Herbal Medicine: How to Use Herbal Medicine in Health and Illness

 We will now discuss the proper use of herbal medicine, including dosage, when to take herbs, and how often to consume each dose.  In addition, we will compare the advantages and disadvantages of teas, tinctures, tablets, and capsules.

Proper Dose

The dose of an herbal preparation you take in a single dose, or throughout the day is a crucial part of getting good results. Taking too little can result in no effect at all, because some herb actions such as immune stimulation require a threshold amount to trigger the response. A great example is echinacea, the well-known immune stimulant often taken to counteract respiratory tract infections like colds. One study showed that when patients took 2 droppersful of the tincture, cold symptoms did not improve more rapidly than in a group of patients that took a placebo. When they took 4 droppers full a day they did experience increased benefits.

I often categorize systems of dosing into “substantial dose” or “highly concentrated dose,” “dilute concentration dose,” and energy medicine (perhaps relating to quantum healing and the effects of placebo). The latter two are hard to study with modern scientific methods because we don’t understand their mechanism of action.

• Many herbal practitioners I have known and respected throughout the years have used the substantial dose in their clinical practice.
• Mildly-concentrated herb preparations or dilute concentration doses might be more appropriate for children, or people who tend to be very sensitive to many medications.

Start Low

Starting with a low dose for a day or two to check for individual sensitivity of any herb or herb blend is usually a good idea. Herbalists often recommend increasing the dose daily for a few days until the full or desired dose is obtained. When stopping an herb preparation, taper off by cutting the dose in half for a few days so as to ease the body out of the treatment, which is less likely to create unpleasant effects.

Substantial dose

A substantial dose of an herb preparation is when you ingest a significant amount of active constituents from the plants, preferably throughout the day to keep levels of the active compounds at effective levels in your bloodstream and tissues. This form of dosing has been widely practiced throughout the world in many traditional societies over the centuries, and still is today, for instance by the millions of people who use traditional Chinese medicine. Using herbs in substantial amounts is also the most supported scientifically, because the active compounds from the herbs can actually be measured in the blood at levels demonstrated to be physiologically active. Using more dilute herbal preparations is less supported scientifically, and was not widely practiced in traditional societies.

Substantial Doses of Specific Herbal Preparations

• Teas. A substantial dose is when you take a handful of dried bulk herbs, traditionally 6-12 grams per herb in a formula, and boil them up for 30-60 minutes then strain, and drink several strong cups of the brew a day.
• Tinctures. For a hydro-alcoholic (a solvent made of water and ethyl alcohol) extracts, also called tinctures, a substantial dose is about ½ to 1 tsp (2-5 droppersful), 3-5 times a day.
• For capsules or tablets that contain dried or powdered extracts (herbs that have their active ingredients removed by a solvent like water or alcohol, and then dried), about 1 gram to 6 grams a day can be a substantial dose.
• Approximately ½ gram can fit into a “00” (average-sized) capsule, and up to 1.0 to 1.5 grams can be pressed into an average-sized tablet. For the most part a substantial dose of a capsule or tablet herbal preparation that contains extracts (not simple powdered herbs which are often much weaker) is 2 or 3 capsules or 1 or 2 tablets, 3 times a day.

Dilute Doses

Dilute doses can be a cup or two of a mild herb infusion made by steeping a teaspoon of herbs per cup of freshly-boiled water for about 20-30 minutes. Adding 1 or 2 droppersful (30-35 drops) of a tincture (about 5:1 concentration) to a cup of mild herb tea like peppermint or chamomile, juice or water and drinking this 2-3 times a day. Two capsules or 1 tablet a day would also qualify as a dilute dose.

• For infants and young children, a dropperful or two of mild tea can be a good dose.

Body Size and Vitality in Determining Dose

For all these doses, take your body size and your vitality into account when determining the proper dose of an herbal preparation. Give a smaller, more gentle dose perhaps more often, to a small person or young child, than you would a large vigorous adult. Pay attention to, and honor individual sensitivities. Some people respond quickly and to smaller doses than others.

When to Take Herbs

To maximize absorption and minimize digestive discomfort, the time of day you take herbal preparations can make a difference. While this may be true, it is still better to take the herbs anytime you remember than not at all.

• For liquid preparations like teas or tinctures added to water, teas, or juices, take them between meals, unless they cause digestive upset, then take just after meals.
• For capsules and tablets, take just before meals.

One of the most important things to remember about the use of herbs is that regularity is a key to success. Taking them sporadically may provide some benefit, but the best effects by far can be achieved through steady use, day after day, at similar times.

How Often to Take Herbal Preparations

The active constituents of herbs are absorbed from the gut, or affect immune tissue directly in the gut. They are often metabolized by the liver to produce other secondary compounds, and these eventually lead to a blood serum level that delivers the activity to various tissues throughout the body.

