The Pancreas
This Gland’s Balancing Act Keeps Us Centered

While probably one out of ten suffer from diabetes, a 1977 HEW study revealed that every other person in the U.S. suffers from hypoglycemia, diabetes’ mysterious sister disorder. True, as our third leading cause of death, diabetes in all its ramifications annually kills 350,000 Americans (just over half the death rate of cancer), and the number of reported ‘hypoglycemia deaths’ is minute by comparison. But once one realizes that hypoglycemia has been identified as a possible cause for at least a major proportion of alcoholism, drug abuse, violent crime, suicide, psychiatric disorders, and many other common ills that result in death or disablement, one begins to get the uneasy feeling that hypoglycemia itself may be the heavyweight, and not diabetes.

The two disorders together form what we might call a national ‘epidemic of being uncentered,’ for both are related to an imbalanced function of the gland that is largely responsible for our being ‘centered’-the pancreas.

The human organism maintains its equilibrium through three general operations: first, it regulates the biochemical qualities of the nutrients absorbed through digestion of food; second , it controls the delicate balance of different substances carried in the blood (which is built from digested food through the actions of the endocrine ( hormone) system); and third, it balances different functions of energy, mind and spirit. The pancreas and its energies lie at the center of all three operations. Even the name, literally translated from the Greek as ‘all flesh,’ is a clue to its central, balancing role.

Its position is another clue: the organ begins at the center of the torso, the solar plexus, its head nestled against the duodenum, its body and tail extending straight out of the left behind the stomach. ‘Solar plexus’ indicates that it is solar energy, captured by plants and bonded to carbon (with oxygen and water ) as carbohydrate, that is unlocked by digestion (controlled) by the pancreas), and is finally released to animate our thoughts, words, and deeds (again, under the guiding force of the pancreas’s energy). Let’s consider the role the pancreas plays in each of these three areas.

THE DIGESTIVE ROLE

The pancreas of a truly healthy person has a rich golden-yellow color, though in sickness and on autopsy its radiant sheen fades to a withered grass color. It somewhat resembles a fish, measuring about eight inches from head to tail. In place of the fish’s solid spine is the hollow pancreatic duct, which runs from left to right (tail to head), collecting the enzyme-rich pancreatic juice and depositing it into the duodenum via the common bile duct (which also delivers bile from the liver and gallbladder).

Virtually all the products of digestion gather in the duodenum, our digestive central clearinghouse. Carbohydrates (especially complex carbohydrates or starches) are first acted upon by starch-digesting enzymes called amylases in the saliva as you chew your food; proteins are the primary target of the stomach’s digestive juices; fats are emulsified by bile from the liver and gallbladder. These actions are but preludes to the pancreatic concerto that follows. Within minutes after you take your first bite, the pancreas is already tuning up and beginning to secrete its powerful enzymes into the duodenum. Closely resembling saliva, the slightly alkaline pancreatic juice-the most versatile digestive fluid in the body-contains different enzymes that act upon all classes of nutrients and foods. The partially digested food then proceeds, together with all its pancreatic enzymes busily at work, downward through the maze of the small intestine where all its usable nutrients are finally absorbed into the bloodstream towards the liver, heart, and lungs for the finale of circulation. It is here that the pancreas’s hormones come into play.

THE PANCREAS’ ENDOCRINE ROLE

Scattered throughout the pancreatic tissue surrounding the pancreatic central duct are tiny, irregularly shaped coils of cells, called the islets of Langerhans after their discoverer. These cell clusters are most numerous in the tail, and have no physical connection with the pancreas’s central duct or digestive function. Four distinct types of cells have so far been identified: A cells, B cells, D cells, and F cells (the first three are also called alpha, beta, and delta). Each cell type secretes its own hormone(s), which do not enter the duct but pass directly into the blood circulation through tiny capillaries permeating the gland’s tissue.

The first violin of this hormonal string quartet is the beta-cell, which secretes insulin, the hormone so well-known in connection with diabetes. The second-diddle alphas secrete glucagon, or ‘anti-insulin,’ which opposes the action of insulin and is also thought to have a role in the development of diabetes. Artificial glucagon is often injected for emergency treatment to counteract an accidental overdose of injected artificial insulin. The mellower violas, the delta-cells, secrete two hormones that maintain harmony within the violins’ counterpoint: somatostatin, which tones down the action of both alpha and beta cells, and gastrin, which does the opposite. Finally, the cello of the group, the F-cells, secrete pancreatic polypeptide, which serves as a bass-line and regulates the entire harmony of both hormonal and digestive functions of the pancreas and the stomach as well.

Insulin is truly a virtuoso, a veritable Paganini of a hormone! Its commonly known role is in lowering blood glucose levels by sending circulating glucose off into body cells to be burned as fuel, or into storage as glycogen (‘animal starch’) in the liver and muscles or as fat in adipose tissue. But insulin has a variety of other functions. Also known as the ‘Storage hormone,’ it causes free-circulating amino acids and fat constituents to leave the bloodstream and build up muscle, fat, and other body tissues. Severely insulin-deficient diabetics often lose weight, muscle, and skin tone for this reason. Insulin is also the sole hormone responsible for the prodigious growth and bodily development of the fetus during pregnancy; the fetal pancreas’s secretion of insulin is fully operational. In macrobiotic terminology, all these functions are considered yang, that is, having a concentrating, gathering, building effect. The effects of insulin are balanced somewhat by the glucagon, and even more so by the action of other organs and glands such as the liver and adrenals.

