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Kidney Tonic (Yang)


CLINICAL APPLICATIONS

* Kidney yang deficiency with diminished ming men (life gate) fire

* Clinical signs and symptoms: low energy and lethargy, aversion to cold, cold extremities, intolerance to cold, urinary incontinence, loose stools, diarrhea, early morning diarrhea, weakness of the lower back and knees, edema of the legs

* Clinical applications: infertility, impotence, spermatorrhea, frequent urination, incontinence, nephrotic syndrome, chronic nephritis, diabetes mellitus, bronchial asthma, sciatica, lumbago, and hypertrophic myelitis

 

WESTERN THERAPEUTIC ACTIONS

* Antiaging functions to stop premature or accelerated aging

* Improves genitourinary functions

* Nephroprotective effect to treat kidney disorders

* Adaptogenic effect to alleviate mental stress and physical stress

* Analgesic effect to alleviate musculoskeletal aches and pains

 

CHINESE THERAPEUTIC ACTIONS

* Warms and tonifies Kidney yang

* Replenishes jing (essence) and tonifies blood

 

DOSAGE

Take 3 to 4 capsules three times daily. Dosage can be increased up to 6 to 8 capsules three times daily as needed to treat more severe symptoms.

 

INGREDIENTS


Dang Gui (Radix Angelicae Sinensis)

Du Zhong (Cortex Eucommiae)

Fu Zi (Radix Aconiti Lateralis Praeparata)

Jiu Cai Zi (Semen Allii Tuberosi)

Lu Jiao Shuang (Cornu Cervi Degelatinatum)

Rou Gui (Cortex Cinnamomi)

Shan Yao (Rhizoma Dioscoreae)

Shan Zhu Yu (Fructus Corni)

Shu Di Huang (Radix Rehmanniae Praeparata)

Suo Yang (Herba Cynomorii)

Tu Si Zi (Semen Cuscutae)

Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle)


 

BACKGROUND

The function of Kidney in traditional Chinese medicine is closely related to the physiology of the genitourinary system in Western medicine. In Western medicine, genitourinary disorders include a wide variety of disorders, such as infertility, low libido, sexual dysfunction, increased urinary frequency, polyuria, urinary incontinence, nephrotic syndrome, and chronic nephritis. In traditional Chinese medicine, these disorders are usually diagnosed as Kidney yang deficiency, Kidney yin deficiency, or both.

 

FORMULA EXPLANATION

Kidney Tonic (Yang) is designed to treat Kidney yang deficiency. Chronic illness may consume the yang qi of the body, causing low energy and lethargy. Deficiency of the Kidney yang may lead to internal coldness, resulting in aversion to cold and cold extremities. In males, Kidney yang deficiency often leads to sexual and reproductive disorders, such as impotence, premature ejaculation, spermatorrhea, and low sperm count. Kidney yang deficiency can also cause deficiency of the urinary function of the body, leading to frequent urination and urinary incontinence. Kidney yang deficiency may impair its functions to regulate water metabolism, leading to edema of the lower legs and loose stools. Because the kidney is located in the low back, Kidney deficiency may cause weakness of the lower back and knees.

        Kidney Tonic (Yang) has Rou Gui (Cortex Cinnamomi), Fu Zi (Radix Aconiti Lateralis Praeparata), Suo Yang (Herba Cynomorii), Jiu Cai Zi (Semen Allii Tuberosi), and Lu Jiao Shuang (Cornu Cervi Degelatinatum) to warm the Kidney yang and raise the ming men (life gate) fire. Du Zhong (Cortex Eucommiae) enhances the Kidney to treat low back pain and soreness associated with yang deficiency. According to the yin-yang theory of mutual dependence, in order to effectively tonify the Kidney yang, the Kidney yin also needs to be nourished. Therefore, this formula also has Shu Di Huang (Radix Rehmanniae Praeparata), Shan Zhu Yu (Fructus Corni), Shan Yao (Rhizoma Dioscoreae), and Tu Si Zi (Semen Cuscutae) to nourish the yin and replenish jing (essence). Dang Gui (Radix Angelicae Sinensis) tonifies blood and nourishes the Liver. Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle) harmonizes the entire formula.

