively treated with dietary and herbal treatment.

So while I’ve not treated H. pylori as a discrete entity, I have had a lot of experience successfully treating all the conditions previously mentioned. Because people have responded positively, I can only assume that the diet and herbs I prescribe regularly such as Triphala inhibit the growth of H. pylori.

Herbs for Gastritis, Acid Reflux, and GI Tract Ulcers

Bitters, triphala, goldenseal, and coptis are among the many botanical remedies taken singly or in a formula for treating gastritis, acid reflux, and gi tract ulcers. These herbs treat a broad range of gastric imbalances but have also substantiated research that they are effective for H. pylori. 

Berberine is a constituent of herbs such as goldenseal, coptis, barberry, Oregon grape and the Ayurvedic herb guduchi (Tinospora cordifolia).  All of these have been shown to have broad-spectrum antibiotic and antipathogenic properties. Studies in vitro have demonstrated that berberine can inhibit H pylori. While these may not be robust enough to eradicate the organism entirely (if that is even possible), when used in a compound herbal formulation for gastritis, or in bitters, along with probiotic foods and a balanced diet, they will certainly contribute to a multilayered comprehensive gut healing regime.

Triphala, an ancient Ayurvedic healing compound consisting of three fruits, Terminalia belerica, T. emblica, commonly known as “amla” and T. Chebula or black myrobalan (Chinese: he zi), also has broad spectrum antipathogenic properties.  Chebula or black myrobalan has been cited as effective against all harmful bacteria and specifically effective for inhibiting urease active of H. pylori.

The remaining two fruits in Triphala are also effective against H. pylori, especially amla (T. emblica). Amla fruit is one of the greatest antioxidants in the plant kingdom and is highly regarded both for its nutritional and for its medicinal benefits. It is claimed as one of the two or three highest known sources of natural tannins and Vitamin C which is impervious to both age and heating. Research confirms what native people of India have known for millennia, that Amla is good for the health of the whole body, especially the liver and GI tract. It is an effective treatment for gastritis, Crohn's, iBS, stomach and duodenal ulcers and to inhibit the growth of H. pylori in the stomach.

Tinospora cordifolia, called “guduchi” and “the body’s protector” is bitter, pungent and astringent with a post-digestive ‘sweet’ effect meaning that it is an antipathogenic herb with tonic-nutritive properties. It is one of the most powerful antipathogenic herbs of special benefit for inflammatory gastric disorders.

Deglycyrrhizinated licorice root (DGL) is a well-established anti-ulceration and mucosal healing agent. DGL can coat and soothe the intestinal lining and promote the healing of inflamed tissue and ulcers. Research suggests that flavonoids in licorice have impressive antimicrobial activity against H. pylori. The flavonoids have been shown to have antimicrobial activity against strains of H. pylori that were resistant to clarithromycin and amoxicillin, two of the primary antibiotics used in triple therapy. Some forms of licorice can elevate blood pressure but because DGL has low glycyrrhizin levels it is safe to take if you have high blood pressure.

Sulforaphane is a naturally occurring chemical found in cruciferous vegetables such as broccoli, cabbage and brussels sprouts. Some studies have demonstrated that it can inhibit H. pylori. Eating cruciferous vegetables, especially broccoli sprouts, will ensure that you get plenty of sulforaphane, but it is also available in capsule form from several supplement manufacturers, including a product called Broccomax.

Some studies have suggested that Vitamin C may inhibit and even kill H. pylori but more research is needed to determine the optimal dosing and program duration. Even if Vitamin C does not eradicate H. pylori, it is still worth taking a controlled dose because studies clearly show that Vitamin C levels in the stomach lining can be reduced when H. pylori is present, largely as a result of the inflammatory and oxidative stress caused by the infection. Vitamin C is also an excellent nutrient for assisting with gut healing.

