As partners in your practice, we love making ourselves available to practitioners to answer any questions they may have about our formulas, treatment, diagnoses, or anything else they made need. We’ve compiled a list of the most common questions practitioners have for us. Click the “Answer” link to show Health Concerns President, Andrew Gaeddert’s responses.
When approaching complex situations, sometimes I’m not sure of the best way to begin treating a patient. What suggestions do you have for handling these cases?
When you are really unsure of how to handle a patient, it’s best to begin with the basics. If the patient has a digestive problem, then start with that system, and assess the syndrome pattern in order to institute the treatment protocol. When the individual is under stress, use the basic stress protocol: Ease Plus™ combined with Calm Spirit® when normal stools or constipation is present, or Ease 2™ combined with Calm Spirit for loose stools. For both combinations, the dosage is two tablets of each formula three or four times a day. For lack of energy, Adrenosen™ or Power Mushrooms™ can be used, although the latter formula should be administered cautiously when heat signs or Yin deficiency heat is present.
Can herbal formulas be combined?
I usually recommend patients take two formulas at the same time since most of the cases that I encounter are rather complex. Because administering three or more herbal formulas can be confusing, I have discovered that it is easier for American patients to take two to three tablets of two different formulas say, four times per day, rather than four tablets or more of a single formula four times per day. This is perhaps because a higher dosage of a single formula is a psychological barrier in that there are “too many pills to take.” On the other hand, patients who lead extremely healthy lives by maintaining an exemplary diet, exercising daily and engaging in stress reduction programs will respond quicker to smaller dosages.
When combining formulas, it is important to avoid duplicating your efforts. For example, I received a call from a practitioner who wanted to prescribe the formulas Enhance®, Clear Heat™, Marrow Plus®, and Source Qi™ to a patient who suffered from chronic fatigue and diarrhea. Instead of administering so many formulas at once, I recommended that the patient use Colostroplex™ and Source Qi until the diarrhea was resolved, and then substitute Enhance for Source Qi. In this case, the most serious symptoms – fatigue and diarrhea – should be addressed first, rather than the root of the problem — heat due to viral infection. To have administered Enhance and Source Qi simultaneously would have duplicated the therapeutic strategy of these two formulas since they are both primarily Qi tonifiers. In this instance, Source Qi was recommended to be taken first because of its diarrhea-resolving property. Because Clear Heat and Colostroplex are both anti-viral remedies, combining them would have been redundant. In this case, I suggested that Colostroplex be used to treat the diarrhea. However, if the patient had high levels of viral activity and more pronounced heat signs, I would have recommended that Clear Heat be taken with Colostroplex. Finally, in this case Marrow Plus was not indicated at the outset even though the patient had low red and white blood cell counts, because the symptoms of diarrhea and fatigue were being resolved first. Once the initial symptoms were cleared, then Marrow Plus could have been administered.
What can I do for patients who are constitutionally sensitive?
In my experience, individuals who are constitutionally sensitive often react strongly to herbs. I once treated a woman who consistently reacted strongly to herbs at the normal dosage (nine tablets daily). However, when the dosage was decreased to two tablets per day, she had excellent results. Another case involved a patient who took only one tablet daily of Astra™ 8 and reported that he hadn’t felt so energetic in years (the recommended dosage is nine tablets daily). For patients who have many food and/or environmental sensitivities, including to herbs, it is best to start them at half to one tablet daily of the formula(s). If there are no untoward reactions, then the dosage can be slowly increased. In many cases, the best way to get patients started is to administer Quiet Digestion™ and Six Gentlemen in order to aid their digestive function.
Is there any reason to be concerned about possible side effects caused by herbs?
Unless the patient is unusually sensitive, side effects from herbs rarely occur. Sometimes, though, there are persons who are allergic to one or more of the ingredients in a particular formula, in which case another formula must be substituted that does not contain the offending element(s). Additionally, misprescribing can cause the patient to either not respond or to react negatively to an herbal formula. This situation calls for a rethinking of the syndrome differentiation in order to confirm whether the formula is, in fact, the correct (or incorrect) one. Another phenomenon is what appears to be a skin rash, which results after taking heat clearing herbs. This is actually a positive reaction in that the pathogenic heat is being vented through the skin.
How can I learn more about individual herbs and formulas?
While I teach several seminars throughout the year, the most comprehensive is called Improving Your Clinical Results with Chinese Herbs. It is a two-part course covering the most therapeutically effective traditional formulas, Health Concerns and other prepared formulas, and the individual herbs in these formulas and their functions. Other classes are offered including , A Practitioner’s Guide to Herb-Drug Interactions, as well as courses focusing on specific disorders and syndromes such as digestive issues, infertility and osteoporosis. Remember, Health Concerns’ Herbal Helpline® is always available to answer practitioner questions.
How can I ensure I am using Chinese herbal formulas effectively?
This is a question I was asked by a colleague who has been in practice for over ten years. Many practitioners are faced with this dilemma because TCM schools in the West do not teach much about using herbal tablets despite the fact that tablets are prescribed more often than herbal decoctions. It’s easy to guess the trend towards using tablets in lieu of decoctions is rooted in their convenience, especially considering decoctions take time to prepare and are usually unpleasant tasting. Health Concerns is proud to offer practitioners a number of resources designed to help them learn more about herbal tablets. First, we have the Health Concerns Clinical Handbook which is updated regularly and provides information about each of the herbal products that we manufacture. We also offer an audio series in which I teach various seminars including: Clinically Effective Protocols, Health Concerns’ Formulas, Focus on Pain and many more.
How long does it take for herbs to take effect?
In my experience, it depends on the physical and emotional health of the individual. Those who are weak or 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 their effects. For example, Bill was one of my clients who was suffering from depression and chronic fatigue. He was taking two medications to treat the depression: Effexor and Depakote. After he started herbal therapy, his pulse and tongue showed remarkable improvement, but he was still not experiencing relief from the chronic fatigue. We altered the herbal protocol to focus more on the depression, and I 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. 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 stopped.
What should be done when a formula is not producing the desired results?
First, check whether the patient is complying with the recommended dosage. Most people are accustomed to pharmaceuticals which are taken at much lower dosages than the herbal treatments of nine to twenty pills per day. If the patient is taking the correct dosage, then the diagnosis needs to be reassessed. If the diagnosis is correct, then we at Health Concerns will be glad to answer any questions through our Herbal Helpline. You can find more information on drug and herb interactions on our website. This article
should be particularly helpful to those interested in this subject.
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 rebalance and tonify the body during recuperation.
Have a question of your own? Our Herbal Helpline® is always available to Health Concerns’ customers. Call (800) 233-9355 ext. 105, or email firstname.lastname@example.org.