The perfect storm of a high-protein diet, digestive disturbances, and anxiety is a common presentation in my clinical practice. Often patients are unable to connect the dots, so to speak, and cannot see the connection between diet, digestion, and subjective symptoms. Let’s explore this commonly seen scenario and discuss a classic formula I use with great clinical success in patients who consume a high-protein diet and experience concomitant gastric disturbances and anxiety.
The TCM Connection
It is extremely common to see patients following a wide array of high-protein diets: Atkins, Paleo, carnivore, “low carb,” etc. When following such diets, it is not uncommon to experience gas, bloating, constipation, loose stool or heartburn. The majority of patients I see who consume a high-protein diet do experience some type of gastric disturbance related to the spleen / stomach and the liver organs; as well as the concepts of food stagnation and phlegm.
In almost every case I encounter, the patient is taking a probiotic and /or a digestive enzyme supplement with minimal relief from symptoms. In such cases, spleen qi deficiency or liver / spleen disharmony with potential food stagnation and / or phlegm are the common patterns from the lens of Chinese medicine.
It is also extremely common to see a wide spectrum of emotional “dis-ease” in patients following strict dietary protocols, such as low-grade anxiety or vague feelings of discontent or low-grade depression and an overall “fog” or malaise. The tongue and pulse in such cases can be very predictable: a wiry and slippery pulse, and a tongue with a sticky coating and teethmarks. However, in many cases the tongue will appear relatively normal to potentially red with red sides. These clinical clues can shift based on the level of involvement of the vitality of the spleen qi and the free flow of the liver qi.
Two of the key questions I ask such patients are the following: “Are you experiencing a healthy hunger signal or is your appetite / interest in food waning?” “Are you experiencing loose stools?” If their appetite is strong and healthy, and they have no loose stools, I am less concerned with their spleen qi and more focused on moving the flow of qi in the liver and stomach.
In such cases, when the symptoms are primarily mild digestive concerns combined with anxiety and potential phlegm, I frequently use the classic formula Ban Xia Hou Po Tang.
Ban Xia Hou Po Tang
Ban Xia Hou Po Tang is a classic formula primarily known for the treatment of the unique symptom of “Plum Pit Qi,” the sensation of something being stuck in the throat with esophageal discomfort / swelling. This sensation of pain or discomfort has been attributed to qi stagnation and phlegm.
Ban Xia Hou Po Tang is now used for a wide range of disorders and patterns related to qi stagnation and phlegm issues in the chest and throat, as well as a wide spectrum of psychological / emotional issues. The classic formula has the actions of dissolving phlegm, coursing and descending the qi, relieving cough, and dispelling wind-cold.
I have found this classical formula to be extremely effective for patients who chronically consume a high-protein diet and experience gastric disturbance with psychological / emotional distress.
As noted earlier, the predictable tongue presentation would be moist with a white, greasy coat; although often it is red and moist or simply normal. The pulse can be slippery and wiry or slippery alone; however, this can also vary.
Combining Formulas
Ban Xia Hou Po Tang can be easily combined with other formulas as needed for such cases depending on the constellation of symptoms and the patient’s unique pattern presentation. I often use Ban Xia Hou Po Tang with Chai Hu Shu Gan Wan for digestive issues occurring with emotional issues in high-protein diets if constipation is a main sign.
Ban Xia Hou Po Tang can also be combined with Bao He Wan and/or Xiang Sha Liu Jun Zi Tang in these cases, depending on the level of involvement of food stagnation and spleen qi deficiency. Clinicians can use their discretion and diagnostic eyes to evaluate each patient’s unique presentation.
Always remember that a patient’s diet can contribute to mental / emotional states and symptoms that may seem unrelated, and often provide unique clues pointing to the use of classical formulas. Simple formulas are often not so simple!
