Category Archives: blog posts

Prevention and Self Care during the Corona Virus Pandemic

Prevention and self care during the corona virus pandemic is key to not only our well being but that of our community.


  • Wash your hands for 20 seconds using friction, soap, and water or use enough hand sanitizer to wet your hands, using friction to rub your hands dry.
  • Don’t touch your face.
  • Practice social distancing of six feet from others.
  • Limit trips out to grocery stores and other essential errands.
  • While there is no proven transmission of the virus infecting a person from a surface, one wonders if you should “clean” items as you bring groceries into your home, or packages off your porch. Here is a how to video
  • Work remotely unless your job is designated as essential.
  • Look to the CDC for the latest recommendations.  This is not a DYI situation.  
Photo by Dhaya Eddine Bentaleb on Unsplash

What is ineffective:

What About Herbs?

You will notice, I didn’t say grab this herb or that.  Herbs are complicated. This virus is too. The danger is if you take an herb/herbal formula to strengthen your immune system, that herb may actually make the illness worse, you have to add additional herbs to kill the virus.  There is nothing that I am aware of that adequately does this on the shelves of your natural food store. You have to go to a licensed herbalist.  

I tried to get the preventive herbal formulas back in February but the herbs and herbal formulas have been back-ordered.  In Chinese hospitals, Chinese herbal formulas are given concurrently with antiviral and other pharmaceuticals for the COVID19 virus. All Chinese healthcare workers are on a preventative herbal formula. Many Chinese citizens are on preventative herbal formulas as well.  Sorry, there is no herbal over the counter go to for COVID19.

Fortunately, despite being inundated with orders, the US herbal companies are meeting the challenge. I hope to within then next week or so (mid-April) be able to offer Chinese herbal formulas specific to the COVID19 virus. These formulas are based on those used in China for the prevention and to address the mild form of the illness caused by COVID19. These are NOT to be used instead of social distancing/hand washing/not touching your face or western medical healthcare.

Unfortunately, one of the best herbs to deal with the serious lung issues resulting from COVID19 has been banned in the United States, and there really is no effective substitute.  This means the most helpful formulas to deal with the cytokine storm are unavailable in the United States. 

So what can you do to help yourself?

Nothing surprising:

  • Eat well!!! Eat a nutritionally dense diet.  Sugar and refined foods all add to inflammation and lower your immunity so it’s best to cut them out or significantly reduce them from your diet.
  • Incorporate turmeric, garlic, oregano into your dishes…don’t go overboard here, just add it to soups, stews, meat dishes, salads and the like.  These herbs are good for inflammation and are antibacterial/antiviral and are good to have in your daily diet regardless of COVID19.
  • Sleep!  Make sure you are getting enough quality sleep. Practice good sleep hygiene!
  • Exercise, out of doors if possible! Air quality has improved since the pandemic began. Make sure you enjoy your time 6 feet from every other person trying to enjoy his or her time.
  • Take care of your mental health: meditating, exercising, taking some “me” time, journalling, blowing off steam to a friend, etc.
Photo by Tom Wheatley on Unsplash

For surviving self isolation, isolating with your family, a list of ideas

By Yourself, for Yourself

  • Take up a new hobby or  break out an old one: a musical instrument, painting, sketching etc.  you can buy supplies online, but expect a delay in delivery
  • Connect with your library online–they have lots of online resources in addition to language learning..  Depending on your library branch you may be able to access The New York Times for free as well as magazines and books. Definitely worth exploring
  • Research your ancestry online
  • Garden or pot some plants
  • Tackle a home project that you just haven’t had the time to get to, such as organizing all your photos 
  • Pick a new or a favorite author and read all their books…or maybe pick a new genre
Photo by Caio Silva on Unsplash

Quality Time with Household Members:

  • Experiment in the kitchen and have a cook off:  who can be the most creative with food items that you have at home.  I found an amazing recipe online by searching: recipe, cardamom, zucchini, lime.
  • Reach out to family and friends via phone, video call
  • When you call that elderly neighbor or relative, consider recording his or her stories.
  • Movie nights, game nights, charades, puzzles etc. with your household members
  • Crossword puzzels–some free ones on line at
  • Try a new language on line–there are several free ones like Mango to get you started  Check your local library online resources for free access.
  • Howl at the moon at 8pm or start another public display of appreciation for our healthcare workers with your neighbors.
Photo by Henry Be on Unsplash

Virtual connection with friends and community

banner photo by UnSplash

Springtime allergies

Photo by Alisa Anton on Unsplash

In the San Francisco Bay Area, spring is in evidence in the blooming of flowers, trees, and weeds.  Weather and temperatures are in a time of flux.  It can be sunny and hot one moment and damp and foggy the next. Wind is common in the afternoon if not in the morning. Late afternoon and evenings can still be quite chilly. Springtime allergies and weather fluctuations can be hard on the immune system!  Not to mention that colds and the flu are still making their rounds.


A few suggestions for staying healthy:

  • Herbs and acupuncture can fortify the body’s immune system to help minimize allergy chinese herbs wansuffering.  Ideally, acupuncture and herbs should be taken prior to the onset of symptoms for best results.
  • Wash your hands before meals. Avoid touching your eyes and nose as well as your mouth as these are points of germ entry.
  • Dress in layers and wear a scarf or high collar and be sure to have appropriate wet weather gear.  Change as soon as possible if you become wet, this includes sweaty workout clothes.   Wearing wet clothes can result in becoming chilled further challenging the immune system which can make one susceptible to illness.
  • Getting an acupuncture treatment when “feeling worn down” or when you feel a cold/flu coming on can help prevent or lessen the severity of a cold or flu.
  • Chinese herbal formulas can help strengthen the immune system to help ward off or lessen the severity of colds and flu.
  • The everyday stress of life also affects our immunity.  Make sure you have “stress relieving activities” built into your daily life…even just a few minutes.  A short walk around the block, meditation, a number of deep breaths, laughter, spending time with friends are ways to maintain sanity.
  • Sleep…make sure you get adequate quality sleep.  Insomnia is a common problem.  Menopausal women, parents of small children, stress, work/home life commitments all can get in the way of falling or staying asleep.  There are numerous ways of getting your sleep back on track.  A consistent nighttime routine, no caffeinated drinks after noon are a few tips.

If you feel the beginnings of a cold act right away:

  • Make sure you get plenty of sleep; tone down rigorous exercise routines until you feel fully recovered.

    Photo by Kelly Sikkema on Unsplash

  • Drink plenty of fluids (room temperature or tea temperature, not cold/icy) and soups (as they are nourishing and easy for the body to digest).
  • Drink fresh ginger tea to help keep a cold from settling in. Drink it as long as any nasal/cough discharge you may be having stays clear (stop drinking if phlegm turns yellow or green).
  • Make sure you are taking Vitamin C in appropriate dosage.
  • You may have discovered Chinese herbal formulas for colds, flu, cough, etc. at your local health food store. I would recommend calling me or consult another Chinese herbalist before taking any Chinese herbal formula as Chinese herbal formulas are made for specific stages of colds and flu. It is important to have guidance so as not to make your cold or flu worse.

If you suffer from allergies:

  • Not always practical…but minimize exposure to allergens.  If you have a cat, you can keep the cat indoors so s/he doesn’t bring pollen in on their fur. Another option is brushing the cat with a dander brush and keeping the cat off bedclothes.

    Photo by Stephanie Krist on Unsplash

  •  Irrigating your nose is a good way to wash out the allergens.  There are several ways to do this.  Instructions can be found at  The Neti Pot makes nasal irrigation easy with its clever design and included instructions.  One piece of advice:  if you plan to use the Neti Pot in the shower or tub, use a plastic model!
  • Chinese herbs are especially effective at fortifying the immune system and minimizing allergy symptoms if taken for the 6 weeks prior to the advent of allergy season.
  • Acupuncture treatments and herbs can be very helpful in alleviating symptoms and lessen the severity of allergies.

If you have specific questions, please feel free to contact me, by phone or e-mail.

Be Well


Part VI:  Quick Reference for the Transition into Menopause

I have covered a lot of ground over the past five blogs and yet it isn’t an exhaustive account of the menopausal journey.  Here I hope to provide a recap, or a menopause/perimnopause resource guide, of the points I covered in my previous perimenopause/menopause posts.  Additionally, I have included  a to-do list of sorts…

My preferred step by step approach to navigating menopause:

Step 1:

  • Eat a nutrient-rich diet, exercise regularly, stretch, rule out other medical problems (thyroid,

    serious ob/gyn issues through a visit with an ob/gyn doctor and blood tests), implement a de-stress routine, get good sleep,  aspire to a balanced lifestyle, and don’t smoke.  If you drink alcohol, experiment with giving it up for a week or so to see if that alleviates hot flashes, headaches, and insomnia–some women over 40 find this really to help. (some of you may be rolling  your eyes)

Step 2:

  • After determining that you don’t have any medical complications and a doctor has ruled out other possible health conditions that can cause any of the symptoms you may be experiencing, try to fill any vitamin, mineral deficiencies by altering your diet or taking supplements if you can’t manage with diet alone.  Deficiencies can be found through blood tests and the help of an MD or a healthcare practitioner who interprets blood tests using what’s called functional blood analysis.

Step 3:

  • If diet and lifestyle aren’t enough, or you would like more support during perimenopause/menopause, try rebalancing your body through acupuncture, herbs (under the guidance of a practitioner–can’t help myself), biofeedback, or other alternative treatment.

Step 4:

  • If after trying steps 1, 2, and 3 to the best of your ability and you still feel lousy,  by all means, try Hormone Replacement Therapy or HRT.  

Perimenopause: the summary:

With your physician:

  1. Go for a routine checkup to rule out other causes of symptoms.  
  2. Request a complete thyroid panel (TSH, Total T4, Total T3, Free T4, Free T3, T3 Uptake, Reverse T3, TPO antibody, TGB antibody) to rule out thyroid involvement.  Irregardless, it’s a good idea to support your thyroid with selenium (2-4 brazil nuts daily if not allergic), vitamin D (careful sun exposure–if  you can–supplement with D3, or foods fortified with D), zinc (seafood, nuts, seeds, beans), iodine (seaweed, fish–get your iodine levels tested before even thinking about going on an iodine supplement as you can make things worse).
  3. Get blood tests:  CBC with differential, vitamin D, C reactive protein, homocysteine, thyroid


    panel (as suggested above) to ensure numbers are within optimal range. These tests will identify possible issues with blood sugar, cholesterol, anemia, digestive and thyroid function and more.  Make sure you are WELL hydrated the three days before you have your blood drawn–it can affect your numbers and give you false positives.  

