Tinnitus-Ringing in the Ear, Treatment Options From Many Traditions

The Western allopathic approach to tinnitus is dramatically different from either Western Herbalism or Traditional Chinese Medicine in addressing this condition.

Western Allopathic Medicine: Tinnitus is the perception of sound when no actualindex3 external noise is present. Tinnitus is a non-auditory, internal sound that can be intermittent or continuous, in one or both ears, and either a low or high-pitch sound. The sounds of tinnitus have been described as whistling, chirping, clicking, screeching, hissing, static, roaring, buzzing, pulsing, whooshing, or musical. The volume of the sound can fluctuate and is often most noticeable at night or during periods of quiet. Tinnitus is often accompanied by a certain degree of hearing loss.

Tinnitus can be either an acute or temporary condition, or a chronic health malady. Millions of Americans experience tinnitus, often to a debilitating degree, making it one of the most common health conditions in the country. The U.S. Centers for Disease Control estimates that nearly 15% of the general public, over 50 million Americans, experience some form of tinnitus. Roughly 20 million people struggle with burdensome chronic tinnitus, while 2 million have extreme and debilitating cases.

In general, there are two types of tinnitus:

  • Subjective Tinnitus: Head or ear noises that are perceivable only to the specific patient. Subjective tinnitus is usually traceable to auditory and neurological reactions to hearing loss, but can also be caused by an array of other catalysts. More than 99% of all tinnitus reported tinnitus cases are of the subjective variety.
  • Objective Tinnitus: Head or ear noises that are audible to other people, as well as the patient. These sounds are usually produced by internal functions in the flow of blood or muscular-skeletal systems. It is often more like the sound of a heartbeat or pulsating. This type of tinnitus is very rare, representing less than 1% of total tinnitus cases.

index2Some medications such as aspirin, ibuprofen, certain antibiotics, and diuretics can be “ototoxic” or cause damage to the inner ear, resulting in tinnitus.

Other possible causes of tinnitus are:

  • Head and neck injuries
  • Loud noises,
  • Ear infections
  • A foreign object, or earwax touching the eardrum
  • Eustachian tube (middle ear) problems
  • TMJ disorders
  • Stiffening of the middle ear bones
  • Cardiovascular disease
  • Diabetes
  • Traumatic brain injury

There are also potential risk factors including the following:

  • Noise exposure from work, headphones, concerts, explosives
  • Smoking
  • Gender – men are affected more than women
  • Hearing loss
  • Age – older individuals have a higher likelihood of developing tinnitus

There is currently no scientifically valid cure for most types of tinnitus. There is, however, remedies that focus on diverting attention, addressing the emotional impact, and or cognitive therapy.

Western Herbalism: Tinnitus can serve as an important marker pointing to other potential health issues, since it a symptom and not a disease. Whatever the cause it tends to worsen in times of tension, stress and or muscle spasms. Stimulates like caffeine or nicotine, which increases vasoconstriction, can exasperate it. Furthermore, it can be caused by damaged fine hair cells of the inner ear. Although this cannot be reversed there might we some reduction felt in using some of the suggestions below. Stress reduction can often be helpful. Some herbs have been used to address tinnitus including black cohosh (Cimicifuga racemosa), goldenseal (Hydrastis canadensis) and more recently ginkgo (Ginkgo biloba).

Traditional Chinese Medicine (TCM): In TCM we know that the images6kidney qi communicates with the ears and that as we age or because of various states of health this can affect our qi, therefore the kidneys are often identified as root causes of tinnitus.

In approaching treatment of tinnitus, it is important to distinguish between an acute or sudden occurrence or a long-term tinnitus that gets worse over time or comes and goes. Furthermore, it is important to determine whether it is an excess-type or a deficiency-type of tinnitus. A key to this determination is that an excess type of tinnitus is often experienced in only one ear, while a deficiency based tinnitus tends to develop in both ears. The deficiency type usually gets better during the day and gets worse at night. A combination of deficiency and excess syndromes is possible, especially in persons with other illnesses or with tinnitus that has persisted for several years.

The following is a description of excess and deficiency patterns that might be able to better pinpoint treatment principles to be used.

Excess type #1, Hyperactive liver and gallbladder fire:

  • Sudden onset
  • Continual sound
  • Excess symptoms (a headache, flushed face, irritability)
  • Excessive anger, fright
  • Excessive use of alcohol

TCM formula: Long dan Xie Gan Tang (Gentiana Comb) with the addition of moutan, ligustrum, for persistent liver fire weakening the Kidney water.

