When you track your health, you might notice that certain symptoms flare up—or completely disappear—during specific times of the year. In our clinic, the seasons a patient feels worst in actually give us crucial clues about their underlying health patterns.
Today, we are going to talk about the different seasons of the year, how they affect our physical and emotional health, the specific organ systems they correlate with, and how we adjust treatment protocols to keep you healthy all year round.
Recognizing that your health changes with the weather is a transformational shift in how you view your body.
In Western medicine, we don’t emphasize seasonal changes much outside of “flu season” or seasonal allergies. But in Eastern medicine, environmental shifts are a core piece of the health puzzle.
Think about a tree. During the spring, the soil and air might seem the same as the week before, but an invisible environmental trigger prompts the tree to develop buds, grow leaves, and expand. Likewise, in the fall, the tree sheds its leaves and slows its metabolism to hibernate for winter. The tree isn’t consciously making these decisions; its physiology is directly reacting to the Earth’s seasonal cues.
Our bodies go through the exact same seasonal shifts. Even if you aren’t paying attention—and even though the changes are as subtle as a slight shift in your energy rather than your thumbnail changing color—your body is reacting to the environment around you.
While the West recognizes four seasons, Chinese medicine typically uses a five-season framework tied to the Five Elements. As the weather changes, the body’s energy naturally shifts its focus from one organ system to the next:
If you live in Houston, you are intimately familiar with the intensity of Summer and Late Summer.
Because Summer is associated with the Heart/Fire element and Late Summer is associated with the Spleen/Dampness element, Houston’s extreme heat and humidity can wreak havoc on certain body types.
This isn’t a coincidence; it is the direct result of the seasonal shift emphasizing heat and dampness in the body.
Absolutely. You have likely experienced this yourself: during the winter, or during long stretches of cloudy, rainy days, your mood dips.
The flip side is also true. If a patient is prone to anger and irritability, the rising, expansive “Wood” energy of the Springtime can cause their Liver energy to become constrained. This can cause people to feel more frustrated, angry, or likely to snap during the spring and summer. Both ends of the emotional spectrum can be highly influenced by the seasons, and both can be successfully treated using acupuncture and herbal medicine.
In Chinese medicine, the environment isn’t just something “outside” of you—it is deeply intertwined with your internal organ systems. As a doctor, I actively adjust my patients’ treatment protocols, acupuncture points, and herbal formulas as we move through the seasonal changes so the body is always supported correctly.
If you want to find out more about how we can tailor a treatment plan to your specific seasonal needs, visit our website at houstonacupuncture.com or email us at office@houstonacupuncture.com.
What if your best health is at the intersection of modern science and ancient wisdom?
I’m Dr. David Cherion. On my show, we bridge the gap between Eastern and Western medicine to help you live longer and finish your story.
Welcome to The Convergence. Welcome everybody. I’m Dr. David Cherion. I am a board-certified physician and licensed acupuncturist practicing in Houston, Texas. Welcome to our show, The Convergence. The Convergence is a show that is exploring the connection point, that intersection between Eastern and Western medicine and how we can use both systems to optimize our health care and get the best possible outcomes.
I started Houston Acupuncture because I wanted to fill a gap in our health care system. In Western medicine, we often measure things with numbers, labs, tests, x-rays, but how we’re feeling as patients doesn’t necessarily correlate with numbers all the time. The labs and the imaging, they don’t necessarily always explain our symptoms. I realized there’s a lot that we just don’t fully understand in Western medicine. And so I’ve been on a quest to find out if there are other systems that can help explain those gaps that we see in Western medicine. That’s what we talk about on this show and how Eastern medicine, how Chinese medicine fills that gap.
So for today’s show, we’re going to talk about migraine headaches, a condition that is incredibly common here in Houston. So many people have migraine headaches and it is really common all over the world. I’m going to give a short overview about migraine headaches from a Western perspective and then we’ll dive into a lot of commonly asked questions about migraines from an Eastern perspective and a lot of questions that patients oftentimes bring up to me in regards to migraines in Chinese medicine.