  4. If considering HRT, start gathering information.  You can initiate a conversation with your physician and other healthcare providers.

At home daily care:

  • Eat right: leafy dark greens, fruit, nuts, seeds, good fats, plant protein, fermented foods.
  • Eliminate smoking, cut down/eliminate highly processed foods and alcohol.
  • Exercise-regularly, including stretching.
  • De-stress measures: meditation, walks, whatever calms you.
  • Practice good sleep hygiene.
  • Consider supportive therapies such as acupuncture, herbs, supplements, biofeedback, massage, etc.

For Bone, Heart health, CA prevention, blood sugar regulation and health in general:  

  • Ensure that you are ingesting fiber, good fat, plant protein, zinc, selenium, vit A, C, D, E, K, B complex, Calcium/magnesium.
  • Soy good, soy isoflavones not.  Soy protein powder and supplements are not recommended as they contain soy isolates (which may mess with hormone levels rather than benefit levels).  
  • Get rid of sugar:  also helps w/ brain, fatigue, blood sugar levels.
  • Avoid highly processed foods. Cut down on caffeine, alcohol, smoking, meat, sugar, and salt (Calcium is drawn out of bones to neutralize increased acidity), also carbonated drinks (phosphorus in these drinks competes for calcium absorption).

IF you have the following symptoms, seek the advice of a medical practitioner and add self-care:

blood pressure, high: Decrease:  salt, caffeine, alcohol, deep fried foods, processed foods, smoking.

Bleeding, heavy:  Eliminate caffeine, alcohol, spicy foods, no smoking.

Hot flashes:  Exercise (not right before bed) 0.5 hr x 3week, phytoestrogen (foods), soak feet in hot water before bedtime, no hot showers right before bed, maybe not during the day.  Liver cleansing foods (rose hip) dark greens. Eliminate alcohol, especially wine at night.

Insomnia: Eliminate alcohol before bedtime, take calcium/magnesium before bedtime (better absorbed) and if not lactose intolerant take with warm milk and a bit of honey if desired to take advantage of the enzyme that induces sleep. Don’t eat 3 hours before bed (acid reflux, hard to sleep on a full stomach) but if you find yourself hovering just below the surface of sleep, have a light protein snack before you go to sleep–it may be your blood sugar levels dropping causing your cortisol to spike inducing a lighter sleep.  

Libido, connection with a partner:

  • Foreplay, touch, emotionally engage, fermented foods.

Vaginal dryness:

  • Keep hydrated (watch diuretics and antihistamines), probiotics, keep active–the more you engage your lady parts in play, the better off they’ll be–use it or lose it as they say. Do Kegel and core exercises. Consider estrogen cream for <1 year.  Try a local personal lubricant such as vitamin E, aloe vera with vitamin E (brands available on Amazon:  Aloe Cadabra, Carrageenan) or Replens which is a lubricant that doesn’t have a natural base, therefore, Replens may affect condoms and may affect vaginal tissues.  Watch out for UTIs!

Fatigue, low energy:

  • Take a B complex vitamin (B vitamins are best absorbed together). You may wish to consider taking a B complex supplement in a pill form and add sublingual B12 (B12 is best absorbed sublingually as we get less efficient at absorbing B12 through our digestive tract as we age.  You can also get B12 shots administered by a doctor, usually a naturopathic doctor).  Cut out sugar. Eat plant-based protein, and take vitamin C, ground flax seed.  Get thyroid checked.

A few foods and supplements that can be especially helpful for mild-moderate symptoms.  Please seek professional help if they do not provide adequate relief.


  • 1-2 tablespoon ground flax seeds (can’t eat seeds whole as our body will just pass them through whole and flaxseed oil doesn’t have the phytoestrogen-rich lignans). For:  hormone balance, depression, joint pain, skin health and it’s a good source of plant fiber.

Brazil nuts 2-4 daily unless allergic to nuts.  

  • These nuts are high in selenium which is helpful for healthy cholesterol levels, thyroid, heart, blood vessels, and cancer prevention.

Multi-vitamin, Calcium/Magnesium (1:5), B complex::

  • If your food sources are not adequate, add high-quality supplements.  You may also want to consider a multivitamin.

Kathleen H Cutter








Please look at my Pinterest Boards to see foods high in various nutrients…you’ll notice a lot of overlap!


Parting Words:  


“The more you know, the more you know you don’t know.”  Aristotle


It is true that you aren’t the first and certainly not the last to go through the perimenopausal journey…you can take cues from the women that have come before you, you can take the advice from me, science, other alternative healthcare practitioners, other conventional healthcare practitioners…but your journey is as unique as you–it is your perimenopausal journey and yours alone.  This can be daunting and be freeing.  I hope that your path smooths out before you, but know that you will get through it and into your Second Spring!

Additional Resources:

Chinese and/or alternative perspective:

Maciocia, Giovanni Obstetrics and Gynecology in Chinese Medicine Churchill Livingstone 1998

Ni, Maoshing Second Spring: Dr. Mao’s Hundreds of Natural Secrets for Women to Revitalize and Regenerate at Any Age  Free Press, NY 2009

Welch, Claudia  Balance Your Hormones, Balance Your Life: Achieving Optimal Health and Wellness through Ayurveda, Chinese Medicine, and Western Science Da Capo Lifelong Book, 2011

Weed, Susan Menopausal Years:  The Wise Woman Way, Alternative Approaches for Women 30-90 Ash Tree Publishing 1992

Wolfe, Honora Lee Menopause: A Second Spring: Make a Smooth Transition with Traditional Chinese Medicine Blue Poppy Printers 1993

Western perspective:

Boice, Judith Menopause with Science and Soul: A Guidebook for Navigating the Journey (emotional aspects addressed more).

Brown, Ellen and Lynn Walker Menopause and Estrogen:  Natural Alternatives to Hormone Replacement Therapy    (somewhat dated but well written and easy to understand)

Corio, Laura E. and Linda G. Kahn The Change Before the Change: Everything You Need to Know in the Decade Before Menopause Bantam Books 2000   info. Resource  under “health info” look to “fact sheets” and “trusted resources”

Northrup, Christiane The Wisdom of Menopause (Revised Edition): Creating Physical and Emotional Health During the Change  Bantam Books 2012

Price, Catherine Vitamania: How Vitamins Revolutionized the Way We Think About Food Penguin House 2015

For online graphics on foods high in certain vitamins and minerals:  A few boards.  One illustrates which foods are high in various vitamins, minerals, good fats. Another on food for certain symptoms, still another for EFT, acupuncture, food journal templates, and recipes

Kathleen Hiatt Cutter, Licensed Acupunct on Facebook for health articles in news

Other references:

Marchant, Jo Cure:  A Journey Into the Science of Mind Over Body  Broadway Books 2017

Mukerjee, Siddhartha 9/11/17 New Yorker magazine article

This is to serve as information only, please seek the care of a medical doctor for symptoms and concerns you may be experiencing.  This is in no way to serve as treatment of any disease or illness.  The following is for information only.  


Part V:  To take HRT or not to take HRT

Step 4:

  • If after trying steps 1, 2, and 3 to the best of your ability and you still feel lousy,  by all means, try Hormone Replacement Therapy or HRT.  


So many people come to me trying so hard (too hard in some cases!) to do the right thing, eat

the right things, and exercise all while working, parenting, caring for their elders, partnering, etc etc..  I always tell my patients…you have to do what is going to get you through the night.  So, if my patients have done Steps 1-3 to the best of their current ability and if they STILL have headaches, hot flashes, night sweats, insomnia, anxiety, etc.; take what is going to give you some peace (within reason, obviously).  In short,  if someone needs HRT, and they don’t have any medical reason not to–it’s a fine option. If you take HRT, it isn’t “a fail.”  You don’t get a girl scout badge for making it through menopause without taking HRT.  


I encourage you to please, please, please discuss the HRT option with your healthcare practitioner.  I am not advising anyone to take it or not to take it.  I don’t know the severity of your symptoms, your personal history, or your personal health history.  These personal details are key on whether or not this option is right for you.  What follows is information to consider with your healthcare practitioner. Hopefully what follows will provide you with some helpful questions to ask as well as to add to the clarity and confidence of your choice to take or not to take HRT.  Clarification is important especially if you have a history of estrogen-sensitive cancer, endometriosis,  blood clots, or fibroids. You want to make sure any prescribing physician knows your complete medical history.  They should also advise you if it is right for you if you have diabetes, asthma, and a few other conditions.  


Notes on supplemental hormones:


Again, I am an acupuncturist/Chinese herbalist. My training and perspective come from this alternative approach to health.  Inherently, the Chinese medical system doesn’t like the idea of taking something to replace what is naturally declining in the body.  Rather, Chinese medicine through lifestyle, diet, acupuncture, and herbs tries to help the body ease through this natural transition.  By replacing our declining hormones with hormones, you are kicking the can down the road. You may be just delaying the symptoms.  Also, aside from dosage, western medicine really doesn’t individualize the treatment of symptoms.    That being said, some women have such a rough time with perimenopause and/or some women cannot afford to take the time, spend the money and effort to do it “naturally,”  so I recommend that you embrace what’s going on for you to get through this time–and if that includes HRT, that’s fine.  


Taking hormones is something you should educate yourself about–and know that conclusive findings have not yet be arrived at.  I remember when I was in school for acupuncture medicine 20 years ago, I worked for two well-known acupuncturists.  While I was alone with a middle-aged patient she turned to me and said: “You are in school, what do you think about HRT?”  I surprised myself when I muttered under my breath, “Well, you women are the guinea pigs, I’m just glad I’m about 20 years out from it.”  And it’s true, long-term studies are just being completed–but still more studies need to be conducted.  The long and the short of the current findings it is that there is some concern about long-term health effects of HRT ( increased cancer diagnosis)  and the “protective” value of HRT hasn’t borne out. However, it did NOT conclude that women on HRT die sooner.