THE ENERGY ROLE

Traditional Chinese medicine has no labels for endocrine glands as such, but describes their energies and functions together with parallel digestive and excretory or circulatory organs. Hence, ‘kidneys’ refers to the physical kidneys and their associated meridians, and to the adrenal glands and gonads as well. By the same token, ‘heart’ may be considered as including the thyroid. The actions attributed to the ‘spleen’ in Chinese medicine actually describe the functions of both the spleen and the pancreas. Though the Chinese never used the term ‘pancreas,’ I will use it here to appropriately designate ‘spleen.’

The Nei Ching, the classic Chinese book of medicine, describes the pancreas as ‘the official of the center,’ and characterizes its energy as soil. Soil is the most harmonizing energy. It refers to the downward, gathering force typical of pancreatic juice and insulin. The soil organs and meridians guide our response to every seasonal and climatic change, balancing us during times of transition. Virtually every illness was considered by the Chinese to involve the soil organs at least secondarily.

In terms of consciousness, the pancreas was held to be the seat of reason, intellect and understanding, empathy, decision-making, and clarity of direction. The pancreas expresses itself in the voice, with a healthy, vital gland producing a distinctively rich, melodious speech and the special gift of song.

If you look at an anatomical chart, you cannot help notice that the liver and stomach together almost exactly replicate the famous Tai Chi symbol of yin and yang. More accurately, though, it is the pancreas lying behind the stomach that forms a complementary unity with the liver-in many ways, the two are mirror images. While the pancreas is animated by the down ward, more consolidating energy that dominates the body’s left side (the brain’s left hemisphere and the descending colon are two other examples), the liver is created and nourished more by the yin, ascending, and more expanding energy that influences the right side. Consequently, the liver is ten times the size and weight of the pancreas. It sends the blood glucose level up while the pancreas sends it down. It takes apart the stores of fat, protein, and glycogen the pancreas builds up. As the pancreas modifies the physical and biochemical properties of nutrients moving down to enter the bloodstream through the intestine, the liver receives the intestines’s new blood and filters, detoxifies, and regulates its biochemical qualities before sending it up to the hear it and lungs for distribution.

Energetically, the times of the pancreas’s greatest activity are afternoon and evening, waning moon, and late summer to fall, and for the liver, morning, waxing moon, and springtime. Opposing the pancreas’s qualities of intellect and comprehension are the liver’s energies of spontaneity, colorful imagination, and spiritual growth or ascendance. The pancreas responds to the sweet (balancing) taste, while the liver is stimulated by the sour (separating) taste. The pancreas keeps us centered and stabilized, and the liver uplifts and maintains our energy’s lightness and freshness. Keeping in mind the opposing, mutually controlling roles of this sweet’n’sour duo, let’s now explore the various disorders of disharmony.

DISORDERS OF THE PANCREAS

The work of our body’s cells is largely fueled by glucose, a simple sugar that is the basic building block of carbohydrates such as fruit, grains, beans, and others. Glucose is derived from the digestion of such foods or, in emergencies by breaking down body tissue, and is distributed throughout the body by the bloodstream. Since either over-or underfeeding the cells leads to sickness, we have a marvelously intricate ensemble of organs and gland functions to keep the blood glucose level steady (normal levels are roughly 80-140 mg per 100cc of blood). Complex carbohydrate foods, and particularly whole grains and dried beans, produce the least potentially toxic byproducts during digestion. Because our digestive and gland functions are designed to work with these foods, they serve best to stabilize this delicately tuned ensemble. Today, however, as the traditional staple food of whole grains has progressively faded from the modern dinner table, we have had to turn to more extreme food groups as dietary staples, and these have a profound effect on that hormonal web. Those that are more yin (expanding and blood glucose-raising) include: tropical fruit and juices; tomatoes potatoes, yams, and other semi-tropically originating vegetables; refined sugar, honey, molasses, maple syrup, and other mono-or disaccharide sweeteners; refined grains and flours; milk and dairy products; coffee, spices, and other stimulants; highly processed foods with their additives; and various medications and drugs, both legal and illicit. The strenuously blood glucose-raising effect of some of these foods stems from their high simple sugar content, which has a more radical impact on the system than the complex sugar molecules of starches such as grains and beans. Others, such as coffee and spices, have no sugar, but strongly stimulate the adrenals and liver, which in turn causes the release of stored sugars and speeds up the metabolism. Those foods that have a more yang effect (heavy, contracting, and blood glucose-lowering) include: eggs, meats, and poultry; salty cheeses; fatty, more aggressively acting or salted fish; heavily salted foods; and overcooked foods (especially animal foods or dry, baked, roasted, or fried grain foods).