The time it takes for an active compound to achieve the maximum concentration in the blood and then decline to ½ half of the concentration is known for some compounds in herbs and is called the serum half-life. In reading research studies it can be seen that his half life is often around 3-4 hours, meaning that many active compounds do not stick around the body all day. Because of this, one can theoretically achieve the best results by taking the herbs 3 times a day, morning, afternoon, and evening. Yet many people cannot remember to take them three times a day, or it is very inconvenient. Taking them in the mid-morning and an hour before bedtime is next best, and taking them once a day is often not as effective, though better than nothing if they are taken every day.

Dose—The Cultural Connection

The dose of herbs, whether capsules, tablets, tinctures, or teas, taken by people seems to be highly related to where they live, and to their belief system about their traditional medicine. In China, pharmacists working with bulk herbs often load up metal dinner plates with handfuls of herbs, each one representing a daily dose. This mound of loose herbs, of all colors, shapes ad sizes and interesting odors will then be wrapped up in paper and tied with a red cord. A bundle of 5 of these are then tied together and considered a week’s dose. It was assumed that during the week the patient might forget to take a dose, or have some tea left over, and one day no herbs were taken, a day of rest.

The remarkable thing about these herbal prescriptions is that each packet contains about 100 to 200 grams of herbs! A packet is added to a pot of water, usually in a traditional clay teapot the patient receives the first time they come to the clinic, and then simmered for one hour. The tea is then poured off and fresh water added, and the pot of tea simmered again for 45 minutes. The two brews are then added together and the patient is advised to drink a strong cup of the tea 2-3 times a day.

This use of a major portion of bulk, dried or sometimes fresh herbs to make a daily tea by boiling in water is common in traditional cultures throughout the world. In South America, Mexico, and in Native American Indian cultures, herbs are often added to large pots and then simmered until a very strong and even foul-tasting brew is made. Several cups or more were, and still are consumed throughout the day, sometimes until vomiting was produced from the action of resins and other irritating chemicals. The purgation was thought to be part of the therapeutic action of the herbs in some cases, relieving the body of toxic wastes and “excess” pathogenic (disease-causing) agents like dampness, heat, or cold.

This approach is not too popular these days, in fact most users of any kind of medicines are very sensitive to the taste. We are lovers of a small pill, quickly swallowed with lots of sweet juice. Yet herbalists feel that tasting a little bitter, sour, or astringent from the herbs is part of the medicine. Herbalists often note that patients start out skeptical of the taste, but grow to associate it with the good results they get, and began to even like the flavors. Try it sometime—wake up your taste buds!

Homeopathy—Like Cures Like and Weaker is Stronger

By strong contrast, the system of homeopathy proposed by Samuel Hannemann around the turn of the 19th century favors very dilute doses often made from toxic plants and minerals. In this system of medicine, small doses of both highly diluted toxic and non-toxic herbs are taken to stimulate healing processes of the body related to symptoms the herbs can actually produce when taken in very large doses (“like cures like”), such as headache or nausea, but also many other symptoms.

These healing processes are proposed to occur through stimulation of the immune, endocrine, and nervous systems by very small levels of active compounds found in the plants. In fact some research has shown that biological activity in animals can be achieved at concentrations of active compound as low as a few micrograms (millionth of a gram) per milliliter of blood—a very tiny concentration indeed! Yet when homeopathic preparations are taken above 20x or so, no actual molecules can be detected in some analyses. At this point, we are perhaps dealing with energy medicine, and this has implications again for what one believes about this kind of healing, because science has no rationale for something that one cannot measure or detect with even the most sophisticated instruments. If one is to keep an open mind, can the efficacy of very highly diluted medicine cannot be dismissed out-of-hand? Perhaps these kinds of medicine can be placed under the category of placebo, until more evidence is available that shows the mechanism of action, which may eventually be found.

Placebo, or a remedy that has no known active ingredients, is a fascinating and integral part of many healing systems. Bedside manner, the enthusiasm of the practitioner, and the trust you place in your healer or practitioner and their medicine (including chanting and blowing tobacco smoke on the patient in some cultures) is all part of placebo. A recent study performed at the University of Chicago shows that nearly half of U.S. doctors use placebo medications with their patients at some point in their practice. The principal researcher, Rachel Sherman, a medical student, said "It illustrates that doctors believe expectation and belief have therapeutic potential."

After all, what is wrong with activating one’s immune system and unlocking the healing potential of the body with a harmless substance, as long as we know and agree that our practitioner may use this modality as one possibility in our treatment regime?

Comparative Benefits of Teas, Tinctures, Tablets and Capsules