Hey, it's Nicholas! 👋

In a previous newsletter, we talked about the herb pair Huang Qi and Shan Yao and their potential effects in lowering blood glucose levels and increasing insulin sensitivity.

Here, we can talk about another curious pair: Xuan Shen and Cang Zhu.

One tonifies yin and the other dries dampness.

How does that work?

If you read the book Chinese Medical Herbology and Pharmacology by John Chen and Tina Chen, it has a short chapter on drug-herb interactions.

And in that chapter, it lists a few pairs of herbs with "definite antidiabetic effects": Zhi Mu and Shi Gao, Xuan Shen and Cang Zhu, and Huang Qi and Shan Yao.

(The idea here is, because these herbs have been shown to lower plasma glucose, they should be used cautiously in patients who are taking diabetes medications in order to avoid hypo- or hyperglycemia.)

We talked about Huang Qi and Shan Yao before. This time let's focus on Xuan Shen and Cang Zhu.

Dampness and Dryness

In the chapter on diabetes in the Clinical Handbook of Internal Medicine, regarding Xuan Shen (scrophularia radix) and Cang Zhu (atractylodes rhizoma), the authors write:

So this is an interesting pair: one of them is cool and nourishes yin, while the other is warm and dries dampness. They seem to be opposites.

They also don't appear very often in traditional formulas for Xiao Ke (wasting-thirst).

Most Xiao Ke formulas focus on clearing heat and tonifying yin. So you may occasionally see Xuan Shen pop up, you never really see warm, drying herbs like Cang Zhu.

(Traditional formulas for Xiao Ke include things like Bai Hu Jia Ren Shen Tang (white tiger plus ginseng decoction), Zeng Ye Cheng Qi Tang (increase fluids and order the qi decoction), Yu Nu Jian (jade woman decoction), and Kidney formulas like Liu Wei Di Huang Wan and Shen Qi Wan. So the focus tends to be on clearing heat and nourishing yin, either in the upper-, middle-, or lower-jiao.)

But this is something that Patrick and I discuss in the course An Herbal Formula for Diabetic Patients: many of the diabetes patients we see have a complex pattern that involves both dampness and dryness.

When I notice this, it's like the patient is really puffy because they're retaining fluids, but their skin is still really dry.

Modern Research

There has been some research into these herbs, but like we saw with Huang Qi and Shan Yao, most of them are done on animals.

One study found that Xuan Shen activates AMPK and inhibits glucose output in hepatocytes, which could have anti-diabetic effects. (pubmed)

Cang Zhu also works on AMPK activation, and it improves fasting glucose levels in mice. (pubmed)

Conclusion

So even though this isn't really a traditional pair for Xiao Ke, there's still some good reasons to use it with contemporary diabetes paitents.

If you would like to see how and why Patrick uses this in his custom formula for diabetic patients, be sure to check out our new course An Herbal Formula for Diabetic Patients.

Want to learn more about herbs for diabetic patients? My friend Robert Gittli created a custom herbal formula to help his diabetic and pre-diabetic patients lower their A1C levels. In this CE course, we dive into how he developed it, what each ingredient does, and how he modifies it for different patient presentations. 4 CEUs/PDA points for $30 Bonus If you purchase the course before this Saturday, you'll also get a short bonus video where Robert talks about his point prescription for loss of smell after covid infection. So sign up soon! Learn More About the Course

This diabetes course finally got approved by the NCCAOM, and I took my cat on vacation to run around and eat some grass, so now I'm going to work on the next course.

If you've seen the 50 Daily Acupuncture Facts course, I'm going to work on an herb version called 50 Daily Herb Facts. So keep an eye out for that.

And in my free time I've also been working on a Herb Quiz App. It's basically taking all my herb quizzes and putting them in one place, but with a better interface. Right now I'm going through and adding pictures to each question and adding a few more features.

That's all for now. Hope you're having a good break.

Nicholas

This is a weekly newsletter to let you know about the weekly updates like livestreams, office hours, and Q&A's. It's also a way to share whatever little TCM tidbit is on my mind. If you prefer not to receive this each week, you can unsubscribe from just the newsletter. You'll still receive major updates when new videos are added, you just won't get this newsletter.