Vitamin U – also known as MSM – is found in raw cabbage. In fact, Vitamin U is not a vitamin at all. Cabbage juice has been studied extensively in Russia and other Eastern European countries for the healing of damaged and eroded intestinal mucosa. It appears to enhance the healing of damaged tissue and may assist in healing ulcers.

When I consider what the most useful single herb I know with these same antiviral, antibacterial, antifungal – in fact, every ‘anti’ property we would need to fight off harmful  pathogens—is, it is Isatis tinctoria, an herb commonly known in old English as “woad,” meaning “weed.” As an ancient East - West cruciferous family medicinal herb, it happens to have all of the same antipathogenic sulfur compounds found in cruciferous vegetables and of course biologic MSM sulfur. Both the leaf and the root of Isatis are used in Traditional Chinese Medicine called da qing ye and ban lan gen respectively. These are classified as bitter and cold, which from an herbalist’s perspective means they are broadly antipathogenic and reserved for short-term use to treat the most stubborn pathogens such as viruses but are equally effective for bacteria and funguses as well.

Acupressure applied to Gall Bladder 20.

According to the World Health Organization (WHO) there are 361 charted acupuncture points on the body. Acupuncturists generally recognize any active point on the body that is particularly sensitive as an acupuncture point, so understood in this way, the number of actual points are limitless.

Within the medical tradition of Indian Ayurvedic medicine, there is a comparable number of points on the body that can be treated called marmas. Like Chinese acupuncture the science of marmani developed in India about 5,000 years ago in Vedic times. Ayurvedic texts describe 117 major marma points. Located at anatomical sites where veins, arteries, tendons, bones or joints intersect, they are similar to the more numerous Chinese acupoints as today they are also stimulated by palpation for both diagnosis and healing. Interestingly, about 75 of the 117 principal marma points exactly correspond to principle acupoints used in Chinese medicine.

Many of the points on the Chinese Gall Bladder meridian, especially on the head and shoulders, treat the condition known in Traditional Chinese Medicine as “Wind.” There are broadly two types of wind: “External Wind,” which includes inflammations on the surface layers of the body including allergic reactions affecting the skin, eyes, ears and nasal sinuses as well as viral and bacterial conditions such as colds, flu, headaches and other common afflictions. “Internal Wind” is completely different and includes more chronic diseases such as epilepsy and Parkinson’s. In both cases, the description “Wind” denotes diseases that represent some fundamental instability.

While not exactly corresponding in location, the Chinese acupoint called feng chi or “Wind Palace,” also less poetically known as Gall Bladder 20 (GB 20), seems closely related in action to the Ayurvedic point Krikatika Marma. These points are located within an inch of each other at the occipital base of the skull can be stimulated to treat allergies, itchy eyes and all kinds of headaches. With effective 4- to 5-second stimulation, one can experience a feeling of immediate clearing in the head which caused one of my acupoint students to dub the point/s a “brain cooler.”

Locating GB20 and Krikatika Marma

Feng Chi (GB20) is in a natural groove located behind the ear at the base of the posterior mastoid (ear) bone where the muscles of the neck attach to the skull. Krikatika marma is on both sides of the central axis leading into the skull at the juncture of the 2nd cervical vertebra.

Fortunately both these points are easy to find and easy to massage even on oneself. To locate GB 20, simply interlock the fingers of both hands palms facing inward and cradle the occiput on the back of the skull. Both your thumbs should naturally fall to the grove connecting the neck and the skull on your neck.  Krikatika marma is one inch towards the center on either side of the cervical spine.

These both connect to the brain and are very powerful. Until you become more familiar with their effect you should stimulate them deeply but probably not more than 4 to 5 seconds each.

  • Both points benefit the head, neck, eyes and ears
  • Relieve local pains such as headaches
  • Relieves tension and both physical and emotional stress
  • Treats respiratory conditions such as colds, flu and asthma

They can be used to immediately relieve allergy symptoms especially of the eyes, ears and nasal passages. Neck pain and stiffness with a decrease in range of motion, stress-related emotional disturbance, middle ear infections, tinnitus, Meniere’s syndrome, and asthma.