As you move away from the stabilizing force of a whole grain-based diet, depending upon which category of food you emphasize, you create one of three tendencies. First, abuse of the yin group over accentuates the rising energy of the liver and weakens the yang, downward force of the pancreas. Second, abuse of the yang group has the opposite effect, over activating the pancreas and causing the liver to stagnate. Excessive quantities of both groups creates a chaotic pattern combining features of both imbalances.

It should be noted here that the kidneys and adrenal glands serve to help keep the balance between liver and pancreas, the right pair teamed more with the liver and the left more with the pancreas, These food abuses also have the corresponding effects on these balancing organs/glands as well; and the adrenals and/or kidneys are usually involved in any blood glucose disorder.

The first abuse leads eventually to diabetes, the second to hypoglycemia, and the third to a generally unstable condition featuring qualities of both that characterizes just about everybody who eats a modern-day diet and is not clearly diabetic or hypoglycemic.

DIABETES

Diabetes is characterized by a weakened pancreas owing to chronically excessive intake of weakening that region and allows food to pass from the stomach directly to the small intestine. In some cases, though, adopting a carefully managed macrobiotic diet can help dissolve stubborn stagnation in this area, leading to a regression of the tumor and allowing that central region to open up again.

HEALING THE PANCREAS

As with all illness, eliminating extremes and establishing a more moderate diet centered around whole grains and cooked vegetables is the most important factor in healing the pancreas. For pancreatic tumors, it is especially important to emphasize a lighter cooking style, with less or no salt seasonings, little or no oil or oily foods, and no over-cooked or roasted and baked foods. (For more details on this subject, see Michio Kushi’s The Cancer Prevention Diet.) In addition to diet, establishing a more relaxed lifestyle and calmer way of thinking is also important; daily meditation and deep breathing can be very helpful.

Dietary treatment for hypoglycemia is commonly misunderstood. Following the false conclusion that refined carbohydrates are the prime cause, many nutritionists recommend more high-fat, high-protein diets, usually involving lots of animal foods-what a tragic mistake! Such a diet, of course, leads to still further stagnation of the liver, kidneys, adrenals, and pancreas, and aggravates the condition in the long run. Since under activity of the adrenals and/or thyroid is often considered (correctly) to be involved, hormone extracts from animal sources are often prescribed as dietary ‘supplements’-reminiscent of insulin therapy. This type of treatment not only obscures the underlying cause, but often creates a profound state of hormonal stress and emotional confusion. Vitamin and mineral supplements are also recommended, often in mega-doses, to alleviate hypoglycemia. Finally, physicians who are untrained in nutrition (which means practically all of them) have been known to say to a patient suffering from ‘low blood sugar,’ ‘You need more sugar; just eat a candy bar.’ I think this prescription needs no comment.

Both diabetes and hypoglycemia can be traced ultimately to the general dietary cause: lack of complex carbohydrate foods, and particularly whole grains. Persons with hypoglycemia should follow a more yin version of basic macrobiotic eating, with an emphasis on fresh-tasting,lightly cooked vegetable dishes, barley and medium-grain brown rice as daily staples, very little salt seasoning, and very little oil. Food cooked in a more wet style, such as grain soups or soft grains, can be helpful, as can vegetables chopped artfully in smaller pieces rather than as large chunks. Though this would seem to e a sheerly esthetic consideration, recent studies on foods’ ‘glycemic index’ have clearly shown that a food’s texture and consistency profoundly affect the body’s insulin and glucose reactions. Animal foods as a rule should be minimized, as should any heavier dishes; salads or par-boiled near-salads and lightly pickled vegetables should be routine. Although cooked fruit is a common macrobiotic dietary suggestion for becoming more yin, many hypoglycemic cannot tolerate simple sugars of any kind; thus vegetable dishes and the absence of strongly yang factors are the mainstay of ‘yinnizing.’

Dietary recommendations for diabetes should include only cooked foods, and generally with an emphasis on more well-cooked dishes, slightly saltier seasoning, vegetable slicing in larger chunks, less fluid, and more root vegetables and hard squashes. Short grain brown rice and millet should be daily staples, and some seaweed side-dish should be eaten daily. All simple sugars, refined foods, and chemicalized foods should be avoided altogether. (For more on this subject, refer to East West Journal, September 1983.)

In all cases of serious illness, a qualified macrobiotic counselor should be contacted to work out individual details of daily diet. Non-insulin-dependent diabetes (Type II) can usually be healed readily; Type I often responds readily at first, with a fairly rapid decrease in insulin requirements, but is much more difficult to heal completely. Shiatsu massage and vigorous physical exercise are beneficial in healing diabetes. Also, periodic ginger compresses over the pancreas region can speed recovery.

The archetypal expression of the pancreas is melodious song. For any pancreas or blood glucose problem, diet is only one part of the path to recovery of stability, health, and happiness. Regular musical expression, particularly emphasizing your sense of melody, is also medicine for your pancreas; but more than that, you can strive to pattern your everyday life in the model of song. Moderation and consistency, avoiding extremes of high and low registers, balanced with spontaneity and a perpetual sense of newness, are the essence of the songwriter’s craft, and they can be yours as well as you compose each day in the image of harmony.

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