I really like when I can use a standard protocol for a disease and receive consistently good results. This is especially true when it is a condition such as rheumatoid arthritis, an autoimmune condition. Specifically, “autoimmune disease” refers to a condition where the body mistakes its own tissues for foreign invaders such as bacteria and viruses and creates antibodies to seek out and destroy those specific tissues. In the case of rheumatoid arthritis, the body attacks its own synovial tissues within the joints.

Besides being an autoimmune disease, rheumatoid arthritis differs from the more common osteoarthritis in terms of cause. Where rheumatoid arthritis is characterized by redness, swelling and eventual crippled joints and may affect all tissues of the body including soft tissues, osteoarthritis is caused by wear and tear of the joints that occurs in most animals as a somewhat normal course of aging.

At the onset RA might first affect the small joints of the fingers and toes with symptoms of warm, redness, stiffness, and swelling in these joints.  Eventually this can spread to larger joints including hips, shoulders and knees with occasional periods of remission. RA can damage the joints within three to six months of onset and individuals with RA may be unable to work after 10 years. Furthermore, it can affect other tissues including theheart, lungs, vascular system, eyes, skin and blood. All of these further complicate diagnosis. Western medicine has no cure for RA.

There is a standard blood test for used to diagnose rheumatoid arthritis.[1] Personally, I don’t refer to the RA factor blood test in my practice to treat a condition such as RA because traditional herbal medicine doesn’t require such a test. Furthermore, sometimes such tests applied to incurable diseases such as RA deepen a commitment in the patient’s mind to having a condition which from the body-mind perspective only makes rallying the complete healing forces of the body more difficult. Additionally, the RA factor test is unreliable; it can test positive in normal people and negative if there are other autoimmune conditions active in your body such as Sjogren’s disease, lupus, and viral hepatitis. Finally, I have treated many people who tested positive for RA successfully, provided the condition is not so advanced as to exhibit severe bone degeneration with twisted, crippled joints. In all cases, significant pain relief can be consistently achieved with the adoption of an anti-inflammatory diet and nature’s wonderful healing herbs.

It is estimated that approximately 41 out of 100,000 are diagnosed with RA per year and 1.3 million American have been diagnosed with it. The risk is somewhat higher for women and begins earlier in life than for men. Heart attack and stroke risk increases as much as 60% one year after diagnosis, people with RA are more liable to infections, and twice as likely to suffer from depression.

Drugs used to relieve symptoms are among the worst in terms of short- and long-term adverse effects. Drugs used in the treatment of RA include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), which are the mildest pharmaceutical treatment option. They range from aspirin to many others including ibuprofen. These help to reduce inflammation but do not halt the progression of the disease.
  • The next in line are corticosteroids, which quickly reduce inflammation and are supposed to be limited to short-term usage.
  • The next group of drugs are classified as disease-modifying antirheumatic drugs (DMARDs) which work to slow down the progression of RA and biologic DMARDs which are often used in combination to increase the efficacy of DMARDs.

Conventional medicine is beginning to acknowledge that dietary changes, lifestyle changes and herbs can relieve RA symptoms. My own clinical experience concurs with this.

There are few serious diseases that I can say seem to respond to a basic treatment protocol. However, so many patients who have come to me diagnosed with RA and osteoarthritis have responded positively to essentially the same basic protocol, which I share with you below.

Adopt an anti-inflammatory diet which consists of eliminating all refined white sugar, refined flour products, dairy, alcohol, and coffee. For some this may include gluten as well as other possible allergenic foods. Instead one should adopt a fiber-rich diet of organic fruits and vegetables, animal products such as naturally and organically raised animal foods, free-range chicken and eggs.

For many this may mean beginning with a special healing diet of kicharee, based on a combination of rice (white or brown), split yellow mungs beans, spices such as turmeric, cumin coriander and ghee.

Omega-3 fatty acids are well known to reduce inflammation throughout the body and are extremely beneficial for the treatment of RA. Various brands are of good quality including Nordic Naturals, Life Extension, Dr. Mercola’s krill oil, Carlsen’s, and Kirkland’s. I suggest a daily dose of 1000 to 1600 milligrams daily.

Alpha Lipoic Acid (ALA) is a powerful detoxifying antioxidant with special affinity for the liver and kidneys. ALA assists in converting glucose into energy, improves insulin sensitivity which asserts blood sugar control and is even known to reduce neuropathy in diabetics. It also naturally increases glutathione, the most powerful antioxidant that is produced naturally by our body. There are many fine products on the market, including Source Naturals time-released capsules available in 100, 300 and 600 mg doses, NOW Alpha Lipoic Acid, Pure Encapsulations Metabolic Xtra, and Vitacost. Take 200-600 mg daily.

A single daily good quality multivitamin should be taken for a few months to remedy any vitamin deficiencies. I use Source Natural’s Life Force Vitamins, but there are many other good quality multivitamins on the market. I usually like anything that Now brand produces. Rainbow Light also has a fine multivitamin.

Herbal formulas:

The single most effective formula I have used with consistent beneficial results is the TCM formula known as Angelica and Loranthes Combination (Du Huo Ji Sheng Tang). The brand I most commonly rely on is Active Herbs formulation called JointsJoy. It is available in easy to swallow pilules or tablets. This consists of a highly concentrated 5:1 herbal formula of 14 herbs, minimal fillers and binders made in a GMP-certified kitchen and imported in accordance with U.S. FDA guidelines. The recommended dose is 6 tablets taken two or three times daily with warm water. Because an RA patient might be taking this supplement for several months, I recommend purchasing a case of 12bottles at a time.

Another formula that is particularly effective when arthritis flares up in cold, damp weather is Feng Shi Xiao Tong Pian which in Active herbs brand is conveniently called ArthritEZ.

In addition, I recommend two capsules of Planetary Herbals’ Triphala complex which assists in normal detoxification, digestion and elimination. Triphala is a basic formula that can be used for all conditions as well as general health and wellness.

Planetary Herbals’ Flex Ability (Shu Jin San) is a Chinese formula consisting of 10 herbs. It treats arthralgia, both osteo- and rheumatoid arthritis, neuralgia, neuritis, numbness and pain in the legs, hemiplegia, chronic B vitamin deficiency, and paresthesia.  It is famous for increasing flexibility and works more on the muscles and tendons. It is available in liquid extract and tablet form. Take two tablets three times daily.

The above three formulas can be taken concurrently or on alternate weeks. 

Finally, every herbal anti-inflammatory protocol should include turmeric (with other herbs as appropriate for the patient's constitution). I use Planetary’s Full Spectrum Turmeric extract at a dose of 30 to 40 drops three times daily.

Other optional herbs and supplements that can be included are MSM (methylsulfonylmethane) and Planetary’s Guggul-Cholest.

One should get moderate daily exercise; a vigorous walk or swim are excellent options. Yoga stretches, besides making for more flexibility and limberness, also work on activating the deep hormonal systems of the body – be careful to not overdo yoga when beginning as it can result in sprains and strains which may limit further exercise at least for a while. Remember, a personal exercise routine is not a competition. Any exercise can be overdone. All one needs is about a half hour daily.

If one has access and can afford it, a series of acupuncture treatments can be extremely beneficial, especially if the acupuncturist employs methods other than just needles such as moxibustion  (applying heat close to acupoints and areas on the body), gua sha (a relatively painless rubbing over specific areas), and cupping therapies. I feel confident that this protocol will absolutely relieve or cure most cases of early stage arthritic conditions of all kinds (before deformity has occurred) and relieve inflammation and pain generally in all cases.

If one wishes to set up a telephone consultation or an office visit with myself, Lesley or one of my associates call (831) 429-8066, East West Herb and Acupuncture Clinic 912 Center Street, Santa Cruz, California.






[1] Sjogren’s syndrome is characterized by dry eyes and dry mouth. It is also an autoimmune disease. In traditional herbal medicine Sjogren’s syndrome is a form of Yin Deficiency. I have also treated this condition successfully with a dietary and herbal protocol.

