Calm™

TCM herbal formula based on Xiao Yao San (Rambling Powder) for stress, anxiety, irritability, and PMS — spreads Liver qi; nourishes Liver blood; clears heat; harmonizes middle jiao; calming; anxiolytic; analgesic; adaptogenic

⚠️ Calm is a qi-regulating formula — prolonged use (4–6 months) may cause qi deficiency in some patients. Those with stressful lifestyles who cannot be without Calm should also take a qi tonic formula such as GI Tonic or Cordyceps 3 at 1–2 capsules daily to maintain optimal qi levels. Contains Dang Gui (Radix Angelicae Sinensis), which invigorates blood circulation — patients on anticoagulant or antiplatelet therapies such as Coumadin (warfarin) should use with caution or not at all due to higher risk of bleeding and bruising.

CLINICAL APPLICATIONS

* Stress, anxiety, nervousness, restlessness

* General symptoms associated with stress such as poor appetite, headache, tension, and insomnia

* Premenstrual syndrome (PMS) with breast distension, irritability, and/or mood swings

Background: Stress is a normal physical and psychological reaction to the demands of life. When confronted with stress, the body responds with a burst of hormones — the "fight-or-flight" response. Once the stress is gone, the body is supposed to return to a normal relaxed state. Unfortunately, the nonstop stress of modern life often keeps the body in a constant stressed state. Over time, this leads to serious health problems affecting the brain (feelings and emotions), heart (hypertension, arrhythmia, atherosclerosis, coronary artery disease), muscles (stiffness and pain), stomach (acid reflux, peptic ulcer disease, irritable bowel syndrome), and immune system (weakened immune system, frequent infection). According to the Five-Elements Theory, the Liver is the most sensitive of all organs to emotional distress — stress and pressure easily lead to Liver qi stagnation, which can overact on the Spleen and Stomach (Wood overacting on Earth). The treatment protocol is to spread the Liver qi, harmonize the middle jiao, and nourish the blood.

Key herb-level clinical data:

— Chai Hu (Radix Bupleuri / Bupleurum): enters the Liver and disperses stagnant qi; calming effect on the brain — promotes relaxation and improves sleep; adaptogenic — helps manage mental stress; analgesic and anti-inflammatory (saikosaponins); antihyperlipidemic — lowers total cholesterol, LDL, and triglycerides; stimulates both humoral and cellular immunity

— Bai Shao (Radix Paeoniae Alba / White Peony): nourishes blood; softens the Liver; analgesic — treats hypochondriac distension (with Zhi Gan Cao); anti-inflammatory and spasmolytic (paeoniflorin, total glucosides of paeony); antihyperlipidemic — lowers total cholesterol, LDL, and triglycerides; clinically with Gan Cao: neck pain, acute back pain, sciatica, lower back and leg pain, leg cramps, restless leg syndrome, heel pain, gastric and abdominal pain, intestinal spasm, menstrual cramps, neuralgia, facial spasms and twitching, trigeminal neuralgia, and dysmenorrhea

— Dang Gui (Radix Angelicae Sinensis / Angelica Sinensis): nourishes blood; softens the Liver; analgesic and anti-inflammatory — potency comparable to or greater than aspirin (acetylsalicylic acid); cardiovascular — inhibitory influence on the heart followed by negative chronotropic and positive inotropic effects; antiarrhythmic against arrhythmia induced by epinephrine, cardiac glycosides, aconitine, and barium chloride; lowers plasma cholesterol and triglycerides; decreases atherosclerosis risk; improves blood circulation (blood viscosity↓, hemorrheological changes); immunostimulant — increases phagocytic activity of macrophages; clinically: low back and leg pain, vascular headache, migraine headache, general pain

— Bai Zhu (Rhizoma Atractylodis Macrocephalae / Atractylodes): strengthens the Spleen and Stomach to prevent Liver (Wood) overacting on Spleen and Stomach (Earth); adaptogenic — enhances duration and relieves restlessness under physical stress; dual effect to regulate the digestive tract — treats either constipation or diarrhea; anti-inflammatory via TNF-α↓ and nitric oxide↓; immunostimulant — increases macrophages, reticuloendothelial system activity, white blood cells, lymphocytes, and IgG