Excess type #2, Phlegm Fire Syndrome

  • Intermittent ringing in the ears
  • Feeling of blocked ears
  • Chest stuffiness
  • Excess phlegm
  • Dizziness
  • Blockage manifesting as difficult urination or constipation

TCM formula: Wen Dan Tang (Bamboo and Hoelen Comb)

  • with the addition of pear, haliotis, uncaria (liver)
  • with lapis, scute, rhubarb and aquilaria (blockage of chest, constipation)
  • with dampness (Ban Zia Bai Zhu Tian Ma Tang)

Diet: avoid fat or spicy food

Deficiency type #1, Deficient Kidney Jing

  • Gradual worsening ringing
  • Dizziness
  • Backache
  • Deficient heat symptoms

TCM formula: Liu Wei Di Huang Wan (Rehmannia Six Formula) and schizandra.

TCM formula Er Long Zuo Ci Wan (Tinnitus Left Supporting Pills)

Deficiency type #2, Sinking Spleen Qi (yang def.)

  • Intermittently occurring tinnitus that is relieved through rest and reduced stress
  • Low energy
  • Poor appetite
  • Loose stools

TCM formula: Yi Qi Chong Ming Tang (Ginseng, Astragalus and Pueraria Comb.)

Lifestyle: stress reduction, adequate kidney and spleen building dietimages5

Ear Massage: There are several sites that have detailed directions for addressing tinnitus through massage:

The bottom line is that the early intervention is necessary for long-term success. If you are experiencing any of the symptoms outlined in any of the treatment options, seek the advice of a Physician or Clinical Herbalist (http://www.americanherbalistsguild.com/herbalists-and-chapters-near-you)

Sources:

Davis, Kathleen FNP. 2016. Tinnitus: Causes, Symptoms, and Treatment. The University of Illinois-Chicago, School of Medicine. Available from

http://www.medicalnewstoday.com/articles/156286.php

Flaws, B Sionneau P. 2001. The Treatment of Modern Western Medical Disease with Chinese Medicine. Blue Poppy Press. p. 55-56.

Hoffmann, D. 2003. Medical Herbalism. Healing Arts Press. P372-373.

Dharmananda, S. Ph. D. 1998. Treatment of Tinnitus, Vertigo, and Meniere’s disease with Chinese herbs. Institute for Traditional Medicine. Available from http://www.itmonline.org/arts/tinmen.htm

 

 

Herbal Tinctures: Getting or Giving the Right Dose

tincturesHerbal tinctures are the backbone of Western herbalism.  Generally, herbal tinctures are made from herbs extracted with a combination of alcohol and water, although glycerine and vinegar can also be used.  They are widely available, economical to produce and use, compact enough to stock in considerable variety and have a good shelf life. They can be combined and are convenient to take.   Dried herbs start to loose their potency after 6 months yet tinctures can last up to 10 years or more.  As a primarily Traditional Chinese Medicine herbalist, I mostly rely on concentrated decoctions, but in some cases when I am working with aerial parts of  plants, or herbs that could benefit from the effects of alcohol, increasing circulation, tinctures are more appropriate.

This posting is based on tinctures made using the weight to volume method.

Understanding dosage rates are important in achieving therapeutic outcomes.  I find that if someone isn’t responding to an herbal formula then analyzing their dosages can be helpful.

As a starting point most commercially available herbal tinctures indicate the weight to volume ratio.  For example, if the label states that it is a 1:5 extraction, this indicates that 1 gram (weight) of herb is equivalent to 5 milliliters (volume) of liquid.

A tincture formula will state the herb and the ratio of herb (by weight) to solvent (by volume), and the % alcohol (ethanol) in water.

Having this information is crucial in understanding the amount of herb that you are recommending or taking per dose.  Furthermore, this information is required by law to appear on the label. along with the serving size suggestion, which we will discuss further on.

In trying to communicate dosage equivalencies I have developed the following chart based on weight to volume ratios.  The side column indicates the common ratios and the top row indicates the volume of tincture consumed (in milliliters).  For example, if you took 1 milliliter of liquid made at a ratio of 1:2 then you would be ingesting a half of a gram of herb.

Tincture Dosage Equivalencydosage ratioSuggested Use:  Different companies have different suggested dosage rates.   Some companies suggest taking a dropper full and others recommended taking a range of drops as a serving size, for example, 20-60 drops.  When a dropper full is suggested the amount consumed depends on the size of the bottle and dropper.  When the suggested dosage on the bottle indicates a number of drops per dose, the amount consumed depends on the viscosity of the liquid.  Since this can change from one company to the next the best we can do is to have an understanding of some equivalents  recognizing that this is an approximation:

  • 20 drops = 1 ml
  • Dropperful from a one-ounce bottle—30 drops
  • Dropperful from a two-ounce bottle—40 drops
  • 5 ml = 1 teaspoon
  • A one-ounce bottle holds approximately 30 ml, 6 teaspoons, 30 dropper full, and 1,000–1,200 drops.

