by Dr. Josh Axe
Cooling foods: Apples, bananas, citrus fruit, kiwis, pears, melon, watermelon, coconut water, avocados, asparagus, celery, cucumbers, tomatoes, cabbage, green leafy vegetables, radishes, zucchini, cilantro, mung beans, water chestnuts, barley, millet, seaweed, raw fish, and yogurt.
Cooling herbs: Aloe vera, skullcap, peppermint, rose, fennel, mulberry, nettles, and andrographis.
Foods to avoid: Fried foods, spicy foods, lamb, red meat, nuts, hard alcohol, excessive oil, and warming herbs. Food prep matters, too. Eat more boiled, steamed, or raw foods than baked, deep-fried, roasted, or barbecued.
Dampness and Dryness
Dampness and dryness are also important yin-yang balance concepts—and they are the second pair of TCM’s pernicious influences. A little bit of dampness in the body is normal; it moistens the digestive tract and mucus membranes. But if there is too much, it causes yeast to build up on your tongue and in your digestive tract. Here’s one way of understanding what it means when your body is too damp: Consider what happens when a basement floods. If it stays damp for too long, mold grows—a problem that, left untended, can be difficult to eradicate, and sometimes leaves the whole house uninhabitable. But if you make an effort to dry out the basement quickly, you prevent mold from growing. Dampness in your body can come from being too sedentary or having problems with the digestive system, especially the spleen, which controls your body’s fluids. Excess dampness is characterized by phlegm, mucus, and candida overgrowth, conditions that, left untreated, can cause physical ailments. Phlegm in the lungs causes congestion and breathing problems; mucus in the digestive tract causes diarrhea; and candida overgrowth can cause fatigue, brain fog, joint pain, leaky gut, and poor digestion, among other things.
Foods to reduce dampness: Lemons, plums, pears, cherries, grapefruit, asparagus, celery, carrots, pumpkin, squash, peas, radishes, barley, corn, rice, oats, chickpeas, beans, walnuts, bone broth, chicken, grass-fed beef, tuna, wild-caught salmon, garlic, and onions.
Herbs to reduce dampness: Alisma, pau d’arco, poria, plantain, gentian, orange peel, oregano, cardamom, parsley, and thyme.
Foods to avoid: Foods that have a moist, almost phlegmy texture, like dairy, egg whites, tofu, oils, fats, bananas, and avocados, as well as refined sugar, wheat products, white flour products, dried fruit, pork, salads, raw vegetables, vegetable juices, and ice-cold water.
Excessive dryness, on the other hand, can be caused by dehydration, or a deeper issue, like a yin deficiency, which, as with heat, can come from pushing yourself too hard or sleeping too little and overstimulating your adrenals. The shifting hormones of menopause can also deplete yin, causing hot flashes and vaginal dryness. Dry eyes and sinuses, and the degeneration of the healthy mucosal lining of the gut, which can lead to gastrointestinal problems, are signs of yin-related dryness as well. Aging skin, constipation, chronic thirst, confusion, and poor memory are also symptoms of excess dryness.
Foods to boost yin and reduce dryness: Apples, mulberries, goji berries, mangoes, pears, pineapple, pomegranate, tropical fruit, watermelon, citrus, coconut, avocados, olives, asparagus, cucumbers, celery, tomatoes, eggplant, green beans, spinach, seaweed, peas, potatoes, sweet potatoes, yams, rice, spelt, fermented soybeans, tofu, sesame tahini, mushrooms, wild-caught fish, eggs, duck, bone broth, yogurt, dairy, honey, and herbal tea.
Herbs to boost yin and moisture: Slippery elm, marshmallow, CBD hemp, mullein, evening primrose, black cohosh, dong quai, and rehmannia.
Foods to avoid: Spicy foods, fried foods, refined sugar, lamb, pistachios, and hard alcohol.
