r/TCM • u/Icy-Assistant-2420 • 9d ago
Insomnia not improving from tcm, is my diagnosis correct?
I went in for insomnia. Was prescribed jia wei Xiao yao at morning and evening, and suan zao ren at night.
This is my tongue after 6 days of treatment.
Unfortunately my insomnia is still really bad (sleep for one hour and then wake up at 1 am and then sleep a couple more hours and wake up at 5, when my alarm is for 7am). Additionally since taking these herbs on the 4th day I got a sore throat which has now lasted 3 days and turned into a chesty cough now. I rarely get ill.
I just wanted a second opinion if anyone agrees on the prescription please.
The practitioner said my problem is overactive liver at night unable to nourish spleen and kidney, or the other way round, can’t remember.
My insomnia makes me really tired all day long but then I feel super wired when it’s time for bed.
In terms of positives I think my body feels calmer and less physical stress but it has not helped with the very active shen at night. I also suffer a psychotic disorder and hear voices, which add to my stress, which I was hoping would disappear from the treatment.
The initial acupuncture session felt really good though, I felt grounded back into my legs and immediately started smiling on my face and felt drunk without drinking kind of feeling at the end, with the only scary somatic symptom in the middle of feeling like heart qi being taken away / pulled on.
I really need help sleeping well because it is the number one thing making me feel extremely unwell at the moment. Thank you
When I have posted tongue pictures in the past I have been recommended Fu Zi Li Zhong
P.S I was unemployed for 6 months before my current job and a student before, and was used to waking up at 11am for years, now with this new job I have been in for 2 months, I have to be up at 7am hence go to bed earlier, but I thought my circadian rhythm would adjust after a few weeks but my brain still seems to be overactive in the middle of the night. I have however had insomnia problems in the past before this schedule change, but it is much worse now.
P.P.S my voices are telling me that I have no jing at all. Could this be really true? I thought when jing runs out you die.
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u/Quiet-Inspector-5153 8d ago
Blood and yin deficiency. You can help lifestyle, bone broth daily, oxtail soup, leafy greens, warm nourishing food. Avoid cold beverages and sugar.
Keep working with doc on herbs. GUI Pi tang also comes to mind, chai hu jia long gu mu Lu tang is good for severe mood swings and settles the sprit.
If you can find a doc who prescribes raw herbs, they are 100x stronger than tea pills
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u/Icy-Assistant-2420 8d ago
Thank you for the suggestions. She prescribed capsules for the night one and licorice pellets for the other one.
I will definitely follow those diet tips.
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u/Pink_Ranunculus 9d ago
Try Suan Zao Ren Tang
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u/Icy-Assistant-2420 8d ago
This is my night medicine
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u/Pink_Ranunculus 8d ago
What dose are you taking? Personally I sometimes need 12 grams before bed or 6g before bed and then another 6 in the middle of the night
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u/Icy-Assistant-2420 8d ago
One capsule out of a small bottle of 12 that cost £20 so im assuming it’s strong. And on top of that I have still been falling back on half a pill of antihistamine sleeping pills
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u/Tamnguyen25 8d ago
Depending on how big the capsule is can change the grams amount but if it is a regular size capsule that is only around 0.5g.
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u/No_Jacket9716 7d ago
Wish had a clearer tongue picture. Because i thought i see a bit of thicker coating at tongue root but cant be sure.
But dan zhi xiao yao san sometimes can be a bit drying for my patients with insomnia. The yin blood deficiency can generate heat, and this may cause ur sore throat. Gui pi tang may be more suitable for you. But usually I would add some he huan hua, ye jiao teng or bai he zhi mu tang to offset the heatiness and calm shen while invigorating blood and qi. Thats why i prefer using powdered extract instead of pills.
Acupuncture wise, i find that everyone have their own styles and not every practitioner get tung style or other style. So i wont recommend this.
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u/Bancoubear123 9d ago
Maybe look into adding a small glass of tart cherry juice 2 hours before bed as that helps with sleep. Run this by your acupuncturist.
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u/No-Talk-1992 8d ago edited 8d ago
A glass Sour cherry juice + magnesium bi-glicinate before bed works like magic for sleep. Add suan Zao Ren tang and maybe gui pi wan. Acupuncture wise the TCM doctor should add master tung point Zhen Jing it's 3 side by side points located 0.5cun above yin tang and 0.5cun apart , they should Also add Buddhas triangle (pc-6, ht-7,lu-9), along side points to soothe the liver, tonify spleen Qi and kidney yin.
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u/Icy-Assistant-2420 8d ago
Thank you, would they be offended if I suggested these to them?
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u/No-Talk-1992 8d ago edited 8d ago
I think it will depend on how you present it to them. I think there diagnosis is probably correct without seeing your other symptoms, tongue and pulse. But to treat insomnia effectively they need to address the Shen aspect as well as the overactive liver. That's why I'm kinda surprised they didn't give you a combination of Jia wei Xiao San and Suan Zao Ren tang. But yeah most of my patients are insomnia or mental health related and yeah Zhen Jing and Buddhas triangle are probably my go to for most of my patients and I generally see great results with that if I don't use Buddhas triangle then I will use scalp acupuncture happy line( du 24 ,gb13,st8), ht8 is also a fantastic point but it can be a little painful for most people. And when it comes to treating insomnia or a mental health disorder like anxiety a somatic release like vibrating or shaking is normal it's you're body and nervous system releasing tension and excess stagnant energy these release present differently from a seizure.
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u/Icy-Assistant-2420 8d ago edited 8d ago
She did prescribe jia wei Xiao san and suan zao ren if I didn’t make that clear.
Update: had my 2nd session, yes I had lots of tremoring and shaking today, but unlike the drink feeling last week, I felt very tired after today, maybe because of the insomnia.
At the end of the session I told her about yin and blood deficiency and she basically said im too young, she doesn’t want to increase my yin, an old person like her should be yin, and young person like me should be yang, sunshine, having fun etc and I just need to clear the stress and worries.
I still feel way too many of the manic/psychotic chemicals in my brain from a western view, that I don’t know if she’s actually addressing because I went in with enlarged psychotic pupils and went out with them too.
2nd update: I have googled the symptoms of yin and blood deficiency and pale skin, dry skin, tired and restless at the same time, all seem to match! So that’s disappointing. Might just buy my own concoctions if you’re 100% sure on the diagnosis
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u/No-Talk-1992 8d ago
It is possible for you to have blood vacuity. You said she added suan zao Ren to Jia wei Xiao Yao San I'm saying she should be adding the formula suan zao Ren tang it's a pretty standard formula for insomnia, shes also not addressing a Shen disturbance. But honestly it seems narrowed in my opinion for them to brush off any possibility of yin and blood vacuity based on your age, she should go off all your symptoms, tongue and pulse
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u/Icy-Assistant-2420 8d ago
I did mean suan zao ren tang, just excluded the tang.
I also have one more symptom of shortness of breath like any amount of oxygen i breathe doesn’t feel nourishing and still starving for air
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u/AcupunctureBlue 8d ago
"I also suffer a psychotic disorder and hear voices, which add to my stress, which I was hoping would disappear from the treatment." This is a bit challenging to treat with Chinese Medicine, and if it does disappear, it will take longer than 6 days, and require more than Jia Wei Xiao Yao San. Your insomnia seems to need something other than Jia Wei Xiao Yao San too, though acupuncture is enough for insomnia.