With all this in mind, these are some things to know and to ask your HRT prescribing health care practitioner.

  1. If you take estrogen, take progesterone
  • Prescribed estrogen encourages undifferentiated cell growth, natural progesterone counters this undifferentiated growth thereby lessening the chance of estrogen-sensitive cancer growth. This same estrogen is the “strongest” of the three types of estrogen in our bodies, it is the one responsible for keeping our bones strong.
  • I’d say most if not all  MDs would give you both estrogen and progesterone.

2.  If you take progesterone, take natural progesterone

  • I am pretty sure most MDs recommend it as studies have shown that the natural progesterone is better than synthetic progesterone at countering estrogen’s undifferentiated cell growth effects.  

3.   If you want to take estrogen, it is best (unless there is a medical reason not to) to take it transdermally/topically.

  • Less estrogen can be prescribed transdermally for the same effect as larger oral doses.  For safety sake, MD’s try to prescribe the smallest therapeutic dose possible to alleviate symptoms.
  • If you have a history of fibroids, this may be one medical reason to consider an alternative to the estrogen patch, ask your MD, they may agree or disagree.


4.  Bio-identical hormones

  • There are conflicting reports on the safety of bio-identical estrogen.  However, it’s generally

    agreed that bio-identical progesterone is safer than synthetic hormones as it checks the undifferentiated cell growth promoted by estrogen.

  • Many people like the idea of taking a  bio-identical estrogen, or estradiol.  Estradiol is one of the three human estrogens.  Standard HRT estrogen, Premarin specifically, is made from conjugated equine (as in horse) urine.  Besides containing the bio-identical estradiol, it contains many chemical compounds found in horse urine as well as non-human estrogen.  
  • As the body recognizes bio-identical hormones as the same “type” as the ones our bodies make,  it is argued that there are fewer bio-identical side effects than those of the regular HRT.


5.  Hormones from compounding pharmacies: where they tailor your hormone prescription for you.

  • Double check with your provider.  Generally, western MDs aren’t fans of compounding

    pharmacies because the amounts of estrogen/progesterone cannot be 100% controlled and consistent.   Your dosage can’t be “guaranteed.”

  • Again, no long-term studies on their safety.



6.  If you are considering HRT for vaginal dryness/painful intercourse

  • Consider taking a locally applied estrone product.  While it won’t help with keeping your bones strong, it is the mildest/safest estrogen of the three human naturally occurring estrogens.  It doesn’t promote undifferentiated cell growth.  There are bio-identical options.

7.  If you are in menopause and you have breakthrough bleeding, ask your prescribing doctor about decreasing the dose–less is better with HRT.

8.  Consider making a plan for how long you will take HRT and how to wean off HRT.

  • Menopause is a natural part of our aging process.  It is not a disease.  We were built for

    AliceMary of

    the decline in hormones and you may want to consider following nature’s plan.  By taking HRT you may be able to better control how jagged that decline happens.  So discuss with your prescribing doctor on how long you may want to be on it and how you can wean yourself off HRT so your transition to the Second Spring is as smooth as possible.  

  • Again, perimenopausal/menopausal symptoms can occur well after your last menstrual period. This may be in part because the estrogen receptor sites refuse to die off, so their cries for hormones will result in ongoing symptoms.  It may also be due to the receptor sites dying off more slowly as they are being fed by HRT. You may be able to help the HRT weaning process go more smoothly by supplementing your diet with phytoestrogens, easing the estrogen receptor sites die off.


It is important to note that the reported safety of HRT, bio-identical hormones and compounding pharmacies is dependent on the source of the information.  Generally, the alternative medical approach doesn’t like synthetic HRT and lauds the more natural approaches.  On the other hand, the medical establishment tends to downplay the negative effects of synthetic HRT as well as the efficacy/safety of natural HRT.  The one thing that can be agreed upon is that “more robust studies need to be done.”

Here I’ll quote Bertrand Russell:  

“The whole problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts.”

The disclaimer.  This is to serve as information only, please seek the care of a medical doctor for symptoms and concerns you may be experiencing.  This is in no way to serve as treatment of any disease or illness.  The following is for information only.   

Next up:  the Cheat Sheet/Recap


Part IV:  Supportive Therapies for Perimenopause and Menopause

Step  #3:  the breakdown

Yet again, a disclaimer first.  This is to serve as information only, please seek the care of a medical doctor for symptoms and concerns you may be experiencing.  This is in no way to serve as treatment of any disease or illness.  The following is for information only.   

Step 3:

  • If diet and lifestyle aren’t enough, or you would like more support during perimenopause/menopause, try rebalancing your body through acupuncture, herbs (under the guidance of a practitioner–can’t help myself), biofeedback, or other alternative treatment.

.Of course, I’m an advocate of seeking supportive treatments throughout the perimenopausal and menopausal years–in fact you don’t have to wait until your 40’s to begin.  Our lives are crazy busy with work and full of active self-care such as exercise and eating right, passive supportive care may make the difference in taking the edge off “life” and to really make a difference during this transition.  


Since my expertise is in acupuncture, herbs, and the Emotional Freedom Technique or EFT, I will limit my discussion to these approaches, however, I support other alternative therapies namely–though not limited to–biofeedback, massage, chiropractic –to support you through the transformation.  

As a Chinese medical practitioner, the main tools at my disposal are acupuncture and herbs.  But, to reiterate, the first step in my treatment is always lifestyle and dietary guidance. I do tailor dietary and lifestyle advice to each of my patients.  I also use functional blood analysis, to help my patients identify nutritional deficits and specific guidance to get their numbers closer to the “ideal”  as I briefly noted in Step #2 in my last post.


Chinese medical approach:


When a person comes to see me for acupuncture and Chinese herbs, it is my objective to re-establish the person’s internal balance–in other words to enable their body help itself.


  • Chinese medicine resolves symptoms by correcting the common root cause of the


    symptoms–it’s not a replacement therapy or a band-aid approach.

  • Chinese medicine does not offer one explanation for everyone’s perimenopausal discomfort nor one solution for everyone’s  perimenopausal symptoms.  Chinese medicine evaluates the individual’s “soil” or landscape and not just the “seed” or the fact that she is of perimenopausal age with certain symptoms.
  • The Chinese medical approach is beneficial for the whole body, not just menopausal symptoms.  You may go in for hot flashes but you may discover your seasonal allergies are alleviated.
  • Chinese medicine is slow medicine, it’s personalized, and it addresses the complex you.  It may take some time and some tinkering for relief to be long-lasting.  It can teach you about yourself and what your body–as opposed to your friends’ bodies–need at this time.


Here is where I could give a summary of Chinese medical theory but it doesn’t lend itself to a concise explanation.  I do plan to devote a future blog post or perhaps a video to explain how Chinese medical practitioners arrive at diagnosis and treatment plan based on an individual’s symptoms.  So, stay tuned.  For now, I’ll briefly present my toolbox.


Chinese medical tools:

Many women feel that their body has been pushed out of kilter during menopause, nothing really looks all that different on the outside, but on the inside things are either slipping out of whack or are just plain wacko.  It’s my objective to help patients return to balance through:

  1. Acupuncture:  You can think of an individual as a closed system.  I do not “add” or “subtract” anything when I treat someone with acupuncture. I use acupuncture as it’s been used for a couple of thousand years.  I help the individual’s body to help itself by altering qi and blood flow so it can nourish the areas that need to be nourished and calm areas where it needs to be calmed.  Initially, depending on the severity of your symptoms, you can expect to have one to two treatments for a week and then you can start spacing treatments out to one a week to once a month.

  1.  Herbs:  In the Chinese medical system, herbs are considered to be internal medicine. Herbs are used to help quell heat, add moisture, and nourish the body.  Also, Chinese herbal formulas are used to help the body to utilize its own resources and abilities by redirecting and recalibrating a person’s system.  Generally speaking, herbal therapy takes up to three menstrual cycles (your typical cycle when you were cycling regularly) to effect change.


A word about taking over the counter herbs:

At the risk of sounding self-serving, I don’t like to give a blanket recommendation for herbs.  As I have stated numerous times….Chinese medicine is an individualized medicine. There is no one herb or herbs that is good for every woman’s perimenopausal experience.  Additionally, herbs are serious business.  Certain herbs commonly advised for perimenopausal symptoms–all symptoms for that matter– that you can buy at your local health food store can interact with other medications you are taking and can be dangerous–or they can be inappropriate for your particular system.  

Ever look at a label of a Chinese medical formula?  You’ll see a long list of ingredients.  That is because herbs act synergistically–herbs accentuate the benefits of one another AND they ameliorate other effects of the herbs that are not wanted.  In short, Chinese herbs are formulated to maximize benefit and effectiveness and lessen any potential side effects.  Furthermore, you are an individual, your complete medical history, medications, allergies, and symptoms should be evaluated by a professional.  I personally cannot take the most commonly prescribed Chinese herbal menopausal formula as my digestive system will be thrown off. Lucky for me (and everyone)  there are several other options!


Emotional Freedom Technique:

Chinese medicine, while it has ancient roots, is not a static medicine.  The Emotional Freedom Technique dovetails quite nicely with traditional Chinese medical approach, as it utilizes acupuncture points towards a traditional Chinese medical goal.  

In Chinese medicine, we look at every illness or disease, as I have stated elsewhere on my website, as having physical, mental, and emotional components.  In fact, if we don’t attend to each of these four aspects, true lasting healing won’t happen.  Take for example insomnia.  The physical symptoms of insomnia are fatigue and not being able to fall or stay asleep.  Anyone who has experienced insomnia for any period of time will admit that insomnia affects their ability to think quickly, their ability to concentrate on tasks, and their reaction time…these are the mental effects of insomnia.  On the flip side, mental stress can cause the physical inability to fall or stay asleep.  Crabbiness and irritability that results from insomnia are potential emotional symptoms.  The “spiritual” aspect of long-term insomnia may be the flagging drive or the inability to connect with people or pleasurable activities.  So, a sleeping pill might knock you out, but it doesn’t address the stress that may be keeping  you up, the quality of sleep induced by a sleeping pill may not be great either….but Chinese medicine hopes to ease both the anxiety as well as the physical reasons why you can’t sleep, so you can return to all that gives your life pleasure.  



