This is another article in the series of commonly asked practitioner questions. In this installment, we first discuss general issues of using herbal products, and then explore how specific conditions are treated.
How should Chinese herbal pills be used effectively?
This is a question that was asked of me by a colleague who has been in practice for over ten years. Many practitioners are faced with this dilemma because the TCM schools in the west do not teach much about using herbal pills despite the fact that pills are prescribed more often than herbal decoctions. Perhaps the trend these days is toward using herbal pills because they are easy to use, as opposed to decoctions which take time to prepare and are often unpleasant tasting.
In terms of how practitioners can learn more about using herbal pills, Health Concerns has a variety of resources. First, we have the Health Concerns Clinical Handbook which is updated regularly and provides information about each of the herbal products that we manufacture. There is also our free webinars to further elucidate the application of our formulas.
How long does it take for herbs to work?
In my experience, it depends on the physical and emotional health of the individual. Those who are weak and have been ill for a long period often respond more slowly than persons who are in better health. For acute conditions, improvement can usually be seen within a few days, while chronic problems can take anywhere between two to four weeks to respond. It should also be noted that patients who are on pharmaceuticals can take longer to respond to herbs because some medications can dull the effects of herbs.
For example, Bill is one of our clients who was suffering depression and chronic fatigue. He was taking two medications, Efexor and Depacote, to treat the depression. After he started herbal therapy, his pulse and tongue showed remarkable improvement, but he was still not experiencing relief from the chronic fatigue. We have since altered the herbal protocol to focus more on the depression, and have suggested that he get out of the house more, start doing some light exercise, and join a support group as well as a yoga class.
Practitioners should be flexible in changing the dosage and therapy when improvement is not seen. Also, for some conditions, especially those that are acute or are acute flare-ups of chronic problems, two formulas can be prescribed until the symptoms subside, after which the dosages are reduced, or one or both formulas are stopped.
What should be done when a formula is not working?
First, check whether the patient is complying with the recommended dosage. Most people are accustomed to taking pharmaceuticals which are taken at much lower dosages than the herbal pill dosages of nine to twenty pills per day. If the patient is taking the correct dosage, then the diagnosis needs to be reassessed. And if the diagnosis is correct, then we at Health Concerns will be glad answer any questions through our Helpline.
How long can an herbal formula be taken?
It should be remembered that Chinese medicine considers disease to be a dynamic process. As the presenting pattern changes, the herbal formula should be modified correspondingly. Clearly, when the condition is no longer present, the herbs should be stopped. For example, cold and flu formulas should not be used after the cold or flu has subsided. For lingering cold and flu symptoms in the absence of a fever, formulas that attack the acute symptoms such as Isatis Gold and Yin Chao Jin, are contraindicated. Instead, formulas such as Ease Two, which is harmonizing, and Power Mushrooms, which is immune strengthening, are recommended, in order to re-balance and tonify the body during recuperation.
What do you think about herbal products manufactured in China that contain antihistamines and other drugs?
Practitioners can be liable for recommending products that contain pharmaceuticals. Furthermore, it is unlawful in the U.S. to sell products that are not properly labeled. Therefore, practitioners should be certain that the products that they recommend have the names of U.S. manufacturers or distributors printed on the label.
Are Astra 18 Diet and Astra Diet Tea really effective for weight loss?
Any serious weight loss program must include a regimen of increased daily exercise, and reduction or elimination of sweets and greasy foods. Consuming fresh fruits and vegetables at five servings of each per day and drinking 64 ounces of water per day is beneficial as well. Astra Diet Tea is designed to harmonize the digestive system and promote energy. In addition, this formula tastes sweet and can thus be a dessert substitute or used to counter sweet cravings. Astra 18 Diet is a constitutional formula that addresses edema, Phlegm, and congestion. Another formula, Drain Dampness, is a formula that target water weight only. For slow metabolism, Rehmannia 8 can used to boost the kidney function and drain dampness. For low energy, Adrenosen can be considered, and for poor digestion, Quiet Digestion. These formulas can be taken one half hour before meals with two large glasses of water to give a sensation of fullness and to curb the appetite.
How are patients with neuropathy treated?
First, the type of pain should be ascertained. If it is a sharp stabbing and burning kind, and there are other signs of Heat, the two formulas that can be used are Mobility 2 and Clear Heat. If the pain is worse in cold damp weather, Mobility 3 and Channel Flow can be recommended. A good general protocol is Mobility 2, which has anti-inflammatory properties (promotes the flow of blood, drains dampness, and stops pain), and Flavonex, which in addition to promoting the flow of blood, tonifies the kidneys.
Do you have any therapeutic suggestions for restless leg syndrome?
This condition is characterized by an intolerable creeping and internal itching sensation affecting the legs. The symptoms often appear at the end of the day, particularly at night. Moving the legs frequently brings relief. In terms of Chinese medicine, this syndrome pattern is best treated with formulas that increase Blood and Qi circulation, such as Flavonex. If the sensation is more of a spasmodic type, then SPZM and Marrow Plus can be used. SPZM is based on an anti-spasm formula that was developed at a hospital in Shanghai. Marrow Plus tonifies and moves the Blood.
What formulas do you recommend for hypertension?
