formula causing tachycardia?

November 28, 2008

Hello, support from my fellow herbalists, please...

I have a patient in whom I want to clear heat, nourish heart & yin,

calm shen. western dx is hyperthyroidism/graves dz. from her sx I

gave her a round of Tian Wan Bu Xin Dan, 3 caps 2x/day to start

(from Evergreen so I know the source to be pure). She reported

after a day that she feels they are making her heart race. I had

her lower the dose temporarily to 3 caps 1x/day to allow her system

to get used to them. Meanwhile I appeal to you... perhaps the ren

shen? another possiblity is the rehmennia.

I had a patient a long time ago who reported heart racing who I had

given a formula created around Si Wu Tang. Since I had given the

formula in raw form I was able to remove one herb at a time and

intuitively I started with the rehmennia(something about it being

foxglove made me suspect it). In that case it turned out to be the

rehmennia, though according to our materia medica tachycardia should

not have been a side effect. This patient responded, I'd say,

homeopathically to the herb. has anyone experienced this?

I'm sure these things make me a stronger practitioner but I get

nervous about prescribing to over-sensative patients. any input is

welcome.

(this message is repeated on Chinese Herbal Acadamy so forgive the

repeat if you saw it there as well...I want as much input as

possible)

Thank you,

Sami

November 28, 2008

Hi Sami. **ANY HERB CAN CAUSE TACHYCARDIA**. Remember that tachycardia has

excess and deficient, empty and full, hot and cold (and so on) differentiations.

Rehmannia, in someone who tends to achieve constraint of the middle burner, can

easily cause middle burner constraint, which obviously leads to liver

constraint, liver heat, liver heat rising -> excess heart heat =tachycardia.

Alternatively, someone with obstructed or stagnant upper burner qi movement can

also express tachycardia when a greasy medicinal increases yin. These are two of

many possible dynamics that lead to tachycardia.

My personal solution with most sensitive patients is to treat them very simply

and midly, extending the treatment length, but creating a whole lot smoother

ride. For me, these patients are like damaged ships in stormy weather. How the

heck can we tell if the motor is working, of the sails are filling, if there are

leaks and where they are, if the keep is broken when a tempest is tossing us

around? First calm the storm. Then, in calm waters it will be relatively easy to

see what's wrong with the ship.

Hope this helps,

Hugo

________________________________

Hugo Ramiro

http://middlemedicine.wordpress.com

http://www.chinesemedicaltherapies..org