For example if using the suggested serving of 40 drops, and 20 drops = 1 milliliter, then you are taking approximately 2 milliliters of a 1:5 tincture and getting approximately .4 grams of herb per dose.  Most commonly it is recommended to take the tincture two to three times a day, so using this same example you  would be consuming between .8 and 1.2 grams of herb per day. Knowing the actual amount of herb that is recommended on a daily basis will help with putting the this into context.  Below is a partial list of recommended daily dosage of some common herbs.

Examples of dosages of some common herbs*:

Herb Daily Dosage
Angelica archangelica 3-9 grams
Ashwagandha 3-12 grams
Astragalus 6-15 grams
Black Cohosh 3-9 grams
Burdock 3-10 grams
Codonopsis 9-30 grams
Dandelion 9-30 grams
Dang Gui 3-15 grams
Echinacea 3-9 grams
Grindelia 3-6 grams
Hawthorn Berry 6-12 grams
Lemon Balm ½-6 grams
Motherwort 10-30 grams
Oregon Grape Root 3-9 grams
Passion flower 3-9 grams
Skullcap 3-9 grams
St. Johns Wort 3-9 grams
Uva Ursi 3-6 grams
Valerian 3-6 grams

* Planetary Herbology, Michael Tierra

In some circles there has been a discussion that the use of alcohol potentizes the action of the herbs, therefore less herb is needed.  Furthermore, the synergistic action of herbal combinations or formulas also increases effectiveness requring less herb.  These are great discussions but I work with aspiring herbalists who are often confused as to how to determine or convert tinctures to actual grams of herbs.  I hope that this helps and would encourage you to take a moment to actually consider that you might not be taking enough herbs to be effective.

Related blog post:  https://herbalgoddessmedicinals.wordpress.com/category/herbal-preparations/

Up coming blog:  How to make tinctures using the weight to volume method.

 

 

More Than Medicinal: Herbal Love Medicine

I recently finished teaching a wildcrafting class on medicinal herbs of Central Oregon. This year I incorporated other cultural uses of plants, in particular, focusing on “Love Medicine”.love   Native peoples used plants, not only as medicine, but also for their ability to affect an outcome. Daniel Moerman, author of Native American Ethnobotany, offers a compilation of ethnographies with over a hundred stories of tribal use of plants including ceremonial, hunting, witchcraft and love medicine.

The term love medicine was used for plants that were often suggested by tribal healers, elders or through the oral transfer of information to have powers beyond their medicinal attributes. Both men and women would use various plants as love charms to lure potential suitors or hold the attention of a “special person”.   In researching this topic it is a bit murky how the plants were utilized. In some cases special perfumes were prepared, in others, rituals were conducted with specific plants. In the book Plains Apache Ethnobotany by Julia A. Jordan people spoke about tribal members who specialized in preparing “love medicines”. In this book, the author describes the use of perfumes that were worn during certain times and specific places. In Daniel Moerman’s book he briefly describes how various plants were used or prepared. As contemporary herbalism as evolved over the last century, many of these spirit-based uses are being lost to us. With that in mind, here are some plants surrounding Central Oregon and how they were used as “love medicine”.

Aquilegia formosa

Aquilegia formosa

Various species of columbine were used as Love medicine. Western Columbine (Aquilegia formosa) was used by the Thompson Indian’s who used it as a charm for women “to gain the affection of men”. The Pawnee along with the Ponca’s used the crushed seeds of columbine, as a love charm also used columbine as love medicine.

larkspur

Delphinium menzieessi

Larkspur, (Delphinium menziessi)- a plant that was toxic to livestock and considered poisonous ironically was used for love medicine. The Thompson tribe’s women used it “to help them obtain and hold the affection of men”, although it wasn’t clear on how it was utilized.

MeadowrueMeadowrue, of which Central Oregon has a few species was not used by local tribes but was used by the Potawatomi as both hunting and love medicine. The seeds were mixed with tobacco by and smoked by men when going to call upon a favorite lady. Meadowrue, (Thalictrum occidentale), was used by the Thompson as a poultice on open wounds for healing. Meadowrue’s root contains berberines, one of the few plants aside from Oregon Grape Root to contain that particular constituent. It was used to loosen phlegm, as blood medicine, and as an analgesic. The powdered fruits were mashed into a paste with water and used on the skin and hair.

spreading-dogbane-apocynum-androsaemifolium-01

apocynum-androsaemifolium

Spreading Dogbane (Apocynum androsaemifolium)-although considered toxic was used extensively by Native Americans as love medicine. The Okanagan-Colville tribe chewed the leaves and the juice, as well as, smoked the dried leaves as an aphrodisiac (Not advised). If you break a spreading dogbane stem or leaf, you will see that the plant contains a bitter, sticky, milky white sap. The sap contains cardiac glycosides that are toxic to humans. The root also contains a potent cardiac stimulant, cymarin. These toxic compounds help protect spreading dogbane from grazing animals. Despite its toxicity, the plant has been used medicinally for a variety of ailments. However, this plant is best enjoyed for its beauty and not as a medicine. Native Americans used the tough fibers of this and other native dogbanes to make threads and cord.

