If you are thinking about using herbs, it’s probably because you have decided to take more personal responsibility for treating your own ailments. What I’m inviting you to think about here is the place that research plays in that personal responsibility. If you use herbs, you must either find a reputable herbalist, or if you want to do it yourself, you must learn what the herbalist knows about the herb you want to use.
Purchase a modern herbal or two. Then go to reputable Web sites for the most recent updates on contraindications. Books can go out of date. Just as I’d rather be treated by a doctor who studied from twenty-first century text books rather than those from the 1850s, I’d rather use herbal information from yesterday than from the 1850s. Web resources are listed in Chapter 6.
Work with your Doctor, but Always Double-check your Doctor
Bottom line: You should always double check any drug, any supplement, any botanical that you put in your mouth. People—be they doctors, authors, herbalists, or pharmacists—all make mistakes. More than 1.5 million Americans each year experience an adverse drug event: receiving the wrong medication, the wrong dose, the wrong instructions for taking the medicine, or some other preventable error. According to the Institute of Medicine (part of the United States National Academy of Sciences), in hospitals, the problem is even worse. In hospitals, if you factor in prescribing, filling prescriptions, administering and monitoring, the error rate rises to an average of one medication error per patient per day.5 These are statistics for prescription medicines dispensed by a system with sophisticated checks in place. Now add a self-administered herb or two into the mix, and you see why you need to take responsibility for knowing about doses and interactions.
For everything you take, you should know what it is, why you’re taking it, and have a rough idea of how it works. This is true for prescription drugs, over-the-counter drugs, and botanicals. If you don’t know, ask someone who does.
Check herb–medication interactions for yourself as well. (See Chapter 6, “Further Resources” for places you can check dosage and interaction of herbs.) Again if you see a problem or just have a question, talk with someone who has more training.
Always talk to your doctor and pharmacist about what you’re taking. It’s nice to have a doctor who is savvy about botanicals. Though most aren’t familiar with botanicals and their effects, an increasing number are reconciling themselves to the fact that some patients insist on using them. Even if your doctor is a skeptic and cracks jokes about you’re acting like you have a doctorate in “oregano,” you still need to let him know what you are taking.
Keep a list of everything you’re taking—herbal, prescription, and over-the-counter—and bring it with you to the doctor when you go. Show the list to your pharmacist as well if the doctor prescribes any prescription drugs. Recheck everything with your doctor and pharmacist every time you begin taking a new medication. If you need surgery, speak up if you are taking any botanicals. Some can cause increased bleeding and changes in heart rate and blood pressure. Your doctor has resources and can check interactions even if he was never trained in herbs in medical school.
Pay Attention
Herbs require that you be aware of what’s happening in your body. It’s like people and their cars. Some know every sound, every vibration, every nuance in the steering wheel and gearshift. Others are completely oblivious. They drive day in and day out without a care or a clue until a dashboard light goes on. Even then their first thought is, “How long has that been on? I wonder if I can drive this until the weekend and get it taken care of then.”
If you are careless and clueless about your body, herbs aren’t for you. You probably won’t recognize the signs of when it’s time to stop taking them. And you may not notice their effects, which can be subtle and occur over the span of weeks or months.
Even if you are well in touch with your body and its normal state of health, you still need to pay attention. Keep track of what you’re taking and any reactions you have to it. Keep a record of all the supplements you take—what they are, how much you take, how often, why. Keeping a record of what did and didn’t work can help you next time you want to use the supplement. If you have a bad reaction, write it down. Make sure your family (or whoever has your durable power of attorney for health care) also has a copy of the list. If you get hit by a bus, the emergency room personnel would like to know if you are taking something that affects heart rate, blood pressure, or clotting time.
Reevaluate Periodically
If your health changes, you need to reevaluate the botanicals you take. If you become pregnant or are nursing, you need to talk with your doctor before taking any herbs. Many of the entries in the herbal section of this book say “don’t use this herb if you are pregnant or nursing.” Frankly, we don’t know the effects of most of these herbs on a fetus or a small baby. Until more information becomes available, it’s probably prudent to avoid taking herbs unless specifically told to do so by your doctor. If you are beginning to feel the effects of age, or develop long-term health issues, check with your doctor. All of these factors can influence the way your body uses herbs.
Lock Everything up
If you have young children, lock up your herbs just as you would drain cleaner and paint thinner. Some essential oils and herbs can kill outright. Others can make a child much sicker than an adult taking the same amount. You might consider doing the same thing if you have pets. I once had a cat who dove head first into a wastebasket to retrieve a broken valerian capsule. Not eager to do my own personal animal testing, I took it from her, but not before she’d hauled it halfway across the bathroom floor in her mouth.
A Chinese formula containing multiple interacting herbs
Label Everything
If you make your own preparations, label everything. Never reuse a container unless you completely remove or cover prior labels. If you carry herbs in a separate container (to the gym or dojo), label that container. If it doesn’t have a label, throw it out. You don’t want to guess wrong.
Get Help If You Want to Mix Herbs
Some herbs interact; some even interact in ways we are not yet aware of. A common—though not always smart—way of combining herbs is to mix several that have the properties you are looking for. In other words, you may mix up a remedy that has one herb for swelling, another for pain, another for tissue repair, another to help you sleep. The end result might have all those properties. Or it might be mud, with one herb’s effects canceling out another’s. Or it might be considerably stronger than you anticipate, with one herb’s effects compounding another’s. The wrong combinations can be like a junior chemistry set experiment gone bad.
In other words, mixing herbs is an advanced skill. Stick to either trusted recipes or find a good herbalist if you want to branch into combinations. Commission E also has lists of herbs that can be combined safely.
For those of you used to Chinese medicine, you might be surprised at how many herbs in this book are used as simples, in other words, one herb alone, not in combination with others. Traditional Chinese medicine has an elaborate system for combining herbs. Frankly, it’s much more sophisticated than any herb combining in the West. They combine herbs to compound the effect, to buffer undesirable qualities, and to treat a complex of symptoms and imbalances in the patient. Through centuries of use, they have charted not just the action of herbs but the interactions between herbs. The combinations they have arrived at are not just a cure for symptoms; they are a treatment of the patient, who has not just an injury, but also a body with various balances and imbalances. If you don’t understand the basis for a particular combination, you won’t know if that basis applies to a particular person and his injury.
Let me say it again: combining herbs is an advanced skill. If you