Give Your Patients (and Practice) the Herbal Advantage
Katie Stage, ND, RH (AHG)
Incorporating herbal medicine into your practice is an excellent way to speed healing and increase patient satisfaction. If you work with your patients on their diets, in some sense, you already discuss herbs. Adding herbal medicine is an easy next step.
Herbs Work!
The first thing to know about herbal medicine is that it works. Herbs have been the primary source of medicine for thousands of years and are effective at addressing a wide range of physiological problems, both acute and chronic. Acute conditions that can be addressed with herbal medicine include wound healing, migraines, pain and infections. However, herbs also can be used to address chronic concerns such as hormone imbalance, adrenal fatigue, hypertension, autoimmune disease, memory loss and diabetes.
In addition to treating specific symptoms or conditions, herbs can provide a tonifying action on the human body. For example, Crataegus spp (hawthorne) berries, flowers and leaves act as a cardiovascular tonic, increasing blood flow to the myocardial cells, gently lowering blood pressure, calming mild arrhythmias and supporting connective tissue throughout the body. Thus, hawthorne is often called "food for the heart." Not only does it address multiple conditions, but it also supports overall health and helps to prevent cardiovascular disease, the leading cause of death.
Herbs are well-tolerated and can be easily formulated to create a custom product, tailored for the individual patient. This type of customized product increases compliance and results.
Important Considerations
While many herbs are safe for most people, not every herb is safe for everyone. Adverse effects are rare and you can minimize them by becoming familiar with a small number of herbs, perhaps 5-10. As you start to work with these herbs, you will notice trends in patient tolerance.
Certain herbs require monitored dosing in order to be used safely. Remember – the difference between a medicine and a poison can be in the dose! These herbs are not typically available over the counter, and are usually only used by experienced herbalists or naturopathic physicians. For example, herbs such as Rauvolfia serpentina (Indian snakeroot) and Piscidia piscipula (Jamaican dogwood) can be helpful, but must be used in the correct dose and with careful attention to possible interactions if the patient is on medications or supplements.
Consult a safety reference book for information on the safety of your selected herbs in pregnancy and lactation. It is always best to be conservative and minimize the use of herbs (and all medicines) during pregnancy, particularly in the first trimester. (I've listed a few useful safety resource books at the end of this article.)
Related to safety is the quality of the herbs. It is of utmost importance to use an herbal manufacturing company with stringent safety practices. First, look for organic or wild-crafted herbs. Cultivated herbs that have been grown with pesticides will not make high-quality medicine. Herbs collected in the wild should be done so in a way that does not deplete native communities.
A good herbal products manufacturer also will have internal processes to ensure its products contain the correct herbs and are free from contaminants such as heavy metals or microbial growth. An herbal manufacturer who puts effort into such quality assurance will be proud to tell you about this, so don't be afraid to call them up and ask!
Delivery Systems
Herbs are available in several forms, which can be selected based on practitioner and patient preference. Hydro-alcoholic extracts, commonly called tinctures or liquid extracts, are herbs extracted in an alcohol and water mix. This is an excellent delivery system, as it allows for fresh or dried plant material to be concentrated in a form that has a long shelf life.
Tinctures can be easily mixed to create a custom formula. Practitioners can purchase large bottles of tinctures and then dispense them into smaller bottles for patient convenience. Tinctures are typically dosed at 2-5 ml, mixed in a little water or other beverage, 2-3 times a day.
Glycerites are glycerin extractions of herbs. Glycerin provides an excellent delivery system for those who cannot take alcohol and for children. Glycerin tastes sweet, but is not metabolized like a sugar, so glycerites are safe for diabetics and those who avoid sugar.
Solid extracts are another type of alcohol-free extract. The herbs are ultra-concentrated and then mixed with a little honey or glycerin to make a product with a thick, jam-like consistency. These are an excellent way to deliver a high dose of medicine in a well-tolerated format.
Within the world of herbalism, tea is more than just a tea bag. Most herbs extract well in water and most people are familiar with the idea of making a tea, so this is an excellent delivery system. Some patients also benefit from the idea of being involved in their medicine: The steeping of the tea becomes a bit of a ritual, reminding them of their healing process. It allows the patient to be intentional about their medicine.
Teas are usually dosed at 1 tablespoon of bulk herb per 8-oz cup of water, taken 1-3 times a day. A bulk tea at this dose will be much more potent than a tea bag. The shelf life of a loose herb or tea blend is two years if kept in a cool, dry and dark place.
Other delivery systems include capsules and topical products. Capsules can be convenient for patients and appropriate when taste is a limiting factor. The most common topical products are salves, which contain herbs, oil and beeswax to make a semi-solid consistency; and suppositories. Salves are excellent for all sorts of lesions, as they can soothe inflammation, fight infections, stop bleeding and aid healing. Suppositories are an ideal way to heal rectal, vaginal and cervical tissue. By allowing the herbs to contact the area of concern, healing is enhanced.
Safety Resources
Brinker F. Herbal Contraindications and Drug Interactions, 4th Edition. Eclectic Medical Publications, 2010.
Mills S, Bone K. The Essential Guide to Herbal Safety. London: Elsevier: Churchill Livingstone, 2005.
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