The first thing that we want to do is to actually define what a migraine is. A lot of people have headaches that they’ve been evaluated for and they might have never been formally diagnosed with a migraine, but they call what they have a migraine headache. It may or may not actually meet criteria for a migraine headache. There are some classic features that can help us distinguish what is a migraine and what is not a migraine. One key thing about migraines: they typically last anywhere from four hours to up to three days. If you have a brief headache that lasts a few minutes or is much shorter than that, it’s probably not a migraine headache.
Migraine headaches also tend to be located on one side of the head, either the left side or the right side, and they usually have a pulsing or throbbing type quality. They’re moderate to severe type headaches; they’re not mild headaches. They’re typically fairly painful and they can be accompanied by other symptoms like nausea, vomiting. You could have photophobia or phonophobia, which means that light bothers you or loud sounds bother you. A lot of times, patients with migraine headaches tend to want to go naturally to a quiet, dark room and just lay down without thinking about it. It’s just more comforting to them because light bothers them, sound bothers them, and those are typical symptoms that are associated with migraine headaches.
Some people also have what are known as auras. These are neurologic symptoms that come before the headache. It can be visual changes, sensory changes. Sometimes people might just have a funny sensation with their eyes. Sometimes people might smell something funny, or they might have a funny taste in their mouth. Some people also can have speech disturbances that happen before a migraine headache. When you have those kinds of symptoms that precede a migraine, we call that migraines with aura. In Western medicine, we used to think that migraines were caused by an increase and tightening of blood flow to the brain and changes in the blood flow. That theory is somewhat out of favor now. More current thinking about migraine headaches involves something called cortical spreading depression. That’s basically where there’s a wave of electrical and chemical activity that moves across the brain. That wave can irritate pain sensors in the brain, triggering migraine headaches. There’s still a lot of research in the area. It’s not completely known, but that’s the general direction science is pointing to.
Now, I don’t want to spend too much time on the Western side because there are a lot of resources that you can find online that go deep into that. I want to give you a brief summary of that, and now I would rather us move on to understanding migraines from a Chinese medicine perspective and how we approach migraines clinically in Chinese medicine.
Question one: How does Chinese medicine patterns explain the root cause of migraines? In Chinese medicine, the location of headaches actually has a lot of significance. We don’t place that much significance on the location of a headache in Western medicine. We do to a certain degree, but not as much as in Chinese medicine. The location of a headache gives a big clue as to what organ system might be causing the headache. In Chinese medicine, the vertex of the head, the very top part, is associated with the liver. If you tend to have headaches in the front, more along the forehead, that’s associated with the stomach meridian. If you have headaches on the side of your head on both sides laterally, that’s associated more with liver and gallbladder. Headaches towards the back are associated with the urinary bladder and the kidneys. Depending on where exactly the headache and the pain is located gives us a big clue as to what organ systems are involved in that.
When we talk about migraine headaches, they are typically one-sided, usually on the left side or the right side, and they’re usually associated with the liver and the gallbladder channels. There’s a strong correlation between liver and gallbladder problems and migraine headaches in Chinese medicine.
Question number two: Does acupuncture and herbal medicine actually work for migraines? The short answer is yes. I’m going to speak primarily from my own experience. In acupuncture and Chinese herbal medicine, really the goal of what we’re trying to do is help the internal organs restore their balance. It’s usually an imbalance in the internal organs that’s manifesting as the migraine headaches. In our clinic, when we treat the patients, we help restore the balance between the organs internally that helps to treat the migraines and really get to the underlying and root problem of the migraine, not just the symptoms.
Like I said earlier, in Western medicine, there’s not a clear rationale as to why migraine headaches occur. We used to think it was related to blood flow. Now, we think it’s more related to electrical and chemical activity. It’s still somewhat unclear. But in Chinese medicine, there’s a much more concrete rationale as to why people get migraine headaches. Like I said earlier, it’s related to the organ systems that are associated with different portions of the head and the brain. Oftentimes with migraine headaches, we’re looking at the liver, we’re looking at the gallbladder. From a physiological standpoint in Chinese medicine, it makes sense that acupuncture and herbal medicine can help because we’re able to address the underlying problem. From an anecdotal point of view, in my experience in my clinic, we have had good results and good experience for patients who are getting treatment for migraines. I’ve seen it help many people.