Emotional Freedom Technique is a method of tapping a sequence of acupuncture points with your own fingers while you are saying things about your discomfort or issue.  It reduces or eliminates the mental-emotional “charge” of a symptom thereby reducing the mental and emotional aspects contributing to–or caused by–symptoms.  It can be a very effective and speedy way to help a person get through a difficult time.  It is a technique that is first done with the guidance of a practitioner and after a few sessions, you can do it at home as self-care.  

Next up:  Step #4

Hormone Replacement Therapy or HRT


Part III: Navigating perimenopause and menopause: identifying and correcting nutritional deficiencies

Step 2:

  • After determining that you don’t have any medical complications and a doctor has ruled out other possible health conditions that can cause any of the symptoms you may be experiencing, try to fill any vitamin, mineral deficiencies by altering your diet or taking supplements if you can’t manage with diet alone.  Deficiencies can be found through blood tests and the help of an MD or a practitioner who interprets blood tests using what’s called functional blood analysis.


Your doctor may have ruled out medical conditions and declared your blood tests results to be “within normal range.” So does that mean that all your symptoms are due to perimenopause or menopause?  Not necessarily.  Your blood tests may indicate that you would benefit from some nutritional support. You may be able to eat your way out of your symptoms…or at least reduce their severity.  In other words, alluding back to the garden metaphor in my first post, you need to amend your “soil” for the best outcome for the “seeds” of the change (into menopause).


Specifically for menopause, you want to make sure you are supporting the endocrine system which is composed of the adrenals, the thyroid, and the sex hormones (estrogen, progesterone, and testosterone to name a few). Dr. Rhonda Nelson, likens the endocrine system to a three-legged stool.  While experiencing menopause, this three-legged stool gets wobbly.  The sex hormones are naturally in decline, throwing the balance.  The adrenals, due to stress perhaps, may be working too hard increasing the wobble. As a result, the thyroid starts to work harder in attempt to even things out. So, it’s important to  “feed” the adrenals, the thyroid, and the sex hormones–to provide them with the nutrients they need to do their job.


So how do you know which nutrients you are lacking in?  How do you know which part or parts of your endocrine system that need to be bolstered? Sometimes it’s as simple as taking an honest look at your diet and admitting it may be less nutrient dense than it should be.  If you want to know more definitively, you can have some blood tests.


Functional blood analysis:


Usually, when you go to your physician, you get a CBC or complete blood count and your doctor may add a TSH test to evaluate your thyroid.  Recently, physicians have started to add a test for Vitamin D levels.  A lab will analyze your blood and your physician will go over it with you if any value seems out of their normal range.  Most labs use what is called a “standard range” for each blood test. This range is derived from the average values for all the people coming to that particular lab—the values are dependent on the population of each lab.  A healthcare practitioner using functional blood analysis to evaluate blood test results uses what’s called a “functional range,” these values are not derived from each different lab’s average set of results, therefore their normal range does not change from lab to lab or region to region. The functional range is a tighter range than that of the standard range.  If you picture the standard range as a bell curve, the functional values are generally at the top of the standard range’s bell curve where the values are more appropriate for healthy individuals. If you don’t catch a value until it falls outside the standard range, it’s harder to correct the imbalance with diet or lifestyle changes, pharmaceutical measures may be necessary.


I like to compare my patient’s blood test results with the functional range values with the objective of nudging their values toward the optimal values BEFORE there is a need for pharmaceutical or medical intervention.  Ideally, the patient would make specific changes in their diet and lifestyle to achieve this, but sometimes supplements are the most realistic way to help a patient to get what they need.  Afterall diet, exercise and a hectic life may get in the way!


A word about the Thyroid:      

A thyroid that isn’t functioning properly can lead to a slew of issues including weight gain, fatigue, dry skin, irritability, and irregular menstrual bleeding. During midlife our adrenals tend to be working overtime, therefore, requiring more effort from the thyroid as I mentioned above.  Also, during menopause estrogen and progesterone hormone levels can affect thyroid function. It’s important to note that TSH levels–again, typically the only thyroid test requested by physicians–may test within the normal or optimal range if estrogen is elevated and progesterone levels are low.   So while you may be symptomatic your thyroid tests may be ”normal.”  An expanded thyroid panel, which includes TSH, total  T4, Total T3, Free T4, Free T3,   T3 Uptake and Reverse T3, may reveal if there is indeed a breakdown and where it is.  The reason why physicians don’t usually don’t request an expanded thyroid panel is that the results will not alter the pharmaceuticals they prescribe.  However, the expanded thyroid panel may indicate how best to nutritionally support their thyroid so as not to suffer symptoms or slide into thyroid dysfunction in the future.  Key nutrients to support thyroid function are selenium, zinc, vitamin D, and iodine.  Not surprisingly, stress is hard on the thyroid–so do your best to alleviate stress too!

photo Mayo Foundation for Education and Research

Please do NOT take supplemental iodine without the advice of a medical health care practitioner who has tested you for iodine deficiency.  If you haven’t first fed your thyroid with selenium, vitamin D, and zinc, or if you already have sufficient iodine, or if you take iodine incorrectly, you may increase any symptoms and it could be determinantal to your overall health.  


If you have been diagnosed with hypothyroidism, you may want to consider taking a more natural thyroid medication like Armour or Nature Throid.  Ask your physician if this is an option for you.  Your doctor may or may not be open to this alternative.


A word on phytoestrogens:

Estrogen is one of our sex hormones that starts to decline during perimenopause. Phytoestrogens are plant (phyto) derived estrogens. They are similar to human estrogens so much so that they can be taken up by our estrogen receptor sites if our own supplies are lacking.  Phytoestrogens are “weaker” than our own estrogen, so our own estrogens will attach to our estrogen receptor sites over any present phytoestrogens. However, by eating phytoestrogens you may be able to help ease perimenopausal symptoms and bone loss if your own estrogen supplies are not sufficient. They are most beneficial to those who have mild menopausal symptoms but can be helpful if trying to wean off of supplemental estrogen.


Again, food is the first medicine! In the table below you’ll note food categories that are important for everyone to partake in.  The table is not exhaustive, I have only included nutrients, symptoms, and overall effects to health that I felt were particularly important for women in midlife.


Food category foods Contains vit/mineral Menopausal symptoms Overall health
fiber Legumes, soy, prunes, vegetables, fruit, whole grains Almost everything BUT doesn’t provide B vitamins, some essential amino acids Hormonal balance Gastrointestinal and heart health, stabilizes blood sugar, cancer prevention, bowel regularity, weight control (you feel more satiated, therefore eat less)
Plant protein > processed meat, meat with hormones/antibiotics Legumes, nuts, beans, seeds (don’t forget quinoa), soy Calcium, protein, if vegan ensure you take a B12 supplement Bone health, hormonal balance Be mindful of how meat is raised, processed, and prepared…this may be more responsible for any ill health effects than the meat itself
Good fats Olive oil, avocado, fish, walnut oil, flaxseed Omega 3, 6, essential for absorbing fat-soluble vitamins and minerals such as calcium, A, D, E, and K Hormone balance, skin and hair issues, memory issues Benefits nervous system, heart health, brain, eyes, cholesterol, inflammation
Fermented foods tempe, vegetables and if you eat dairy: kefir, yogurt Probiotics.  Additional nutrients available dependent on which food is fermented therefore may include antioxidants, anti-inflammatory, fiber Keeping the vaginal flora happy! Feed that gut microbiome–we’re only just discovering the importance of the gut biome on overall health! Suffice it to say scientists expect it affects mood and brain function.
Dark leafy greens Kale, chard, collard spinach, mustard, dark lettuces, broccoli Calcium (except for spinach, chard), vitamins a, c, k, many have iron, folate, potassium, fiber Bone health Cancer prevention, help heart, gut, immunity, anti-inflammatory
phytoestrogens whole grains, veggies, seaweed, fruits,

soy (160 mg daily)

Lignan found in:  ground flaxseed (not oil) 1-2 tablespoons daily, and seeds such as pumpkin, sunflower, sesame, and poppy, whole grains (rye, oat, barley), bran (rye, oat, wheat), berries

Hormonal balance, estrogen dominance or imbalance of progesterone,reduced hot flashes, decreases vaginal dryness, help with vaginal tissue atrophy, decrease heart disease by lowering  cholesterol, LDL cholesterol, and triglycerides, may inhibit bone loss, lower breast Antitumor, antioxidant
Bioflavonoids (mild estrogenic) Pith of citrus peel, try tea from rose hips, nettle (Lamium album), citrus fruits, plums, apples, berries, peaches antioxidants Vaginal lubrication, pelvic tone, strengthen the bladder, joint health, water retention, hot flashes, heart health, muscle cramping Anticancer

Please look at my Pinterest board for a graphic on food sources for given nutrients.

A word on supplements:

If you have followed me all on facebook, you’ll know I’m a big fan of Gastropod.  It covers the science and history of food–it’s got my geeky heart!  Anyway, a great listen is their “V is for Vitamin” episode:   They interview Catherine Price, author of the great book “Vitamania:  How Vitamins Revolutionized the Way We Think About Food.”  The long and the short of it:  eat your vitamins.  Eat your nutrients in their intended form: as whole foods rather than eating the different nutrients as a bunch of separate components in the form of pills. When we eat a carrot, we get more than the beta-carotene and vitamin C, we get all the chemicals that make up this orange root vegetable–our knowledge of nutrition is really new and we just don’t know how the rest of the carrot synergistically acts to make it healthful and nutritious.  

photo Kathleen Hiatt Cutter


I am not a big fan of supplements.  I agree that a healthy individual who eats the rainbow daily with organic whole foods probably doesn’t need a multivitamin. If your diet is poor or your system is out of whack and you test for deficiency–you may want to supplement.  But whole foods, foods that are not processed are a superior way to acquire your nutrition.  


