How to differentiate between "internal heat" during seasonal changes? The distinction between heart fire, liver fire, and stomach fire, and the correct way to eat bitter melon.

Whenever the weather changes, people experience breakouts, poor sleep, or mouth ulcers, often citing "I'm feeling hot" or "I'm experiencing internal heat" as the cause. This is a common expression in Hong Kong, and Traditional Chinese Medicine does have a corresponding theory behind it. But the problem is:"Getting too much internal heat" is not a diagnosis, but a general term for a group of symptoms.—In traditional Chinese medicine, the same set of symptoms can be classified into different organs, and into excess heat or deficiency heat, with treatment directions that are even opposite; in modern medicine, they also have different causes and treatment boundaries.

This article addresses precisely this ambiguity. First, it clarifies the distinct manifestations of the five types of internal heat—heart fire, liver fire, lung fire, stomach fire, and kidney fire—each with its own symptoms and treatment approaches; mixing them together obscures the meaning of diagnosis. Then, it explains why excess heat and deficiency heat cannot be treated the same way, and why…People with deficiency heat or spleen and stomach deficiency should not eat bitter and cold foods indiscriminately.Finally, the properties and practical ways of consuming bitter melon are discussed, including...Why you must see a doctor if you have mouth ulcers for more than three weeks?。

First, here are the answers: five key points

If you only have two minutes, here are the five things you absolutely need to take with you from this article:

1. "Getting too hot" is a colloquial term for "heat syndrome" in Traditional Chinese Medicine.This indicates a mild form of internal heat, not a modern medical diagnosis, nor does it correspond to a specific disease. Its value lies in reminding you to adjust your lifestyle and diet, not in self-diagnosing.
2. Fire is divided into five internal organs, and further divided into deficiency and excess.Traditional Chinese medicine classifies "heat" into heart fire, liver fire, lung fire, stomach fire, and kidney fire, each with its own typical manifestations; it is further divided into excess heat and deficiency heat.The same symptom can be either real or false.—For example, mouth ulcers may also be caused by spleen and stomach deficiency and cold.
3. Do not drink bitter and cold drinks to relieve heat whenever you feel hot.The Office of Traditional Chinese Medicine Regulation of the Department of Health explicitly reminds the public that bitter and cold medicines can easily damage the spleen and stomach, and cause dryness and damage to yin.It can worsen symptoms of deficiency heat.Bitter melon is indeed a bitter and cold food.
4. Bitter melon does not become "warm" after cooking.The "ripeness" mentioned in ancient texts refers to the fruit ripening and turning red on the vine, not cooking. The bitter melon we eat daily remains cooling even after cooking.
5. If a mouth ulcer has not healed after three weeks, you should see a doctor or dentist.A persistent ulcer can sometimes be a sign of oral cancer—this is the last thing you should dismiss as just "getting too much internal heat."

II. What does "getting too much internal heat" mean in Traditional Chinese Medicine?

What Hong Kong people often refer to as "heatiness" is called "getting too much internal heat" in more standard Chinese. The Office of Chinese Medicine Regulation of the Department of Health clearly defines the scope of this term in a dedicated article, "How Traditional Chinese Medicine Clears 'Heatiness'":

"Some people experience symptoms commonly known as 'heatiness' or 'internal heat' after consuming fried foods, excessive smoking and drinking, staying up late and overworking, experiencing anxiety, or being under too much stress. This falls under the category of 'heat syndrome' in Traditional Chinese Medicine, which refers to a milder form of internal heat."

There are two key points to note in this statement. First,"Getting too hot" is a milder form of internal heat.This is not a serious illness; true heatstroke and high fever belong to another level. Second,Its triggering factors are very everyday life.—Frying, smoking and drinking, staying up late, and stress can all be adjusted.

Based on the same article, the causes can be categorized into four types:External pathogens invade the interior and transform into heat.(For example, summer heat, dryness)Excessive emotional distress can lead to heat.(Long-term emotional tension and high stress)Improper diet leads to food stagnation and internal heat.(A fondness for spicy and fried foods, tobacco and alcohol), andOverwork leads to yin deficiency and yang excess.(Staying up late and overworking leads to insufficient Yin fluid and a relative excess of Yang).