There have been different scientific studies done on acupuncture and Chinese medicine for migraine headaches. If you look at the scientific studies, the results are somewhat mixed. Some studies show benefits, some studies don’t show a lot of benefit. One of the weaknesses that I’ve noticed in a lot of the trials is that they try to study Chinese medicine using a Western framework. What I mean by that is they’ll take Chinese medicine, but they’ll put it in specific categorized treatment protocols that are standardized. When they do that, it eliminates one of the key important distinctions of Chinese medicine, which is the ability to differentiate diseases based on internal pathophysiology.
For example, if you have two patients who come in with migraine headaches, from a Chinese medicine perspective, they might need two completely different types of treatment, but in a lot of studies, they get standardized to receive the exact same treatment for both of the patients. They end up not being able to adequately treat the underlying problem. In Chinese medicine, the treatment options for migraine headaches could be myriad. There could be so many different types of problems that are being addressed when we treat patients. Even the same patients might need different treatments as their treatment course progresses. As their condition changes from the time they start treatment to later on down the line, their herbal regimen or their acupuncture regimen will change over time as well as they change, as their condition changes. Trying to put everybody into a one-size-fits-all treatment protocol just doesn’t work well in Chinese medicine.
The quality of the practitioner, the experience of the practitioner, makes a very big difference in Chinese medicine. It’s not like Western medicine where you can kind of follow a typical algorithm and you start with this medication, then you move to this medication, then you move to a stronger thing if nothing else works. Chinese medicine is very individualized. It’s very practitioner-dependent and that can make a huge difference in the results that you see. So it can be difficult to standardize those things in large clinical trials. But short answer is yes, Chinese medicine, acupuncture, and herbal medicine can help with migraine headaches.
Question number three: Can Chinese herbal medicine help reduce migraine frequency or severity? Yes, Chinese medicine can absolutely help reduce the frequency and the severity of migraine headaches. When you come to our clinic, that is the goal of our treatment. We’re trying to get your migraine headaches reduced or completely to go away. When you come see us for migraines, our aim is to reduce how often you get them, reduce how intense they are, and ideally eliminate them completely. Migraine headaches can be incredibly debilitating. They can keep people from being able to work. They can keep people from being able to participate in their family life, from doing the things that they enjoy doing. Our goal is to get your migraines under control when you come to our clinic—bring the severity down, bring the frequency down, try to eliminate it completely so that you can keep living your life, doing the things that you need to do.
A lot of patients come to see us because they want to get off their migraine medications or the medications that they’re taking just aren’t working for them. Whenever you come, wherever you’re starting from, when you come to our clinic, we’re going to see how frequent your headaches are, how severe they are, what medications you’re taking. As the treatment goes on, week by week, month by month, we’re monitoring how is the severity coming down, are you able to titrate down some of those medications, are you able to get off of any of your medications? We’re watching that as the treatment goes along. Even just getting it down a little bit for a lot of patients can make a huge difference in their life and their ability to function and their ability to do things.
For every patient that comes with migraines, usually at the first visit, I quantify a few things. I ask, “How often are you having migraines? How severe are the migraines?” Usually on a scale of 1 to 10. How do the migraines impact your life? What are they keeping you from doing? How much medications are you taking for your migraines? Which medications? How frequently? What strength? What dosage? How long do your migraine episodes last? How many migraine episodes do you have every year or every month or every week? As we go through our treatment process, we want to see all of those things come down. That’s our goal for all of our patients in my clinic.
Next question: How long does it take for acupuncture and herbs to improve migraines? This is a really common question. Most patients want to know at the first visit, how long should I expect to take? How long should I plan for treatment? Everyone’s a little bit different. My general approach is to tell patients to plan on giving the treatment at least about three months. That’s usually a good window to see meaningful change. My typical protocol for most patients with migraines is the first month I’m going to see you about weekly. During that time, we’re going to be making some of the biggest changes to your herbal formula and your acupuncture treatment that we’re going to go through. Usually after the first month, if we can get to a stable point, then we cut back to about every other week and we do that for the next couple months. Then we space it out even less based on how you’re doing. Hopefully by the time we get to about three to four months, we’re able to see that you’re making some steady progress and transition you to more maintenance type care.