Stagnation and Wind
Stagnation and wind is the final pair of pernicious influences. Just like it sounds, stagnation is characterized by a sense of stuck-ness or lack of internal movement—so it includes problems like bruises that heal slowly, constipation, and cold hands and feet, a sign of poor circulation. Pain—both emotional and physical—is an indication of stagnation as well. Chinese medicine practitioners like to say, “If there is free flow, there is no pain; if there is no free flow, there is pain.” Qi stagnation can result in headaches or discomfort after eating as well as emotional problems like anger or depression, while blood stagnation is often the underlying problem in conditions like premenstrual pain, endometriosis, or heart issues. One of the best ways to release stagnation is with movement. Acupuncture can be extraordinarily helpful as well, since it opens the energy channels throughout the body.
Foods to get qi moving: Citrus fruit, peaches, plums, artichokes, asparagus, beets, broccoli, cauliflower, carrots, celery, radishes, onion, garlic, squash, mustard greens, watercress, turnips, sauerkraut, miso, garlic, fennel, horseradish, and apple cider vinegar.
Herbs to get qi moving: Bupleurum, milk thistle, turmeric, cypress, citrus peel, sandalwood, cardamom, and dandelion.
Foods to avoid: Fried foods, fatty foods, oils, dairy, cheese, butter, sugar, spicy foods, red meat, lard, beer, hard alcohol, processed foods, and artificial preservatives.
Wind is characterized by too much movement in the body. Think of it as being invaded by an unwelcome agent, like a virus, parasite, bacteria, or too much cold or heat. The flu and other viruses are wind-related illnesses, and wind invades the lungs and immune system first. But it can also manifest as everything from eye twitches, shaky hands, muscle cramps, and pain that moves around the body, to neurological illnesses like Parkinson’s or migraines. Wind is often caused by unhealthy lifestyle habits, like too much alcohol and stress, which weaken the lungs and immune system.
Foods to expel wind: Plums, pears, cherries, grapefruit, coconut, asparagus, watercress, broccoli, celery, carrots, pumpkin, squash, radishes, rice, oats, flax, pine nuts, chickpeas, beans, bone broth, liver, chicken, tuna, salmon, garlic, and onion.
Herbs to expel wind: Cilantro, coriander, sage, peppermint, ginger, oregano, cardamom, parsley, and thyme.
Foods to avoid: Dairy, egg whites, refined sugar, fried foods, fatty foods, beef, wheat products, white flour products, bananas, dried fruit, tofu, pork, salads, raw vegetables, vegetable juices, and ice-cold water.
Demystifying common TCM diagnostic tools
Thousands of years ago, TCM practitioners didn’t have the benefit of modern technology that allows us to peer inside the body. So in order to identify what type of imbalance a patient had, they devised other ingenious strategies, like looking at the tongue, feeling the pulse, and examining the facial complexion. Based on those diagnostic tools, they would recommend a personalized diet, specific herbs, lifestyle practices, and often perform a treatment, like acupuncture. Here’s a deeper look at the three main diagnostic tools of TCM:
Tongue diagnosis is, as it sounds, a way of understanding the root cause of your condition by examining your tongue. So don’t be shocked if a TCM physician asks you to stick out your tongue without saying “Ahhh.” Just as modern doctors listen to your heart and lungs, Chinese medical practitioners believe the appearance of the tongue holds important clues to your health. They look at four factors: color, shape, coating, and moisture. The tongue’s color points to the condition of the blood, qi, yin, yang, fluids, and yin-related organs like the heart, lungs, spleen, liver, and kidneys. Its shape can also provide clues to the health of the blood, qi, yin, yang, and bodily fluids. The coating is related to yang organs, like the small and large intestines, stomach, bladder, and gallbladder, and can give doctors a sense of where the problem lies. And the moisture of the tongue indicates the relative dampness or dryness of the body in general.
What’s more, each area of the tongue is connected to particular organs. The tip relates to the heart. Just behind that is an area linked to the lungs. The center of your tongue corresponds with your spleen and stomach. The area behind the center is linked to the intestines. And behind that, the very back of the tongue is connected to the bladder and uterus. The root of the tongue corresponds to the kidneys. The sides of the top of the tongue are linked to the gallbladder, and the outer edges are linked to the liver. For instance, i
f you have blood stagnation, your tongue might have a purplish hue with dark spots. Someone who has too much heat might have a red-tipped tongue with a thin yellow coating in the middle. See the illustration on here for other examples.