Have you ever talked with someone who thought that herbs didn’t work because they did little for them despite all their commercial hype? Or have you ever taken (or given) an herb and you (or the person) not only didn’t improve but got worse? The reason for these experiences may actually be simple – the energy of the herb was not matched to that of the person or the condition experienced and so it wasn’t effective.

The energy of herbs is extremely important to consider when choosing herbs. Some herbs are cooling, others warming; some are drying, others moistening. Some drain while others build. As well, people have energetic constitutions, too. Some folks have coldness, or heat; others dryness or dampness. Some have an excess state (too much of something – think about how you feel after eating too big of a meal for example). Other people are weak, deficient, or depleted.

Thus, which herb you choose depends not only on its own energies but also that of the person taking the herb. If the person has a condition of coldness, for instance, they need herbs with a heating energy. If they are dry, they need moistening herbs. And if they’re weak, they need herbs that build strength, immunity, or blood. If herbs are not energetically matched to the person in this way, either they’ll have no results or else problems can arise.

For example, when I mention the herb, turmeric, what first comes to mind? That it’s great for pain? Perhaps, but it actually might make you dizzy instead. How about black cohosh? Think it’s mainly great for menopause? Think again. It may help some women but others might experience no benefit at all. And how about feverfew? Use it for headaches? It might work, but it only treats one type of headache. Since there are as many as five or more causes for headaches, each requires a different herbal energy and feverfew may not match that.

To be even more specific, if you give a building herb, such as ginseng, to someone who has stagnation with symptoms of burping, belching, mood swings, nausea, pent-up emotions, headache in the temples, or is easily angered or irritated, it would just make them feel worse. That would be like adding more cars to rush hour traffic. On the other hand, if someone is weak, tired, or perhaps even anemic, you wouldn’t want to give them elimination therapies as those would only weaken them further.

I learned the importance of the energy of herbs very early when I first started using herbs. Like many beginner herbalists, I began with the typical allopathic approach, that is, “this herb is good for that condition.” Then one day I got a very bad flu. A friend told me garlic is good for flu, so I took garlic. I got much worse. I was curious why and soon learned that my flu was a condition of heat (high fever, sweating, feeling hot) and garlic itself is a heating herb. Taking garlic meant I only got hotter and my symptoms intensified

Let’s take turmeric again as another example since it’s such a popular herb today. Because it’s the best anti-inflammatory available to forestall heart and brain problems and to treat pain, many people consume it regularly. While that helps some folks, others actually have reactions they don't even realize occurred because of the turmeric. I have seen many such cases over the years.

This is because turmeric is warming and drying in energy. That means it’s perfect for folks who have pain and swelling from heat and dampness such as heavy, swollen joints, yellowish and smelly diarrhea, urinary tract infections with pain and even bleeding, herpes, or yellow leukorrhea for example. But those who have dryness, anemia, or Blood Deficiency with such symptoms as dry cough, stools, skin, mouth or nails, dizziness, blurry vision, night sweats or heat flushes, can get worse since the cooling, drying turmeric only depletes these substances more. If taken for extended periods or overdosed, it can lead to insomnia, burning in the hands and feet, hypertension, or heart palpitations, for starters. [Note: Turmeric tuber (yu jin) is cooling while turmeric rhizome (jiang huang) is heating. Both promote the flow of Qi and Blood, but  the rhizome treats painful obstruction (arthritic conditions) while the tuber does not. Both herbs relieve gall bladder jaundice, but the tuber is stronger than the rhizome. Turmeric found in the grocery store is probably the rhizome.]

Each herb has specific energies that determine its true use. Start observing the energy of herbs and the conditions they treat rather than using one herb for a specific condition. Giving herbs allopathically regardless of the energy of the herb or the person taking it is what causes others to believe that herbs don't work. Even worse, it gives herbs a bad rap. Learn to use herbs energetically and you’ll more efficiently and effectively experience the wonder of herbs and their healing powers.

Lesley Tierra is teaching a 4-hour intensive on herbal energetics Oct 5, 2017 before the AHG Symposium held at the Oregon Garden Resort (in Silverton, outside of Portland, Oregon). Come learn about the differences between cooling, warming, moistening, drying, eliminating, and building herbs, their flavors and directions, and how all of these affect a person’s body and the disease experienced. This class is valuable regardless of your herbal training or background and may be applied to all herbal approaches.

The following is a guest blog post by East West graduate and faculty and professional herbalist Nancy Angelini.

Viral influenza is generally categorized as H1N1 (swine flu) or H5N1 (avian/bird flu). These are the two largest categories of flu, with the swine flu being the more easily transmitted than bird flu.

Usually, bird flu is an aggressive upper respiratory infection, while the swine flu has digestive derangement in addition to sinus congestion, sore throat and cough. The real way to know which one is epidemic at any given time is to test for it. Deaths are associated with both. While the pediatric and geriatric population are traditionally considered high-risk for flu, these aggressive flu strains put everyone at risk.

Multiple studies from the National Institutes of Health show moderate efficacy of flu vaccines, but even this is inconsistent across age ranges and from season to season, with very limited protection on occasion. Some people are completely convinced that the flu vaccine works; whether or not this is the placebo effect for some is anyone’s guess. In some cases, physician-prescribed and over-the-counter remedies for flu symptoms fail and people die. In others, they work swiftly.

Flu Management with Homeopathic and Herbal Medicines

Natural remedies can be good and effective alternatives to the many biomedical approaches that may drive the disease deeper and do not release it from the body. Serious relapses occur with the wrong approach; the longer the body must fight the infection, the more fatigued it gets.

Both avian and swine flu strains are virulent and must be managed aggressively, meaning dosing with both homeopathics and herbs 3 to 4 times daily, for at least a week (if not two) followed by continued consistent dosing a week after symptoms abate. These virulent flus can last five to six weeks in total if not managed aggressively.

Natural isopathics (a subset of homeopathic remedies based on the concept of ‘same cures same’) are available as “prevention” for seasonal influenza. I use yearly homeopathic/isopathic formulas made by Professional Formulas with my clients, especially the elderly and youth, as protection from serious flu illness. I find they work and are an important part of my GP herbalist approach as an alternative to traditional flu vaccines. If you are among those who have negative reactions to the flu vaccine, but still wish to have some type of protection, check out the isopathic flu formulas.

When I become ill, it is very difficult for me to stand in the kitchen cooking up traditional herbal or dietary flu remedies. If I am on the road, I have to make do with what I find at local health food stores. Recently I was in just this situation when I caught the flu. Based on symptoms of mild sore throat, low-grade fever, violent chills, mild sinus congestion, dry/constricted/unproductive but spastic cough, fatigue and general malaise (and the fact that I was not at home until a week and a half into the illness), my personal approach to treatment was the following:

  • Boiron’s Cold Calm homeopathic medicine - 1 tablet, 4x daily
  • Planetary Herbals Cherry Bark Cough Syrup - 1 tablespoon every 2 to 3 hours alternated with ivy leaf extract
  • Vitamin A (retinol palmitate) – 10,000 IU, once daily
  • Gan Mao Ling - 2 tablets, 3x daily
  • Host Defense Breathe Formula - 2 droppers full, 3x daily
  • Supercritical Care 200B Probiotic and Inulin Prebiotic from Advanced Naturals – 1 capsule daily
  • Triphala – 2 capsules at night
  • Supercritical extracted oregano oil - 1 gel cap daily

I did a Dr. Singha’s mustard bath and gently sweated myself after arriving home on a long flight from the West Coast. To my regimen I added thyme essential oil and lemon balm leaf extract suppositories (hand-made) each night. Also, I cut open an onion and left it on the night stand next to my bed (which smells, but disinfects the air). Had my cough progressed, I would have added formulas targeted to the deep lung and not bronchioles.

