Liver Yang Rising
The information provided here is not a replacement for a doctor. You shouldn't use it for the purpose of self-diagnosing or self-medicating but rather so you can have a more informed discussion with a professional TCM practitioner.
At a glance
Preliminary reading: What is a pattern? The Liver in Chinese Medicine The concept of Liver Yin Deficiency The concept of Yang
Key attributes
Chinese name: 肝阳上亢 Pinyin name: Gān Yáng Shàng Kàng
Pattern nature: Full/Empty
Common combinations: Liver Yang Rising with Blood and Yin Deficiency
Causes
Precursor patterns: Blood Deficiency Liver Blood Deficiency Kidney Yin Deficiency and three other possible precursors
Common causes: 1. Emotional Stress, 2. Diet
Diagnosis
Common symptoms: Tinnitus Deafness Insomnia Headaches Dizziness and nine other symptoms
Pulse type(s): Wiry (Xian)
Tongue description: Pale, normal or slightly red on the sides with no coating
Treatment
Treatment principle: Subdue Liver Yang, nourish Liver Yin and Blood
Common formulas: Liu Wei Di Huang Wan Qi Ju Di Huang Wan Tian Ma Gou Teng Yin and four other formulas
Pathology
Long term Deficiency of Liver Yin, Liver Blood or Kidney Yin can cause Liver Yang rising upwards. This pattern is also called "Arrogant Liver Yang". If left unchecked for many years, it can lead to Liver Wind Agitating Internally.
The symptoms mentioned here are fairly similar to these of Stagnant Liver Qi turning into Fire. However, the latter is purely an Excess pattern. The Fire dries up the Body Fluids and cause some clear sign of Dryness such as constipation, red eyes and face or scanty dark urine.
Liver Yang Rising, on the other hand, is both Excess (the Yang rising) and Empty (Deficient Yin or Blood) at the same time. The typical Excess symptoms are headache, tinnitus, deafness, propensity to outbursts of anger and etc. The typical Empty symptoms are Blurred vision, Insomnia, stiffness and numbness of the muscles, neck, knees, shoulder and upper back. There also some Empty-Heat manifestations such as dry mouth or dry skin.
Therefore the treatment should be focusing on subduing Rising Yang as well as nourishing Liver Yin and Blood.
Many factors can result in this pattern, emotional stress and diet are the two most dominant reasons. Other causes include excessive exercises and sexual activities, prolonged physical exertion and chronic menorrhagia.
Causes
Precursor patterns: Liver Yang Rising can derive from Blood Deficiency Liver Blood Deficiency Kidney Yin Deficiency Liver Yin Deficiency Rebellious Liver Qi Kidney and Liver Yin Deficiency
Emotional Stress: Emotional problems, such as anger, frustration and resentment, are the most obvious causes for this pattern, especially if these emotions are suppressed over a very long time. Anger drives Rebellious Liver Qi upwards.
Diet: If excessive Liver Qi rises, it can cause Liver Yang Rising. Eating in a hurry, eating while working or getting angry at meal time can lead to the pattern.
Diagnosing Liver Yang Rising
Diagnosing a pattern in Chinese Medicine is no easy feat and should be left to professional practitioners. In particular one has to know how to differentiate between different types of pulses and tongue coatings, shapes and colors as well as learn to read from a long list of seemingly unrelated symptoms.
Pulse type(s): Wiry (Xian)
Tongue description: Pale, normal or slightly red on the sides with no coating
Main symptoms: Tinnitus Deafness Insomnia Headaches Dizziness Dry mouth Dry throat Stiff neck Irritability Blurred vision Stiff shoulder Feeling work-up Stiff upper back Outbursts of anger
Diagnosis commentary: Key characteristic symptoms of this pattern are the irritability, wiry pulse and headache, especially on the temples, eyes or lateral side of the head.
Treating Liver Yang Rising
Treatment principle
Subdue Liver Yang, nourish Liver Yin and Blood
Herbal formulas used to treat Liver Yang Rising
Liu Wei Di Huang Wan
Source date: 1119 AD
Number of ingredients: 6 herbs
Key actions: Enriches the yin and nourishes the Kidneys.
Formula summary
Liu Wei Di Huang Wan is a 6-ingredient Chinese Medicine formula. Invented in 1119 AD, it belongs to the category of formulas that nourish Yin and tonify.
Besides Liver Yang Rising, Liu Wei Di Huang Wan is also used to treat Blood Deficiency or Yin Deficiency.
Qi Ju Di Huang Wan
Source date: 1350 AD
Number of ingredients: 8 herbs
Key actions: Nourishes Kidney and Liver Yin. Improves vision.
Formula summary
Qi Ju Di Huang Wan is a 8-ingredient Chinese Medicine formula. Invented in 1350 AD, it belongs to the category of formulas that nourish Yin and tonify.
Besides Liver Yang Rising, Qi Ju Di Huang Wan is also used to treat Interior Wind or Liver Yin Deficiency.
Ling Jiao Gou Teng Tang
Source date: Qing dynasty
Number of ingredients: 10 herbs
Key actions: Cools the Liver. Extinguishes Wind. Increases Fluids. Relaxes the sinews.
Formula summary
Ling Jiao Gou Teng Tang is a 10-ingredient Chinese Medicine formula. Invented in Qing dynasty, it belongs to the category of formulas that pacify and extinguish Internal Wind.
Besides Liver Yang Rising, Ling Jiao Gou Teng Tang is also used to treat Liver Wind agitating Internally due to extreme Heat or Liver Wind agitating Internally due to Liver Fire.
Diet recommendations
Eat a simple diet of legumes, grains, , cooked vegetables and greens. Avoid foods which are raw and cold, fried and greasy, hot and spicy and any caffeinated drinks including coffee, black tea, cocoa colas. Also avoid chips of all kinds, turkey and red meats, chocolate, nuts and nut butters, avocados, cheese and dairy, alcohol, drugs and stimulants. The foods that decongest and help the Liver include vegetables, bitter foods and dark leafy greens, such as kale, collards, dandelion, mustard, beet and mustard greens. Lemons also clear Heat and congestion from the Liver.
As for exercise, gentle stretches are helpful, such as Yoga, Tai Chi and Qi Gong. You should avoid strenuous exercise and exertion.
Consequence patterns
Liver Yang Rising may turn into Liver Fire
Liver Wind agitating Internally due to Liver Yang Rising
Liver Yang rising may generate Wind if it persists for many years. This usually happens only in the elderly.