- time of day a symptom presents: Night urination? Night sweats? Loose stools early in the morning?
- Time of the year: Lower back pain in the colder months? Stress during the holidays? Stuffy nose during spring?
- Time in your life: Have you just started puberty? Menopausal? 30s? 70s?
When something occurs has just as much significance as the symptom itself. Take frequent urination. If it’s during the day, is it simply because you’re taking in a lot of fluids? If so, is it out of habit or because you’re thirsty? Does the fluid intake help quench your thirst or are you still feeling a bit parched?
If it’s frequent urination at night, do you have any accompanying symptoms like back pain or weak knees? I would look at your chart to check your age, because it is more common to see night urination in the young and the elderly. What if you were 25? I would look into your lifestyle, accompanying symptoms and past history to see why your kidney yang or kidney yin wasn’t pulling its weight.
Patients always seem intrigued that I spend time asking about their bowel movement and even more time clarifying the actual time of day it occurs. The same goes for a cough, is it most persistent at night or during the day? These little (well quite big, actually) details can reveal so much.
Now it seems western science is starting to pay attention to time as well. Yale professor Erol Fikrig said a ‘direct molecular link between circadian rhythms and the immune system’ had been found, which could have ‘important implications for the prevention and treatment of disease’. As a result drug companies have started screening drugs at different times of the day.
Image: Ernst Vikne via Flickr
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