        In conclusion, Kidney Tonic (Yang) tonifies Kidney yang and treat related biomedical disorders.

 

CAUTIONS & CONTRAINDICATIONS

* This formula is contraindicated in cases of Kidney deficiency with dampness accumulation.

* This herbal formula contains herbs that invigorate blood circulation, such as Dang Gui (Radix Angelicae Sinensis). Therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use this formula with caution, or not at all, as there may be a higher risk of bleeding and bruising.[1],[2],[3]

* Patients who wear a pacemaker, or individuals who take antiarrhythmic drugs [i.e., Tambocor (flecainide) and Procanbid (procainamide)] or cardiac glycosides [i.e., Lanoxin (digoxin)], should not take this formula. Fu Zi (Radix Aconiti Lateralis Praeparata) may interact with these drugs by affecting the rhythm and potentiating the contractile strength of the heart.[4]

 

CLINICAL NOTES

* This formula is relatively warm. It should be taken as needed to treat Kidney yang deficient conditions. However, once the desired effect is achieved, the dose should be lowered or the formula may be discontinued.

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Urinary dysfunction due to Kidney yang deficiency: deep and weak pulse on the right chi.

* Reproductive dysfunction due to Kidney yang deficiency: weak pulse on the left chi.

 

SUPPLEMENTARY FORMULAS

* With Kidney yin deficiency, add Kidney Tonic (Yin).

* For diarrhea due to Spleen qi and Kidney yang deficiency, add GI Tonic.

* For extreme low energy, add Imperial Tonic.

* For impotence or spermatorrhea, add Vitality.

* For male infertility, add Vital Essence.

* For female infertility, add Blossom (Phase 1-4).

* For edema, add Herbal DRX.

* For hypothyroidism, add Thyro-forte.

* For back pain, add Back Support (CR).

* For leg pain, add Knee & Ankle (CR).

* For low adrenal functions, add Adrenal +.

* For asthma, add Cordyceps 3 or Respitrol (Deficient).

* For osteoporosis, add Osteo 8.

* For forgetfulness, add Enhance Memory.

* For vaginal dryness, add Balance Spring.

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Shenshu (BL 23), Taixi (KI 3), Ganshu (BL 18), Pishu (BL 20), Geshu (BL 17), Guanyuan (CV 4), Qihai (CV 6), Mingmen (GV 4).

 

Classic Master Tung's Points:

* Diarrhea: Qimen (T 33.01), Qijiao (T 33.02), Qizheng (T 33.03), Sihuashang (T 77.08), Sihuazhong (T 77.09), Sihuaxia (T 77.11), Menjin (T 66.05), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21)

  *   Back soreness/weakness: Linggu (T 22.05), Chongzi (T 22.01), Chongxian (T 22.02), Wanshunyi (T 22.08), Wanshuner (T 22.09), Zhongbai (T 22.06), Zhengjin (T 77.01), Zhengzong (T 77.02), Zhongjiuli (T 88.25), Tongshen (T 88.09), Tongwei (T 88.10), Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Shuijin (T 1010.20), Shuitong (T 1010.19), Chengshan (BL 57), Biyi (T 1010.22), Zhitong (T 44.13)
  *   Edema of the legs: Fuchang (T 77.12), Shuiqu (T 66.09)
  *   Infertility (female): Fuke (T 11.24), Huanchao (T 11.06), Tongshen (T 88.09), Tongbei (T 88.11), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Jiemeiyi (T 88.04), Jiemeier (T 88.05), Jiemeisan (T 88.06), Mufu (T 88.38)*, Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14). Moxa lower abdomen.