III. The Fire of the Five Internal Organs: The heart, liver, lungs, stomach, and kidneys each have different fires.

Traditional Chinese medicine believes that "all five internal organs and six bowels can be affected by fire." An article from the Office of Traditional Chinese Medicine Regulation of the Department of Health lists various manifestations according to the internal organs; this section directly uses its framework:

Zang-fu organs	Common symptoms	The article cites dietary therapy as an example
Heart Fire	Mouth ulcers, irritability, insomnia, flushed face, and thirst	Imperata cylindrica root and sugarcane juice, lotus seed and bamboo leaf tea
Liver fire	Irritability, dry and red eyes or excessive eye discharge, headache, tinnitus, bitter taste in the mouth	Summer mulberry and chrysanthemum tea (for liver yang hyperactivity), wolfberry and chrysanthemum tea (for liver and kidney yin deficiency).
Lung fire	Dry and swollen throat, hot and dry mouth and nose, red and swollen nose.	Pear juice, Ophiopogon japonicus tea, lily porridge
Stomach fire	Dry mouth, bad breath, swollen and painful gums, excessive hunger, burning pain in the stomach.	White fungus and lotus seed soup (for stomach yin deficiency), mung bean soup or lotus leaf tea (for damp-heat in the stomach and intestines)
Kidney fire	Lower back pain and weak legs, hot flashes, night sweats, dry mouth with no thirst, irritability, insomnia, dizziness, and tinnitus.	Black sesame seeds, walnuts, goji berries, and turtle jelly

Having read this far, you should have noticed something:These five groups of performances have a lot of overlap.—Both heart fire and kidney fire can cause "irritability and insomnia," while liver fire and stomach fire can affect the mouth. This is why traditional Chinese medicine emphasizes "differentiation of syndromes" rather than "symptomatic treatment": it relies on questioning to piece together the overall pattern, rather than simply blaming heart fire for insomnia.

Why it's not advisable to confuse "heart fire" with "liver fire"

Online health articles often combine the two into a single category called "heart and liver fire," and then list the symptoms together: irritability, insomnia, irregular menstruation or severe menstrual cramps, repeated damage to the oral mucosa, dry mouth and tongue, constipation, and dark yellow urine with low volume.

The problem is that this set of symptoms actually spans two organs, and the treatment approaches for the two are different:

• Heart FireThe core of the treatment is "mouth sores, irritability and insomnia, flushed face and thirst"—the direction is towards calming the mind, nourishing the heart and soothing the nerves.
• Liver fireThe core symptoms are "irritability, dry and red eyes, headache, tinnitus, and bitter taste in the mouth"—the approach is to clear the liver and relieve depression.

After the merger, the most practical identification point disappears:If your main symptoms are mouth ulcers and insomnia, focus on the heart; if your main symptoms are dry eyes, headache, irritability, and bitter taste in the mouth, focus on the liver.It is certainly possible for both to occur at the same time, but that requires a doctor's judgment, and it is not enough to simply label oneself as having "excessive heart and liver fire".

Also worth mentioning is stomach heat. It's commonly believed that stomach heat is directly linked to dietary habits—a fondness for fried and spicy foods, and frequent consumption of iced drinks—which largely aligns with the official description of "dry mouth, bad breath, swollen and painful gums, increased hunger, and burning pain in the stomach." However, it's important to note:In Traditional Chinese Medicine, frequently drinking iced beverages falls under the category of "cold" in traditional Chinese medicine.The relationship between it and stomach fire is not a simple cause and effect, but rather a different manifestation under the broad category of "improper diet". Equating frozen drinks directly with "causing stomach fire" is to confuse two sets of logic.

IV. Excess Heat and Deficiency Heat: Why Can't We Simply "Clear" It?

This section is the most practical, yet most easily overlooked, part of the entire article. Traditional Chinese medicine classifies "heat" into two types: excess heat and deficiency heat.The two processes are handled in opposite directions.。

	actual heat	Deficiency heat
Causes	Liver meridian stagnation and heat, blood stasis and damp-heat accumulation	Insufficient Qi, blood deficiency and malnourishment, and deficiency of Yin essence
direction	Suitable for purging – relieving depression, removing dampness, and clearing heat.	Suitable for tonification: tonifying qi, nourishing blood, nourishing yin, and clearing deficiency heat.
Common symptoms	Red face, bitter taste in mouth, constipation, dark yellow urine, red tongue with yellow coating	Hot flashes and night sweats, dry mouth but no desire to drink water, hot palms and soles, fatigue
Eat bitter and cold foods (such as bitter melon and herbal tea).	Direction matches	May worsen

The original text from the Office of Traditional Chinese Medicine Regulation of the Department of Health is quite direct:

"If symptoms of heat such as mouth ulcers, sore throat, and constipation occur, it is important to first determine whether it is due to deficiency heat or excess heat. Mouth ulcers may also be caused by spleen and stomach deficiency and cold, toothache may be caused by kidney yin deficiency, and constipation may be caused by qi deficiency and cold constipation. Therefore..."If you have internal heat, you should not simply take bitter and cold purgatives like the "Twenty-Four Flavors" to clear the heat.Because bitter and cold medicines can easily damage the spleen and stomach, and cause dryness and depletion of yin, they can worsen symptoms of deficiency heat.