If you eat the SAD or Standard American Diet–one that lacks fresh fruit and vegetables, whole foods and is ladened with highly processed foods, fast foods–in other words high in calories and not nutrient dense.  For general health, you may want to consider taking calcium magnesium supplement along with a B complex and a multi-vitamin.  If you do take supplements, I’d advise taking a high-quality whole food supplement if possible, not a synthetically derived supplement. Again, I like to ingest recognizable foods whenever possible for best absorption and benefit.  I prefer Standard Process as they grow the vegetables on their organic farm whenever possible and they strive to source what they can’t grow from sustainable and organic farms.  Unfortunately, you have to buy Standard Process supplements from a healthcare practitioner. Local health food stores have other options.  


photo by Ijy

Worthy to consider:  

You may have also heard that our kale of today is not the same as our grandmothers’.  This is because the soil is less rich in minerals as it has been exhausted.  It hasn’t been rested between growing seasons and is not properly amended.  So, arguably the food we eat is less nutritious now as the soil is nutrient-poor, the resulting crops are less nutrient dense. Here, you’ll note, is the literal soil and seed!   Interestingly, a few years back there was a study that concluded that organic produce is NOT more nutritious than conventional produce. In short, just because a food is labeled as organic, it doesn’t mean the soil is mineral and nutrient dense. Either way,  organic is advisable as it fewer pesticides and it’s arguably better for the planet. Also, organically produced foods may, with their better farming practices and standards,  have better soils in the long term.


Next time:  Step #3

Outside help to support the menopausal journey.

Disclaimer: This is to serve as information only, please seek the care of a medical doctor for symptoms and concerns you may be experiencing.  This is in no way to serve as treatment of any disease or illness.  The following is for information only.  



The second installment of a five part series.

My preferred step by step approach to navigating the menopausal journey:

Step 1:

  • Eat a nutrient-rich diet, exercise regularly, stretch, rule out other medical problems (thyroid, serious ob/gyn issues through a visit with an ob/gyn doctor and blood tests), implement a de-stress routine, get good sleep,  aspire to a balanced lifestyle, and don’t smoke.  If you drink alcohol, experiment with giving it up for a week or so to see if that alleviates hot flashes, headaches and insomnia–some women over 40 find this really to help. (some of you may be rolling  your eyes)

Step 2:

  • After determining that you don’t have any medical complications and a doctor has ruled out other possible health conditions that can cause any of the symptoms you may be experiencing: try to fill any vitamin, mineral deficiencies by altering your diet or taking supplements if you can’t manage with diet alone.  Deficiencies can be found through blood tests and the help of an MD or a health care practitioner who interprets blood tests using what’s called functional blood analysis.

Step 3:

  • If diet and lifestyle aren’t enough, or you would like more support, try rebalancing your body through acupuncture, herbs, biofeedback, or other alternative treatment under the care of a licensed practitioner.

Step 4:

  • If after trying steps 1, 2, and 3 to the best of your ability and you still feel lousy,  by all means, try Hormone Replacement Therapy or HRT.  

In my 11/2/17 post “Introduction: Perimenopause and Menopause,” I alluded to the importance of your “well taken care of soil” for the smooth transition into menopause. Sounds like pretty good advice for everyone at every age, right?  But what more can we do during this transitional stage?   You may be asking yourself what exactly you should be eating or not eating to ward off fatigue, hot flashes etc….

I’m glad you asked…..let’s begin with step #1

Step #1:

  • Eat a nutrient-rich diet, exercise regularly, stretch, rule out other medical problems (thyroid, serious ob/gyn issues through a visit with an ob/gyn doctor and blood tests), implement a de-stress routine, get good sleep,  aspire to a balanced lifestyle, and don’t smoke.  If you drink alcohol, experiment with giving it up for a week or so to see if that alleviates hot flashes, headaches and insomnia–some women over 40 find this really to help. (some of you may be rolling  your eyes).

Chinese medicine is a holistic medicine so what follows may not seem to specifically pertain to perimenopause or menopause, but again, we are talking “soil”…the basis on which all health–or lack thereof–emerges from.  To repeat, some things are not within our control to change such as genetics, past traumas, and environmental exposures.  So, work with what you have to the best of your ability on every given day.

We are learning now that our obesity epidemic in America is in part due to the SAD, or Standard American Diet.  This diet tends to be of highly processed foods, with little fresh fruit, vegetables, fish, or legumes.  Not only does this set us up for obesity and its related increase in diabetes, cancer, heart health, etc, it means our body is working harder with less nourishing, higher calorie fuel….we are putting our bodies at a disadvantage as we age and are facing more health challenges.

In Chinese medicine, the first medicine is considered to be food. Traditionally, the Chinese start off the day with a rice porridge with various “medicinal” foods cooked in or added to it to address their constitution (ie. if they are old or weak or young or robust) and according to how they are feeling (say, if they have been exposed to someone with a cold/flu or are currently experiencing fatigue). So, traditionally, the Chinese eat mindfully by listening to their bodies’ needs and signals.  Second, the traditional Chinese diet is extremely varied and certainly more so than our Standard American Diet.  If you eat the same foods every day (say salad, chicken, and pilaf) you are supplying your body with the same combination of nutrients—blocking the uptake of the same nutrients and allowing the absorption of those same nutrients.  If you vary it, you are expanding the combinations of the foods and the nutrients offered, blocked, and/or absorbed. You are allowing, for instance, better absorption of an iron-rich food (calves’ liver) if you eat a food rich in vitamin C (say citrus fruit).  You also need dietary fat to absorb the fat soluble mineral calcium and vitamins E, K, A, and D.  A varied, nutrient-rich diet allows better chances of ensuring absorption of all of the required vitamins and minerals.  

Now, this might stress you out…now you have to think of “optimal food combinations” to maximize nutrient values on top of shopping, planning, cooking, and satisfying everyone that comes to your table.  Deep breath!  What I tell my patients is to do the best you can do each day and try and plan on rotating in some new foods or new combinations of foods.  It’s best to plan before you go shopping for the week!  Also my diet mantra: variety, variety, variety, moderation, moderation, moderation.  Food is a very real and accessible source of enjoyment (not to mention legal!)…so make sure you still enjoy eating!  If you eat birthday cake, don’t furtively eat three huge slices in the middle of the night while binge-watching a show.  Take a regular sized slice, sit down and enjoy each bite, chew slowly and savor it.  It’s better to enjoy the slice while in good company and certainly without disturbing tv or news going on in the background.  Don’t berate yourself before, during, or after you eat it, don’t rush through it, don’t distractedly raise the fork into your mouth while you are wondering why Game of Thrown took such a nasty turn.  Relish each bite and be thankful.  You’ll get far more satisfaction if you eat one piece slowly and mindfully than if you hurriedly eat three slices either mindlessly or racked with guilt and shame. You’ll body will probably feel better too! Again, eat in moderation and with variety.

If you want to read an article justifying this to a degree here you go:

Now then, what to eat:

The following table lists specific perimenopausal/menopausal symptoms and the vitamins and mineral that can help alleviate or lessen their severity.  This is not an exhaustive list, but it may give you some quick “go to” foods to feed your body optimally.  You can also look at my Pinterest board for some lists on specific foods for symptoms, honestly, it may be easier to follow than the below table:



peri-menopausal symptom vitamin/mineral Foods containing/lifestyle Avoid the following
Hot flash/night sweat
Phytoestrogen, “liver cleansing foods,” Vit B complex, Vit C, Vit E (400-800IU) take for 4-6 weeks to notice effects and vitamin E’s effectiveness may wear off after time, magnesium, potassium  
Soy, flaxseed, eat smaller more frequent meals, keep hydrated, exercise ½ hour daily, away from bedtime so as not to raised body temp. Before sleep Spicy foods, soy protein powder and supplements not recommended as they contain soy isolates (mess w/ hormone levels rather than benefit), avoid hot showers/baths and rigorous exercise just before bed, abstain from alcohol in hours before bed.  Avoid chocolate, hot drinks,caffeine, MSG, sodium nitrate (found in some lunch meats, bacon,etc), sulfites 9red wine, dried fruits, cheddar cheese)
Hair thinning, dry
Omega 3, selenium, protein
Good fat, brazil nuts, vegetable protein, good hair care practices/products
Ask your hairstylist for hair care products and styling do’s and don’ts.
cramps Magnesium, Vit C, A, E, D,  vitamin B complex, omega 3 Leafy greens, fish, flaxseed, raspberry leaf tea, ginger tea (if your bleeding isn’t heavy) hormone-free meat Try eliminating dairy (has estrogen naturally occurring)
insomnia calcium/magnesium before bed, tryptophan
Dark leafy greens, pumpkin seeds Bedtime routine, see section below, daily exercise, chamomile tea before bed.
Alcohol near bedtime, caffeinated drinks–cut down, out or limit to the beginning of your day
Depression Omega 3, phytoestrogen, B complex, C, magnesium, calcium, zinc Flax seed, good fats, soy, exercise, natural light (or SAD light in winter), exercise alcohol
anxiety calcium Meditation, relaxation, exercise Caffeine, Today’s news. Avoid stressors if possible, also see:
headaches phytoestrogens, magnesium Ginger tea, good fats, veggies listed above, relax
Alcohol, track down any food triggers such as MSG, chocolate, nitrate containing foods (lunch meats, bacon), moldy cheese. Anxiety, insomnia, avoid blood sugar fluctuations, some medications
Joint pain Glucosamine sulfate, chondroitin

