11 Flavors Warm the Gallbladder, Low Cholesterol, Depression & Anxiety

by Bob Flaws, Dipl. Ac. & C.H., Lic. Ac., FNAAOM, FRCHM

Keywords: Chinese medicine, Chinese herbal medicine, Wen Dan Tang (Warm the Gallbladder Decoction), low cholesterol, anxiety, depression Most lay people today think the lower their cholesterol, the better. However, low cholesterol is increasingly being identified by Western medical researchers as a potential problem. Normal cholesterol levels should be between 180-200mg/dL. However, 10% of the population has cholesterol levels below 180mg/dL. Cholesterol is a necessary precursor for the creation of hormones, such as estrogen, progesterone, testosterone, DHEA, and other corticosteriods. Studies have linked low serum cholesterol levels of increased risk of hemorrhagic stroke and increased mortality in the elderly., For instance, the 24th American Heart Association Conference on Stroke and Cerebral Circulation found that those with total serum cholesterol below 180mg/dL had twice the risk of hemorrhagic stroke than those with a cholesterol level of 230mg/dL. Similarly, other studies have linked depression and anxiety to chronically low levels of serum cholesterol. In a study of 121 healthy young women, Duke psychologist Edward Suarez found that those with cholesterol levels below 160mg/dL were more likely to score higher on measures of depression and anxiety than women with normal or high cholesterol levels. Interestingly, cholesterol drops postpartum, and some researchers are wondering if this accounts for most, if not all, postpartum depression. An even larger study conducted by Dutch researchers on 30,000 men found evidence of a link between low cholesterol levels and an increased risk of depression. So the days of thinking the lower the cholesterol, the better are numbered.

As psychiatrists now know, essentially all patients who are depressed are also anxious. In other words, the hard and fast division of depression from anxiety disorders is also quickly becoming a thing of the past. In terms of cholesterol, it is hypothesized that low cholesterol alters the way the brain cells function. Edward Suarez believes that low cholesterol results in fewer serotonin receptors, thus preventing the brain cells from using this mood-stabilizing neurotransmitter, and serotonin re-uptake inhibitors (SSRIs such as Paxil, Zoloft, and Prozac) are used clinically to treat both depression and anxiety. According to Dr. Joseph Mercola, MD director of the Optimal Wellness Center, the cause of low cholesterol in most people is non-freely flowing bile from the gallbladder. Bile is necessary to emulsify fats in the digestate. If a person does not have enough bile to emulsify these fats, then they cannot be absorbed by the intestinal villi and converted into cholesterol. Therefore, Dr. Mercola thinks that chronically low cholesterol levels are primarily due to a dysfunction of the gallbladder.

While the above is cutting-edge Western medical science, Chinese doctors have known about the connection between mood disorders and liver-gallbladder function for hundreds, if not thousands, of years. In Chinese medical psychiatry, the most common disease mechanism of anxiety is a liver-spleen disharmony resulting in malnourishment of the heart spirit. Because the spleen is the latter heaven root of qi and blood engenderment and transformation, liver depression assailing the spleen causing it to be vacuous and weak may result in a heart qi and blood vacuity. Hence the heart spirit is not properly nourished and constructed and becomes abnormally disquieted. Symptoms of depression include irritability, taciturnity, social avoidance, sleep disturbances, fatigue, a tendency to sorrow and tears with little reason, and loss of appetite, while symptoms of anxiety include excessive thinking and worry, a susceptibility to fear and fright, heart palpitations, chest oppression and pain, shortness of breath, dizziness, and spontaneous perspiration. Chinese medical practitioners should have no problem recognizing these symptoms as combination of liver depression qi stagnation and heart-spleen vacuity. In Chinese medicine, this combination of patterns is referred to as heart-gallbladder qi timidity or heart-gallbladder qi vacuity pattern. In this case, the word ÒgallbladderÓ is a rhetorical device which encompasses both the liver and gallbladder. As a rhetorical device, it emphasizes the liverÕs active or yang role in digestion and the engenderment and transformation of qi and blood. Nevertheless, the very name Òheart-gallbladder qi timidityÓ underscores the Chinese medical relationship between the liver-gallbladder and anxiety. Because liver depression and spleen vacuity both commonly lead to the engenderment of phlegm and because enduring depression often transforms into heat, heart-gallbladder qi timidity is often complicated by phlegm and heat.

When anxiety and/or depression present a pattern of heart-gallbladder qi timidity with phlegm and heat, the treatment principles are to course the liver and rectify the qi, fortify the spleen and supplement the qi, nourish the heart and quiet the spirit, transform phlegm and clear heat. Typically, for these purposes, Chinese doctors choose some version of Shi Wei Wen Dan Tang (Ten Flavors Warm the Gallbladder Decoction) or Shi Yi Wei Wen Dan Tang (Eleven Flavors Warm the Gallbladder Decoction). Blue Poppy Herbs 11 Flavors Warm the Gallbladder formula is specifically designed to address this very condition. One of the diagnostic indicators of depressive heat is a bitter taste in the mouth upon arising (if severe, possibly throughout the day), and a bitter taste in the mouth is due to non-freely flowing bile which is entering the blood stream instead of the intestinal tract. Because it address a bitter taste in the mouth, this formula does treat the gallbladder dysfunction that Dr. Mercola believes is at the root of low cholesterol. This formula may be used alone or in combination with SSRIs in the treatment of depression and/or anxiety, in which case, 11 Flavors treats the root of the problem, while the SSRIs merely increase the amount of serotonin in the brain. In any case, there is a very nice convergence of state-of-the-art Western medical science and ancient Chinese medical wisdom as it relates to low cholesterol and depression-anxiety. This same pattern often describes patients with labile hypertension which, if left unchecked, over time may result in hemorrhagic stroke, and 11 Flavors may be used to treat this pattern of hypertension as well.


1 www.mercola.com/1999/feb/14/low_cholesterol.htm

2 Http://unisci.com/stories/20013/0803014.htm

3 www.pslgroup.com/dg/fff8a.htm

4 www.mercola.com/2000/mar/26/cholesterol_depression.htm

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