This passage contains three "maybes," which are worth remembering one by one:

• Mouth ulcers may also be caused by spleen and stomach deficiency and cold.Not all ulcers are caused by fire.
• Toothache may also be caused by kidney yin deficiency.While swollen and painful gums are often associated with stomach heat, dental problems should be ruled out first when dealing with toothache.
• Constipation may also be due to qi deficiency and coldness.—Not all constipation requires "clearing heat." The causes and dietary care for constipation are discussed in a separate article on this site.Causes of constipation, dietary care, and timing of seeking medical attention）。

5. Seasonal Acne Breakouts: Traditional Chinese Medicine calls it "internal heat," but what does modern medicine consider?

"Breakouts during seasonal changes" is a common complaint. From the perspective of traditional Chinese medicine, facial acne is a typical manifestation of "heat"; from the perspective of modern medicine, the mechanism is quite specific.

How does acne form?

The UK NHS explanation is:Hair follicles become clogged with excess oil and dead skin cells, allowing bacteria to grow inside and cause inflammation and pus.Therefore, it's not a case of "heat rising to the top," but rather a combination of four factors: sebum, keratin, bacteria, and inflammation.

Common triggering factors include:

• Hormonal changes—Adolescence, menstrual cycle, menopause, pregnancy
• certain diseases—For example, polycystic ovary syndrome, rosacea
• drugSome medications can worsen acne.
• Skin care or hair care products—May make skin oily

It's worth noting that seasonal changes themselves are not listed as a cause by the NHS. Increased acne during seasonal changes is more commonly explained by…At the same time, skincare habits, sleep patterns, and stress levels changed.—For example, switching to more moisturizing products after the weather gets warmer, or sleeping less.

Diet and Acne: Where is the Evidence?

The NHS acne page does not list specific dietary recommendations. There are some research directions worth considering, but it's important to note that they discuss…Overall Dietary PatternNot a single food:

• A controlled study involving 58 adolescent males divided the participants into low-glycemic index and high-glycemic index groups, and compared the severity of facial inflammation lesions after eight weeks.PubMed 22253996These types of studies are small-scale and short-term, and while they may provide some direction, they are insufficient to conclude that "a certain food can cure acne."
• A systematic review of the relationship between glycemic index, dairy consumption, and acne concluded that both may be involved by influencing insulin, insulin-like growth factor, and androgens, but the evidence regarding dairy products is inconsistent.PubMed 35373155）。

From this angle, the bitter melon's location is very clear:It is a low-calorie, low-glycemic-load vegetable.It is reasonable as part of the overall diet; butNo studies have shown that eating bitter melon can treat acne.Using it as a "cure-fighting food" goes beyond the scope of general nutritional support.

Two things more important than what to eat

• Don't push.The NHS clearly states that picking or squeezing pimples can cause scarring.
• Do not scrub vigorously.This will irritate the skin and actually worsen acne.

If you have a lot of pimples, they are deep in the skin, painful, have left scars, or are affecting your mood, the NHS recommends seeing a doctor—in these cases, adjusting your diet and skincare products is not enough.

6. Oral ulcers: One of the easiest problems to be overlooked due to "internal heat".

Many people deal with mouth ulcers and swollen gums by "drinking a bowl of bitter melon soup." This section will clarify three things: how ulcers usually develop, what their causes are, and when you should seek medical attention.

It usually heals on its own within one to two weeks.

The NHS states that oral ulcers are very common.It usually heals on its own within one to two weeks.,andThere is no quick and effective methodIt takes time to heal. This is important—if the ulcer really heals within a week or two, it's because it was going to heal on its own, and it's not necessarily due to the bitter melon soup.

The causes are much more complex than "internal heat".

The NHS divides the causes into two groups. The first group consists of those you can avoid:

• Bit the inside of the cheek
• Dentures or braces that don't fit properly, or rough fillings or sharp teeth.
• Cuts or burns while eating (from hard foods or hot drinks)
• Food intolerance or allergy
• Toothbrush too hard, or toothpaste too irritating.
• Fatigue, stress, anxiety

The second group is one that you may not be able to control:

• Hormonal changes (such as during pregnancy)
• Physical constitution and family predisposition
• Vitamin or mineral deficiency—including iron, zinc, folic acid, vitamin B, and vitamin D.
• Some medications (including certain nonsteroidal anti-inflammatory drugs, beta-blockers, and nicorandil)
• Early stages of quitting smoking

ifMultiple ulcers appeared simultaneously.In such cases, one should consider hand-foot-mouth disease, oral lichen planus, Crohn's disease, celiac disease, and conditions with weakened immune systems (such as HIV infection or lupus). These are not conditions that can be treated with "drinking a bowl of soup".