— Fu Ling (Poria): strengthens the Spleen and Stomach; adaptogenic — helps deal with physical stress

— Bo He (Herba Menthae / Mint): fragrant and acrid properties help disperse Liver qi stagnation

— Sheng Jiang (Rhizoma Zingiberis Recens / Fresh Ginger): fragrant and acrid properties help disperse Liver qi stagnation

— Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle / Honey-Prepared Licorice): analgesic — treats hypochondriac distension (with Bai Shao); gastroprotective — prevents and treats gastric and duodenal ulcers via inhibition of gastric acid secretion, binding and deactivation of gastric acid, and promotion of recovery from ulceration; clinically: 100 patients with gastric or duodenal ulcers treated with 90% effectiveness; antiarrhythmic — marked effectiveness treating palpitations and artificially-induced arrhythmia; positive cognitive effect — improves mental functions and ameliorates memory impairment (BACE1 inhibitor)

— Zhi Zi (Fructus Gardeniae / Gardenia): clears heat; reduces irritability and anger; calming effect on the brain — promotes relaxation and improves sleep; antihypertensive via stimulation of the parasympathetic nervous system; gastroprotective — acid-neutralizing, antioxidant, inhibits Helicobacter pylori, reverses ethanol-induced gastric lesions; anti-inflammatory via TNF-α↓ (vascular inflammation in endothelial cells)

— Mu Dan Pi (Cortex Moutan / Moutan Bark): clears heat; reduces irritability and anger

WESTERN THERAPEUTIC ACTIONS

* Calming / anxiolytic — Chai Hu (brain relaxation, sleep↑); Zhi Zi (brain calming, sleep↑, antihypertensive); Zhi Gan Cao (cognitive function↑, memory↑)

* Adaptogenic — Chai Hu; Bai Zhu (physical stress endurance↑); Fu Ling (physical stress relief)

* Analgesic / anti-inflammatory — Dang Gui (≥ aspirin potency); Bai Shao + Gan Cao (spasmolytic, 15+ clinical pain conditions); Chai Hu (saikosaponins); Bai Zhu (TNF-α↓, NO↓); Zhi Zi (TNF-α↓)

* Cardiovascular — Dang Gui (antiarrhythmic, cholesterol↓, triglycerides↓, atherosclerosis↓); Zhi Gan Cao (antiarrhythmic, palpitations); Bai Shao + Chai Hu (antihyperlipidemic)

* Gastroprotective — Zhi Gan Cao (ulcers, gastric acid↓); Zhi Zi (gastritis, H. pylori↓); Bai Zhu (constipation/diarrhea dual regulation)

* Immunostimulant — Chai Hu (humoral + cellular immunity); Dang Gui (macrophages↑); Bai Zhu (WBC↑, lymphocytes↑, IgG↑)

CHINESE THERAPEUTIC ACTIONS

* Spreads Liver qi (Chai Hu, Bo He, Sheng Jiang)

* Nourishes Liver blood (Bai Shao, Dang Gui)

* Clears heat; reduces irritability and anger (Zhi Zi, Mu Dan Pi)

* Harmonizes middle jiao; strengthens Spleen and Stomach (Bai Zhu, Fu Ling, Zhi Gan Cao)

DOSAGE

Standard: 3–4 capsules three times daily on an empty stomach with warm water. Dosage may be increased to 6–8 capsules three times daily if necessary to alleviate symptoms for a few days. Once stabilized, reduce back to 3–4 capsules three times daily.