Platanthera leucostachys_Mono Lake Cty Park_2002-07.05

Platanthera leucostachys

Bog Orchid (Platanthera leucostachys)-a plant we recently identified in the Ochoco Mountains, was used extensively by the Thompson tribe as a wash for various joint and muscle aches. It was used in the sweat lodge for rheumatism. Women “hoping to gain a mate and have success in love” used the Bog Orchid as love medicine as a wash. Although I could find no report of its toxicity, it was only used externally, so beware.

arrowhead

Sagittaria latifolia

Arrowhead, (Sagittaria latifolia) which is found in northern Jefferson County and on the west side crest of the Cascades was used as love medicine by the Thompson is usually found at the margins of ponds or marshes. The enlarged rounded starchy tubers from the plant form at the ends of underground plant runners (rhizomes). When dislodged from the mud, these tubers will float to the surface. They are edible, and may be boiled or baked and eaten as a potato-like food. Native Americans harvested and consumed these tubers, which in some areas were known as wapato. The Thompson spoke about its use as a love charm and for witchcraft.

pineappleweek

Matriciaria disoidea

Pineappleweed (Matriciaria disoidea)- was used by native peoples ranging from Alaska to Montana. A close relative to German Chamomile it had similar uses for digestion and fevers.   Native peoples used the aromatic plants as perfume, sometimes mixing them with fir or sweet-grass and carrying the mixture in small pouches to concentrate the fragrance. Pineappleweed, provided a pleasant smelling insect repellent, and the fragrant dried plants were used to line cradles and stuff pillows.  The Okanagan-Colville buried the tops of Pineappleweed mixed with human hair to prevent loved ones or relations from going away.

prairie smoke

Geum triflorum

Prairie Smoke or three-flower avens (Geum triflorum)-is in the rosaceae family; so that tells us that it probably has astringent actions. Avens were used by many native peoples ranging from toothache remedies, fevers, antidiarrheal, gastrointestinal and as a gynecological aid. Primarily the roots were used. Several tribes used it for love medicine, including the Iroquois, who used the compounded roots as an emetic to vomit and cure themselves of love medicine. The Okanagan-Colville used and infusion of the roots as a love potion by a woman who wanted to win back the affection of a man. Mathew Woods wrote about it in his book The Earthwise Herbal: A Complete Guild To New World Medicinal Plants. He spoke about the roots of avens containing phenols, tannins and essential oil, along with noting that he felt Prairie Smoke has an affinity to the female system: the latter for Stagnant blood .

sierra shoot star

Dodecatheon jeffreyi

Last but not least Sierra Shooting Star or Tall Mountain Shooting Star (Dodecatheon jeffreyi) was used as love medicine by the Thompson tribe. Women used the flowers “to obtain the love of men and to help them control men”.

This is just a small sampling of the vast number of plants that were utilized. As the profession of herbalism evolves in North America there is greater and greater emphasis being put on evidenced based medicine and a movement away from traditional knowledge along with the reduction in the number of the plants that are used in commerce. Despite this tendency towards retraction, my hope is that we continue to keep love 2plant stories, and other cultural values which plants offer, alive.

Making Holiday Herbal Goodies: Soaks, Sprays, Scrubs and Masks

It is that time of year again when I teach a series of herbal gift-making workshops.  Since many of you following this blog are not local I thought I would share some of my favorite recipes, along with, some ideas for packaging. Feel free to experiment with any of these recipes, if you don’t have the exact ingredients or can think of something else that would enhance the action of the formulas.

cello bagSoaks:  The first set of recipes are for a variety of herbal soaks.  For packaging,  the ingredients in these recipes can be divided into large press n’ brew tea bags or  jars with an attached cotton muslin tea bag, which can then can be reused.  Mountain Rose Herbs has several of types of bags available.  I prefer the press n’ brew bags.  I divide the recipe into 4 bags, iron them shut and then combine these bags into transparent cello bags tied with ribbon and labeled with kraft paper tags.

Bright Eyes Herbal Tea Soakseye bags

4 Tablespoons Chamomile flowers

3 Tablespoons Chrysanthemum flowers

2 Tablespoons Peppermint Leaf

3 Tablespoons Sage Leaf

4 drops lavender oil

Measure everything into glass jar, shake and divide between three large press n’ tea bags.