* Infertility (male): Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), and Endocrine, Kidney and Testicle points on the ear. Moxa du (governing) channel on the back.

* Urinary incontinence: Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tongshen (T 88.09), Tongwei (T 88.10)

* Impotence: Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Tongshen (T 88.09), Tongwei (T 88.10), Sanshen (T 44.27)*. Bleed tender points on the Kidney area of the back from L1-L5 with cupping. Bleed before needling for best result. Moxa for 30 minutes the Kidney area on the back from L1-L5, Guanyuan (CV 4), and Zhongji (CV 3).

* Spermatorrhea: Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tongshen (T 88.09), Tongwei (T 88.10), Shuijin (T 1010.20), Shuitong (T 1010.19), Tianhuangfu [Shenguan] (T 77.18). Moxa Guanyuan (CV 4), Zhongji (CV 3), Zhongshu (GV 7).

* Nephritis (chronic): Tianhuangfu [Shenguan] (T 77.18), Dihuang (T 77.19), Renhuang (T 77.21), Huoying (T 66.03), Tongshen (T 88.09), Houzhui (T 44.02), Shouying (T 44.03), Shuixiang (T 66.14), Shuixian (T 66.15), Tongwei (T 88.10), Tongbei (T 88.11)  

 

Master Tung’s Points by Dr. Chuan-Min Wang:

* Kidney yang deficiency: Tianhuangfu [shenguan] (T 77.18), Dihuang (T 77.19), Renhuang (T 77.21)

 

Balance Method by Dr. Richard Tan:

* Bilateral: Rangu (KI 2), Dazhong (KI 4), Fuliu (KI 7)

* Left side: Shenmen (HT 7), Shaohai (HT 3), Zulinqi (GB 41), Yanglingquan (GB 34), Weizhong (BL 40), Shugu (BL 65)

* Right side: Zhongzhu (TH 3), Tianjing (TH 10), Houxi (SI 3), Xiaohai (SI 8), Taixi (KI 3), Yingu (KI 10)

 

Auricular Medicine by Dr. Li-Chun Huang:

* Enuresis: Bladder, Urethra, Ear Center, Pituitary

§ For nocturia, add Forehead and Exciting Point.

§ For enuresis due to trauma of spinal cord, add Lumbosacral Vertebral.

* Urinary incontinence: Urethra, Occiput, Lumbosacral, Liver Pituitary, Bladder, Nervous Subcortex

* Kidney deficiency: Kidney, Pituitary, Endocrine, Liver, Heart, Thalamus, Adrenal Gland

* Raynaud’s disease: Sympathetic, Hot, Finger, Lesser Occipital Nerve, Large Auricular Nerve, Coronary Vascular Nerve

 

NUTRITION

* Increase intake of the following warm foods and fruits such as lamb, lychee, longan fruit and spices such as pepper, garlic, onions, basil, rosemary, cumin, fennel, cardamom, anise, leeks, chives, scallions, thyme, saffron, wormwood, mustard, chili pepper, and wasabi.

* Avoid raw or cold food/beverages such as sashimi, sushi, salads, steak tartar, and seared meat. Eat all cooked vegetables and nothing straight from the refrigerator.

* Avoid the following cooling foods: tofu, tomato, celery, asparagus, bamboo, seaweed, kelp, bitter melon, cucumber, gourd, luffa, winter melon, oranges, grapefruit, pear, banana, papaya, watermelon, white radish, mustard leaf, potherb mustard, Chinese kale, napa, bamboo sprout. Long-term use of cold fruits and vegetables like the ones listed above may be damaging to the Spleen. To make the property more neutral, one can add about 20 pieces of Gou Qi Zi (Fructus Lycii) when cooking.

 

The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:

* Recommendations: warming foods, chicken, lamb, scallions, sesame seeds, fish, baked tofu, soybeans, walnuts, eggs, lentils, black beans, lotus seeds, a little wine, ginger, and cinnamon bark tea.