Supplementary formulas: Stomach pain, heartburn, gastric and duodenal ulcers — add GI Care. Severe emotional disturbance with anger, neurosis, or insomnia — use Calm (ES). Stress, anxiety, and insomnia in patients with deficiency — use Calm ZZZ. Constant worrying with excessive dreams — combine with Schisandra ZZZ. Hypertension — combine with Gastrodia Complex or Gentiana Complex. Depression — add Shine or Shine (DS). Hot flashes and night sweating during menopause — add Balance (Heat). Lack of vaginal lubrication during menopause — add Balance Spring. Infertility due to stress — use Blossom (Phase 1–4). Prolonged Liver qi stagnation causing benign breast lumps, breast tumor, or mastitis — use Resolve (Upper). Dysmenorrhea — add Mense-Ease. Hyperthyroidism — add Thyrodex. Acute headache — add Corydalin (AC). Chronic headache — add Corydalin (CR). ADD/ADHD — add Calm (Jr). Irritable bowel syndrome (IBS) due to stress — add GI Harmony. Ulcerative colitis due to stress — add GI Care (UC). Excess heat — add Gardenia Complex. Blood stagnation — add Circulation (SJ). Stress- or hormonal-related acne — add Dermatrol (Clear).

Nutrition: A diet high in calcium, magnesium, phosphorus, potassium, and vitamins B and E is recommended — these nutrients are easily depleted by stress. Encourage consumption of apricots, winter melon, asparagus, avocados, bananas, broccoli, brown rice, dried fruit, figs, salmon, garlic, green leafy vegetables, and soy products. Avoid all sugars (cake, desserts, candy, chocolate, soda, canned juice, soft drinks, caffeinated drinks, stevia, agave, xylitol, corn syrup). Avoid fermented foods (cheese, fermented tofu) and dairy (milk, cream, yogurt, cheese, ice cream). Avoid warm/hot natured foods that damage qi and yin: heat-producing fruits (mango, durian), stimulants (coffee, alcohol, energy drinks), and spicy/pungent/aromatic vegetables (pepper, garlic, onions, basil, rosemary, cumin, fennel, anise, leeks, chives, scallions, thyme, saffron, wormwood, mustard, chili, wasabi). Avoid artificial coloring and processed meats (lunch meats, hot dogs, sausages) — nitrites are linked to inflammation and chronic disease.

Tao of Nutrition (Dr. Maoshing Ni and Cathy McNease):

— PMS: At least one week prior to the usual onset of PMS symptoms, consume ginger, green onions, fennel, orange peel, spinach, walnuts, hawthorn berries, cinnamon, black pepper, and Chinese date. Avoid cold foods, raw foods, excessive fruits, vinegar, all shellfish, coffee, stimulants, sugar, dairy products, and smoking.

— Restlessness and emotional instability: Make a tea of wheat bran, licorice root, and dates. Drink three times daily until symptoms are relieved.

Lifestyle: Regular exercise, adequate rest, and normal sleep patterns are beneficial for stress reduction. Relax the mind and body through meditation, yoga, breathing exercises, imagery exercises, tai chi chuan, and qi gong. Get away from the daily routine to do something different and enjoyable whenever possible — laughter really is the best medicine. Noise greater than 65 decibels can cause psychological disturbance; greater than 90 decibels can cause emotional damage; greater than 120 decibels can cause nervous system and hearing damage. Shift outlook on life and look at changes as challenges rather than threats.

CASE STUDIES

— 74-year-old female (B.C.): Insomnia, irritability, neck and shoulder tension; overweight; drank vodka nightly; Liver qi stagnation. Calm 4 capsules 3x/day. Result: able to relax and sleep easier; neck and shoulders much looser.

— 42-year-old female (S.P.): Insomnia and restlessness; Type A personality; Liver depression affecting the Heart. Calm. Result: restlessness and emotions decreased; more balanced through the day; slept better at night; less desire to clean the house at night.

— 55-year-old female (S.S.): Menopause — hot flashes 10x/day, irritability, difficulty staying asleep; on sleeping aids causing grogginess; arthritis in thumbs, constant throat clearing, acid reflux; BP 120/80, HR 78; yin deficiency and Liver qi stagnation. Balance (Heat) 3 capsules 3x/day + Calm 3 capsules 3x/day. Result: less irritable; no more hot flashes; sleep improved; sleeping aids only occasionally needed; acid reflux improved.