Here’s my own lesson from being exposed and fighting this flu valiantly: I neglected to use the bird flu homeopathic this year. Although I did not come down with severe illness, I was surely not the best version of myself. I haven’t had an upper respiratory imbalance for six years so I was a bit taken off guard. Nevertheless, I went straight at it hammer and tong and didn’t let up for three weeks. Though my symptoms are all but gone, I am continuing treatment now to make sure that a relapse does not occur.






Recently, a colleague sent me the following question:

A friend in Canada tested positive for H. pylori bacteria. Of course, the Western doctor he goes to wanted to start heavy antibiotic treatment. Plus, he said he would need to be on some 'pill' for the rest of his life! He is refusing until he can seek out alternative answers to this. He is 70 yrs. old, does not have a hiatal hernia, just a bit of indigestion at times.

What is Helicobacter pylori?

Helicobacter pylori is a common bacterium that many have with or without any noticeable symptoms. Recently a study found that Otzi, the 5,300-year-old ice-mummy, was also infected with H. pylori. Today it is estimated that it is present in about half the population.

H. pylori is known to produce an enzyme, urease, that allows the bacteria to live in harsh acidic environments such as the stomach. Urease reacts with urea to form ammonia which can neutralize enough of the stomach acid to allow organisms to survive in tissues for years. It is highly contagious and is transmitted through saliva, fecal contamination in food or water, and poor hygienic practices in general. As stated, the good news is that most people do not exhibit any symptoms. However, if enough of the stomach acid is neutralized, it can be a factor behind many acute gastrointestinal problems such as gastritis and GI tract ulcers.

The Herbal Approach to GI Inflammation

I’ve been involved with the study and practice of herbal medicine since 1968. In all of that time, I focused on treating the patient more than the disease. This is because my model, traditional herbalism, does not focus on treating specific pathogens associated with a disease, but the whole disease complex itself.

In other words, a Western herbalist may treat gastrointestinal symptoms caused by H. pylori with herbs not specifically targeted to eradicating the bacterium, but with herbs that reliably treat ulcers, abdominal and acid reflux. An Ayurvedic herbalist might treat these conditions as a humoral imbalance of excess pitta. A traditional Chinese herbalist would treat it based on Eight Principles and pattern analysis. In all three models, there is no particular advantage in testing and discovering that the inflammation is caused by H. pylori.

Today, many complementary health practitioners seeking to impress their patients too often resort to describing their diseases based on a Western medical model. The problem is that herbs are more food-like than drugs, exerting a broader function on restoring homeostasis and health. Still, many herbs do have specific tropisms or indications. For the patient described above, look to herbs that treat symptoms of ulcers, acid reflux, belching, bloating, nausea, vomiting, and abdominal pain as symptoms of gastritis. All of these conditions are effectively treated with dietary and herbal treatment.

So while I’ve not treated H. pylori as a discrete entity, I have had a lot of experience successfully treating all the conditions previously mentioned. Because people have responded positively, I can only assume that the diet and herbs I prescribe regularly such as Triphala inhibit the growth of H. pylori.

Herbs for Gastritis, Acid Reflux, and GI Tract Ulcers

Bitters, triphala, goldenseal, and coptis are among the many botanical remedies taken singly or in a formula for treating gastritis, acid reflux, and gi tract ulcers. These herbs treat a broad range of gastric imbalances but have also substantiated research that they are effective for H. pylori. 

Berberine is a constituent of herbs such as goldenseal, coptis, barberry, Oregon grape and the Ayurvedic herb guduchi (Tinospora cordifolia).  All of these have been shown to have broad-spectrum antibiotic and antipathogenic properties. Studies in vitro have demonstrated that berberine can inhibit H pylori. While these may not be robust enough to eradicate the organism entirely (if that is even possible), when used in a compound herbal formulation for gastritis, or in bitters, along with probiotic foods and a balanced diet, they will certainly contribute to a multilayered comprehensive gut healing regime.

Triphala, an ancient Ayurvedic healing compound consisting of three fruits, Terminalia belerica, T. emblica, commonly known as “amla” and T. Chebula or black myrobalan (Chinese: he zi), also has broad spectrum antipathogenic properties.  Chebula or black myrobalan has been cited as effective against all harmful bacteria and specifically effective for inhibiting urease active of H. pylori.

The remaining two fruits in Triphala are also effective against H. pylori, especially amla (T. emblica). Amla fruit is one of the greatest antioxidants in the plant kingdom and is highly regarded both for its nutritional and for its medicinal benefits. It is claimed as one of the two or three highest known sources of natural tannins and Vitamin C which is impervious to both age and heating. Research confirms what native people of India have known for millennia, that Amla is good for the health of the whole body, especially the liver and GI tract. It is an effective treatment for gastritis, Crohn's, iBS, stomach and duodenal ulcers and to inhibit the growth of H. pylori in the stomach.

Tinospora cordifolia, called “guduchi” and “the body’s protector” is bitter, pungent and astringent with a post-digestive ‘sweet’ effect meaning that it is an antipathogenic herb with tonic-nutritive properties. It is one of the most powerful antipathogenic herbs of special benefit for inflammatory gastric disorders.

Deglycyrrhizinated licorice root (DGL) is a well-established anti-ulceration and mucosal healing agent. DGL can coat and soothe the intestinal lining and promote the healing of inflamed tissue and ulcers. Research suggests that flavonoids in licorice have impressive antimicrobial activity against H. pylori. The flavonoids have been shown to have antimicrobial activity against strains of H. pylori that were resistant to clarithromycin and amoxicillin, two of the primary antibiotics used in triple therapy. Some forms of licorice can elevate blood pressure but because DGL has low glycyrrhizin levels it is safe to take if you have high blood pressure.

Sulforaphane is a naturally occurring chemical found in cruciferous vegetables such as broccoli, cabbage and brussels sprouts. Some studies have demonstrated that it can inhibit H. pylori. Eating cruciferous vegetables, especially broccoli sprouts, will ensure that you get plenty of sulforaphane, but it is also available in capsule form from several supplement manufacturers, including a product called Broccomax.

Some studies have suggested that Vitamin C may inhibit and even kill H. pylori but more research is needed to determine the optimal dosing and program duration. Even if Vitamin C does not eradicate H. pylori, it is still worth taking a controlled dose because studies clearly show that Vitamin C levels in the stomach lining can be reduced when H. pylori is present, largely as a result of the inflammatory and oxidative stress caused by the infection. Vitamin C is also an excellent nutrient for assisting with gut healing.

Vitamin U – also known as MSM – is found in raw cabbage. In fact, Vitamin U is not a vitamin at all. Cabbage juice has been studied extensively in Russia and other Eastern European countries for the healing of damaged and eroded intestinal mucosa. It appears to enhance the healing of damaged tissue and may assist in healing ulcers.

When I consider what the most useful single herb I know with these same antiviral, antibacterial, antifungal – in fact, every ‘anti’ property we would need to fight off harmful  pathogens—is, it is Isatis tinctoria, an herb commonly known in old English as “woad,” meaning “weed.” As an ancient East - West cruciferous family medicinal herb, it happens to have all of the same antipathogenic sulfur compounds found in cruciferous vegetables and of course biologic MSM sulfur. Both the leaf and the root of Isatis are used in Traditional Chinese Medicine called da qing ye and ban lan gen respectively. These are classified as bitter and cold, which from an herbalist’s perspective means they are broadly antipathogenic and reserved for short-term use to treat the most stubborn pathogens such as viruses but are equally effective for bacteria and funguses as well.

turmericTurmeric has become increasingly popular over the last decade, first for blood purification and then for joint pain. As it's hit the mainstream, its uses have narrowed at the same time. While turmeric is a fabulous herb with many beneficial applications, it's also quite powerful and can strongly imbalance the body if over-used or misused. Most people aren't aware of this and definitely should be.

First, the good news. While both turmeric tuber and rhizome are considered medicinal, the rhizome specifically is both the spice used in Indian cooking and western herbalism. It has a warm energy with a spicy and bitter taste and enters the Spleen, Stomach and Liver. It invigorates the Blood and Qi and has analgesic, emmenagogue, cholagogue, antibacterial, antifungal and anti-inflammatory properties.

