1. TCVM Geriatric Food Therapy
Roger Clemmons, DV, PhD, CVA, CVFT, ACVIM (neurology)
Gainesville, fl

2. What is aging?
“ At age 50 years old, the liver starts to decline, the lobe of the liver starts to become thinning and eyes start unclearness.
At age 60 years old, the heart Qi starts to decline causing worry and sadness, Qi and blood is sluggish and weakness causing favor in lying down.
At age 70 years old, the spleen Qi is deficient and the skin desiccates and withers.
At age 80 years old, the lung Qi debilitates, the corporeal soul (po) is gone causing error during talk.
At age 90 years old, the kidney Qi parches, all other four zang organs and channels are exhausted”
Huang Di Nei Jing
The Yellow Emperor’s Classic of Internal Medicine

3. TCVM Geriatric Medicine & Aging
Jing Deficiency
Zang‐fu organ function declines with age
Kidney is ruler of prenatal essence
SP/ST is the origin of post‐heaven Qi
Generalized
Qi Deficiency Blood
Qi stagnation/stasis

4. TCVM Geriatric Medicine & Aging
Combination of excess and deficiency
Deficiency: mostly Qi deficiency, then Yin Yang
Excess: mostly stagnation and phlegm
Zang‐Fu Qi activities
Heart: ability to circulate blood
Lung: respiratory actions to inhale/exhale
Kidney: ability to pull air down from lung, reproductive ability, bone growth and metabolism control of sphincters (urinary/fecal)
Yang ability to warm the body as it declines (late stage)

5. What age is considered old?
Small/Medium breeds: dogs 7‐10 years and older
Large to Giant Breeds: 5‐7 years and older
Cats:7‐10 years and older
Chronic illness or Jing deficiency can make animals age before their time
Signs of illness or disease may be subtle or just energetic disharmony prior to clinical symptoms
Multiple disharmonies or imbalances can occur at the same time

6. TCVM Geriatric Medicine & Aging
Qi Deficiency: LU, HT, SP, Kid
General weakness
Exercise intolerance
Decreased appetite, anorexia
Muscle atrophy
Loose stool or too frequent defecation/ urination
Urinary or fecal incontinence
Dyspnea
Tongue: pale, wet, thick
Pulse: weak, thin

7. TCVM Geriatric Medicine & Aging
Yin Deficiency: LU, HT, LIV, KID
Panting
Cool seeking
Thirsty
Dry signs: eyes, mouth, skin, fur, nails
Small/ fine flake dander
Mental anguish (Heart Yin)
Leads to Yang deficiency when fluid is consumed
Tongue: red, may have coating
Pulse: thin, wiry, or choppy

8. TCVM Geriatric Medicine & Aging
Ya ng Deficiency: Generalized
Warm seeking
Cold back
Lethargy
Food stagnation/ stasis
Edema
Tongue: pale, wet
Pulses: deep, weak (R<L)

9. TCVM Geriatric Medicine & Aging
Stagnation
Sleep more, less active
Difficulty getting up, painful
Anxious, confused, unaware
Vomiting or constipation
Tongue: dark, purple
Pulse: fast, wiry

10. TCVM Geriatric Medicine & Aging
Blood Deficiency: SP, LIV, Kid
Chronic stagnation, Qi deficiency, Yin deficiency
Dull, dry fur coat with thick flake dander
Pale and dry pads and nails
Anxiety, depression, insomnia, poor memory
Muscle tremors
Tongue: pale, dry, thin
Pulse: deep, weak (L<R), choppy

11. TCVM Geriatric Medicine & Aging
Phlegm
Substantial
Secondary excess pathogen in the lungs
Mass, growth, nodules
Non‐substantial
Physical‐ lymphadenopathy, arthritis, joint deformity
In Channels‐ numbness, tingling, dysfunction
In Heart‐ anxiety, depression, crazy in the mind mansion
In GB/ KID‐ stones (Kidney, Bladder)
Tongue: thick, greasy, white coating (thin or thick)
Pulse: slippery

12. TCVM Geriatric Medicine & Aging
Vital birth energy and fluid are used up
Lowered metabolic rate
Less activity
Less energy requirement (up to 20%)
Increased stagnation in joints
Intestinal transit time decreased
Difficult to extract the same nutrients or energetics from food
Weak digestion, may not be able to handle whole grains
Lowered excretion of nutrients
Decreased organ reserves
Decreased body mass
Decreased ability to regulate blood sugar
Takes longer for postprandial glucose to be metabolized
Receptor abnormality decreases insulin response
Decreased ability to metabolize carbohydrates

13. Geriatric Food Requirements
Higher Protein
Compensates loss of lean body mass
Decrease protein turnover rates
Decreased Fat
Helps maintain body weight
Enhanced Antioxidants
Supports declining immune systems
Omega-3-Fatty Acids
Helps with joint and kidney function

14. Goals of Treatment Increase the QUALITY OF LIFE
Slow Disease Onset or Progression
Warm the middle burner
Nourish Kidney Essence
Prevent too much Qi or Blood consumption
Help the body breakdown, digest, assimilate, disperse and use as many vital nutrients as possible
For the Mind, Body and Soul

15. Goals of Treatment Feed moderate amounts of food, often
Nutrient extraction
Glucose assimilation
Prevent Stomach Qi stagnation
Feed easily digestible food
Well cooked‐ middle Jiao cannot heat
Food preparation‐ finely chopped
Sprouts of grains, grasses, legumes and seeds
Soups, stews, congee
Digestive enzymes & probiotics
Feed nutrient rich foods
Organic‐ greater nutrient composition
Non‐processed foods
Feed warming foods
Energetics
Temperature

