Circulation™

TCM herbal formula for cardiovascular and circulatory disorders with decreased blood flow to the heart — vasodilating; cardiotonic; antiplatelet; anticoagulant; antihyperlipidemic; invigorates blood circulation in the upper jiao; eliminates blood stasis; warms Heart yang; dispels damp and phlegm; unblocks meridians; relieves pain

⚠️ DO NOT use this formula to treat acute myocardial infarction — acute heart attack is a medical emergency; call 911 immediately. This formula is for maintenance of cardiovascular and circulatory health, not crisis management. Contraindicated during pregnancy and nursing. Contains Dang Gui (Radix Angelicae Sinensis) and Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) — patients on anticoagulant or antiplatelet therapies such as Coumadin (warfarin) should use with caution or not at all. Patients on Coumadin (warfarin) should not fluctuate daily consumption of vitamin K (found in alfalfa, cauliflower, liver, and dark green vegetables including broccoli and spinach). Maintenance treatment of approximately 6 months is necessary to stabilize the condition.

CLINICAL APPLICATIONS

* Cardiovascular disorders: coronary heart disease, angina pectoris, ischemia, and atherosclerosis

* Circulatory disorders: poor cerebral and body circulation, numbness of the limbs, peripheral neuropathy, and similar problems

Background: Heart disease is the number one cause of death in the United States (CDC, 2012). It refers to diseases involving the heart and/or blood vessels — coronary heart disease and atherosclerosis. Risk factors include hypercholesterolemia, hypertension, obesity, smoking, and physical inactivity. As a result, blood flow to the heart is impaired, leading to ischemia, angina, and in severe cases, myocardial infarction and sudden death. Proper management requires integration of preventative and treatment measures: lifestyle changes, diet modifications, and medical intervention.

TCM differentiation: Cardiovascular and circulatory disorders are characterized by Heart yang deficiency with blood stagnation and damp and phlegm accumulation. Treatment focuses on warming Heart yang, dissolving damp, eliminating phlegm, and invigorating blood circulation. Herbs with vasodilating effects allow blood to flow smoothly with decreased resistance; cardiotonic herbs enable blood to reach peripheral parts of the body; antiplatelet and anticoagulant herbs prevent blood clot formation; antihyperlipidemic herbs address atherosclerosis.

Key herb-level clinical data:

— Ren Shen (Radix et Rhizoma Ginseng / Chinese Ginseng): replenishes vital qi; mimics effect of cardiac glycosides — makes the heart beat stronger and more rhythmically; antihyperlipidemic — 6g/day for 8 weeks: HDL↑, total cholesterol↓, triglycerides↓, LDL↓, plasma malondialdehyde (MDA)↓

— Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae / Salvia / Red Sage Root): antiplatelet, anticoagulant, and thrombolytic effects; one of the most effective herbs to improve blood circulation; improves microcirculation; strengthens myocardial contraction; adjusts heart rate; clinical study 1: effective in treating 323 patients with coronary artery disease; clinical study 2: Dan Shen + Ge Gen effectively treated 100 consecutive coronary patients (mean age 58 ± 8 years); clinical study 3: formula with Dang Gui + Chuan Xiong + Xie Bai + Dan Shen and others — 99.06% effective rate in 106 patients with ischemic heart disease; caution with anticoagulants

— Mao Dong Qing (Radix Ilicis Pubescentis / Pubescent Holly Root / Ilex Pubescens): marked vasodilating effect — dilates blood vessels and increases blood perfusion to coronary arteries; lowers blood pressure; reduces oxygen consumption of cardiac muscles; clinically effective for coronary artery disease and ischemic stroke

— Bai Shao (Radix Paeoniae Alba / White Peony Root): vasodilating — marked action to dilate aorta and peripheral blood vessels; slight decrease in blood pressure; antihyperlipidemic — paeoniflorin significantly lowers total cholesterol, LDL, and triglycerides vs. control group; nourishes blood; relieves pain

— Chuan Xiong (Rhizoma Chuanxiong / Ligusticum / Sichuan Lovage): vasodilating — dilates blood vessels, lowers blood pressure, increases blood perfusion to coronary arteries, decreases cardiac oxygen consumption; antiplatelet — marked inhibition of thrombus formation and platelet aggregation in a dose-dependent manner; clinically used for angina, coronary artery disease, cerebral embolism, and ischemic stroke

— Dang Gui (Radix Angelicae Sinensis / Angelica Sinensis / Dong Quai): positive inotropic effect — strengthens cardiac contraction and improves overall blood circulation; antiplatelet — significant antiplatelet effect similar to aspirin; invigorates blood circulation; dispels blood stasis; caution with anticoagulants