Gastrodia Relieve Wind is a good general formula. It is based on the traditional remedy known as Tian Ma Gou Teng Yin, and addresses a hypertension syndrome pattern that is caused by internal Wind. Gastrodia Relieve Wind contains herbs that help dispel Wind, move the Blood, and help the Kidneys grasp the Qi downward. I should say at this point that in my experience, not all cases of hypertension can be treated successfully only using herbs. Many individuals require dietary and lifestyle modifications, as well as herbs and anti-hypertensive drugs as needed. It is also important to keep in mind that the longer the patient is on conventional anti-hypertensive medications, the less likely they are to be completely weaned of these drugs. Finally, patients should be carefully monitored when their anti-hypertensive drugs are being reduced. For information about other syndrome patterns of hypertension, practitioners are referred to my book Chinese Herbs in the Western Clinic.
What formula best treats night time urination and bedwetting?
Astra Essence. This formula is very effective in treating night-time urination. For signs of Kidney Yang deficiency and Coldness, Virility Caps can be combined with Astra Essence. Childhood bedwetting also responds to Astra Essence, although this condition is often accompanied by a psychological component such as stress, which should be addressed as well. Formulas that help ease stress include Ease Plus and Schisandra Dreams.
What herbal options are available for treating poor memory, forgetfulness, difficulty concentrating, or even Alzheimer’s?
Flavonex is a good general formula that contains ginkgo biloba extract, which has been receiving much popular attention these days. The formula also has herbs that promote the circulation of both Qi and Blood. In terms of Chinese medicine, Flavonex helps to harmonize the kidneys and heart. For lethargy and fatigue, Astra Essence can be used as an adjunct to Flavonex, since the former contains Astragalus which in addition to enhancing the immune system, is capable of nourishing the brain. Astra Essence also other herbs that are Kidney tonics; in Chinese medicine it is said that if the kidney essence is sufficient, the brain is nourished and the memory, concentration, and sight will be sharp.
Research has revealed a correlation between Alzheimer’s and an excessive amount of aluminum in the brain (Lancet, 338: 390, 1991). Food additives, douches, antacids, anit diarrheals, aspirin, aluminum containers and cookware can be sources of aluminum. Therefore, when the patient is found to have an excessive amount of aluminum or other heavy metals, the formula Ecliptex can be used to detoxify the system. To aid the detoxification process, patients should be advised to drink at least six to eight glasses of water daily. Finally, a thorough biomedical diagnosis should be done in order to rule out other causes of Alzheimer’s and similar brain dysfunctions; such causes can include brain tumors, hypothyroidism, vitamin and mineral deficiency, and drug reactions.
Which formulas help counter nightsweats and spontaneous sweating?
In Chinese medicine, nightsweats and spontaneous sweating signify that the healthy Fluids necessary for maintaining homeostasis are leaking out. For sweating from the palms, soles, and chest, consider formulas that address yin deficiency such as Nine Flavor Tea. The former treats yin deficiency that accompanies immune disorder and a dry cough, while the latter formula contains yin tonics along with herbs that resolve thirst. Both formulas are effective for afternoon and nightsweats. For cold patterns and systemic sweating, Astra C can be used. This formula is based on the classical Jade Screen Powder, and consists of three herbs, astragalus, atractylodes, and siler, all aimed at bolstering the protective qi. When the protective qi is weak, sweat leaks out through the pores and the body is vulnerable to attack by pathogens. Astra C can be combined with formulas such as Virility Caps or Backbone, to strongly tonify the yang. Virility Caps can be used for listlessness and malaise, while Backbone for low back pain and weak limbs. Yet another formula that can be combined with Astra C is Shen Gem, which is based on Gui Pi Tang, and tonifies the heart and spleen to relieve palpitation, anxiety, insomnia, in addition to sweating (sweat is the fluid of the heart).
What is your current protocol for treating hepatitis, especially hepatitis C?
About 80% of patients experience a decrease in liver enzymes by taking the formulas Rehmannia & Milk Thistle (reformulated Ecliptex) (3 capsules TID) and Clear Heat (1-3 capsules TID) faithfully for three to six months. I recommend adding Astra Isatis (3 capsules TID) when the patient is immune-compromised or is suffering severe fatigue. For jaundice, severe flank pain, abdominal pain, nausea, and fever, Coptis Purge Fire can be used as the primary remedy. This formula can be combined with Channel Flow ro help reduce pain, or GB-6 to improve the appetite and blood and Qi circulation. Of course, biomedical diagnosis and treatment is recommended for patients with hepatitis.
When Resinall K is used externally for pain, how much should be applied?
Classically, the Resinall K formula is used internally for pain due to injury or trauma. However, it can be applied externally for chronic pain, dermatological conditions caused by poor blood circulation, and for scars and sores. For a small surface area such as an injured toe or finger, just dab on a few drops. For larger areas, such as an entire limb or the back, mix one part Resinall K with three parts alcohol– rubbing alcohol, spirits, or rice wine. Resinall K can be mixed with hot water, but water is not as penetrating as alcohol. Once applied, massage the remedy into the affected area. It should be noted, that prior to applying Resinall K, the skin should be cleaned thoroughly with soap and water and disinfected with alcohol.
Does Health Concerns have formulas that contain echinacea, ginkgo, or saw palmetto?
These are western herbs that have been reported on in the popular media. It should be mentioned that their popularity is not just based on empirical usage, but also on extensive research. Therefore, Health Concerns does have formulas that contain these herbs; the formulas are Isatis Gold, Flavonex, and Essence Chamber.