Omega 3

flaxseed, good fats Inflammatory foods (processed foods)
fatigue/low energy B complex, especially B12 Flaxseed, seaweed,  Check for anemia, thyroid, relax and exercise, nap for only 20 minutes (ideally while lying on your right side so the blood can “pool” in your liver to fully energize Sugar, refined foods
Low libedo Fermented foods See vaginal dryness below,
Vaginal dryness/tissue atrophy Phytoestrogens, fermented foods Keep hydrated, soy, if you don’t use it, you’ll lose it. Consider locally applied estrogen cream for <1 year.  Also, local application lubricants such as  Vit. E or aloe vera w/ Vit E (possible brands available on Amazon: Aloe Cadabra, Carrageenan), look to for a clearer guide on this topic! Antihistamine, diuretics, be mindful of exhausting yourself and countering it with coffee, alcohol, and sugar…it can decrease lubrication
Yeast infection Plain yogurt, acidophilus probiotic, daily doses 100-600IU of vitamin E for 4-6 weeks 1-2Tbps. Plain yogurt inserted into vagina every 1-2 days
Urinary incontinence Vit D Pelvic and gluteal muscle strengthening, regularly scheduling voiding bladder May be triggered by estrogen supplementation, caffeine
probiotics, water, Vit C 1000mg
Hydrate!  Cranberry juice, pelvic floor exercises, 1 cup plain yogurt 4-5 times a week, cotton underwear, urinating/showering after intercourse.
Consider different birth control, condoms(some)  and diaphragms can be contributing factors. Lubricants (see lubricants link above)
Heavy bleeding
Check with your ob/gyn, B complex, vitamin E, calcium, possibly iron (confirm you have iron deficiency anemia first)
Supportive only eat meat that is hormone free, flax seed, raspberry leaf tea eliminate caffeine, alcohol, spicy foods, no smoking, sugar, processed foods, avoid phytoestrogens, see if going off dairy for a few weeks helps
Skin dryness
Vit C (1000mg) and E (400-800 IU), omega 3 and 6, phytoestrogen, fiber,
Good fats, soy, water, moisturize, flax seeds, zinc if acne, exercise, good sleep
CA prevention, bone health, heart disease
Vit A, E (400-800 IU), K, D, magnesium, potassium, phytoestrogens. Lignans, omega 3, antioxidants (Vit C, E, A, Calcium), selenium, flavonoids (polyphenols)
Soy, good fats, weight-bearing exercise, cruciferous veggies (broccoli etc), brazil nuts, fish, green tea, protein/calcium-rich foods such as tahini, oatmeal, tofu, oats, sardines, salmon, yogurt, nettles, seaweed, amaranth sugar, highly processed foods. caffeine, alcohol, smoking, meat, and salt (calcium is drawn out of bones to neutralize the increased acidity of salt),  carbonated drinks (phosphorus in these drinks competes for calcium absorption), watch salt intake
Brain fog Omega 3, zinc, B complex, selenium, C, E, D, antioxidants
Good fat, brazil nuts, blueberries, exercise
Sugar, processed foods
Weight gain Phytoestrogen, omega 3 Soy, good fat, exercise, check thyroid, Processed foods, sugars, binge eating
Hormone imbalance phytoestrogens, bioflavonoids, lignans Pith of orange and grapefruit, cherries, cranberries, blueberries, whole grains, flax seeds Processed foods, sugar
Digestive health (bloating, gas, acid reflux) Fiber, hydrate, Beans, legumes (add slowly!), cooked foods, Eliminate foods straight out of freezer (including ice), processed foods, don’t’ eat within 3 hours of bed
Eye health Vit k, antioxidant (Vit C, E, A, calcium) Fresh fruit vegetables

The Takeaway:

Eat a diet high in vegetables, fruit, whole grains, nuts (if you aren’t allergic), legumes and stay away from processed, high calorie but poorly nutritious food.  In the table above you will note that I gave specific amounts for some of the vitamins.  That is because these amounts are suggested for a particular symptom.  Otherwise, a good B complex, calcium-magnesium, vitamin D3, and multivitamin should be adequate–if your diet is lacking.  I think it’s worth investing in good quality, all natural supplements rather than synthetic if possible.  



Flax, ground seed:  1-2 tablespoons daily.  Apparently, ground flax seed is higher in lignans than flax oil.  Lignans are a phytoestrogen, so I’d definitely use ground flax seed rather than the oil to get the most benefit for peri-menopausal symptoms. Heating/cooking with the seed will break down the beneficial properties, so you can sprinkle it on foods after they are cooked.


Though some studies have shown that soy isoflavones are safe for women who are at risk for cancer or who have cancer, I am not a fan of soy protein powder or supplements. I equate it to the fact that oranges are good but orange juice is not.  The sugar of the eight oranges in your glass of juice is unmitigated by the pulp/fiber of the eight oranges you would have to eat to get that same sugar load.  In short, soy powder and supplements are too concentrated.  Additionally, soy protein powder and supplements are not recommended as they contain soy isolates (they may mess with hormone levels rather than benefit them). Fermented soy products (miso, tempeh, nato) are best according to Chinese medicine,  as non-fermented soy products (as in tofu, soymilk)  are considered “cold” and can be difficult to digest and to extract the vitamins/minerals.



Brazil nuts are high in selenium which is good for blood vessels, the thyroid (super important to keep happy during the transition through menopause, I’ll get to that later), and are high in protein.  By eating 2-4 a day, you can take care of several things at once!






Regular exercise is key.  There are conflicting reports about the best way to exercise:  some studies conclude that intervals of heart rate raising exercise within a workout is key, others advocate the benefits of simply walking, still others conclude that walking for 10 minutes 3 times a day if you have a sit down job is more beneficial for you than sitting all day and  exercising for 30 minutes before or after work.  What is clear is that movement is key, the body does not like being immobile!


For perimenopausal hot flashes, in particular, you may want to exercise in the morning, not close to bedtime as you’ll raise your body temperature possibly prompting night sweats.  Regular exercise can stop or greatly reduce hot flashes. I cannot emphasize this enough….exercise is the best way to get rid of or greatly reduce the number and intensity of hot flashes.  Weight-bearing exercise is important to keep our bones strong so make sure you incorporate any of the following: walking, jogging, hiking, running, racket sports, weight training, (most if not all) dancing.  Basically, any exercise that forces you to work against gravity.  While swimming and cycling are great aerobic exercises, they aren’t considered to be weight bearing, therefore, don’t benefit bone strength/health as much.

Whatever exercise “routine” you select, make sure you enjoy it.  A teacher of mine once advised that you aren’t human unless your feet walk on dirt for an hour a day….that might not be the answer for everyone, but he had a point:  do what feeds your soul (if you are lucky and persistent enough to find it).  Or make it fun: a dance class at the Y or local tai qi or yoga class.  Make sure your body loves it too.  Even after 25 years post ankle reconstruction, it is still a struggle for me not to run, but forcing myself not to run opened up a new way to appreciate my time in the woods.

Stretching helps joint health and improves balance as we age. You may have seen all the elders in San Francisco park or in the parks of China lined up and doing tai qi.  This is an excellent exercise for elders (and people on their way to becoming elders) because it really opens up the joints increasing flexibility and joint lubrication.  It is considered a “yin” exercise for the “yin” part of our lives.  In other words, tai qi is too yin od an exercise when our yang dominates.  Tai qi is not an appropriate exercise for a healthy child who by nature is the very definition of yang.  They need an exercise that matches all that energy that can be literally exploding out of them.  This is why it is so important for kids to be out running around at recess, after school, and also when….but that’s another blog post.

Sleep hygiene:

This seems to be a hot topic on the internet these days…but it is important.  Bedtime routines, not looking at screens the hour or more before bedtime, not eating too much before bed…but perhaps not being hungry either.  Here is sleep advice with  added perimenopausal symptom insights…..

photo Kathleen Hiatt Cutter

  1. Bedtime routine:  the body operates better with predictability and consistency!
  2. Bed before 11: in Chinese medicine, this is important as it helps your “liver,” your liver is really important to keep happy during perimenopause.  Also, you want to work with, as opposed to against, your internal clock.  
  3. No screens the hour before bedtime: messes with our melatonin and serotonin levels–which help us sleep.
  4. If you have trouble falling asleep or have cramping legs:  calcium and magnesium supplements with warm milk (if you can tolerate/drink dairy–enzyme in milk does help induce sleep-grandma was right).
  5. Don’t eat a large meal before bed as it can make for a restless night.  However, if you find yourself hovering just below wakefulness much of  the night, it might be low blood sugar, try eating a bit of protein before bed—yogurt if you eat dairy, a small piece of toast with avocado or peanut butter, or 7 oz of pumpkin seeds (has tryptophan which makes you sleepy)….you don’t want something hard to digest.  This should keep your blood sugar levels from dipping so much that they trigger a cortisol surge and therefore wakefulness.
  6. Limit all liquid intake after 6 pm, perhaps no more fluids after 4 pm, you might have to experiment: to cut down on nighttime urination….make sure you drink plenty in the day before your cut off time!
  7. Eliminate caffeinated drinks after noon—experiment if you have to have caffeine:  you may find that you are becoming more sensitive to caffeine and need to limit such drinks to earlier in the day.
  8. Eliminate alcohol before bed:  alcohol may make you fall asleep quicker but it will affect your blood sugar levels while you sleep and may wake you up or not allow you to sleep deeply.  Many of my patients are surprised to find that they are affected more and differently by alcohol than they did when they were younger.  In Chinese medicine, alcohol is consider warming….and perimenopausal women tend to be warmer–it’s like throwing on an extra blanket.  Nighttime alcohol may increase night sweats, hot flashes, and headaches as well.
  9. Bedroom temperature should be on the cool side–for a more restful sleep and fewer night sweats/hot flashes.
  10. Have an extra pair of jammies to change into/out of, to ensure comfort and return to sleep after significant night sweats–hopefully, the other things you are doing to help yourself will eliminate this need soon!
  11. If night sweats and hot flashes are a problem:  try soaking your feet only in warm water before bed for 5-10 minutes, it may help draw the heat out of your upper body–also it may make you sleepy!
  12. Herbs:  there are numerous herbal formulas that are excellent for sleep.  Please seek the advice of an herbalist before selecting them by yourself or with the aid of a health food store employee.  Many herbs interact with common pharmaceuticals and they may not be the right herbal combination to help with your sleep disturbance.
  13. I understand you may be tempted to seek relief from a pharmaceutical sleep aid, but I would strongly advise against it. The quality of sleep is not great, they may be habit-forming and they may be dangerous.  One example is  

De-stress measures:


This can take many forms:  time in nature, listening to music, meditating, exercising–whatever forms help you to calm, center, relax and feed your soul.  Our bodies need extra attention and time at this stage in our lives–which can generally be more stressful with the demands of work, children, aging parents, and in the stressful world we live in.  


Balanced life:

Achieving a balanced life may seem like an impossible task for some (or all!)  Even during the most hectic of days, make sure to fit in moments of reflection and gratitude—in the car behind the wheel (but don’t zone out!), as you are standing over the stove, taking a shower.  Try to work in time each day for yourself so you can hear what your “inner voice” has to say.  You may be surprised–or relieved to hear what it has to tell you.  This is where the navel-gazing comes into play.  Our priorities change as we age, it’s important to recognize any changes and while we can’t necessarily immediately make changes we can perhaps make small changes to new goals or freedoms.