Turmeric rhizome treats amenorrhea, dysmenorrhea, sports injuries, trauma pain and swelling, flank, gastric or abdominal congestion and pain, and eases painful obstruction due to Wind, Cold and Damp with Stagnant Blood, particularly in the shoulders. It's also used for gallstones, hepatitis, wounds, bruises, toothache, hemorrhage, arthritis and cataracts. Further, the rhizome is anti-inflammatory, antioxidant and purifies the blood and liver. It also strengthens digestion, improves intestinal flora, aids in digestion of protein, and treats gas, colic and jaundice.

With all these great uses, what could be harmful about turmeric? Well, now for the bad news. Turmeric is very bitter and so strongly dries the Blood and Yin. If taken for extended periods or overdosed, it can cause dizziness, blurry vision, insomnia, dry eyes, burning in the hands and feet, steaming bone disorder and night sweats.

I have had many a patient come in with such symptoms, uncertain as to what may have caused them. Because they didn't have a typical Yin Deficient constitution, we investigated further and found high doses of turmeric supplements often the culprit.

Because it is so highly touted in the western marketplace for pain relief, people tend to take tons of turmeric. It's not unusual for people to take supplements indiscriminately. If such and so is good for this or that, then people automatically take it and for extended periods of time. As well, they think if some is good or helpful, then more is better. And then they continue to take it preventatively when it may no longer be necessary. While either of these approaches is fine for many supplements, for turmeric it is not.

Turmeric does indeed reduce pain and swelling, but overdosing with it or taking it for prolonged periods does deplete the Blood and Yin. This is even more true for vegetarians, vegans and women during menses and so these folks should be particularly careful with this herb. It takes a long time to nourish Yin again, and the dampening herbs that do so put the digestive system at risk.

When recommending any herbs and supplements, first consider a person's constitution along with all their signs and symptoms before making your choices. Further, it's best to not use most herbs for a single commercial use. This may cause subsequent negative impact on other aspects of the body, which in turn, can give a bad reputation to that herb because it now has dangerous "side effects."

Most herbs are mild in nature and don't have side effects, just improper use. Narrowing an herb's use to one famous commercial application not only loses the knowledge of the herb's other effects and can harm people, but also endangers herbalism for us all. Let's keep our traditional knowledge of herbs alive and use them within the context of the whole person's needs and not just support its one commercial use. This not only benefits people, but also supports herbal medicine for us all.

A much-touted recent investigation by the New York State Attorney general’s office claimed national store brand herbal supplements sold at GNC, Target, Walgreens and Walmart in fact did not contain the herbs shown on their labels. Instead they found such things as mustard, wheat, radish and other substances.  All four stores were given cease-and-desist letters demanding that they stop selling a number of these supplements.

It was claimed that few of the products investigated were found to contain the herbs on the labels and many may have contained potential allergens that were not identified on the list.

According to the New York Times, the letters stated that “contamination, substitution and falsely labeling herbal products constitute deceptive business practices and, more importantly, present considerable health risks for consumers.”

The American Botanical Council (ABC) quickly issued a rejoinder to the action of the NY AG in a press release “ABC Says New York Attorney General Misused DNA Testing for Herbal Supplements, Should Also Have Used Other Test Methods as Controls.”

As an herbalist I’m well aware that there is and historically has always been a problem of contamination and adulteration of herbs. I’m all for the Attorney General of New York or any other regulatory agency serving as a watchdog and enforcement agency for such matters. I do not hold any great sympathy for the companies that were investigated and found at fault. When it comes to herbs, I’m more in favor of customers purchasing from reputable manufacturers whose specialty is manufacturing and marketing herbal products. Ideally it would be reasonable and much better if such companies had actual herbalists as part of their staff.

The problem with this overzealous and misguided investigation is that the only method for testing they used is a process called DNA barcoding, which identifies individual ingredients through a kind of “genetic fingerprinting.” “DNA” has a ring to it that is particularly appropriate if a prosecuting attorney is seeking the conviction of a serial rapist or sociopath but unfortunately when applied to herbal identification as a ‘stand alone’ method, it is widely regarded in scientific pharmacognosy as unreliable. It’s not clear whether whole herb products were tested, or herbal extracts. It is well known in the industry that DNA testing is not reliable for extracts or preparations involving heat that leave little genetic material intact after processing.

Leading pharmacognocists have pointed out this problem and the obvious absence of controls involved with the procedure. It could have only been ignorance on the part of the New York attorney general Eric T. Schneiderman and his staff, that before publicly condemning these outlets and their products and issuing ‘cease and desist’ orders that industry testing standards be applied. These would be HPLC (high performance liquid chromatography), HTLC (high performance thin layer chromatography) or infrared spectroscopy.

Unfortunately this makes it look more like another smear at an industry that someone doesn’t like rather than a sincere effort at regulation.

The American Botanical Council, an independent organization that along with the herbal industry generally is sympathetic with the Attorney General’s concern regarding deception and adulteration of dietary herbal supplements, takes issue with the obvious oversight regarding more sophisticated methods of testing and evaluating herbs that are available.

The investigators tested 24 products, each claiming to be seven different herbs, echinacea, garlic, ginkgo, ginseng, saw palmetto, St. John’s wort, and valerian. According to the press release, only 21% of the store-brand herbal supplements contained DNA from the plants listed on the products’ labels, with Walmart’s products containing no DNA from a botanical source.

Checking the labels of Walmart’s herbal products, all except echinacea are described as standardized extracts. This only should be cause for any credible investigative agency to employ testing methods other than DNA genetic barcode testing. Wouldn’t it be ironic if instead of being the lowest potency, because they are all standardized extracts they turn out to have the highest potency compared to their rivals, GNC, Target and Walgreens?

Other problems with this sensationalistic smear against the herbal industry which has now wormed its way through myriad media outlets and the Internet is that the individual the Attorney contacted to conduct the DNA genetic barcode study was Prof. James A. Schulte II PhD, of Clarkson University in Potsdam, New York. Dr. Schulte’s background is in evolutionary biology and reptilian zoology and is not recognized as an expert in botany, pharmacognosy, or natural product chemistry.

Another fact for critical relevancy is that the highly respected University of Mississippi’s National Center for Natural Product research issued the following statement:

“The AG’s test results do not comport with other recently published research on herbal dietary supplements. Two recent tests from reputable laboratories on commercial ginkgo extracts have found ginkgo in all or almost all of the samples tested.”

Herbalists welcome fair and unbiased regulations for its industry. I know herbs are not regulated as drugs but as foods or food supplements, but even at that level, the fact that some unscrupulous entrepreneurs decided to exploit ma huang (Ephedra sinica) for instance, as a type of speed for weight loss and recreational use, got shut down. However the upshot of all of this is that one of the most valuable herbs for upper respiratory problems including asthma, emphysema and respiratory allergies is banned from the market place.

Herbalists generally and certainly herbalists who own herb manufacturing companies make a point of promoting quality in the market place. As to the company I have been associated with, Planetary Herbals, the levels of testing and accountability that even a single product must undergo before it is placed on the market is exhaustive to say the least.

The public who relies on herbs and natural supplements for their health needs as well as those of us who involved in the various aspects of producing and marketing them, all have a stake in reasonable, high quality industry standards. While it’s questionable that those seeking herbal supplements would look to purchase the at stores such as Walmart, Walgreens and Target, I’m just happy that they are available to the mass market and if people are looking for higher quality brand names, they should seek out specialty herb stores, herbalists and natural food stores. Nevertheless there are several quality manufacturers who produce decent quality herb products for private labeling.

Speaking with Nutra Ingredients USA, Dr. Pieter Cohen of Harvard, an outspoken critic of the industry, is quoted as saying “If you’d said 10% of the products couldn’t be identified, then I’d have believed that, but 80%? That’s unbelievable.” GNC, a generally high quality national distributor of natural supplements and one least likely to be selling bogus herb products, has taken to using Dr. Cohen’s even while agreeing to comply with the AG’s letter.