Instructions:  Cover tea bags with boiling water, let cool until slightly warm then apply.

foot soaksDetoxing and Warming Foot Soak

1/4 cup dead sea salts

1/4 cup Epsom salts

2 Tablespoons dry mustard

2 Tablespoons dried ginger root

2 Tablespoon cinnamon stick, broken up

2 T. of Dong Quai root (angelica sinensis)

1/4 cup of Mugwort leaf

1 Teaspoon Cayenne power

4 Tablespoons of dried Dandelion Root

Put herbs into mason jar, cap and shake.  Package in jar with muslin bag or divide into 5 press n’ brew bags.

Instructions: Put herbs in large pot with 2 quarts of water. Bring to boil, and simmer for 15 minutes. Add to foot basin with enough cold water to allow feet to soak. Soak until cool.

Skin Soothing Milk Bath Soaks

¼ cup of goat milk powder

1 cup of powdered dry milk

½ cup of non-GMO corn starch

1 cup of oatmeal ground finelybath bags

¼ cup of dead sea salt

2 Tablespoons of rose petals

2 Tablespoons of lavender flowers

10 drops of rosemary essential oil

10 drops of carrot seed essential oil

10 drops of neroli essential oil

20 drops of rose hips extract

Combine oatmeal in blender and grind until powder, then combine the ingredients in blender and blend until essential oils are incorporated. Package in jar with muslin bag or divide into 8 press n’ brew bags.

Instructions: Put bag into bath and then fill with hot bath water, let cool until comfortable temp to enter bath.

bottleSprays:  The next set of recipes are facial and aftershave sprays.  I use bottles with spay atomizers from Specialty Bottle.  Their two ounce bottles are ideal for this use.  I also use kraft paper tags for labeling these as well.

Healing Facial Toner

1 Tablespoon comfrey leaf

1 Tablespoon chamomile flowers

1 Tablespoon Calendula petals

1 Tablespoon Rose petals

2 oz of witch hazelfacial spray

2 oz of vodka in jar

10 drops of carrot seed essential oil

5 drops of lavender essential oil

5 drops clary sage essential oil

5 drops of cedarwood essential oil

Combine herbs with witch hazel and vodka in jar, shake well and let sit in warm space for 1 week. Strain herbs and combine remaining essential oils, shake well and bottle.

Anti-aging Facial Spray

2 Tablespoon of aloe gel

1 Tablespoon of witch hazel

3 oz of cucumber hydrosol

6 drops of carrot essential oil

4 drops of clary sage essential oil

2 drops of geranium essential oil

3 drops of frankincense essential oil

Combine all ingredients together in jar, shake and then fill bottles.

imagesBay West Indies Aftershave Splash

This essential oil is distilled from the Bay Rum Tree (Pimenta racemosa). It is a common scent in men’s aftershave products.

1 cups of witch hazel extract

1 ounce of rum

zest from half organic orange

1/2 cinnamon stick

6 peppercorns

1 sprig of rosemary

1 tsp of corianderafter_shave

1 bay leaf

3-cloves

3-whole allspice

1 tsp teaspoon aloe vera gel

1 tsp of glycerin

15-25 drops of Bay West Indies Essential Oil, depending on preference

Combine all ingredients in 1 quart mason jar, cover and shake well.  Let sit for 2 weeks, shaking daily.  Strain and fill bottles.

jarsScrubs:  The internet is filled with recipes for scrubs but I wanted to offer up a few of my favorites.  In terms of packaging I use a 4 ounce jar with swing-top lid, which is convenient when using in a shower.  There are many places to download printable labels, but this is one site I often use http://putitinajar.com/crafts/printables/  I use full sheet shipping labels and then print out my labels.  There are numerous examples of labels available at craft supply stores for this purpose if you don’t want to trouble yourself with downloading and printing.

Seaweed Detox Salt Scrub

2 tablespoons comfrey root

2 tablespoons Calendula flower

1 ½ cup of sesame oil

scrubs¼ cup of bladderwack seaweed powder

½ cup of kelp powder

2 cups of dead sea salt

½ cup of Rhassoul clay

¼ cup of castor oil

10 drops of rosemary essential oil

10 drops of lavender essential oil

Combine the comfrey and calendula herbs with the sesame oil, heat on low for 20 minutes.  Remove from heat, let cool and strain out herbs.  Combine remaining ingredients, mixing well.  Add more clay if necessary to make it the consistency of peanut butter.