16. Goals of Treatment Avoid pro‐inflammatory foods
Nightshades: bell pepper, eggplant, white potato
Goiterogentc: cruciferous‐ raw: broccoli, kale, cabbage, turnip, radish, horseradish, rutabaga, canned food
Feed anti‐inflammatory foods/supplements
Alternate lower meat diet‐ lower PG
Lower saturated fats‐ lower PG
Increase omega‐3 FA‐ lower PG/leukotrienes
Cold water fish, mackerel, trout, salmon, tuna
Increase Vitamin C
Also generates collagen
Cantaloupe, strawberries, peppers, cranberry
Supplements to help alleviate arthritis pain
MSM, SAM‐e, alfalfa, dandelion, turmeric, white willow bark

17. Goals of Treatment
Treat imbalance or disharmonies as early as possible
Older animals take longer to heal or recover
Use ½ to 2/3 dose of herbs for longer time (maybe for life)
Avoid very strong herbs or use them for short periods of time
Too bitter: Coptis (Huang Lian)
Too cold: Gypsum (Shi Gao)
Bitter‐cold herbs cause Yang‐Qi damage
Too hot: Aconite (Fu Zi)
Too pungent: Ephedra (Ma Huang)
Hot‐pungent herbs consume Yin
Select Tonic herbs or mild regulating herbs
Tonic: Codonoposis (Dang Shen), Angelica (Dang Gui)
Movers & shakers of Qi: Citrus (Chen Pi)
Moving Blood to resolve stagnation: Ligusticum (Chuan Xiong)
Transform phlegm: Fritillaria (Chuan Bei Mu)
Don’t forget about tui‐na, acupressure, acupuncture and daily EXERCISE!!!!!

18. Qi Tonics Energetics: Neutral to warm
Meat: beef, chicken, duck, goose, lamb, quail, eggs, catfish, carp, eel, herring, trout
Grain/Legumes: brown rice, coix, glutinous rice (caution with digestion), millet, lentils, soy bean, string bean
Vegetables/Fruit: peas, potato, sweet potato, yam, shiitake, cherry, date, lychee, fig
Nuts: chestnut, coconut, peanut, walnut
Other: molasses

19. Qi/Yang Tonics Energetics: warming or hot
Meat/oil: chicken, liver (esp. chicken, lamb), kidney (esp. lamb), mutton, venison, beef, shrimp, catfish, anchovy, trout, olive oil
Grains/Legumes: oats, white rice, corn, quinoa, broad bean
Vegetables/Fruit: carrot, squash, winter squash, pumpkin, ginger, garlic, pepper, apricot, citrus, peach, plum
Nuts: walnut
Other: brown sugar, rice vinegar, cinnamon, cloves
Avoid: cold food‐ cereal grasses (wheat grass, barley grass), seaweed

20. Blood/Qi/Yin Tonics Neutral foods:
Meat: pork, eggs, goose, duck, catfish, salmon, sardine, tripe, quail
Grains/Legumes: corn, sweet rice, soy bean, string bean
Vegetables/Fruit: yam, sweet potato, white potato, grapes
Other: green tea

21. Blood Tonics Energetics:
Tonify SP to help digestion and absorption of nutrients to make more blood
Digestive enzymes, probiotics
Chicken, duck, goat, rabbit, carp, eel, aduki, rice, winter squash, carrot, turnip black bean, peas, sweet potato, nutmeg
Tonify KID Blood/ Jing
Dark foods with salty flavor (not too much)

22. Blood Tonics Generalized
Meat/ Dairy: beef, bone marrow, liver, duck, goat, goose, salmon, sardine, eggs, milk (goat/ sheep)
Grain/Legume: amaranth, barley, coix, rice, wheat germ/ grass, aduki bean, black bean, soybean, tempeh
Vegetables/ Fruit: reishi, shiitake, alfalfa sprout, artichoke, spinach, sweet potato, chard, kale, watercress, apricot, avocado, fig, date
Other: sesame/ sunflower seed, parsley, microalgae, bee pollen, miso, molasses

23. Stagnation Focus: Improve Qi/Blood Flow
Meat: chicken, lamb, venison, shrimp, crab
Vegetables/Fruits: carrot, radish, watercress, mustard greens, hawthorn berry, citrus inc peel,
Other: vinegar, ginger, garlic, turmeric, clove, dill, coriander, chestnut

24. Phlegm Focus: Strengthen spleen, drain damp, transform phlegm
Strengthen Spleen: beef, salmon, tuna, millet, oats, rice, sweet potato, pumpkin, apple, cherry, dates & jujube, winter squash, ginger
Drain Damp: barley, rye, mung bean, soy bean, alfalfa, celery, radish, mushroom, lemon, garlic, horseradish, mustard green
Transform Phlegm: Clam, oyster, apple, pear, citrus and peel, seaweed, garlic, thyme, pepper, peppermint, almond
Avoid: thick, damp, sticky food: dairy, fat, raw, too yin, alcohol

25. Treatment of CCD Selegiline 0.5-1 mg/kg QD AM FDA approved
69% improved vrs 52% placebo
Vitamin E (& other antioxidants)
Up to 50 mg/kg
Ginko biloba
1-2 mg/kg BID extract
Acetylcysteine
5-25 mg/kg BID
St John’s wort
2-4 mg/kg
Westlab Pharmacy
WESTLA