Don’t smoke:

We have all heard about the detrimental effects of smoking, suffice it to say it will exacerbate any perimenopausal symptoms you are experiencing.  

Doctor checkup:

If you are symptomatic, it’s a good idea to get the once over by your MD to rule out any other condition that actually may be responsible for your symptoms.  Ask your doctor to do a thyroid work up as well as a complete blood panel.  These blood tests will give you some data points on how your thyroid, blood sugar, cholesterol levels are doing and  if you have any specific vitamin or mineral deficiencies  as well as if any organ system seems “off.”  I will expand upon this in a later post.

Next time:  Step #2 in navigating menopause

Disclaimer.  This is to serve as information only, please seek the care of a medical doctor for symptoms and concerns you may be experiencing.  This is in no way to serve as treatment of any disease or illness.  The following is for information only.   



Part I: Perimenopause and Menopause: An Introduction

First of a five part series

Recently, at Laura Marquit’s Joyful Movement Pilates studio in Fairfax, California, Laura and I gave a lecture followed by a short discussion about perimenopause and menopause and possible approaches to dealing with this natural transition.  Honestly, I felt honored and humbled that a dozen or so women came to hear us speak.  Several people who couldn’t attend wondered if I could pass along what I shared during the lecture.  Additionally, many women at the lecture asked some great questions and had great input.  I thought I’d follow up and recap here.  Please feel free to pass this information along and contact me with further questions and comments.  

But of course, a disclaimer first.  This is to serve as information only, please seek the care of a medical doctor for symptoms and concerns you may be experiencing.  This is in no way to serve as treatment of any disease or illness.  The following is for information only.   Now then….

There is so much information here, that I have broken it down into more readable chunks.  

First:  What are menopause and perimenopause?

What menopause is:

Menopause is when a woman has not had a menstrual period for a full year. The reproductive hormones that are responsible for producing menstruation–and creating life–are in decline leading up to the final period.  A woman is no longer fertile after menopause as the ovaries have stopped releasing eggs.  Generally, menopause occurs for women between the ages of 48 to 55, the average age for menopause is 51.  This seems to be the case across cultures and throughout the ages.  Menopause will occur if both a woman’s ovaries are removed, and menopause can be caused by some diseases, chemotherapy, and radiation. A woman will not be thrown into menopause if she keeps her ovaries but has her uterus removed.  If you undergo premature menopause, whether or not it’s medically induced, hormone replacement therapy or HRT is usually prescribed by an MD to ensure bone strength and for protection against heart disease.


Chinese medicine refers to menopause as the Second Spring….in other words, life without hormones.   Once we have reached menopause, we have transitioned into another stage of life: that of the wise woman.


In Chinese medicine, and in many other cultures, menopause is regarded as a milestone.  It is an opportunity for us if we consciously take advantage of it, that can result in some profound and fulfilling changes.  This may take some work in the form of some navel-gazing, asking some tough questions, reprioritizing, and maybe carrying out some surprising decisions and changes in our relationship dynamics with our new found state of mind.  Menopause  finds us less hormonally driven, there is a quiet, or perhaps less noise from the hormone “devil on our shoulder.”  The devil will have mellowed and the angel will have grown a little more assertive to create a hybrid of sorts…..a return of the carefree days of pre-pubescence polished with the patina of life.  All of life’s hard knocks, lessons, and experiences both good and bad resulting in personal growth and evolution.  You have become a pearl.

How does this transformation to a wise woman happen, you ask…

I’ll bet it’s a mix of the decline of the bonding, nurturing aspects of reproductive hormones and the payoff of personal growth that the years have given us the opportunity to weather.  Women who have tended to children and partners and less so to the world beyond their families often notice a shift.  They start to recognize the world beyond taking care of family or others, they want to engage with the greater world or try something new–priorities and emotions change as we hit midlife.  


Chris Everet blamed her divorce on menopause  I think she may be blaming perimenopause.  During this transitional time, did she find her voice?  Did she reflect upon what her life was and decide that it just wasn’t right? Did she do it mindfully?  According to the article, she has regrets in her process.  It’s the transition that is tough, not so much menopause itself.  (and yes, hot flashes and other annoying symptoms can last past the last period…I’ll get to that)


Perimenopause–the journey to and through menopause:


Menopause is not a disease, rather it is a natural state.  As a woman, if you live long enough, you outlive your ability to procreate.  Nature didn’t want us to begin mothering in our later years yet it doesn’t kill us off either.  We can live quite a healthy, long life post hormones if we take care of ourselves.  Perimenopause, with or without symptoms, is considered to be the few years before menopause.  This can be extremely rocky time for some and a breeze for others.   Symptoms such as hot flashes, night sweats, insomnia, mood swings, and more may occur.  Sometimes these symptoms can last beyond our last menstrual period.

Why do some women suffer so while others seem to get by so easily?  Well…let’s look at what’s happening first through a western medical lens.


Western medical:

When you start gliding towards menopause, your sex hormone supply is doled out in smaller and smaller amounts.  However, this is not necessarily a gradual coast, it can be a pretty jagged downward trend…this can create havoc in your body increasing “menopausal symptoms.” While the supply of hormones is declining your hormone receptor sites–the cells that are expecting to be receiving their hormone fix–haven’t dwindled in number nor do they demand any fewer hormones.  They are starving and they are letting you know–by creating symptoms.  In other words,  the dwindling supply, say of estrogen, cannot meet the demand of the still robust estrogen receptor sites.  These receptor sites are going through withdrawal and can throw up some pretty demanding requests to get their estrogen….hot flashes and night sweats to name a couple.  For some, these receptor sites don’t die off well after the last period.  


So, what makes it harder on some and easier for others?

Siddhartha Mukherjee used a wonderful analogy about individuals suffering from a disease. Basically, the disease is the “seed” and the “soil” is the disease’s host. This analogy explores the angle that manifestation of this particular disease is dependent on the “habitat” of the host.  

So, I’d like to give him credit for the analogy and riff off of it to explain Chinese medicine.  Every garden has soil, the quality of soil can vary between separate garden beds.  One garden bed may be well aerated, amended with great organic compost in just the right amounts, supplemented with great microbes provided by the manure of well-treated chickens, watered well, and ph checked then balanced.  An adjacent bed could be neglected, and still, another could be worthy of a Superfund site designation–you get the picture.  So, think of your body as its own garden bed independent of everyone else’s around you. Everyone’s individual garden bed is made up things we cannot change, such as genetics, family of origin dynamics, environmental exposures, and our past good and bad life choices–such as traumas, smoking, drinking, drugs, poor dietary choices, lack of exercise, hard living–or the opposite of all that.  Genetics and our past life experiences are mixed with what we are doing now:  food choices, exercise, stress levels, relationship dynamics, work life, life circumstances, etc.  This soil is the landscape of which menopause is played out upon.  Our “soil” can affect the way our body is capable of dealing with the “seed” of change–of menopause.  


This is what I love about Chinese medicine, it looks at the individual landscape and helps to rebalance the body that exhibits symptoms of menopause.  This I will get to later on….


Mukerjee, Siddhartha 9/11/17 New Yorker magazine article

images: Kathleen H Cutter and

Next up:   Now what to do about menopause…

Facing Winter and the Holiday Season

During the winter and the holiday season, despite our best intentions, things can get a bit tense. Between family and out-of-town guests, rich food, shopping, social obligations, and expectations we may find ourselves growing tense, anxious, and irritable. So much for a joyous season! Here I’d like to suggest ways in which you can best be prepared to deal with the hoopla. I’d also like to share some techniques you can use to get back to a calm state after you find yourself “worked up.”

Preparation: There are a few things you can do to reconnect with yourself and what you need—for you! This may be the greatest gift we can give to ourselves and by proxy to our families. When we are more connected with ourselves we are able to give to our families from the heart without resentment. In other words, when we feel taken care of, we live and interact with others from a feeling fullness. Children especially sense when we are less than 100%…they can sense when we are tired, distracted by “things” at this time they tend to demand more attention at that moment. heartBegin: the snowball effect.   Starting the day in the right frame of mind—from a state of fullness–is important to face whatever the day brings. Part of your morning routine should be acknowledging and “wearing” the best part of yourself for others to see…even if it is still asleep or you don’t feel particularly lovely about yourself at the moment. It may take some practice, but acknowledging yourself as a strong, capable, and good person who has something of value to contribute will change how people perceive and treat you as well as how you feel about yourself.    

Sleep: More and more studies stress the importance of good nights sleep. With those of us in care giving roles, a 40+hour work week, or with young children that may seem laughably impossible. Try to take a nap if you can. If that still seems comical, try lying on your right side for 10 minutes. In sleep left sideChinese medical theory the liver is where the blood gets replenished. By lying on your right side the blood can “pool” there thus increasing restorative powers. Try lying down with your baby/child for 10 minutes of his/her nap, shut the door to your office and find a corner to curl up for a few minutes.  At the very least, shut your eyes while sitting in your chair, take 10 deep breaths–out breath equal to the in breath …then get back to it! Insomnia?  That is a topic for another post. But of particular note during the season of celebrating (or stressing) is about alcohol. Alcohol may seem to help us fall asleep quicker, but sleep will be disturbed and less restorative, another reason to drink responsibly!  

Drink water: Other options to drinking water are non-caffeinated teas. Coffee can increase feelings of anxiety or stress. If you are a die hard coffee drinker try substituting one or more cups of coffee to a green or black tea. There are so many wonderful teas available now. Jasmine green tea teapotis my particular favorite. Your body may respond very differently to the caffeinated tea than coffee. Iced drinks are not recommended: room temperature or hot. Our bodies need to be hydrated to help our immunity ward off colds and flu not to mention, the dry weather and forced air.  