Ed Smith, herbalist and founder of Herb Pharm, one of the country’s largest herbal supplements manufacturers, recently stated, “I feel we should definitely condemn the NY AG’s very flawed ‘expose´.’ If he gets away with this then he and/or others will do similar sloppy and misleading work again. We should hold them to the same high level of professionalism that they demand of us.”

With the herb industry reaching an estimated 5.3 billion dollars in 2011 (according to Mark Blumenthal), unlike previous legal battles with regulatory agencies, the industry is showing signs of maturity welcoming appropriate regulatory actions for the good of all but criticizing what in this instance appears to be poor methodology on the part of New York attorney general.

(Added 2/11/15) In the most recent response to the New York attorney general’s cease and desist order GNC, a reputable supplements manufacturer and distributor has rebutted the AG’s accusations: 

GNC: Tests and re-tests show that ‘products contain the ingredients stated on the labels at the levels indicated on the labels’

By Stephen Daniells+, 10-Feb-2015

GNC Holdings has responded to the NY Attorney General’s actions with full and robust responses to every question raised in the cease and desist letter, including original test results and the results of retesting that was performed on the product lots cited in the letter.

Gluten sensitivity and the TCM Spleen

The unique concept of the ‘Spleen’ in TCM encompasses far more than the standard Western physiological organ. The TCM Spleen is a Yin organ whose function is described as “transformation and transportation.” What is transformed is food, air and water and these are transported via the blood stream to all the cells of the body.  The Spleen represents the innate metabolic potential enabling deep level transformation of food and assimilation of energy. The Stomach, the Spleen’s Yang counterpart, is responsible for “ripening and rotting” or the initial stages of digestion.

Spleen Yang is similar to the Ayurvedic concept of “agni” in that it is metabolic fire that is responsible for digestion and blood circulation. Spleen Qi is responsible for the production of daily functional energy, the result of healthy digestion. Spleen function extends to the production of ATP by mitochondria in the cells – how cellular energy is produced. Knowing this gives greater depth of meaning and understanding of herbs classified as Spleen Qi and Yang tonics, such as ginseng, codonopsis and astragalus.

A fundamental precept of TCM theory is that the ‘Spleen abhors dampness.’ Consider the Spleen as a candle flame immersed in a slow-rising medium of fluid causing the flame, the spark of life to flicker and diminish.

Excess dampness is typical of individuals who suffer from hypo-thyroid, resulting in a somewhat more rounded or pear-shaped body. Obviously we might want to diminish all those factors that contribute to increasing dampness. Two of the most dampening foods that would be better limited for such individuals is dairy and wheat – and especially flour products.

According to TCM theory, Dampness is the result of partially metabolized food and excess fluids, with cold drinks being harmful to Spleen Yang and Agni as you might imagine. All these negative food factors together with metabolism diminishing with aging illustrate how Dampness is considered the most difficult condition to resolve in TCM.

When Dampness accumulates it thickens and forms Phlegm, another TCM evil. When Dampness and Phlegm reach higher toxic levels, they stagnate and become either cold or hot (inflammatory) identified as cold dampness or phlegm or hot dampness or phlegm. Such a distinction in TCM is important because it leads to herbs and formulas that treat cold or hot dampness or phlegm.

The most common symptoms associated with these Spleen imbalances precisely correlate with the symptoms individuals claim to result from gluten sensitivity.

Therefore any strategy intended to correct the symptoms of gluten sensitivity should include herbs that tonify Spleen Qi, remove Dampness and possibility dissolve Phlegm. Any formula that does this should improve digestion, increase energy and eliminate or lessen the symptoms caused by Dampness and Phlegm.

One formula that is ideal for this is called Six Major Herbs (Liu jun zi tang) or Six Gentlemen Tea pills.

Six Gentlemen Tea Pills consist of the following:

  • Codonopsis or ginseng – tonifies Spleen Qi
  • White atractylodes – Tonifies and warms Spleen Qi and Yang and drains Dampness
  • Poria mushroom – drains dampness and helps the Spleen
  • Honey-fried licorice – Tonifies Spleen Qi and harmonizes the formula
  • Ginger-fried pinellia root – dissolves Phlegm and removes Dampness
  • Tangerine peel (chen pi) – circulates Qi, helps digestion and dries Dampness

(The first four ingredients comprise Four Gentlemen (Si jun zi tang), the basic formula for tonifying Spleen Qi.)

Still another formula for tonifying the Spleen and aiding digestion is Six Gentlemen plus saussurea and cardamom. This formula more strongly targets weak digestion while the version with pinellia and citrus peel targets Dampness and Qi congestion.

I and a number of my colleagues have successfully treated mal-digestive disorders which included individuals who complained of IBS and gluten sensitivity.

Dr. Alan Tillotson of Chrysalis clinic in Delaware has treated hundreds of patients with these disorders.  Beside employing a diet appropriate for each patient, not unlike the different aspects of what is now called the FODMAP diet, he uses a specially made, 20% concentrated form of neem oil along with ajwan seed based on a formula he received from his Nepalese Ayurvedic doctor-teacher, the late Dr. Manas. This is used to destroy the harmful bacteria from the gut. In addition he gives other herbs such as Chinese Spleen tonics to strengthen digestive Qi.

I had a patient who was grain intolerant and morbidly obese. All she craved was sugar and the only foods she could tolerate were meat and vegetables. That’s the point where we started – recommending that she eat only meat and vegetables but absolutely no sugar. In addition, after a week or two on the diet when her sugar cravings subsided somewhat, I suggested she introduce a teaspoon of whole grains once daily. If there was no problem, she could gradually increase the amount as tolerance allowed. After a month, this woman was able to eat a healthy serving of whole grains, (brown rice, whole wheat, barley etc.) presoaked for a day or two before cooking, without any problem.

Another patient a man in his mid-30s with severe ulcerative colitis who had a lifelong history of vegetarian diet, thought that perhaps he had contracted parasites while practicing yoga in India. An important aspect of this case was that as virile as the man appeared to be he was always complaining of feeling deathly cold. I began by telling him that he needed to include animal protein as a mainstay in his diet. Fortunately, he didn’t turn tail with this suggestion as many vegetarians and vegans would. However he was extremely slow and tentative in changing his diet in this way. Consider that as a general rule, vegetarians and vegans are most likely to be the ones over-consuming sugar-forming carbs.

As this individual was making the dietary change, I prescribed a number of herbs including adding more ginger to his diet, and various Chinese formulas that so long as he took these, he was significantly improved. Because our relationship extended over the course of a few years and he would periodically stray, he would often wind up on the doorstep of my clinic with severe, debilitating diarrhea and bleeding.

Once he came and it was the end of the week and he was in extreme dire straits again. I decided to put to the test that the traditional Ayurvedic formula triphala, which I was the first to make popular in the West in the Planetary Herbals line, and is most often used as a laxative but the ancient texts say is effective for both constipation and diarrhea.  I recommended that he take this ancient time-honored formula chronically, 2 or 3 ‘00’ sized capsules of the powder every two waking hours. Over the course of three days until the next time he returned, he said the triphala had done the job and his bowels had returned to normal again.

For more details on this young man’s case, as well as more information about Triphala, click here.

Ayurveda, Traditional Chinese and Traditional Western herbal medicine all essentially believe that health is absolutely dependent upon healthy digestion and by implication, a healthy gut with balanced intestinal bacteria to maintain healthy digestion which forms the basis of the immune system for the entire body.  While triphala is used as a gentle food-like herbal mainstay in India, in China, 13th-century herbalist Li Dong Yuan founded the much revered Spleen-Stomach School which held that disease was caused by injury of the digestive system incurred through intemperate eating and drinking, overwork, and the seven emotions (stress). His most famous formula, which combines warm Qi tonic herbs with bitter clearing herbs is Ginseng and Astragalus Combination (Bu Zhong Yi Qi Tang). Because I frequently use this formula for practically all chronic metabolic disease, it is available in the Planetary line as Ginseng Elixir.