Things I can do myself

The NHS's recommendations are quite specific and have nothing to do with "clearing heat"; the key point is...Reduce stimulation and give time：

• Use a soft-bristled toothbrush; avoid toothpaste containing sodium lauryl sulfate (SLS).
• Drink frozen beverages through a straw to reduce contact with the ulcer site.
• Eat softer foods; avoid very spicy, very salty, and very sour foods.
• Avoid rough, crunchy foods (such as toast and potato chips) and excessively hot drinks.
• Regular dental checkups

Pharmacists can recommend some aids, such as antibacterial mouthwash, pain relief gel or spray, steroid lozenges, and salt water gargle (half a teaspoon of salt dissolved in a cup of warm water, gargle and spit it out, do not swallow).

This is the part of the whole process that is most easily overlooked. Treating a month-long ulcer as "internal heat" and continuing to drink bitter melon soup and wait is the least ideal approach.

7. Poor sleep and "heart fire"

Insomnia and excessive dreaming are often categorized as "excessive heart and liver fire." In Traditional Chinese Medicine classifications...Heart fire does indeed correspond to "irritability and insomnia".Kidney fire and liver fire can also affect sleep, so "not sleeping well" is not a single syndrome in traditional Chinese medicine.

From a modern perspective, the factors affecting sleep are more closely related to daily life:

• caffeine—Coffee, strong tea, some energy drinks, and cola; if consumed after the afternoon, the effects on sensitive individuals can last until late at night.
• Irregular work and rest scheduleCatching up on sleep during holidays and staying up late on weekdays can disrupt your biological clock.
• Using screens before bedEmotional stimulation before bedtime
• Stress and anxietyThis point actually points in the same direction as the traditional Chinese medicine concept of "excessive emotional distress leading to heat."
• environmentTemperature, light, noise

In practice, if you only sleep poorly for one or two nights occasionally, adjusting your caffeine intake and sleep schedule is usually sufficient. If...It lasted for several weeks and affected my daytime mental state and work.If symptoms are accompanied by significant low mood and anxiety, medical attention should be sought instead of simply relying on "heat-clearing" remedies. The UK NHS also provides specific guidelines for insomnia (…).NHS: Insomnia）。

8. The properties of bitter melon: the true meaning of "cold when raw, warm when cooked".

This is the most important point to clarify about bitter melon, and also the most practical.

In Traditional Chinese Medicine, bitter melon is considered to be cooling.

Several major herbal texts provide fairly consistent descriptions: *Diannan Materia Medica* states it is "bitter in taste, cold in nature, and enters the heart, spleen, and lung meridians"; *Compendium of Materia Medica* states it is "bitter in taste, cold in nature, and non-toxic"; while modern dictionaries such as *Dictionary of Traditional Chinese Medicine* and *Chinese Materia Medica* mostly describe it as "bitter in taste and slightly cold in nature." Regarding its effects, it is generally summarized as follows:It relieves summer heat, improves eyesight, and detoxifies.It is used for summer heat and thirst, diabetes, red and painful eyes, etc.Bitter melon at the Medicinal Botanical Garden of Nanjing University of Chinese Medicine）。

in other words,There is no dispute that bitter melon is a food that clears heat.The problem lies in the next step.

"Raw is cold in nature, cooked is warm in nature"—this "cooked" does not mean boiled.

The most widespread claim is that "raw bitter melon is cold in nature... cooked bitter melon becomes warm in nature and can nourish yin and blood, strengthen the spleen and kidneys." This claim has some basis, but it is misunderstood.

The original text of "Benjing Fengyuan" is:

"Momordica charantia,Raw green, cooked redRaw, it is cold in nature; cooked, it is warm in nature.

The *Ben Cao Qiu Zhen* (Seeking Truth in Materia Medica) states it more clearly: "It is said that raw herbs are cold in nature, while cooked herbs are warm. Raw herbs, being cold in nature, are used to clear heat, relieve irritability, and brighten the eyes; therefore, they should be used in a warming manner."Ripe redThey took the child to eat.