Eating Soups and stews are the best choices at this time of year because a soup packed with veggies and legumes (or meat) make it easy for our bodies to easily absorb their nutrients. Slow cookers make meal preparation really easy: chop, add water, add a few spices and turn it on before you run out the door in the morning (any of you laughing?) Parties and holiday treats can weigh us down leading to bowel changes, bloating, abdominal discomfort, feelings of sluggishness and lethargy, and even mood changes. Make note of these reactions and try to figure the culprit(s). This information puts you in charge…you can make a soupchoice of “momentary” enjoyment or the consequence. You may be experiencing “food intolerance.” You may want to consider a rotation diet if not an elimination diet…if there is interest in this you can call me for a consultation.



Exercise: Walk, run, ride, swim, go to the gym…get that body moving. When you move your body, Chinese medical theory says that you “move congested liver qi” in other words, you relieve stress, depression, help clear toxins out the body.   Just listen to your body and listen for it’s messages about its limitations. Consult your doctor before beginning any new exercise routine and exercise smart. This includes changing out of wet exercise clothes and take a warm shower after you are swimmingdone…you don’t want to get a chill!




Connect through a passion: Whether playing an instrument, running, hiking, listening to music, gardening, painting or sculpting—connect with some activity that gives you more energy and a sense of deep satisfaction. This will help bring clarity and peace to your deepest levels.  






You have found yourself upset..what to do now.  

During the situation: the triangle One of my favorite techniques to use with a difficult person is to visualize a triangle between that person and myself. It can be any size; you can shrink it and enlarge it during the situation. This triangle is a black hole. I had a client with narcissistic sister. Her sister, using their past closeness and sense of sisterly obligation, tried to get my client to bail her triangleout of another tough spot. My client, knowing that by helping her out was enabling this dynamic to continue, “placed’ the triangle between them. By doing this, my client disengaged and was not drawn in by her sister. She was able to sympathize with her sister’s predicament and yet not take it on.

The aftermath of a situation:  Whether you are dealing with a minor fender bender, a heated family confrontation, or a “scare/near miss,” your body has been changed physiologically. Your heart rate may be accelerated, you may notice you are perspiring; a feeling of anxiousness won’t seem to leave even though the “danger” is over. It is important to take your body out of “high alert” status. Here are a few techniques.    Do something physical: Go for a run, brisk walk, dance, or ride, whatever it is to do the “flight” after the fright. Fully engage your respiratory system. Really take deep breaths and consciously breathe the situation out—visualize it leaving you.   Can’t leave the kids/work to go do something physical: Put on some crazy music and dance it out with your kids or listen to your Ipod. see no evilMadly paint/chalk the sidewalk/butcher paper or scribble on a pad of paper.

Change how you look at the situation and change your emotion:

I was riding my bike in a dedicated bike lane when someone opened a door immediately in front of me. Shock, horror, fear gripped me as I sailed through the air over the door, I was able to tuck and roll and shortly stood up to the amazement of the crowded sidewalk and drivers. Anger welled up in me “Never….open…the….door…into….a….bike….lane.” I said to the woman through gritted teeth. My bike frame was cracked and I could have been severely injured by someone being careless. Her child looked at me, clearly scarred. My perspective changed. I was immediately glad it was I who was hit. Children ride that route all the time, as do parents with children on the backs of their bikes, they would not have cleared the door thus certainly be hurt. There could have been bikes following me creating an awful pile up. I was so thankful that I wasn’t the one that opened the door. Relief, thankfulness flooded through me. “Look, I’m okay, I’m not hurt,” I said to the kid turning my arms to show him that not even my clothes looked worse for the wear. Granted, I was still in shock and I took large doses of trauma herbs and topical liniments for the next few days, but in the end, I am not upset with the lady who did something dumb. We all do dumb things thoughtlessly. I was thankful of the reminder to be mindful and not to have a broken bone!

That’s the short course. Hope it helps and I hope the holidays are restorative and full of good company and joy.

Best of the season to you and yours,

Kathleen Hiatt Cutter  

Digestive Issues


For thousands of years, digestive issues have been a very common reason why people seek the help of an acupuncturist. One of the classic Chinese medical texts is Li Dong Yuan’s Treatise on the Spleen and Stomach published in 1249. This text discusses and offers treatment protocols for numerous digestive disorders that are still relevant today.

There are a myriad of digestive problems and diseases including but not limited to:

  • allergies
  • appetite changes
  • bloating
  • constipation
  • cramping
  • diarrhea
  • fatigue
  • gas
  • headache
  • heartburn

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  • indigestion
  • joint pain
  • low metabolism
  • nausea
  • celiac disease
  • colitis
  • Crohn’s Disease
  • GERD
  • IBS (irritable bowel syndrome)
  • ulcerative colitis

….I could go on and on.


Acupuncture and Chinese herbs can improve digestive issues immensely but before heading off to the acupuncturist or any other medical practitioner, it would be helpful to do some detective work to maximize the benefit of your treatments.


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Identifying the culprits:


Many things can throw our digestion here is a short—not exhaustive–discussion.


Western Pharmaceuticals:


Sometimes it’s obvious: chemotherapy is a well-known cause of nausea and vomiting. Giving up the chemo is not necessarily an option…at least not without the supervision and advice of a Western MD.


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Look at you medications labels and discuss possible medication alternatives with your MD. Your acupuncturist/herbalist may be able to offer up alternatives to western medications, but be advised an acupuncturist/herbalist cannot advise you to stop taking ANY prescription medications. If you wish to reduce or stop taking western pharmaceuticals, that has to be done under the advisement of a western MD.

If you do suffer from any side effects from chemo and/or radiation, an acupuncturist/herbalist may be able to significantly reduce or minimize them. It is best to let your Western MD know that you are also working with alternative practitioners. These days, Western Mds are more open to these adjunct therapies.


Food allergies and intolerance:

So what is the difference between food allergies and food intolerance? The first causes a potential life-threatening reaction (swelling of the throat, tongue, face, skin reactions) and the second are non-life threatening negative reactions to ingestion of a food. In short, digestive issues are created.



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If you know you are allergic to a food. Avoid it. Period.







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So, if you suspect you are intolerant to a food but want confirmation, there are two ways of doing this.One is to undergo testing. This can be done by blood, stool, saliva and/or hair analysis. Insurance may pay for some tests and not others. Tests often have to be ordered by your Western MD. Acupuncturists in the state of California are authorized to order these tests. Determining which tests to undergo are something you will want to work with your MD or acupuncturist. The office staff of the medical practitioner will either help you work with your insurance, or they will have you directly pay the lab. This can be very pricey depending on which tests you order. Acupuncturists and nutritionists, as well as MDs, have their favorites!


The less expensive way can be quite difficult. Under the guidance of your acupuncturist or other healthcare professional, you can do an elimination diet. This diet requires you to eliminate common food allergens for a period of six weeks (generally speaking) and re-introducing one food item at a time. In this way, you can see (or feel) which food items trigger your symptoms.



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Meanwhile, you can also just keep a journal before you go into your appointment noting what you eat when and then add any symptoms you have at what time of day. You may be able to see a pattern….such as 1-5 hours after you eat bread that you feel hazy or tired. Don’t worry, if you don’t see a pattern the acupuncturist or other practitioner may be able to see one.




Crohn’s and celiac disease are common hereditary problems. The gold standard test for celiac disease is a very invasive procedure, so elimination of gluten and noting improvement in digestive and overall health is often recommended instead. In the end, it really doesn’t matter if you have an allergy to gluten, as celiac sufferers have, or “merely” an intolerance to gluten. Bottom line: if you


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eliminate gluten from your diet and your symptoms disappear you should stay away from gluten-containing foods. Trace amounts of gluten may not affect a gluten intolerant person and send the true Celiac into a tailspin, but either way, gluten should be avoided.





For complete information on celiac disease you can consult


Hereditary diseases cannot be “cured” by acupuncture or herbs, but the symptoms often can be alleviated or minimized. Also, the immune system can be strengthened through herbal formulas and acupuncture so the body overall is stronger and can function better.

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Many women regularly suffer from bloating, diarrhea, or constipation before their menstrual cycle begins. A Chinese herbal formula goes a long way in helping to avoid these upsets. A noticeable change can happen anywhere from the first to the third cycle after the commencement of a formula. Other PMS symptoms also can be addressed by this same formula. Acupuncture before bleeding begins can also be effective.





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Individuals about to take the stage, give a presentation, meet a deadline, take an exam, deal with family members are met with “butterflies” in the stomach. Sometimes a more serious reaction to stress happen, so what to do?







Advice to all: Eating habits to enable the best digestion:

Cook your foodcooking chicken

  • Your mouth and stomach start enzymatic activity when you anticipate a meal through messages from your senses. Ideally, you should be able to smell food, say as during cooking, for 15 minutes before you start to eat. If you don’t smell food first and immediately eat, it’s like exercising without a warm-up.


Don’t watch TV, read, argue/get upset over a meal:

  • Any of these things take your mind off what you are doing and you may eat more than you want, not chew thoroughly, or eat too quickly. Mindlessly eating is not satisfying and can cause weight gain.
  • I have a client with GERD. Oftentimes when she had a meal with her colleagues, she would have to leave the table hurriedly…to gag or to vomit. She has learned that she cannot eat a meal if there is a heated discussion.
  • Food should be eaten in a social setting; good company and conversation slow down your intake

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Eat regular meals

  • Three larger meals or five smaller meals at regular intervals allows the digestive organs to finish the entire process of breaking down food before beginning the cycle again. This allows for a smooth running system

Eat breakfast

  • Without breakfast, metabolism goes into “starvation mode” and hoards calories. Also, digestive organs are at their peak of energy between 7-11 am….that’s when you can get most from meals the most easily.

don’t eat and then lie down

  • It can cause indigestion.
  • Instead, take a short walk or relax.

don’t eat 3 hours before bed:

  • as above
  • It may cause disturbed sleep.

Moment of intention before eating

  • Think about what you are eating and why. Give thanks. Think about how the food came to your table (it was sown/grown, harvested, processed, trucked, prepared etc). Intention can shift your


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    state of mind away from the troubles of the day. You may experience better results from regular “moments of intention.”


Acupuncture and herbs

  • Talk to your acupuncturist/herbalist to find an individualized formula for you and your digestive unrest. He or she will also come up with an acupuncture treatment that is highly individualized for you.


If there is a particular subject you wish to have me discuss, I welcome requests.

Until next time, be well,

Kathleen Hiatt Cutter, L.Ac.