It consists of:

  • Asian Ginseng Root – Tonifies Qi
  • Astragalus Root – Tonifies and boost Qi
  • Licorice Root – tonifies qi and harmonizes the other formula ingredients
  • Bupleurum Root – Clears heat and inflammation, regulates and boosts Qi
  • Chinese Cimicifuga Rhizome – clears heat and boosts Qi
  • White Atractylodes Rhizome – Dries Dampness, warms and tonifies Spleen Qi
  • Dang Gui Root – Moves and tonifies Blood
  • Jujube Fruit – tonifies Spleen Qi

This formula may be good to use for symptoms of gluten sensitivity, especially when there is low energy and chronic autoimmune symptoms.  It can be taken together with Six Gentlemen teapills described above.

The point here is that if you are experiencing symptoms, whether it be from eating grains with gluten or any other food allergy or sensitivity, consider that there may be more fundamental digestive imbalances that should be addressed. While food is ultimately your best medicine, when it comes to digestive imbalances, herbs can be considered a natural extension of food. There are many factors that can imbalance our digestive process; poor food combining is certainly one. If we eat foods that don’t mix very well in our gut or digest at different rates such as fruit juice, fruits and grains, grains and heavy protein, and so forth, for all GI systems these can be a challenge and for some the result is bloating and gas. Furthermore, excess intake of ice cold foods and drinks wreak havoc on a healthy GI tract.

It may come as a surprise for some to realize that raw foods can be a challenge for sensitive stomachs.

I once had a student in England who presented himself as a hippie with dreadlocks and was a follower of the raw food diet. (Keep in mind anything I say here reflects the individual I describe and while exemplifying sound nutritional principles may not be true for everyone). Following the Ayurvedic principle of three basic constitutions, someone with a more fiery (called “pitta”) constitution may be able to survive on a vegan or raw food diet. This young man in his late 20s, however was all vata, or “air.” He specifically felt that he was gluten intolerant though he was not tested for celiac disease. Eventually as I told him to at least cook his vegetables and eat more first-class protein derived from animal sources and include certain warming spices such as mustard seed, dried ginger, cardamom, cumin, coriander, turmeric and one of the most effective digestive herbs of all, asafoetida (“Hing” in Hindi), he found that he was digesting his food better and he was longer gluten-sensitive.

Besides triphala, the Ayurvedic tradition, considering digestion as the key to health, has a particularly large number of herbs and formula combinations intended to correct any number of different digestive imbalances. Of course most of us enjoy curry, which is a combination of various spices including cumin, coriander, turmeric as the three core herbs. Various individuals and companies make their own unique blend, using other herbs such as ginger, asafoetida, mustard seed, dill, fenugreek, black pepper, long pepper, ajwan to name only a few. The intention is not only for flavor but to enhance digestive and prevent and treat many of the conditions that many attribute to gluten sensitivity.

India has a large number of formulas used for various digestive complaints. These include, Avipattikar (Planetary Herbs’ newest formula called Avi-Pro Reflux Rescue) one of the most effective formulas for heartburn and acid reflux; Hingashtak (called “flatulence pills’ in India) based on hing and other spices specifically used to prevent gas and bloat, and lavangadi churna for acidic stomach. Traditionally a lacto-vegetarian culture, India realized long ago the particular digestive challenges that are the result of a diet consisting of mostly grains, beans, pulses and vegetables. As a result, various digestive spice blends known  as ‘curry’ are important for supporting healthy digestion and assimilation. 

Herbs are special foods, especially when it comes to digestion. I once had a patient who had severe digestive discomfort from many things that she would eat. This was long before the present gluten-sensitivity and food-allergy epoch but I bet that if she were here today, she’d easily fit into that niche. I tried all kinds of specific herbal dietary approaches with her – though I remember I wasn’t much into bitters in those days so she never was given this. What did work was probably in effect similar to an herbal bitter. The basic principle was to give her a formula with a small amount of many herbs – perhaps as many as 10 or 15 Western herbs. I can’t think of all the herbs that were in her tea but it included wild yam, berberis, cramp bark, wild cherry, gentian, sarsaparilla, blessed thistle, a half portion of rhubarb root, ginger, hawthorn, fennel seed, chamomile, elecampane. In fact I never could precisely remember all the ingredients in her formula so it was slightly different each time she came. This was essentially a combination, similar to a bitters formulation but without the alcohol. All she needed to do was drink a half-cup of this tea before and/or after meals and she never experienced any digestive complaint.

One of my first teachers, the late Norma Meyers’, favorite treatment for digestive problems including bloat and gas was to take a pinch of every spice in the spice cabinet, mix it in some warm water. This would alleviate most digestive disturbances within 15 to 30 minutes if not sooner.

In the Western herbal tradition, the mainstay for all digestive complaints falls under the category of “bitters.” Each country in Europe including Russia promotes their favorite national bitters formulation, which is used to aid digestion and considered a virtual heal-all for most diseases. Bitters may well be the shining example of traditional Western herbal medicine. Bitters such as the Italian Fernet Branca, or the famous Swedish Bitters, consists of a number of herbs, mostly bitter, typically containing bitter gentian root and various other bitter herbs and spices extracted in alcohol. These are taken as a virtual panacea for most diseases but especially for problems with digestion, many of which such as gas, bloating, heavy-headed feelings and low energy, are on the list of common complaints of those who believe they are gluten-sensitive/intolerant.

Recently one of my students who was convinced they were experiencing adverse reactions to wheat, wrote, “For a while, the reactions only happened when combining wheat with dairy/fats; now it seems no matter what I have it with, wheat is still an issue - the reactions happens when I've had even a minimum of a small slice of homemade sourdough bread with just jam on it, for example.  The form: flour, sprouted grain, fermented/sourdough, pasta, cake, etc, no longer matters."

I suggested she experiment and either trick herself by not knowing if wheat was being consumed or take it with bitters. Two days later she reported: "Last night I didn't feel like dealing with rice/mung noodles or making zucchini "noodles" so went for it with some fancy organic Italian pasta -- took bitters (my own formula included elecampane, one of my new favorite herbs) before dinner, then had the pasta/bolognese with parmesan grated on top, then more bitters about 20-30 minutes after eating. Guess what -- NO awful reaction like I've been having!!! I even treated myself to a few small bites of a local boulangerie's fabulous baguette today, with cheese. Still no reaction. So I don't know what's up with the NCGS stuff.”

The point here is not to prove the non-existence of NCGS by a single anecdotal case but I suspect that the majority of the 17 million who claim to have gluten sensitivity and do not have celiac disease fall into a similar situation where whether they were psychologically influenced by the anti-gluten “group think,” or may be suffering from a bout of poor food combining and mal digestion, are really not sensitive to gluten at all. Most of us don’t register our minor digestive problems until they rise to an acute state. It is healthy digestion, not gluten-free, that is the key to good health.




Continuing the discussion of berberine-containing plants as Chinese-Western substitutes for each other, we first looked at using goldenseal in place of the Chinese herb, coptis (or vice versa if you can’t find cultivated goldenseal). Here we consider another substitution – barberry/Oregon grape for the Chinese herb phellodendron.

Barberry/Oregon Grape – Phellodendron

The exact substitution of barberry or Oregon grape for phellodendron is not as clear-cut as is coptis for goldenseal (or vice versa). Although all these herbs contain berberine and are cool to cold in energy and have a bitter flavor, phellodendron has a special property for which barberry or Oregon grape do not directly substitute. I’ll explain why below after I present each herb.

Barberry (Berberis vulgaris; Berberidaceae family) and Oregon grape (Mahonia spp.; Berberidaceae family) are both so similar that they are discussed and used interchangeably by most herbalists. Barberry is from Europe while Oregon grape is from – well you can guess where (although it’s found all throughout the Pacific Northwest). Like goldenseal, however, Oregon grape is on the “to watch” list for becoming endangered and so it’s important to only use the cultivated plant or barberry instead.