The key lies in "Raw green, cooked redFour words—"Ripe" refers to the fruit ripening on the vine and turning from green to red.It's not about cooking it in a pot. This is further explained in the *Sui Xi Ju Diet Manual*: "Bitter melon is bitter and cold in nature, clearing heat, brightening the eyes, and calming the mind..."When cooked, it turns reddish in color, tastes sweet, and is neutral in nature.It nourishes the blood and liver, moistens the spleen and tonifies the kidneys. Note that it says "..." here.neutralIt is not "warm in nature".

stage	Appearance	Properties	Traditional Chinese Medicine Uses
Unripe (the kind we eat daily)	Turquoise	Bitter, cold (or slightly cold)	Clears heat, relieves summer heat, improves eyesight, and detoxifies.
Mature	Orange-red, with cracked skin	It has a sweet taste and neutral properties (some herbal texts describe it as "warm").	Nourishes blood and liver, moistens spleen and tonifies kidneys; seeds invigorate qi and strengthen yang.
Cook until done (heat the green bitter melon).	Still green	Still cold	The heat-clearing principle remains unchanged, and the cold nature remains the same.

What should someone with a weak spleen and stomach do if they want to eat bitter melon?

It's not that you can't eat it at all, but there are three ways to reduce discomfort:

• Thermomixing ingredientsGinger, garlic, fermented black beans, and a little chili are common ingredients in Cantonese cuisine, which also aligns with the traditional Chinese medicine concept of matching cold and hot properties.
• Control the portion sizeStart with small amounts and observe the body's reaction.
• Do not eat on an empty stomach.—It is more irritating to the stomach and intestines when the stomach is empty.

As for ripe, red bitter melon, it's rare to find in the market, and its effects have shifted from "clearing heat" to "nourishing blood and liver," which is different from the common perception of it as "cooling down." Using it to clear heat is the opposite approach. A separate article on this site explains the differentiation of cold and heat constitutions and dietary pairings.Summer Heat Relief and Individuals with Hot or Cold Constitutions: Timing, Quantity, and Safety Precautions for Eating Ice）。

9. The nutritional value of bitter melon, and two widely circulated misconceptions.

Putting aside traditional Chinese medicine, bitter melon is indeed a vegetable that should be included in the daily diet from a nutritional perspective.

Item (per 100 grams, raw)	numerical values	significance
calorific value	17 kcal	Low in calories, easy to incorporate into weight management
Vitamin C	84.0 mg	High content; Hong Kong Food Safety Centre tests local bitter melon showed 88 to 120 mg.
folate	72 micrograms of DFE	Folic acid deficiency is one of the known causes of oral ulcers.
Dietary fiber	2.8 grams	Higher than the average of 1.9 grams for vegetables.
鉀	296 mg	It can help with blood pressure, but patients with kidney disease need to control it.

Here is a link worth pointing out:Folic acid and vitamin C are both related to the health of the oral mucosa.Folic acid deficiency is one of the causes of mouth ulcers listed by the NHS. This gives bitter melon a...Limited, verifiableIts location—it is one of the sources of both of these nutrients,But this does not mean that eating bitter melon can cure ulcers.There are many causes of ulcers, and most of them heal on their own; assuming they are all due to nutritional deficiencies will lead to missed examinations.

There's already another article on this site that specifically compiles information on the nutritional components, blood sugar and blood lipids of bitter melon, as well as the safety limits for its consumption. That article traces each figure back to the original research for verification, including the often-misunderstood animal experiment on "tumor shrinkage" (…).Nutritional Information and Evidence on Bitter Melon: How to View Research on Vitamin C, Triterpenoids, and Blood Sugar）。

Mistake 1: "The vitamin C content of lemons is 2.7 times that of lemons."

It's often said that bitter melon contains "about 2.7 times the vitamin C of lemons, 7 times that of tomatoes, and 15 times that of apples." This is correct in general, but the multiples need to be recalculated using the same database. Based on the USDA FoodData Central, per 100 grams:

Comparison Objects	Vitamin C	Bitter melon is about several times that amount.	Popular opinion
Bitter melon (flesh)	84.0 mg	—	—
Lemon (peeled)	53.0 mg	Approximately 1.6 times	2.7 times (slightly high)
tomato	13.7 mg	Approximately 6.1 times	7 times (close to)
Apple (with peel)	4.6 mg	Approximately 18 times	15 times (relatively low)

The multiple will vary depending on the variety, origin, and database used, so there's no need to specify a particular number; however, if you do want to give an example, you must give a correct one. Saying "taller than a lemon" is correct, but saying "2.7 times that of a lemon" is an exaggeration of almost double.

Mistake 2: "Bitter melon contains quinine, which will stimulate uterine contractions."

This phrase is widely circulated in Chinese health articles, but its content doesn't match.

Quinine comes from the bark of the cinchona tree.This is the source of antimalarial drugs, not a component of bitter melon. Identified active components of bitter melon include cucurbitane-type triterpenes (momordicin I and II, various momordicosides), charantin, polypeptide-p, vicine, momordin, etc.PMC: A Review of Studies on the Components of Bitter Melon and Oral Cancer Prevention— No quinine.