* Avoid cold foods, cold fruits, and raw foods.

 

LIFESTYLE INSTRUCTIONS

* Avoid exposure to the cold, such as water sports or exposure to cold and windy weather.

 

CASE STUDIES

* E.F., a 34-year-old female, presented with infertility. Additional symptoms included urinating seven to eight times each day and her periods had light cramping and white discharge. It was noted that her cycle was 32 days. Objective findings included pale face with cold hands. The TCM diagnosis was Spleen and Kidney yang deficiencies. It was noted that she had two years of unsuccessful IUIs and was just beginning IVF. Kidney Tonic (Yang) was prescribed at 3 capsules three times per day while on her IVF protocol. In result of taking the herbs, the patient experienced a successful IVF procedure and was currently six weeks pregnant. In addition, her urinary output became normalized. She was taken off the formula once she had become pregnant. Submitted by M.P., Muskego, Wisconsin.

* The patient had stopped taking birth control in 2009, which she had been using for nine years total. Currently she was having no periods, which had been occurring for the past 3.5 years. It was noted that she had implantation failure, two miscarriages, and infertility. Her doctors had stated that she had low estrogen as well as progesterone with no exogenous support. Blossom (Phases 1-4) for infertility and Kidney Tonic (Yang) to replenish jing (essence) were prescribed. Within six weeks of taking herbs and receiving acupuncture, she had a full five-day period with no clots. Her endometrial lining became 10 mm, where 8 mm is required, and ovulation was present. She and her husband were ready to conceive naturally. Submitted by N.T., Bethesda, Maryland.

* J.L., a 70-year-old male, presented with multiple symptoms including low energy, back pain, cold sensation, and frequent urination. Objective findings included difficult walking with weakness in the knees as well as a decreased range of motion. Blood pressure was 140/72 mmHg and heart rate was 77 beats per minute. The practitioner diagnosed this condition as Kidney yang deficiency. For treatment, Kidney Tonic (Yang) was prescribed. After taking the herbs for three weeks, the patient reported an increase in energy and decrease sensation of cold; however, coldness of extremities was still present upon palpation. He mentioned he would continue taking the herbs and receiving acupuncture. Submitted by J.C., Rosemead, California.

* A.P., a 55-year-old female, presented with multiple symptoms of always feeling cold, absence of thirst, tiredness, and loose stools. Blood pressure was 131/82 mmHg. Objective findings included cold abdomen and back. The TCM diagnosis was Kidney and Spleen yang deficiencies and Kidney Tonic (Yang) was prescribed with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to treat the condition. After one month of taking the herbs, the patient began to have more energy, her stools were well formed, and she felt warmer overall. Submitted by J.M., Breckenridge, Colorado.

* A 73-year-old male presented with pain in the right leg around the thigh area; aggravation was noted after exertion such as walking. Slight relief was experienced with the application of heat as well as rest. Sleep and urination issues were also present. The practitioner diagnosed this condition as Kidney yang deficiency. For treatment, Kidney Tonic (Yang) was prescribed at 3 grams per day. As a result of taking the herbs, the patient noticed an increase in mobility, was able to decrease the amount of pain medication she was taking, and his pain level went from a level 7 to a level 1 out of 10. He was no longer waking up as much during his sleep and his flow of urination was more consistent. It was mentioned that 4 grams per day was too much as it seemed to aggravate his prostate/urination condition; 3 grams was more suitable for him. Submitted by L.M., Las Vegas, Nevada.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

Kidney Tonic (Yang) is formulated specifically to tonify Kidney yang and raise ming men (life gate) fire. From the Western perspective, this formula improves genitourinary functions, treats kidney disorders, and alleviates musculoskeletal aches and pains. Furthermore, Kidney Tonic (Yang) contains many herbs with general adaptogenic and antiaging functions.