Chocolicious Body Scrub

1/4 cup of Epsom salt

1/4 cup of Dead Sea Salt

2 Tablespoons of cocoa powder

½ tsp of cinnamon

1 Teaspoon of vanilla

3 Tablespoon of melted coconut oil

Combine all ingredients together mixing well, then fill jars.

facial masksMocha Facial Scrub

1 cup sugar

2 Tablespoon of cocoa powder

2 Tablespoon of finely ground coffee

1/3 cup of oatmeal powder*

5-7 Tablespoons of sesame oil

2 Tablespoon of Aloe Vera Gel

1 teaspoon of Vit. E oil

Combine all ingredients together mixing well, then fill jars.  * put oatmeal in blend and grind finely

blue jarMasks:  Ever since I was a young girl I loved using facial masks.  Over the years I have enjoyed exploring the full range of masks from fresh fruits to honey to clay.  Here are two of my favorites. For packaging I use hexagon shaped jars, along with kraft paper tags.

Goat Milk and Clay Pore Refining Masque

1/2 cup of French Clay

4 Tablespoon of slippery elm powder

4 Tablespoon of dried goat’s milk powder

2 Tablespoon of comfrey root powder

2 Tablespoon of rose powder

1 Tablespoon of sandalwood powder

20 drops of carrot seed essential oil

10 drops of clary sage essential oil

10 drops of lavender essential oil

5 drops of cedarwood essential oil

Combine all in blender and blend until well mixed.  Fill jars

Instructions: Moisten 1 Tablespoon of the masque with milk, yogurt or water. Apply to face and leave on until dry, rinse and pat dry.

Rose, Frankincense and Sandalwood Facial Mask

2 Tablespoons Rose powder

2 Teaspoons Sandalwood powder

2 Tablespoons Frankincense powder

1/2 cup of sugarfacial mask

3 Tablespoons cosmetic white clay

½ cup of sesame seed oil

5 drops of black pepper essential oil

6 drops of coriander essential oil

2 Teaspoons of Vit E.

Mix all ingredients together in bowl and mix well.  Mixture should be thick adding more clay if necessary. Fill jars.

Happy Holidays

Resources for herbs and Tea Bags:

https://www.mountainroseherbs.com/

http://www.oregonswildharvest.com/owh/browse/bulk_herbs,_teas_and_spices

For bottles:

http://www.specialtybottle.com/

For cello bags and other packaging:

http://www.papermart.com/HOME

Happy Holidays to you and yours

 

 

 

Consumer Beware: The Rampant Under Dosing of Herbal Products

The world of herbal supplements is often confusing and making heads or infusiontails out of dosages, etc. takes time, research and a bit of math. Many folks buy herbs from their local health food stores, through the Internet or from alternative care providers. More often than not, they follow the instructions that appear on the bottle. I have analyzed many formulas that clients have brought to me and I am always struck by the fact that what they are taking is far below the recommended daily therapeutic dosage. As an herbalist, I contend that if folks are not seeing the intended effects it is either due to under dosing or not addressing the root cause of their condition. For the purposes of this article I am going to concentrate on the issue of under dosing and although I know that this topic is potentially controversial, it nonetheless needs to be examined.

I believe that under dosing is rampant due to the following: the true cost of taking herbs therapeutically, herbal profit margins and the risk adverse nature of supplement manufactures. To illustrate my point we will look at several forms of existing herbal products in relationship to recommended daily therapeutic dosages.

Let’s start by picking an herb. An average recommended dose of Vitex (Chaste Tree) berry is 3-6 grams a day of dried ground herb, as stated in several prominent books on herbalism. For this analysis I will use this as my baseline for establishing a daily therapeutic dose. When we look at using tinctures several leading tincturesbrands provide Vitex tinctured at a 1:5 ratio (a standard ratio that many manufactures use, I believe based on profit margins). This measurement is an herb to liquid ratio, meaning that 5 milliliters of liquid equals one gram of herb. If you want to take the therapeutic dose of 3 grams of Vitex a day, you would need to take 1 teaspoon of tincture, three times a day (1 tsp is approximately 5 milliliters). When we look at the cost of this dose, a standard 1-ounce tincture bottle would last two days (1 oz equals 6 teaspoons). At an average cost of $10 a day this would cost $40 a week. If you take the upper range of the recommended dose – 6 grams, you would need to double the amount of tincture equaling an ounce of tincture a day at $10 a day this would be approximately $70 per week.

Most tincture bottles provide recommendations based on a drop dosage. In the case of Vitex a review of several manufacturers suggest an average of 30 drops (30 drops equals approximately 1 ml although this depends on the viscosity) three times a day. There are several ways to look at this, but the simplest is to remember that 5 milliliters of a 1:5 ratio equals one gram of Vitex. If this amount is taken 3 times a day you would be taking 3 milliliters of Vitex or less than 1 gram of herb which is far below the low range of the 3-6 grams a day. Some herbalists would make the case that tinctures are a more concentrated form of herbal preparation due to their bio-availability of chemical constituents thereby lower dosages are appropriate. This might indeed be true and depends on your frame of reference. Either way it behooves us to take the time to do the research and math to figure out the actual dosage that you are taking or recommending.