Both barberry bark/root bark (pipperridege bush, tree turmeric, jaundice berry, sowberry) and Oregon grape root (holly grape, mountain grape, creeping barberry) have a cool energy and bitter flavor and affect the Liver, Gallbladder, Stomach, and Large Intestine in the middle and lower parts of the body. They have cholagogue, alterative, hepatic, laxative, anti-inflammatory, bitter stomachic, antimicrobial, and astringent properties. They are some of the mildest and best liver tonics known and treat jaundice, hepatitis, enlargement of the liver and spleen, gallstones, arthritis, acne, boils, psoriasis, dry eczema and other skin diseases, conjunctivitis, fevers, cancer, tumors, constipation, arthritis, amoebic and bacillary rheumatism, chronic dysentery, and yellow and foul-smelling diarrhea or leucorrhea. As well, these herbs clear a thick yellow coat on the tongue, particularly in the center or rear of the tongue, indicating they clear damp heat and food stagnation in the stomach and intestines (i.e. help digestion and elimination).

The California natives used Oregon grape for all chronic degenerative diseases, especially cancer and arthritis. A related variety of this species, Yerba de la Sangre (“herb of the blood”) has similar properties and was used by the Spanish-American tradition as a blood purifier, specifically for syphilis, and as a mild diuretic laxative. Ayurveda uses barberry (both Berberis aristata and B. vulgaris; tree turmeric) primarily to detoxify the liver along with all its other berberine effects of treating cancer, infectious yeast, and hypoglycemia.

Phellodendron bark (Phellodendron chinense, P. amurense; huang bai; Amur cork-tree; Rutaceae family) also has a cold energy and bitter flavor but affects the Kidneys, Bladder, and Large Intestine. In other words, it directs Qi downward. It also has anti-inflammatory, antipyretic, cholagogue, and antibacterial properties, and lowers blood sugar. It treats inflammation, yellow diarrhea or dysentery, hemorrhoids, and jaundice along with infections and yellow discharges form the anus, vagina, or penis, and red, swollen, and painful legs, knees, and feet. Topically, it is used for damp skin sores and lesions like psoriasis and eczema.

(Avoid using barberry/Oregon grape during pregnancy since it stimulates the uterus; don’t use phellodendron if there’s coldness symptoms such as no thirst, clear, copious, runny, and frequent discharges, excretions, secretions, and urination, cold extremities, pale face, lips and nails, lack of sweating, diarrhea or loose stools, poor appetite, or a weak stomach.)

So far so good in terms of using barberry/Oregon grape as a substitute for phellodendron. Now phellodendron has a unique property for which it is hard to substitute – it clears Heat associated with deficiency, which the Chinese call “Kidney Fire” (a heat that arises from progressed Yin Deficiency) with symptoms of night sweats, afternoon or tidal fever and sweating, and seminal emissions, which can lead to migraines and hypertension among other conditions. Deficient Heat arises much like your engine overheating from lack of oil or fluids. Similarly in the body, when there is a deficiency of cooling and moistening fluids (Yin), the organs can “overheat,” which causes Heat to rise up in the body (as heat tends to do in general), leading to the above symptoms.

While barberry and Oregon grape are milder bitter barberine herbs than their stronger buddies such as goldenseal, they do not clear Kidney Fire. However barberry does have a helpful property that can assist in this function. In Culpeper’s Medicine, A Practice of Western Holistic Medicine, by Graeme Tobyn (published by Element, 1997, p 206), it is stated that barberry is moistening and slightly cooling. Herbs that are cool and moist don’t necessarily tonify Yin but they can protect it and clear some Fire, too. Oregon grape root is slightly bitter, very unlike the strongly bitter of goldenseal and coptis, but not particularly moistening. I once tasted some fresh phellodendron and along with the slightly bitter flavor, it also had a moistening quality.

And yet, we also want to pay attention to the impact of phellodendron on the kidneys and urinary bladder as neither barberry nor Oregon grape has this influence. While they do treat very similar conditions in the lower part of the body, neither impact the Kidney with its Fire symptoms of night sweats, afternoon fever, or seminal emissions due to deficient Yin. So how do we adjust for this function?

How about combining marshmallow root with barberry/Oregon grape to get a closer substitution for phellodendron? Here’s why.

Marshmallow root (Althea officinalis; Malvaceae family) has a cool energy and sweet and mildly bitter flavors and affects the Small and Large Intestines, Lungs, Stomach, Kidneys, and Bladder! It is cool and moistening, tonifies Yin, cools the blood and has nutritive tonic, alterative, diuretic, demulcent, emollient, lithotriptic, anti-inflammatory, vulnerary, laxative, expectorant, and antispasmodic properties.

Although marshmallow doesn’t contain berberine, it is a wonderful anti-inflammatory herb that treats among other conditions, infections or inflammations of the stomach, intestines, urinary bladder, or kidneys. A wonderful demulcent that lubricates the body and protects it against irritation and dryness, it is a Yin tonic useful for wasting and thirsting diseases such as tuberculosis and diabetes. It also settles acid indigestion, soothes dry cough, colitis and ulcers, lung inflammation, sore and irritated joints, gastritis, colitis, ulcers and the urinary system, irritations associated with diarrhea and dysentery, kidney and bladder inflammations, difficult or painful urination and kidney stones or gravel while stopping any associated bleeding. Applied topically it treats skin conditions, inflammations, and infections such as wounds, burns, boils, ulcers, abscesses, bruises, gangrene and blood poisoning.

This sounds like marshmallow not only has a similar impact to barberry and Oregon grape but also has phellodendron’s special action of clearing Kidney Fire. That makes it a great adjunct for the action of berberine-containing herbs in general. For some people, the direct substitution of barberry or Oregon grape will work perfectly in place of phellodendron, but if there are any deficient heat signs, then it is best combined with marshmallow to have a more similar effect.

For quite a while, I’ve been curious about Western alternatives to Chinese herbs. I’m particularly interested in creating effective alternative formulas to traditional Chinese ones (to know why, read my prior blog, Are Herbs from the West Really the Best?). As I investigate possible substitutions, I’m running into several problems. It’s possible to match an herb’s energy and flavor but that doesn’t mean it always has the same actions. Each herb is unique, just as twins have differences even though they may look and act alike. So it’s more difficult finding Western herbal substitutes for Chinese herbs than you might think.

As far as I know, Michael was the first to establish Western-Chinese-Ayurvedic herb "cross-overs" when he began to identify energetics of Western herbs in the 70’s.[1] As he created substitute formulas for Chinese ones using Western herbs, he discovered that he actually ended up with something that served a different purpose than the original formula but was effective for treating other conditions. While new formulas are valuable, I’m intrigued with crafting alternatives that serve the same intended purpose as their traditional Chinese counterparts and yet have Western herbal substitutes when possible.

Planetary Herbalism

Western herbalism today is spreading its wings into many other countries and incorporating non-native herbs. This is occurring for many reasons. First of all, if you can’t find the herbs you need in your own backyard or local community, then you must purchase them from other sources. However, while you may think you are buying an herb from the West, the overwhelming majority of herbs by volume used in the U.S. are imported from other countries. I find this both amazing and enlightening.

Secondly, many herbs traditionally used in the West aren’t available anymore, are hard to find, or are endangered and so can’t be found at all. Lastly, certain herbs have simply not yet been identified in Western herbalism, such as the true Qi, Blood, Yin and Yang tonics. What this means is that many people end up using non-Western herbs along with Western ones. Because of this, we are headed toward a planetary system, one which combines herbs that best treat a particular condition regardless of their geographic origin.

So can we find Western substitute herbs for Chinese formulas and be just as effective? This is exactly what I intend to explore over the next months in these blogs. Join me on this journey and help me out. This job is much bigger than any one person, so send in your comments, experiences, and ideas and let’s explore this together!

How to Choose Herbal Substitutes

Many people think that Western herbalism is purely allopathic, and today it mainly is, but Western herbs were applied according to energetic systems in the past, such as Cherokee herbalism, the Greek humour system, and Culpeper’s assignments (which delineated herbal energies as warm, slow, or sticky, and as treating particular parts of body). Today it’s just as important that we employ some energetic system when using herbs, whichever one, just so long as you choose one to guide you.

