(251) Side Effects of Tonics

[HB KIM]

Q:   I diagnosed a patient with Yin deficiency and administered a Yin tonic formula.  The patient feels heavy and tired and wants to sleep a lot since she started taking this formula a few days ago.  As I understand it, tonics should give more energy, so it seems contradictory that the patient feels more fatigued.  Can you explain this?  Could this be a healing crisis phenomenon?  Or does this mean that my diagnosis was wrong?

A:   If using Yin or Blood tonics possibly causes slight heavy feeling in the body and maybe even slight tiredness, this could mean that body is "working overtime" metabolizing the herbs and creating the Yin and body fluids.  Patients may experience more sleepiness and calmness while taking the herbs.  On the other hand, using Yang or Qi tonics will cause the patient to feel more energetic, wake earlier in the morning and be more active, while decreasing fatigue.

Overuse of Yin/Blood tonics will create an overly heavy feeling and somnolence.  This is considered a side effect.  Overuse of Yang/Qi tonics will result in headache, dry mouth and red eyes.  In addition they may have problems falling asleep or waking too early in the morning.

Yang tonics supplement Yang and create a physiological, metabolic, and emotional Yang state in the body.  Vice versa, Yin tonics supplement Yin and create a physiological, metabolic, and emotional Yin condition in the body.

If a child is hyperactive or irritable, using an appropriately modified Liu Wei Di Huang Wan can help to balance the Yin-Yang state of the body.  If an elderly person feels heavy and fatigued, using an appropriately modified Bu Zhong Yi Qi Tang + Lu Rong can help to balance the Yin-Yang state of the body.

Of course, the diagnosis is very important.  If, for example, the patient had a Damp condition, using Yin tonics could exaggerate those Damp symptoms.  In general, Yin tonics are contraindicated for Yang deficiency or Damp/Phlegm conditions; Yang tonics are generally contraindicated for Yin deficiency with heat signs or Heat.  The most effective formulas are delicate combinations of both, administered in the context of the correct diagnosis.