        Kidney Tonic (Yang) contains many herbs that strongly improve and treat sexual and reproductive disorders. Jiu Cai Zi (Semen Allii Tuberosi) has an aphrodisiac effect. According to one study on sexual behavior in male subjects, administration of Jiu Cai Zi (Semen Allii Tuberosi) is associated with an increase in mounting frequency, intromission frequency, and ejaculation frequency, and a decrease in mount latency, intromission latency, and ejaculation latency.[5] Shan Zhu Yu (Fructus Corni) and Suo Yang (Herba Cynomorii) have positive reproductive benefits. Administration of Shan Zhu Yu (Fructus Corni) is associated with substantial stimulatory effects on sperm motility from 25.8 +/- 7.7% to 42.8 +/- 10.3%.[6] Administration of Suo Yang (Herba Cynomorii) is associated with significant increase in spermatogenesis. It significantly increases in epididymal sperm count, absolute testes weights, and the expression of GDNF (glial cell-derived neurotrophic factor) at both the mRNA and protein levels in testes of male subjects.[7]

        Kidney Tonic (Yang) also contains many herbs to treat urinary functions and kidney disorders. Pharmacologically, the extract of Shan Zhu Yu (Fructus Corni) has been shown to induce diuresis and lower blood pressure.[8],[9] Clinically, use of these herbs, and others, showed effectiveness in one study to treat frequent urination in elderly patients characterized by Kidney yang deficiency. Of 64 patients who received herbal therapy for three weeks, 17 had complete recovery, 21 showed significant improvement, 21 showed slight improvement, and 5 showed no change.[10] According to another study, use of these herbs showed beneficial results to treat six patients with nephrotic syndrome unresponsive to drug treatment (steroids). Improvements included resolution of symptoms and reduction of protein in the urine.[11] For prevention and treatment of diabetic nephropathy, use of Shan Zhu Yu (Fructus Corni) showed beneficial effect.[12] Lastly, 12 patients with stones were treated with satisfactory results, using an herbal formula containing 30 grams of Lu Jiao Shuang (Cornu Cervi Degelatinatum) as the main ingredient. [13]

        Many herbs in this formula have functions to relieve pain and treat musculoskeletal disorders. One report stated that Dang Gui (Radix Angelicae Sinensis) has marked analgesic and anti-inflammatory effects to relieve pain and reduce inflammation.[14] Another study showed that use of Dang Gui (Radix Angelicae Sinensis) and others via injection was associated with a 97% rate of effectiveness to relieve low back and leg pain.[15] Furthermore, use of Rou Gui (Cortex Cinnamomi) was associated with a 98% rate of effectiveness to treat low back pain.[16] Additionally, according to one report, 27 patients with severe pain of the back and legs were treated by local injection of a Gan Cao (Radix et Rhizoma Glycyrrhizae) solution, with complete relief of pain in 20 patients and moderate relief in 7 patients. Patients with acute conditions received injections every other day for four to seven treatments; those with chronic conditions received injections every other day, for eight to fourteen treatments.[17]

        In summary, Kidney Tonic (Yang) is a great formula that improves genitourinary functions, treats kidney disorders, and alleviates musculoskeletal aches and pains. It also has general adaptogenic and antiaging effects to alleviate mental stress, physical stress, and premature aging.[18],[19]

 

COMPARATIVE ANALYSIS

One striking difference between Western and traditional Chinese medicine is that Western medicine focuses and excels in crisis management, while traditional Chinese medicine emphasizes and shines in holistic and preventative treatments. Therefore, in emergencies, such as gunshot wounds or surgery, Western medicine is generally the treatment of choice. However, for treatment of chronic idiopathic illness of unknown origins, where all lab tests are normal and a clear diagnosis cannot be made, traditional Chinese medicine is distinctly superior.

