Liver Yang Rising

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At a glance

Key attributes

Chinese name: 肝阳上亢      Pinyin name: Gān Yáng Shàng Kàng

Pattern nature: Full/Empty

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 two 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

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: Nutritive tonic for the Liver and Kidney Yin Essence (nourishes the parasympathetic nervous system).

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.

Read more about Liu Wei Di Huang Wan

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 Kidney and Liver Yin Deficiency or Liver Yin Deficiency.

Read more about Qi Ju Di Huang Wan

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.

Read more about Ling Jiao Gou Teng Tang

Tian Ma Gou Teng Yin

Source date: 1958 AD

Number of ingredients: 11 herbs

Key actions: Calms the Liver. Extinguishes wind. Invigorates the blood. Clears heat. Tonifies the Liver and Kidneys.

Formula summary

Tian Ma Gou Teng Yin is a 11-ingredient Chinese Medicine formula. Invented in 1958 AD, it belongs to the category of formulas that pacify and extinguish Internal Wind.

Besides Liver Yang Rising, Tian Ma Gou Teng Yin is also used to treat Liver Wind agitating Internally due to extreme Heat or Liver Wind agitating Internally due to Liver Yang Rising.

Read more about Tian Ma Gou Teng Yin

Da Chai Hu Tang

Source date: 220 AD

Number of ingredients: 8 herbs

Key actions: Harmonizes and releases the Lesser Yang. Drains internal clumping due to Heat.

Formula summary

Da Chai Hu Tang is a 8-ingredient Chinese Medicine formula.

Read more about Da Chai Hu Tang

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 Fire Blazing

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.