— 32-year-old male (S.F.): Stress, anger, irritability; Liver qi stagnation. Calm up to 8 capsules as needed. Result after 2 bottles: less stressed, decreased anger; calmer when taking herbs.

— 57-year-old female (J.C.): Nervousness, insomnia, anxiety, desire to stop smoking, night sweats; red tongue with no coating; Kidney yin deficiency with heat and Liver qi stagnation; menopause and hypothyroidism (Western). Calm + Shine + Nourish (Nourish daily; Shine and Calm as needed). Result after 6 months: improved sleep; calmer and more balanced overall with positive attitude.

— 27-year-old female (S.T.): PMS — severe cramping and moodiness; choppy pulse, purple tongue; Liver qi and blood stagnation. Mense-Ease 4–6 capsules 3x/day + Calm as needed. Result after 1 cycle: less menstrual pain, less cramping and moodiness; Calm had immediate effectiveness.

— 36-year-old female (L.S.): Tight upper back muscles, neck tension, fatigue; very stressful job; easily irritated; no patience; knots in upper back, stiff neck with limited range of motion; Liver qi stagnation. Calm 3 capsules/day for 1 week. Result: much more at ease; able to handle stress at home and work; overall tension lifted; muscles more relaxed.

— 52-year-old female (S.M.): Irritability, easily stressed; red tongue with peeled coating; Liver qi stagnation. Calm 3 capsules 3x/day + acupuncture 2–3x/week. Result after 2 days: much calmer and not as angry.

— 42-year-old female (S.F.): GI disorder — diarrhea with extreme urgency, worse with stress; wiry thready pulse, red tongue with long center crack, dark circles under eyes; Liver overacting on Spleen. GI Harmony + Calm. Result: well-formed bowel movements; also avoided caffeine and went to bed before 11 PM.

— 18-year-old male (D.H.): Stress and anxiety from feeling overwhelmed; wiry pulse, reddish purple tongue; Liver blood and qi stagnation. Calm 3–8 capsules 3x/day + counseling. Result after 1 week: less stressed, less anxiety.

— 35-year-old male manager: Stress, anxiety, anger; rapid pulse, red face; Liver qi stagnation and Liver yang rising. Calm 4 capsules 2x/day. Result: significant improvement noted by patient and wife; regression when not taking herbs; felt "less control of life" without them.

— 27-year-old female restaurant cook: Stress from new job and relationship problems; unable to relax; purple tongue, wiry pulse; Liver qi stagnation. Calm for 2 weeks. Result: condition improved tremendously; stress unchanged but felt more relaxed.

— 40-year-old housewife: Migraines, stress, poor sleep; woke frequently; stress-related headaches for years; Liver qi stagnation with heat rising. Calm for 4 weeks + Corydalin (AC) for headaches. Result at 2 weeks: headaches less severe and less frequent. At 4 weeks: headaches very mild and under control; no longer needed Western medications; calmer, sleeping better, less stressed.

— 38-year-old female administrator: Insomnia and TMJ; Liver fire rising, Kidney and Heart not communicating, depression; had not slept the night before; nervous; jawbone pain from clenched jaw. Calm 3 capsules 3x/day + acupuncture. Result at 2nd treatment: much calmer and more relaxed; effective for depression, anxiety, and Liver fire symptoms.

— 42-year-old female (S.C.): Stress from domestic situations — constipation, bloating, neck tension, insomnia, anorexia, fatigue, tearfulness, sadness; pale scalloped tongue with midline crack, soft soggy pulse; depressive disorder (Western); Liver qi stagnation. Calm 3 capsules 3x/day. Result: much better; voice more animated; more character in face; more shine in eyes; neck tension, insomnia, constipation, and sadness gone.