        In traditional Chinese medicine, Kidney yang is responsible for the proper functioning of the body and its energy, including growth, maturation, and aging processes. Therefore, a decline in Kidney yang leads to symptoms such as low energy and lethargy, aversion to cold, cold extremities, intolerance to cold, urinary incontinence, loose stools, diarrhea, early morning diarrhea, weakness of the lower back and knees, and edema of the legs. Specific indications include infertility, impotence, spermatorrhea, frequent urination, incontinence, and many others. In short, Kidney yang regulates many systems in the body, including but not limited to urinary, sexual and reproductive systems. Proper use of Kidney yang tonics ensures optimal health and prevents deterioration of these conditions.

        Western medicine, on the other hand, considers many of these symptoms to be non-specific and non-diagnostic. Furthermore, laboratory tests are generally normal, despite the patients still having various signs and symptoms. Under these circumstances, Western medicine struggles to identify a specific diagnosis and appropriate treatment. As a result, these conditions continue to deteriorate, becoming increasingly debilitating on a daily basis.

 



[1] Chan K, Lo AC, Yeung JH, Woo KS. Journal of Pharmacy and Pharmacology 1995 May;47(5):402-6.

[2] Pharmacotherapy 1999 July;19(7):870-876.

[3] European Journal of Drug Metabolism and Pharmacokinetics 1995; 20(1):55-60.

[4] Forensic Science International, 1994 June 28; 55-8.

[5] Guohua H, Yanhua L, Rengang M, Dongzhi W, Zhengzhi M, Hua Z. Aphrodisiac properties of Allium tuberosum seeds extract. College of Life and Environment Science, Shanghai Normal University, Shanghai, PR China. J Ethnopharmacol. 2009 Apr 21;122(3):579-82.

[6] Jeng H, Wu CM, Su SJ, Chang WC. A substance isolated from Cornus officinalis enhances the motility of human sperm. Department of Anatomy, Taipei Medical College, Taiwan. Am J Chin Med. 1997;25(3-4):301-6.

[7] Yang WM, Kim HY, Park SY, Kim HM, Chang MS, Park SK. Cynomorium songaricum induces spermatogenesis with glial cell-derived neurotrophic factor (GDNF) enhancement in rat testes. Department of Prescriptionology, College of Oriental Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Republic of Korea. J Ethnopharmacol. 2010 Apr 21;128(3):693-6.

[8] Chang Yong Zhong Yao Cheng Fen Yu Yao Li Shou Ce (A Handbook of the Composition and Pharmacology of Common Chinese Drugs), 1994, 368:376.

[9] Li C.P. Chinese herbal medicine. A publication of the John E. Fogarty International Center for Advanced Study in the Health Sciences (US Depart of Health, Education & Welfare). 1974, 120 pp.

[10] Xin Zhong Yi (New Chinese Medicine), 1997; 1:48.

[11] Shen De Yan Jiu (Research of Kidney), 1981; 93.

[12] Xu H.Q. & Hao H.P. () Effects of iridoid total glycoside from Cornus officinalis on prevention of glomerular overexpression of transforming growth factor beta 1 and matrixes in an experimental diabetes model. Biol Pharm Bull. 2004, 27(7): 1014-1018.

[13] Shang Hai Zhong Yi Yao Za Zhi (Shanghai Journal of Chinese Medicine and Herbology), 1982; 10:3.

[14] Yao Xue Za Zhi (Journal of Medicinals), 1971; (91):1098.

[15] Xin Zhong Yi (New Chinese Medicine), 1980; 2:34.

[16] Zhong Xi Yi Jie He Za Zhi (Journal of Integrated Chinese and Western Medicine), 1984; 2:115.

[17] Zhe Jiang Zhong Yi Za Zhi (Zhejiang Journal of Chinese Medicine), 1980; 2:60.

[18] Zhong Yao Yao Li Yu Lin Chuang (Pharmacology and Clinical Applications of Chinese Herbs), 1990; 6(4):6.

[19] Tong Ji Yi Ke Da Xue Xue Bao (Journal of Tongji University of Medicine), 1989; (3):198.