I sometimes think of GB 20 as a “lobelia” point because like the herb Lobelia inflata, it has such powerful antispasmodic (Wind-relieving) properties. Similarly, stimulating Krikatika affects the upper lobes of the lung, stimulating bronchodilation and the relief of asthma.

GB 20 and Krikatika marma offer instant relief of Meniere's disease which is a disorder of the inner ear that causes episodes of spinning vertigo, feeling of fullness in the ear and fluctuating hearing loss which is progressive, ultimately leading to permanent loss of hearing and ringing in the ear (tinnitus).

Meniere's disease affects only one ear and can occur at any age but usually starts between the ages of 20 and 50. It's considered a chronic condition, but various treatments can help relieve symptoms and minimize the long-term impact on your life. There is no known cure for Meniere’s disease and there are a variety of Western drugs usually with varying degrees of undesirable side effects, ranging from anti-nausea drugs and valium to steroids and even surgical intervention to cut off neurological response. Certainly for this disease alone, GB 20 and krikatika marma, with no side effects, are worth trying.

GB 20 and Krikatika marma are also useful for those who may experience brain fog and eyestrain from study or working with a computer for long hours. It seems quite natural that one might raise their finger-clasped hands above and behind their head occasionally not only to stretch and take in more oxygen but also to drop down as they take a deep inhale and maintaining a brief inhaled breath allow their thumbs to stimulate these two acupoints points for the price of one. One can easily extend the benefit of these points by massaging back and forth between these two points.

Note: this can be a very powerful experiential treatment.  Start out cautiously massaging no more the 4 or 5 seconds on each side and wait an hour or so before repeating.

Itchy, Severely Inflamed Eye

One of the common problems associated with aging is dry eyes. This can be complicated with an increased allergic sensitivity to airborne allergens. One randomized, placebo-controlled study showed that stimulation of GB 20 in dry-eye patients was significantly improved after 4-weeks of treatment.

I recently had a patient with a severe eye inflammation exhibiting symptoms of severe itchiness, redness, and swelling which caused him to go to his ophthalmologist for a remedy.

The ophthalmologist diagnosed it as inflammation caused by allergy and prescribed some exorbitantly expensive cortisone-based eye drops for relief. It was at this point that my patient sought alternative treatment. Because he would be traveling and it would not be convenient to make an herbal eyewash, I showed him how to massage GB 20.

This point worked like a charm, making it unfortunate that he had already spent nearly $200 for a tiny container of no more than a tablespoon of cortisone eyedrops which he never used. (Believe it or not, it was a cheaper brand from the original prescription which with even Medicare would have cost over $600!)

The first treatment priority was to allay the itching. Each time he felt an urge to rub his eyes he would massage GB 20 for 4 to 5 seconds as described. The itching completely stopped, lasting at first for an hour and after a few times, each time longer until the itching was completely gone.


  1. Shin MS, Kim JI, Lee MS, et al. Acupuncture for treating dry eye: a randomized placebo-controlled trial. Acta Ophthalmol. 2010 Dec;88(8):e328-33. doi: 10.1111/j.1755-3768.2010.02027.x. Epub 2010 Nov 10
  2. MS, Kim JI, Lee MS, et al. Acupuncture for treating dry eye: a randomized placebo-controlled trial. Acta Ophthalmol. 2010 Dec;88(8):e328-33. doi: 10.1111/j.1755-3768.2010.02027.x. Epub 2010 Nov 10.
  3. Takayama S, Seki T, Nakazawa T, et al. N. Short-term effects of acupuncture on open-angle glaucoma in retrobulbar circulation: additional therapy to standard medication. Evid Based Complement Alternat Med. 2011;2011:157090. Epub 2011 Mar 7. PubMed PMID: 21437193
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