— Xie Bai (Bulbus Allii Macrostemonis / Chinese Chive Bulb / Macrostem Onion): disperses painful obstructions due to turbid-phlegm congealing in the chest; warms and facilitates flow of yang qi in the chest; antiplatelet — markedly inhibits platelet aggregation and prevents clotting; antihyperlipidemic — marked effectiveness to lower plasma cholesterol and triglycerides

— Gui Zhi (Ramulus Cinnamomi / Cinnamon Twig): warms and facilitates flow of yang qi in the chest; promotes peripheral blood circulation; unblocks stagnation in channels and collaterals; channel-guiding herb

— Ge Gen (Radix Puerariae Lobatae / Kudzu Root / Pueraria): vasodilating — dilates blood vessels to lower blood pressure; clinical study: Dan Shen + Ge Gen effectively treated 100 consecutive coronary patients

— Hong Hua (Flos Carthami / Safflower): invigorates general blood circulation; dispels blood stasis

— Jiang Xiang (Lignum Dalbergiae Odoriferae / Rosewood / Dalbergia): invigorates general blood circulation; dispels blood stasis; relieves pain

— Hou Po (Cortex Magnoliae Officinalis / Magnolia Bark): antiatherosclerotic — marked effect to prevent and treat atherosclerosis by lowering plasma lipids, decreasing arterial lesions, and suppressing aortic oxidative stress (free radical↓, malondialdehyde↓, oxidative DNA damage↓); regulates qi; expands chest; relieves congestion

— Sha Ren (Fructus Amomi / Cardamom / Amomum): regulates qi; dissolves dampness

— Zhi Shi (Fructus Aurantii Immaturus / Immature Bitter Orange): regulates qi; expands chest; relieves congestion

WESTERN THERAPEUTIC ACTIONS

* Vasodilating — Bai Shao (aorta and peripheral vessels↑, BP↓); Chuan Xiong (coronary perfusion↑, cardiac O₂↓, BP↓); Mao Dong Qing (coronary perfusion↑, BP↓, cardiac O₂↓); Ge Gen (BP↓)

* Cardiotonic — Ren Shen (cardiac glycoside-like, stronger and more rhythmic heartbeat); Dang Gui (positive inotropic, cardiac contraction↑)

* Antiplatelet / anticoagulant / thrombolytic — Dan Shen (antiplatelet + anticoagulant + thrombolytic); Dang Gui (antiplatelet, comparable to aspirin); Chuan Xiong (thrombus↓, platelet aggregation↓, dose-dependent); Xie Bai (platelet aggregation↓, clotting↓)

* Antihyperlipidemic — Bai Shao (paeoniflorin: cholesterol↓, LDL↓, triglycerides↓); Ren Shen (HDL↑, cholesterol↓, triglycerides↓, LDL↓, MDA↓); Xie Bai (cholesterol↓, triglycerides↓); Hou Po (plasma lipids↓, arterial lesions↓, aortic oxidative stress↓)

* Antiatherosclerotic — Hou Po (plasma lipids↓, arterial lesions↓, free radical↓, MDA↓, oxidative DNA damage↓)

* Clinical formula studies — Dan Shen: 323 coronary artery disease patients; Dan Shen + Ge Gen: 100 consecutive coronary patients (mean age 58); Dang Gui + Chuan Xiong + Xie Bai + Dan Shen: 99.06% effective / 106 ischemic heart disease patients; Mao Dong Qing: coronary artery disease and ischemic stroke; Chuan Xiong: angina, coronary artery disease, cerebral embolism, ischemic stroke

CHINESE THERAPEUTIC ACTIONS

* Replenishes vital qi; strengthens Heart (Ren Shen)

* Invigorates blood circulation in the upper jiao; eliminates blood stasis (Dan Shen, Hong Hua, Dang Gui, Jiang Xiang, Chuan Xiong)

* Warms Heart yang; facilitates flow of yang qi in the chest (Xie Bai, Gui Zhi)

* Disperses turbid-phlegm congealing in the chest (Xie Bai)

* Promotes peripheral blood circulation; unblocks channels and collaterals (Gui Zhi)

* Nourishes blood; relieves pain (Bai Shao)

* Regulates qi; dissolves dampness; expands chest; relieves congestion (Sha Ren, Zhi Shi, Hou Po)

DOSAGE

Standard: 2–4 capsules three times daily on an empty stomach with warm water. Take daily for maintenance of cardiovascular and circulatory health. Maintenance treatment of approximately 6 months is necessary to stabilize the condition. Do NOT use to treat acute myocardial infarction.

Preventative: Patients with high risk of cardiovascular disorders may benefit from preventative treatment at low doses. Risk factors include family history, obesity, sedentary lifestyle, and cigarette smoking.