Can pregnant women eat bitter melon?The recommendation remains conservative, but the rationale needs to be changed.There are three relatively tenable reasons:

• Momordica charantiaseedReproductive toxicity has been reported in animal studies.PubMed 25469128）
• Traditional medications and some data have always listed pregnant women as having to consume these products with caution.
• Limited human evidence from pregnant women

Practical advice is:It is generally fine to eat bitter melon as a common vegetable in moderation; however, bitter melon seeds, bitter melon seed oil, and concentrated bitter melon supplements should be avoided.If you have any doubts, it is more reliable to ask a doctor or a registered Chinese medicine practitioner directly than to find answers online.

10. Who needs to pay special attention?

Condition	Why should we pay attention?	suggestion
Spleen and stomach deficiency and cold(Cold hands and feet, prone to diarrhea, poor appetite)	Bitter melon is bitter and cold in nature, and may damage the spleen and stomach; cooking does not change its cold nature.	Control portion size, add ginger, garlic, and fermented black beans, and avoid using on an empty stomach.
Deficiency-heat constitution(Hot sweats, dry mouth but no desire to drink water)	Bitter and cold in nature can cause dryness and damage to yin, thus aggravating deficiency heat.	Consult a registered Chinese medicine practitioner first; do not attempt to "reduce internal heat" with bitter melon on your own.
Pregnant women and breastfeeding mothers	Bitter melon seeds have been reported to have reproductive toxicity in animal studies; however, human evidence is limited.	Vegetables are acceptable in moderation; avoid seeds, seed oils, and concentrated supplements.
Kidney disease patients	Potassium content is 296 mg/100g, which is moderately high.	Control portion sizes as directed by your doctor or nutritionist.
People who need calcium supplements	Bitter melon contains oxalic acid, which may affect the absorption of calcium from food.	It is not advisable to rely on bitter melon as a primary vegetable for an extended period of time.
G6PD deficiency (favism)	Bitter melon seeds contain the same components as broad beans (vicine and convicine).	As a vegetable, it is generally acceptable; avoid seeds and concentrated products.
Taking blood sugar lowering drugs	Bitter melon may have a synergistic effect with its blood sugar-lowering properties.	Monitor your blood sugar and consult your doctor before taking any supplements.
child	A safety review has reported cases of hypoglycemia in children after consuming large amounts of bitter melon products.	There is no need to worry about consuming vegetables normally; concentrated supplements should not be taken.

Traditional Chinese medicine emphasizes holistic health in its approach to constitution management. Another article on this site discussing TCM theories of the spleen and stomach and dietary therapy can be used as further reading.How does Traditional Chinese Medicine (TCM) regulate the digestive system? Daily health maintenance methods including diet, acupressure, and food therapy.）。

11. How to eat bitter melon in a practical way

Serving size: Half a bowl is one serving of vegetables.

The Department of Health recommends eating at least two servings of fruit and three servings of vegetables daily, or "two plus three" a day.One serving of vegetables is equivalent to half a bowl of cooked vegetables, melons, mushrooms, or beans.(Based on a 250 to 300 ml bowl)Department of Health Elderly Health Services）。

So half a bowl of cooked bitter melon is one serving.There is no set number for "how much bitter melon you must eat every day".It is also not recommended to eat only one type of vegetable for a long time – a variety of vegetables is more meaningful than eating only one type.

How to cook to retain vitamin C?

Vitamin C is water-soluble and is lost during cooking. Research from the Hong Kong Centre for Food Safety indicates that…Blanched vegetables contain an average of one-third less vitamin C than stir-fried vegetables.Because some of it dissolved in the water used to blanch the vegetables.Centre for Food Safety: Nutrient content of fruits and vegetables).soStir-frying is better than blanching for a long time.Prolonged simmering should also be avoided.

Reduce bitterness, but don't rely on adding sugar.

• After slicing thinly, soak briefly in salt water or blanch briefly (but this will cause some vitamin C to be lost).
• Cooking it with minced garlic, fermented black beans, eggs, tomatoes, or meat can balance the bitterness.
• Choose light-colored varieties such as white jade bitter melon, which have a milder bitterness.
• It's not recommended to use large amounts of sugar, honey, or thick broth to mask bitterness—that would turn a low-calorie vegetable into a high-sugar dish.

It is not recommended to drink large amounts of bitter melon juice over a long period of time.

Drinking large amounts of bitter melon juice daily is completely different from eating a serving of vegetables: the former is highly concentrated, comes in a large quantity, and skips the chewing and satiety process. Furthermore, bitter melon is cooling in nature, making long-term, excessive consumption unsuitable for people with weak spleen and stomach. If you really want to drink it, it's best to do so in small amounts, after meals, and not on an empty stomach.