Taking your pulse allows TCM practitioners to feel what’s going on inside your body. They’re feeling not only for the speed of your pulse but also its depth, evenness, and quality. Pulse depth and strength reflects your level of qi, and pulse quality—whether it’s choppy or flowing—can offer clues about myriad health issues. What’s more, different sections of the pulse correlate to different organs. By taking my wife’s pulse, my dear friend and Chinese medicine mentor Gil Ben-Ami was able to tell that Chelsea was pregnant two weeks before it was detected by a pregnancy test.
Face mapping, also known as mien shiang, stems from the ancient TCM belief that your skin reflects the state of your health—so a TCM practitioner may scrutinize your complexion as well. According to TCM, each part of your face corresponds to a different organ. Pimples or redness on your forehead might indicate issues with your small intestine or digestive problems, while rosy cheeks may mean you have stomach inflammation, since the cheeks correspond with the stomach, spleen, and respiratory system.
If you feel a little confused, don’t worry. These ideas are unfamiliar to most people in the United States at the moment. But within ten years, I believe they will become far more mainstream, because ancient medicine is in the midst of a long-overdue resurgence. The 2019 version of the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems, which categorizes thousands of diagnoses and has a powerful influence over the healthcare agendas in dozens of countries, features details about traditional medicine, including Chinese medicine. Similarly, scientists from leading universities in the United States and Europe, including UCLA, Duke, and Oxford, are exploring the efficacy of traditional treatments for illnesses like diabetes and cancer—research that will begin to reveal how and why these approaches can be effective.
Meanwhile, growing numbers of people are becoming disenchanted with Western medicine and are increasingly captivated by ancient remedies. Sales of age-old herbal remedies are soaring. During the Covid-19 pandemic, stores struggled to keep ancient antivirals, like elderberry and oregano oil, in stock. And meditation and yoga are so popular they’re no longer considered alternative. Dozens of apps, thousands of classes, and millions of people have already endorsed these profoundly beneficial practices.
This growing interest gives me hope that we’re in the midst of a medical renaissance. As more and more of us recognize the pitfalls of treating superficial symptoms, we can begin to restore the healthcare system’s ability to see disease as multifactorial—and treat patients as whole human beings. In any case, I believe it’s time for everyone to understand what these treatments have to offer, and I hope that by the time you finish this book, you’re as excited about their promise as I am.
CHAPTER 3
Eat Right for Your Ancient Element
A Personalized Approach to Understanding Yourself—and Using Food as Medicine
You are unlike anyone else on the planet. In other words, you’re one in 7.5 billion. It’s pretty amazing, when you think about it. While all human beings are far more alike than different, each of us has distinct traits that make us one of a kind—our fingerprints, of course, but also our bodies’ genomes, the cellular operating instructions that make each of us who we are. In fact, in 2015, a consortium of scientists released the results of the 1000 Genomes Project, which concluded that there are four to five million differences between one person’s genome and that of anyone else.1
Even so, most contemporary health and diet advice remains one-size-fits-all—a strategy that clearly doesn’t work. If you’ve ever unsuccessfully tried a diet or health protocol that worked for a friend or colleague, you know what I mean. In some ways, these failures are worse than never trying at all, because in their wake you often blame yourself. You beat yourself up. You think you have no willpower or you’re weak or flawed in some deep, fundamental way.
I can’t tell you the number of patients who have come to me over the years, looking distressed and ashamed, and said, “What’s wrong with me? Why is everyone else successful with this approach and I’m not?” Well, I’m here to tell you the same thing I tell my patients: There’s nothing wrong with you. It’s not you who has failed. It’s the cookie-cutter approach.