We have patients who get better after the first treatment. We also have patients who it takes four, five, six months before they start seeing improvement. Everyone’s case is different. It doesn’t necessarily depend on how long you’ve had it, how short you’ve had it, how severe it is. It really has everything to do with how complex your case is internally. That’s not something that I can tell until I actually see you, talk to you, examine you, look at you, and come up with the diagnosis. It really has to do with how complex your case is from a Chinese medicine standpoint. We have patients who seem really complicated from a Western medicine standpoint, but from a Chinese medicine standpoint, their disease is actually fairly straightforward. And we have the vice versa—patients who might just complain of minor symptoms and things that we don’t think are a big deal in Western medicine, maybe just common sniffles or allergies. But then when I look at them from a Chinese medicine perspective, their physiology and their pathology is much more complex. It’s really individualized and we can only really know until I see you, until I evaluate you, until we really start the treatment process.
Next question: What’s the difference between Chinese medicine migraine pattern and a Western diagnosis of migraines? I talked a little bit about this earlier, but I’m going to spend a little bit more time on it because it’s really important for you guys to understand how we think about health and disease in Eastern medicine. In Western medicine, when you have a certain classic presentation of symptoms, we call that migraine headaches. Like I said, it’s on one side, it’s pulsing or throbbing, you have photophobia, phonophobia, all the classic symptoms. We’ll call that migraine headaches. But in Chinese medicine, just because two patients have the same set of symptoms doesn’t mean that the pathophysiology that’s causing all of that is exactly the same for those two patients.
For example, I could have five patients come into my clinic one morning with migraine headaches and they would have migraine headaches from five completely different causes. Earlier I talked about how oftentimes the liver is associated with migraine headaches. You can have other organs, not just the liver, but just taking the liver for example. I could have one patient come in with what we call heat in the liver. The next patient could come in with blood deficiency from the liver. The third patient might come in with a liver generating wind. The next patient might come in with Qi stagnation. Every single patient that’s coming in for migraine has a unique set of reasons that their body is acting the way it is and causing them to have migraine headaches. That’s a big difference between Eastern and Western medicine. In Western medicine, we’re grouping the disease based on the end symptoms. But in Eastern medicine, we’re really looking at what is the root cause that’s leading to these symptoms. Or to put it another way, in Western medicine, we tend to classify diseases based on their final outward manifestation, while in Eastern medicine, we classify diseases more by their root internal causes.
Next question: Can migraines be caused by emotional stress in Chinese medicine? Yes. A lot of patients ask this. A lot of our patients are in stressful environments, whether that be at home, at the workplace, many different things. At baseline, a lot of us are living in a stressful society and a lot of patients are concerned that the stress that they are having is contributing to their health problems. A lot of times patients can make a clear connection. Patients might notice that when they are stressed, their symptoms get worse, their migraines get worse. A lot of times they notice that when the stress goes away, their symptoms go away. So oftentimes, patients are able to make that connection, but not always. Sometimes it’s more convoluted than that. This applies to other diseases too, not just migraines. It could be affecting other diseases that people have and they notice a clear connection between stress and when they have flare-ups.
When it comes specifically to migraines, I usually ask patients as part of my standard questions for not just migraines, but all kinds of things. Do they notice any triggers? Anything that makes their symptoms worse, anything that’s going to make their problems worse? We’ll go through a lot of different triggers that patients commonly have. We’ll go through triggers like food, clothing, environment, seasonal changes, and stress is one of them that often comes up. I may not even ask about stress specifically, but patients bring it up as something that they have thought about as triggering their problems. Oftentimes for migraines, not always, I do see stress as a trigger for patients who are having migraine issues. A lot of them, even if they haven’t made that complete connection, they do respond that they have been under stress, they have experienced a lot of stress in their life either currently or in the past, and there was an association they felt with their migraines.
One of the reasons that this happens in Chinese medicine, again, has to do with the internal organs. In Chinese medicine, the different organs are associated with different emotions. For example, the liver is associated with worry and with stress. The lungs are associated with grief in Chinese medicine. The heart is associated with anger. The kidneys are associated with fear. The different emotions that we experience connect with different organs. When you are overburdened by a certain emotion, it tends to affect a different organ system. Oftentimes with migraine headaches, with liver association, we do see stress, we see worry. When you have severe stress or stress that’s just compounding over time or stress that you’ve been going through for years, it disrupts the smooth flow of Qi and blood in the body.