12. When should you seek medical attention?

Other situations where medical attention is warranted:

• There are also ulcers in other parts of the body.(Skin, genitals), or joint pain, redness and swelling
• Persistent swelling, pain and bleeding of gumsFirst, see a dentist to rule out periodontal disease and gingivitis.
• AcneLarge number of cases, deep locations, pain, existing scars, or affecting mood.
• Insomnia lasting for several weeksIt affects daytime mental state, work, or mood.
• Unexplained weight loss, persistent fever, night sweatsThese should not be explained by "internal heat".
• Constipation lasting more than two weeksIt may be accompanied by abdominal pain and bloody stools.

Seek immediate help in the following situations:Difficulty breathing, difficulty swallowing, massive oral bleeding, and confusion—Call 999 Or go to the emergency room. For general health inquiries, please call the Department of Health's health education hotline. 2833 0111。

XIII. Frequently Asked Questions

Are "getting too much internal heat" and "inflammation" in Western medicine the same thing?

No. There is some overlap—for example, redness, swelling, and pain—but the concepts are different. "Inflammation" is the body's immune response to injury or infection, with clear physiological mechanisms and diagnostic indicators; "internal heat" is a classification in Traditional Chinese Medicine (TCM) of a group of heat-related symptoms, falling under the category of "heat syndrome," diagnosed through questioning and palpation. For the same person with oral ulcers, TCM might diagnose it as "heart fire," while Western medicine would consider trauma, stress, nutritional deficiencies, or infection. The two languages can coexist, but they should not replace each other.

Is getting breakouts during seasonal changes just a sign of internal heat?

Not necessarily. Acne forms when hair follicles become clogged with sebum and dead skin cells, leading to bacterial growth and inflammation. The main triggering factors are hormonal changes, certain diseases, medications, and skincare products. Increased acne during seasonal changes is more commonly due to changes in skincare habits, sleep patterns, and stress. From a Traditional Chinese Medicine perspective, acne can be a manifestation of "heatiness," but the equation "acne breakout = internal heat" is not valid—especially for sudden, large, deep, and painful pimples; in such cases, a doctor should be consulted.

Can I drink bitter melon soup if I have mouth ulcers?

You can drink it, but don't treat it as a treatment. Mouth ulcers usually heal on their own within one to two weeks; the NHS clearly states there are no quick fixes. What truly helps is reducing irritation (using a soft-bristled toothbrush, chilled drinking straws, and avoiding spicy and rough foods) and giving it time. More importantly:If an ulcer has not healed, enlarged, bleeds, or becomes more painful after three weeks, you should see a doctor or dentist.Because prolonged illness can sometimes be a sign of oral cancer. Using bitter melon soup to "wait for it to heal" is the easiest way to delay treatment.

Does bitter melon become less cooling after it's cooked?

No. The ancient text's statement that "raw bitter melon is cold in nature, cooked bitter melon is warm in nature" actually means "raw bitter melon is green, cooked bitter melon is red"—"ripe" refers to the fruit maturing on the vine and turning from green to red, not cooking. The green bitter melon we eat daily, after being cooked...Still coldThe terms "cold" and "hot" refer to the properties of the ingredients, not their temperature upon consumption. People with weak spleen and stomach will not be safer just because they drink hot soup. To reduce discomfort, add warming ingredients such as ginger, garlic, and fermented black beans, control the portion size, and avoid eating it on an empty stomach.

Does bitter melon contain quinine? Can pregnant women eat it?

Momordica charantiaQuinine-freeQuinine, derived from the bark of the cinchona tree, is a source of antimalarial drugs. Bitter melon has been identified with components including cucurbitane-type triterpenes, charantin, polypeptide-P, and vicine. However, recommendations for pregnant women remain conservative, for various reasons: bitter melon seeds have been reported to have reproductive toxicity in animal studies, traditional medicines also recommend caution for pregnant women, and human evidence is limited. In practice, moderate consumption as a common vegetable is generally acceptable, but bitter melon seeds, bitter melon seed oil, and concentrated supplements should be avoided.

Is bitter melon really higher in Vitamin C than lemon?

Yes, but not as much as commonly believed. According to USDA estimates per 100 grams, bitter melon contains 84.0 mg, and lemon (peeled) contains 53.0 mg, approximately 1.6 times, not 2.7 times. Compared to tomatoes, it's about 6 times, and compared to apples, about 18 times. These multiples can vary depending on the variety and database, so they shouldn't be written rigidly; however, the statement that "bitter melon is very high in Vitamin C" is correct. Local tests by the Hong Kong Centre for Food Safety also show that bitter melon is one of the vegetables with the highest Vitamin C content.