That’s especially true when it comes to diet. While conventional wisdom holds that there’s one dietary pattern that is healthy for everyone, the truth is there is no single perfect diet. Let me say that again: There is no single perfect diet. Remember, our bodies are as unique as our individual fingerprints and our genomes, which means we respond to food (and drugs and exercise and stress and lack of sleep) in different ways, too. As a result, for you to achieve optimal health, you need a customized approach to eating that suits your unique makeup.
There’s a lot of talk about personalized medicine these days. Hundreds of Western scientists are looking at using our unique genetic codes to understand individual differences in how we metabolize drugs or have a predisposition to a certain illness. The sad truth is that this may just lead to more unnecessary treatments—cases in which people are prescribed drugs preventatively, before they’ve even developed any condition. This approach gets at the root of Western medicine’s fatal flaw: It believes that short of taking a drug, there is nothing you can do to treat or prevent an illness.
That philosophy couldn’t be more wrong. Ancient practitioners recognized that our bodies have a natural capacity to heal, and that with the support of appropriate herbs, foods, and exercises, the body will in most cases heal itself. So TCM practitioners developed a system for understanding individual patients’ emotional, physical, and spiritual health—one that would help them identify each individual’s vulnerabilities and weak spots and make diet and lifestyle recommendations to prevent and heal disease based on those unique characteristics. This system, known as the five elements of ancient medicine, offers remarkable insights into your whole being—your physical traits, body type, emotional tendencies, and dominant organs, as well as diet tweaks and lifestyle strategies that can be particularly beneficial to you.
I think of the five elements of ancient medicine as the original form of personalized medicine. This paradigm offers a customized approach to diet and health—one that, based on my experience with hundreds of patients, can be especially helpful for people who have tried and failed to lose weight and get healthy in the past. I’m excited to share it with you because it can help you better understand and care for your unique body, mind, and health.
Why the five elements can offer unique insights into your health
Have you ever taken a personality profile test like the Enneagram, the Myers-Briggs Type Indicator, or the DISC (Dominance, Influence, Compliance, Steadiness)? If so, you know how valuable these tools can be in helping you understand more about yourself—your strengths, your weaknesses, your skills, your passions. Well, the five elements structure is like the ancient prototype for these tests, and to this day it remains the most comprehensive.
Ancient healers knew that every one of us has a deep connection with the earth and its elements, and they used five essential features of nature—fire, earth, wood, metal, and water—to explain the complex traits of our bodies and minds. They believed that these five qualities from the natural world exist within every human being—not literally, of course, but metaphorically. According to the theory, every human being is a unique composite of all five elemental categories, but typically one or two elements—known as one’s “dominant elements”—best represent how a person thinks and feels, as well as what helps them thrive physically and emotionally, and what can thwart their efforts to get healthy.
Just as you might fit, to varying degrees, into several different Enneagram or DISC categories, the five elements can manifest in a variety of combinations.
You might be dominant in fire and earth, for instance, but still have traces of wood, metal, and water. And your particular blend describes who you are—whether you’re prone to impatience (a trait of people strong in the wood element), or you’re incredibly well organized (like metal element types), or you’re more introspective (as those strong in the water element tend to be).
When I began using the five elements approach in my functional medicine practice, I saw over and over again how beneficial it could be for understanding individual differences in emotional and physical health and helping to guide treatment choices as well as lifestyle and diet recommendations. For instance, when I was actively seeing patients, a friend, Nancy, came to my office. She was thirty-three and had been struggling with infertility for five years. She had also had several miscarriages. That pattern—having difficulty both conceiving and carrying a baby—told me that she was struggling in her water and earth elements. The water element relates to conception as well as the adrenal and reproductive organs, while earth is connected to carrying a baby as well as the pancreas and spleen.
Nancy was eating a paleo diet that was high in fat, nuts, and seeds, and low in carbs—a diet that can be super healthy for certain individuals. But healthy fats and nuts and seeds can increase stress on your spleen and liver, and when you’re having trouble conceiving you want to nourish all your organs and treat them gently. Worse, she was incredibly stressed about her inability to get—and stay—pregnant, and her anxiety and fear were overtaxing her adrenal glands.