She lives with a flatmate and is currently single.

She works for a large multinational company and was given a promotion recently.

At 18 she struggled with Anorexia Nervosa and she suffered from Amenorrhea shortly thereafter. She currently menstruates roughly once every four months. She also suffers from Insomnia.

For the past three years she has had digestive problems (diarrhea and bloating).

She takes Lunesta to help her sleep.

She gets faint very quickly if she has not had enough to eat.

Her last menstrual cycle was 4-5 months before our first consultation so she was due to menstruate again shortly (and did). Her period has been regular during times of stability.

She likes to have advanced warning of any changes to her schedule as she does not like surprises.

Her problems with eating began when she was 17 and continued until she left for University two years later. The problems "resolved themselves" while she was there, however, during her final year at University she struggled to sleep every night. She began taking Lunesta to help her through her exams.

After her exams she went home and her sleeping returned to normal. However, as soon as she started looking for work her insomnia returned.

Between the ages of 22 to 24 she recalls sleeping very well and being content. This was a time of good stability for her.

It is clear when talking to her that she has a nervous disposition.

She struggles to get to sleep and everything has to be very quiet and dark for her to fall asleep. She wakes very easily with her alarm.

She has a dull agni but loves to snack. When we discussed this she realized that she often snacks not due to hunger.

She watches what she eats and has a very controlling diet. Her diet includes cooked vegetables, fruit, alcohol, fish and meat

She noticed that dairy caused mucous so she cut down, she doesn’t take coffee (green tea instead), white bread or pasta, cream, butter, sugar, uncooked vegetables. She eats few complex carbohydrates.

While the restrictions are generally good (eg, removing processed foods), she stopped eating fruit completely at one point because she believed it was causing her diarrhea. She avoids uncooked vegetables for the same reason.

She admits that she doesn’t have a regular meal time and instead will snack throughout the day.

She eats fruit (apple, pear) at 7:30 and when she gets to work she’ll have rye toast, yoghurt (soy, goat’s milk). She then has a late lunch of last night’s dinner, healthy salad followed by a snack at 3:30pm. Dinner consists of salmon, veggies (roasted), sweet potato.

Before bed she likes to have either yoghurt, toast, or carrot bread.

During our discussions she realized that she ate a snack before bed because her parents had snacks at bedtime and warned her not to go to bed hungry – ie, she understands that she eats not because she is hungry but because she remembers her parents telling her to. In Ayurveda this is referred to as a Satmya (a learned habit).

Her tongue shows no sign of toxins and is a healthy pink. However, it shows signs of chronic malabsorption.

She has good teeth, they are large and very straight (she’s never had braces).

She is remarkably small for her frame (I noticed this when we first met) and it would seems that her ideal frame is larger and firmer than she is currently.

Pulse: Her pulse shows congestion and undernourishment in the dhatus (tissues). However, it shows bala (strength) in the shrotas (channels).

Her skin, hands and nails are in excellent health.

Her bowel movements tend to be more liquid and contain undigested food

Prakriti: uncertain

She has several possibilities as to her constitution and even though she is relatively young, her vikriti is obscuring her prakriti.

Her prakriti contains Kapha (her physical features and her need for structure), Pitta (her tendency to be a perfectionist and driven), and Vata (can not be ruled out because it may not just be a vikriti).

Vikriti: VATA

Several signs implicate Vata as a cause of her complaints (irregular period, insomnia, poor digestion, bloating, malabsorption). It is clear that apana vayu is not balanced and along with (and resulting in) an overactive udana vayu, this is causing her anxiety/nervousness.

Vata became aggravated when, or possibly before, she stopped eating when she was 17. The lack of nutrition and sustenance caused Vata to become aggravated and the disease in now in the prasara (overflow or third) stage.

Her condition is described as nirama Vata (imbalanced Vata without toxins).

She was prescribed herbs that worked on her agni resulting in her bowel movements becoming more solid and digested. She said she felt "constipated", however, as we discussed this she realised that this "constipation" was in fact normal evacuations - she had become so accustomed to diarrhea that normal seemed abnormal.

A mix herbs that pacify Vata and work on the digestion to enkidle the agni enabled her to properly assimilate her food and receive more nourishment from her meals.

With her agni improving, I prescribed ashwagandha and liquorice root to regenerate her tissues and further balance Vata.

We discussed her relationship with food at length and she realized that, when she eats regular meals at regular times, she feels better and her digestion is much improved. We also talked about what the foods she avoids and slowly introducing them back into her diet (most notably the complex carbohydrates).

The most beneficial change to her condition is contained in her diet. By undereating, she is aggravating Vata which results in a host of ailments (some of which are showing up presently). Herbs will go some way to re-balancing her agni and pacifying the problems, however, in the longer term a nutritious and wholesome diet will be of more significance that any herbs she may take.