Can people with a constitution prone to heat eat bitter melon?

Be cautious. Bitter melon is bitter and cold in nature, while the treatment for deficiency heat is to "tonify"—boost qi, nourish blood, nourish yin, and clear deficiency heat. Bitter and cold medicines can easily damage the spleen and stomach, and cause dryness and damage yin, which may worsen the deficiency heat. An article from the Office of Chinese Medicine Regulation of the Department of Health clearly reminds people not to take bitter and cold purgatives as soon as they feel hot. If you have symptoms such as hot flashes, night sweats, dry mouth but no desire to drink water, and hot palms and soles, it is recommended to consult a registered Chinese medicine practitioner first, rather than trying to "cool down" with bitter melon on your own.

How much bitter melon should you eat every day?

There is no specific recommended upper limit. Following the "two plus three daily" principle, half a bowl of cooked bitter melon constitutes one serving of vegetables; one serving of bitter melon out of three daily vegetable servings is a reasonable amount. The key is to eat a variety of vegetables and avoid eating only one type for an extended period. People with weak spleen and stomach or sensitive digestive systems should start with small amounts and observe their body's reaction.

Can I drink bitter melon juice every day?

Not recommended. Drinking bitter melon juice and eating a serving of vegetables are two different things—the former is highly concentrated and served in a large quantity, skipping the chewing and satiety process; in addition, bitter melon is cold in nature, so long-term consumption in large quantities is not suitable for people with weak spleen and stomach. If you really want to drink it, it should be in small amounts, after meals, not on an empty stomach, and should not be used to replace regular meals or medication.

How long does it take for mouth ulcers to heal? When should I see a doctor?

It usually heals on its own within one to two weeks.Still not better after more than three weeksIf an ulcer is larger than usual, located closer to the back of the throat, bleeds, becomes more painful, or becomes redder, you should see a doctor or dentist—a persistent ulcer can sometimes be a sign of oral cancer. Additionally, if you also have skin or genital ulcers, painful and swollen joints, or recurring ulcers, you should get checked, as these may be related to nutritional deficiencies, immune status, or digestive tract diseases.

XIV. Sources of Information

• Hong Kong Department of Health, Chinese Medicine Regulation Office, "How Traditional Chinese Medicine Clears 'Heat'".cmro.gov.hk
• UK NHS, Mouth ulcers (reviewed in March 2024).nhs.uk
• The UK's NHS, <Acne>.nhs.uk
• Insomnia (NHS, UK)nhs.uk
• Hong Kong Centre for Food Safety, <Nutritional Content of Fruits and Vegetables>.cfs.gov.hk
• Hong Kong Department of Health Elderly Health Service, "How to Practice the Fruit and Vegetable 2+3 Practice".elderly.gov.hk
• Bitter melon (recorded in "Diannan Materia Medica", "Compendium of Materia Medica", "Benjing Fengyuan", "Bencao Qiuzhen", "Suixiju Diet Manual" etc.) at the Medicinal Botanical Garden of Nanjing University of Chinese Medicine.njucm.edu.cn
• <Diverse roles of bitter melon (Momordica charantia) in prevention of oral cancer> (Compilation of bitter melon components and nutrients).PMC Full Text
• 〈Effect of the glycemic index of carbohydrates on Acne vulgaris〉,Nutrients。PubMed 22253996
• 〈Diet and acne: A systematic review〉，JAAD International。PubMed 35373155
• 〈Reproductive toxicity of Momordica charantia ethanol seed extracts in male rats〉,Iranian Journal of Reproductive Medicine。PubMed 25469128
• USDA FoodData Central, bitter melon 168393, lemon 167746, tomato 170457, apple 171688 (per 100 grams of raw material).fdc.nal.usda.gov

Health Declaration:This article is for health education purposes only and cannot replace a diagnosis by a Traditional Chinese Medicine (TCM) practitioner, a Western medicine diagnosis, or a dental examination. The TCM concept of "internal heat" is part of a theoretical system, and determining one's constitution requires observation, listening, questioning, and palpation. The organ classifications and dietary therapies listed in this article are for illustrative purposes only and do not represent suitable application for any individual. Bitter and cold foods and prepared Chinese medicines are not suitable for everyone, especially those with a cold constitution. If oral ulcers persist for more than three weeks, bleed, or become more painful, seek medical attention as soon as possible and do not self-diagnose as "internal heat." Pregnant women, children, the elderly, kidney patients, and those taking long-term medications (especially blood sugar lowering drugs and anticoagulants) should consult a doctor, registered TCM practitioner, or pharmacist before adjusting their diet or choosing any supplements.

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