Supplementary formulas: Cardiovascular or circulatory disorders affecting the entire body — add Circulation (SJ). Hypertension with dizziness or vertigo — add Gastrodia Complex. Hypertension with anger or flushed face — add Gentiana Complex. Edema and water accumulation — add Herbal DRX. High cholesterol and triglycerides — add Cholisma. High cholesterol and triglycerides with fatty liver and obesity — add Cholisma (ES). Diabetes mellitus — add Equilibrium. Obesity — add Herbalite. Excess heat accumulation — add Gardenia Complex. Excess damp/phlegm — add Pinellia Complex.

Nutrition: Eat foods high in fiber (fruits and vegetables) and low in fat and cholesterol. Avoid sweets, chips, fried and greasy foods, junk foods, ice cream, and alcohol. Avoid smoking and second-hand smoke. Increase garlic and onions — reduce serum cholesterol. Beneficial foods: raw nuts (except peanuts), olive oil, pink salmon, trout, tuna, Atlantic herring, and mackerel — rich in essential fatty acids. Eliminate sodium, MSG, baking soda, canned vegetables, diet soft drinks, preservatives, meat tenderizers, saccharin, and softened water. Increase niacin — lowers total cholesterol by up to 18%, increases HDL by up to 32%, lowers triglycerides by up to 26% (slow-release form preferred). Other beneficial supplements: vitamin B5, vitamin C, vitamin E, chromium picolinate, lecithin, and coenzyme Q10. Allow 2–3 hours between the last meal and bedtime.

Tao of Nutrition — Coronary heart disease (Dr. Maoshing Ni and Cathy McNease): Increase: American ginseng, brown rice, black fungus, sea cucumber, vinegar, shiitake mushrooms, celery, seaweed, lotus root, cassia seeds, jellyfish, chrysanthemums, hawthorn berries, water chestnuts, mung beans, pearl barley, peach kernels, ginger, soy sprouts, mung sprouts, other sprouts, wheat bran, persimmons, bananas, watermelon, sunflower seeds, and lotus seeds. Avoid: fatty foods, stimulating foods, spicy foods, coffee, smoking, alcohol, simple carbohydrates (sugar and white flour), salt, stress, tension, worrying, emotional stimulation, and lack of sleep.

Lifestyle: Exercise — keeps blood vessels elastic, flexible, and unclogged. Avoid alcohol and tobacco — increase cholesterol buildup and hardening of arteries. Healthy diet and lifestyle changes can reverse arteriosclerosis and its complications — must be applied daily and continuously for a long time without interruptions.

CASE STUDIES

— W.Y., 62-year-old male: Insomnia from stress and anxiety; waking 2–3 times per night; red cheeks and purple lips; blood stagnation with Liver fire. Circulation 2 caps 2x daily + Calm (ES) 2 caps 2x daily. Result at 1 week: sleep improved to waking only once per night. Dosage of Circulation increased due to persistent blue legs.

— 58-year-old male: Chest oppression; dry unproductive cough; hand and periorbital swelling; pain at Dabao (SP 21) during movement; bright red blood in stool; epistaxis; abdominal bloating; tremors on slight exertion; swollen pale scalloped wet tongue with thin coat and red tip; superficial forceful pulse; phlegm retention in Heart with Spleen qi and Heart blood deficiency. Circulation 1 cap 2x daily + Gui Pi Tang 2 caps 2x daily + special formula 1 cap daily + Cactus Comp as needed + magnet 10,000 gs at site of discomfort nightly. Long-term protocol.

— F.L., 53-year-old female: Recent TIA (transient ischemic attack); right-sided facial pulling and numbness; difficulty smiling and closing right eye; drooping of right facial muscles; partial facial flaccidity. Circulation 3 caps 3x daily. Result: no recurring TIA episodes at subsequent follow-up visits. Concurrent constipation with hard stools, abdominal pain, cramps, and bloating resolved with Gentle Lax (Deficient) 4 caps 3x daily.

Related Reading

Also see: Circulation (SJ) – for cardiovascular and circulatory disorders affecting the entire body | Cholisma – for high cholesterol and triglycerides | Cholisma (ES) – for high cholesterol with fatty liver and obesity | Gastrodia Complex – for hypertension with dizziness | Gentiana Complex – for hypertension with anger or flushed face | Equilibrium – for diabetes mellitus | Herbalite – for obesity | Herbal DRX – for edema | Gardenia Complex – for excess heat | Pinellia Complex – for excess damp and phlegm | Cardiovascular & Blood Pressure Support Collection | Heart & Cardiovascular Health Collection.