— 41-year-old female (M.M.): "Adrenaline-rush" sensations — heat flushes to face, mood swings, anxiety; red and purple tongue, red face; stress-related anxiety attack (Western); Liver stagnation and yin deficiency. Calm 2 capsules 3x/day + Balance (Heat) 2 capsules 3x/day. Result: calmer affect and personality; "feeling good"; increased energy; sound sleep.

— 37-year-old female (L.A.): Insomnia — difficulty falling and staying asleep; neck and shoulder stiffness, TMJ pain, heavy menstrual flow with clots; marital problems; seeing psychotherapist; BP 123/86, HR 88; salmon pink moist tongue with fissures, swollen with red tip, slippery thin pulse; Spleen qi and Heart blood deficiencies with Liver qi stagnation. Calm. Result: tension eased; sleep improved slightly; TMJ resolved after 8 acupuncture treatments. After 2 months, Schisandra ZZZ added — slept through the night much more soundly.

— Female (unnamed): Stress, irritability, PMS, loose stool, crying for no reason, muscle tension, nervous trembling in hands; felt overwhelmed and worried incessantly; BP 115/75, HR 87; pink tongue with red tip and thin white coating, wiry left pulse, slippery right pulse; Spleen qi deficiency with Liver qi stagnation. Calm 3 capsules 3x/day the week before period. Result: immediate response — "nerves" calmed, stomach settled, felt more emotionally stable.

— 45-year-old female (D.S.): Insomnia, mood swings, cramps, fatigue; slightly purplish pale tongue with teeth marks, thin white coating, deep wiry pulse; Spleen qi and blood deficiency. Nourish + Calm + Schisandra ZZZ. Result: sleep improved; moods balanced; energy increased.

— 36-year-old female: Long history of anxiety, irritability, insomnia, mood swings, dream-disturbed sleep; slow full wiry pulse, red tongue tip and sides; Liver qi stagnation. Calm 3 capsules 3x/day. Result: subtle mood changes — not as irritable; able to focus on work and maintain higher productivity; slept better without disturbing dreams.

— 44-year-old female (J.W.): Infertility and history of miscarriage; high stress "bottled up" inside; cold hands and feet; back pain, low energy, severe menstrual cramps, PMS; pale purplish swollen tongue with teeth marks and red tip, wiry slippery pulse; BP 125/86, HR 83; low FSH; Spleen and Kidney yang deficiencies with Liver qi and blood stagnation. Menatrol then Calm. Result on Calm: stress level decreased within 1 week; energy increased; tongue color changed from purple to pink and slightly dusky; actively trying to conceive naturally.

— 32-year-old female (E.P.): 2½-year history of vertigo with insomnia, palpitations, anxiety, nausea; IBS with alternating diarrhea and constipation; unsteady gait; unable to drive; anxiety disorder (Western); Liver fire. Calm + Gentiana Complex 2 capsules each 3x/day (increased to 3 capsules each). Result at 3 weeks: IBS resolved; Gentiana Complex discontinued. At 6th treatment: all symptoms improved. At 15th visit: Calm switched to Schisandra ZZZ — sleep improved from 5–6 hours interrupted to 6–7 hours uninterrupted.

Related Reading

Also see: Calm (ES) – for severe emotional disturbance, anger, neurosis, or insomnia | Calm ZZZ – for stress, anxiety, and insomnia with deficiency | Schisandra ZZZ – for constant worrying and excessive dreams | Shine – for depression | Gastrodia Complex – for hypertension | Gentiana Complex – for hypertension with Liver fire | Mense-Ease – for dysmenorrhea and PMS cramping | Balance (Heat) – for menopausal hot flashes and night sweating | GI Care – for stomach pain, heartburn, and ulcers | GI Harmony – for IBS due to stress | Corydalin (AC) – for acute headache | Resolve (Upper) – for benign breast lumps from Liver qi stagnation | Blossom (Phase 1–4) – for infertility due to stress | Gardenia Complex – for excess heat | Stress & Sleep Collection.