When we look at the comparison of therapeutic dosage in relationship to herbal capsules under dosing becomes even more apparent. For examplecapsules many leading manufactures supply Vitex at 400 mg per capsule (400 mg equals .4 gram) with a recommend daily dose of 2 to 3 capsules a day. In doing the math this translates to consuming .8 gram of Vitex at 2 capsules a day and 1.2 gram of Vitex at 3 capsules a day, far below the recommended daily therapeutic dose. In fact to get to 3 grams you would have to consume 8 capsules a day and at 6 grams a day you would have to consume 16 capsules a day.

I have done similar analysis of Traditional Chinese Medicine, medicinal mushrooms and standardized herbal supplement formulas only to find that the dosages on the bottle fall far below therapeutic recommendations. So what is the answer?

  1. Invest in a comprehensive book on herbs that lists therapeutic dosages in grams for example Planetary Herbology by Michael Tierra.
  2. Determine the therapeutic dose for a given herb.
  3. Read the information in the box (Supplement Facts panel). What is the recommended serving size? What is the suggested dosage?
  4. Do the math. Compare the supplements recommended daily dose to the therapeutic dose.
  5. Look for fluid extracts which are tinctured at 1:1 or 1:2 ratio or other concentrated forms of herbal preparations.

 

Wildcrafting: Developing a bioregional approach to herbalism

Much has been written about the importance of developing a bioregional approach to herbalism particularly in relationship to sustainability.  As anSlide01 herbalist having an understanding of your bioregion allows you to more fully engage with your surroundings and to have an intimate knowledge of its micro environments and plant populations.  Many of the “popular” herbs that we rely on are grown all over the world.   Their energy footprint including transportation costs, etc., as well as, the sometimes unethical practices of harvesting can be mitigated by utilizing herbs “outside your door”.  I believe our challenge as herbalist’s is to discover, utilize and teach others about what grows locally, so we can become more self-reliant and less dependent upon mail order herbs.  This article is an outline of the process that I have used and teach in my bioregional wildcrafting classes.

Slide04Defining a bioregion:  This is a helpful process in trying to understand the various ecosystems that encompass a specific area and to being able to identify various plant populations that grow within in them.  In my case I live in Central Oregon (Crook, Deschutes and Jefferson counties) which comprises a variety of ecosystems.  Using the following link: http://www.plantmaps.com/interactive-oregon-ecoregions-l4-map.php  which is specific to Oregon I have identified the various ecosystems that the Environmental Protection Agency (EPA) has defined that make up the area that I live.  I assume that these interactive maps are available for all parts of North America.

Plant Identification:  This by far is the most challenging part of the process and I have spent endlessSlide09 hours scouring photo’s and plant descriptions to determine a plants identity. We are fortunate that we live in an era where there are so many resources available to us including on-line plant databases, plant identification apps and books.  Searching for plant lists is another helpful tool.  These lists are often available through native plant societies, university databases, herb schools and various other sites.

Here are a few links for plants specific to Oregon:

http://science.halleyhosting.com/nature/bloomtime/lists/or/or.html

http://www.oregonflora.org/atlas.php

http://www.botanicalstudies.net/botany/plantlists.php

Slide06Before you start this process it is vitally important to identify poisonous plants that grow in your area.  Typically I will review plant lists and determine if the plant that is listed has a history of use (see traditional use section below). Having a plant list in hand is a great first step, but you still have to be able to positively identify plants that you find.  Having a basic understanding of botany is particularly helpful in reading through plant descriptions or having the ability to identify plant families at least narrows down the Slide17possibilities.  Having a working knowledge of plant families can be quite helpful in at least narrowing down your search. A great book is Thomas Elpel’s “Botany in a Day: the Patterns Method of Plant Identification” and his website:   http://www.wildflowers-and-weeds.com/Plant_Families/Plant_Families_Index.html

In looking for a plant identification book I prefer one that is indexed by the color of the flowers the number and type of leaf pattern.  A rule of thumb is to identify the plant from three different sources before making the final confirmation as to its identification.   There are some excellent websites featuring photos of plants in the Pacific Northwest, Mark Turner’s book and internet site is extremely helpful:  http://www.pnwflowers.com.

Finally Hitchcock and Cronquist book “Flora of the Pacific Northwest” is an invaluable resource for species identification.  Once you have identified the plant then researching its medicinal value is the next step in the process.