The liver is the organ that is responsible for the flow of Qi and blood throughout the body. When you have severe stress, it impacts the liver. It inhibits its ability. It prevents it from smoothly distributing the Qi and the blood throughout the body. You get what we call stagnation of the liver. You can have liver Qi stagnation, liver blood stagnation, and then what is happening is the blood and the Qi start accumulating. They start being constrained. They don’t flow throughout the body and this can then generate heat within the body and the heat will manifest itself and it’ll come out through migraine headaches. It’ll rise to the head. It can then cause pain and that’s the body’s way of releasing some of this pent-up constraint that’s happening within the liver system.
In my clinic, when I’m treating patients with migraine headaches, if stress is a big part of it, I do ask them what are the stresses. Are there ways that they can reduce the amount of stress in their life? Do they have options of things that they can change to either remove themselves from the stressful situations or reduce it in any way? We’re still going to treat them using acupuncture, herbal medicine, and we’re going to do our part, but depending on how severe it is. In my clinic, in addition to the acupuncture and herbal medicines that we provide as treatment, I do also talk to patients about things that they may be able to do in their personal life or in their work life to help reduce the amount of stress or anxiety that they’re experiencing because that can make a big impact on the treatment.
One thing that I’ve also noticed is that a lot of times as we start treating patients and as we start getting to their root problem, even if they don’t necessarily change from their stressful environment, we do see that they’re able to handle stress better. Maybe nothing necessarily changes, but because their health is improving and because their liver energy is flowing better, they’re more able to handle stressful situations that they previously were not able to handle, their capacity increases. That’s one thing that also is a benefit from getting treatment from Chinese medicine.
Okay guys, our last question for today. Are there specific Chinese herbal formulas used for migraines? The answer to this is yes and no. We don’t have a single one migraine pill you take. We don’t have a migraine formula that we use for all patients. If someone is trying to sell you a migraine pill, herbal composition, or some migraine formula specifically just for migraines in Chinese medicine, that’s wrong. They’re missing the entire principle of Chinese medicine and the process of individually diagnosing patients. But I can give you an example of a type of formula we may use in certain instances.
So I talked about liver disorders. Now let’s take an example of what I call liver Qi stagnation. The liver is not flowing and distributing the Qi of the body very well. If a patient has a liver Qi stagnation and they have migraine headaches, one common formula that is used is a formula called Chai Hu Shu Gan San. It contains Chai Hu—Chai is an herb which is commonly used for the liver and it goes to the liver and it helps to smooth and regulate the flow of Qi within the liver. A lot of times when we have patients that have had stress for years or compounded over time and it’s affecting the liver, it’s affecting the smooth flowing of the liver Qi, Chai Hu is a common herb that we use for that. Oftentimes for migraine headaches from this problem, we can use a formula like Chai Hu Shu Gan San. That’s one example of a formula that we might use. For most patients, we’re going to modify it to some degree. I don’t usually just give the same patent type of formula to everybody. Usually patients are going to have some unique attributes from one person to the next that we need to make small adjustments to. Even, like I said, over time their condition changes—even you as a single patient might have your condition change from one week to the next or one month to the next. So we have to keep making adjustments and keep tweaking it to make sure it’s specifically and uniquely addressing your individual scenario when you come see us.
But again, the key point is this: In Chinese medicine, if you come in with a migraine, we don’t just give you a migraine pill that’s a one-size-fits-all. It’s individualized. It has to be specific for your condition, and that’s the only way to treat the underlying root problem.
All right, everybody. I hope that gives you a little bit of information and understanding of how we treat migraine headaches at our clinic. It’s a different approach than what you might be accustomed to in Western medicine and in typical traditional Western clinics. Honestly, it’s even a lot different from a lot of acupuncture clinics and Chinese medical clinics. I hope this video helps to give you a brief understanding of just how I think about medical conditions and disease and how we treat our patients.
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