Traditional Uses:  There are numerous books written about the medicinal value of medicinal herbs although they tend toroot digging feature more common or popular herbs.  In my bioregion which is mostly scrub and sagebrush these are not helpful.  Identifying Native American use of plants has been the most helpful path as I have found.  For my area I have identified the following Native American tribes who have used plants specific to my bioregion.

  • Cowlitz-South central Washington
  • Klamath-Southern Central Oregon
  • Okanagon-Colville reservation in Washington and British Columbia border.
  • Warm Springs-North central Oregon
  • Paiute-Great Basin region, Warm Springs reservation*
  • Shuswap-Southern interior plateau of British Columbia
  • Skagit- Upper, Northern Cascade Range, Washington
  • Snohomish-Northeastern side of Puget Sound, Washington
  • Thompson-Southwestern British Columbia
  • Umatilla-along the Umatilla and Columbia Rivers in Oregon
  • Washo-Near Lake Tahoe on the Calif.-Nevada border.

*Confederated Tribes of Warm Springs Indian Reservation comprised of Warm Springs, Paiute and Wasco tribes.

Armored with this information I have done searches and read some of the original ethnographies that are available through inter-library loan.  Additionally I have almost wore out my copy of Daniel Moreman’s amazing book “Native American Medicinal Plants“.   Two other invaluable books in researching traditional uses are Steven Foster and Christopher Hobbs, “Western Medicinal Plants and Herbs” and  “American Medicinal Plants” by Millspaugh.  It is important to recognize that the information we have available is by no means exhaustive and only a reflection of the information that was collected through a colonial framework.

index

Rosa woodsii

Materia Medica:  Once you have identified the plant’s traditional and/or contemporary uses it is helpful to start to categorize its medicinal properties so that you can incorporate into your materia medica and medicine making, noting which parts of the plant are used.  For example, if a plant is within a certain family such as Rosaceae you already know that it is probably astringent due to the tannins. For example Woods’ Rose (Rosa woodsii) was used by the Paiute tribes as a decoction of the root for diarrhea, a poultice of various parts of the plant as a burn medicine, a decoction of the inner bark of the shrub for colds, a poultice of the mashed fungus galls for open boils, and an infusion of the leaves were taken as a spring tonic.  The Thompson tribe used the hips to help women in labor to hasten delivery and a decoction of the roots were taken by women after childbirth to tonify the uterus.  They also made a decoction of branches of rose, chokecherry and willow for diarrhea and vomiting.  Pioneer women used the hips of wild rose in jelly, pudding and syrups.  Knowing these uses helps you to incorporate it into your arsenal for addressing any number of conditions where you might have used other astringent herbs.

lomatium dissectum

Lomatium dissectum

Another example is Fernleaf Biscuitroot (Lomatium dissectum) which was used by the numerous tribes including the Paiute, Northern Paiute, Thompson and Okanagan-Colville tribes.  It was used as a dermatological aid for sores, for pulmonary issues including tuberculosis, as an analgesic for pain and arthritis, a decoction of the roots was taken for colds and numerous other uses. In looking at contemporary information on this plant, it has been found to have antimicrobial and antiviral potential.   It is fairly easy to see how one could incorporate the roots into oil for salves, cooked roots into cough medicine and roots soaked in alcohol as a liniment.

Astragalus purshii

Astragalus purshii

Research pays off, for example some plants have a documented use of being used internally yet they have emetic potential such as Wooly-pod Milk Vetch (Astragalus purshii).  Astragalus purshii  was  primarily used externally as a wash, although the Kawailsu tribe did use it internally for menstrual pains.  As a dermatological aid a decoction of the whole plant was used as a wash for the head, hair and body.  It was also used in the sweat lodge as a disinfectant, and was poured over hunting equipment, when the hunter was having “bad luck”. Since it does mention that it could be an emetic I would recommend only using this plant externally.  It is important to be stewards of the land therefore ensuring continued abundance of the plants that we harvest.  There are several websites that outline the steps to take to ensure we are properly caretakers of our bioregion.  Explore, learn and share your knowledge.

Ethical Wildcrafting and Stewardship:

  1.  Follow the abundance
  2. Avoid and protect unusual, threatened and endangered plants
  3. Gather in small, thoughtful numbers
  4. 
Browse, don’t graze
  5. 
Know where (and where not) to harvest
  6. Be okay with an empty basket
  7. Err on the side of less
  8. Promote abundance
, spread seeds, try to take parts of roots, not the entire plant
  9. Harvest to the plant’s needs
  10. 
Bring the right tools
  11. Assess for environmental toxins
  12. Share your gratitude-giving thanks

https://www.unitedplantsavers.org/images/pdf/2012_nursery_directory.pdf

http://7song.com/files/Wildcrafting%20Herbalist.pdf