To substitute Western herbs for Chinese ones then, several factors are important to take into account. These include an herb’s flavor, nature, energy, unique characteristic and more, as follows:

Flavor: Acrid, sweet, bitter, salty, sour (some include bland or astringent)

Energy: Heating or cooling, dampening or drying, building or eliminating, etc.

Direction and movement: Inward, outward, dispersing, consolidating and so on

Body systems or parts/Organs & meridians affected: For example – digestive, respiratory; spleen, lungs, gallbladder; datu (tissues)

Properties: Diaphoretic, diuretic; Qi-regulating, aromatic transform Damp, etc.

Pattern: The traditional energetic system being used and thus, the pattern, humour, or other assessment being treated – this is the major purpose of using a particular formula and so the substitute herbs should also treat, or be used to assist treatment of, that specific pattern.

Special Use: An herb’s special action such as ma huang (ephedra) has the special action of dilating the bronchioles; bupleurum and pueraria harmonize the exterior and interior; and hawthorn berries support heart function but also remove food stagnation from meat and fats.

Plant part: A flower has a different energy and action than a root or bark. It may be tempting to substitute chamomile for bupleurum, for instance, but is it really adequate even if given in much higher doses?

Formula: Because herbs work together and influence each other in a formula, the other herbs being used must be considered as well.

Of all the above factors, the most important to match when choosing an herbal substitute is the flavor of an herb. This is because an herb’s flavors delineate its actions. I’ve even seen it written that herbs don’t treat disease but are vehicles for flavors and their actions! (For more in-depth explanation of the value and importance of flavor, see Michal’s blog, "Herbal Flavor vs. Taste: What’s the Difference?")

According to the Nei Jing (Inner Classic), the thousand year-old book of Chinese medicine, each flavor affects the body as follows:

Acrid: disperses, moves                             

Sweet: builds, slows, harmonizes

Bitter: dries, drains, firms

Sour: gathers, astringes

Salty: descends, softens

Bland: leaches, promotes flow

Astringent: strongly tightens, and draws but is not necessarily sour in flavor

The flavor of an herb is different than its taste. Taste refers to the senses in the mouth and tongue senses (taste buds) and how they interact with food and drink. Flavor, on the other hand, encompasses many senses, not just taste, and these include how it acts on the body, or its overall actions. This is why flavor is the primary focus when choosing herbal substitutes.

Technically, no herb really can substitute for another. Each herb has a unique personality and so the best we can do is approximate as good a substitute as possible. Sometimes one herb may work well, such as elecampane for pinellia, while other times dui yao combinations must be used (two herbs that work synergistically together to create a specific action and achieve a dependable therapeutic effect that is different than when used alone or with any other herb).

Overall, it’s important to not over-think these substitutions. It’s easy to do so and then you end up with a formula that’s either too complicated, or doesn’t serve the original intended purpose.

Other Considerations

There are several other factors to consider when choosing Western substitutes for Chinese herbs:

  • Keep in mind that herbs considered "Chinese" are from the Imperial Materia Medica used today, which was derived from agreed-upon herbs by the Chinese empire. However, there were far more herbs used by village healers who actually considered some of these unlisted herbs more powerful. When we take the full Chinese herbal spectrum into account, there are many commonalities worldwide.
  • When creating a Western formula to substitute for a traditional Chinese one, the thrust and purpose of the Chinese formula should be primary in considering different herbal alternatives. In other words, what pattern does the formula treat? What is the final action desired? It’s possible to choose herbal substitutes for each herb in a Chinese formula that seem appropriate in terms of flavor, energy and organs affected, and yet the overall end product of the formula may actually have a different thrust than the initial one. This is fine when designing new formulas, but if creating a substitution, the treatment principle and approach should match the original Chinese formula.
  • Consider WHY each herb is included in a formula, i.e., its specific purpose, for that might not always directly treat the presenting pattern, but support it. For example, white peony is a weak Blood tonic that has a cool energy (Blood tonics are generally warm to neutral in energy) and yet because white peony preserves and protects the Yin, it is included in Blood-tonifying formulas.
  • Guard against choosing herbal substitutes with commercially hyped Western uses such as St. John’s wort for depression or black cohosh for menopause. St. John’s wort only treats depression from Excess Heat, so if creating a substitution for say the formula, Xiao Yao Wan, which treats depression due to Qi Stagnation and Blood Deficiency, this herb isn’t appropriate and so other herbs should be considered instead.
  • Know that some herbs don’t need substitution. For instance, baked licorice can be Western licorice stir-fried in honey, or mint could be peppermint or lemon balm, or berberine-containing herbs such as phellodendron (huang bai) could be substituted with other berberine-containing herbs such as Oregon grape or barberry, or goldenseal for scutellaria.


Let’s Get Started

Which herbs should we try to find substitutes for first? I think it may be useful to consider categories of herbs that really need substitution. Western herbalism has many effective alteratives, diaphoretics, diuretics, expectorants, laxatives, and emmenagogues, so what categories are missing? Where do we need to find substitutes or broaden our herbal horizons? What herbs need substitution because they are hard to find, no longer available or illegal (or unethical) to use? These are all good starting points.



[1] Western herbs have been energetically classified in the past, but most of those systems are either obsolete (Greek, Egyptian, Culpeper) or only known to a few (Cherokee, Pueblo).


Many people in the West eschew herbs from other countries because they only want to use western herbs. While local herbs are the easiest and most convenient choice, they’re not necessarily the best and even more so, not always possible. Even if you’re an avid gardener who cultivates a large variety of herbs, you still won’t have all you may want, if for no other reason than your local ecosystem limits what’s available to you.

Further, the herbs you need might not even grow in the West (or at least haven’t been discovered or harvested yet). That means most people at some point will have to buy the herbs they need. You probably look for organic herbs, like I do, but not every western herb may be found in organic form. And an herb is not necessarily non-organic just because it’s from another country.

Ultimately, the question all this raises in me is, what makes an herb "western?" Because it‘s native to the West? Grows in the West? Is commercialized and so known to the West? Or was used by old-time western herbalists? And how do we define a "western" herb, especially since our western herbal borders have spread to include adaptogens from eastern Russia, tonics from South America, and resins from the Middle East?

When it comes to sourcing herbs from faraway places, perhaps the problem many people specifically have is around herbs bought from China and India. Most people’s concerns about these herbs revolve around their cleanliness. Certainly pollution is growing in China and India, compounding their past use of adulterants, coloring agents, and heavy metals. And yet, many western herbs are adulterated, too. 

Consider that many Chinese and Ayurvedic herbs are actually wildcrafted from high altitudes on mountains, volcanoes, or other remote areas. Further, many Ayurvedic formulas are extensively prepared with prayer and mantra and go through lengthy purification processes. Surely if the concern is purity, such herbs are adequate for western consumption?

Even if "impure" Chinese herbs are used, I’ve still seen them benefit people tremendously. I’ll never forget a patient I once treated in the late 1980s who had Crohn’s disease. She could only eat eight foods and yet she progressed well on irradiated Chinese herbs. This is probably because those herbs’ tonifying properties were stronger than any toxicity or devitalization they might have had. In this case, the disease was worse than the medicine being taken. Even impure herbs are still better to take than drugs loaded with their many side effects.

In the end, I don’t actually think pollution is the full problem behind people choosing to exclude Chinese or Ayurvedic herbs. Many plants from other countries are now readily incorporated into mainstream western use, such as ginseng, albizzia, astragalus, goji berries, reishi, ashwagandha, triphala, eleuthero, rhodiola, myrrh, and suma. These Chinese, Ayurvedic, East Russian, Middle Eastern, and South American herbs have been commercialized and so are now well received. Plus, there are good sources that provide reliable Chinese and Ayurvedic herbs today.

Further, and this may surprise you as it did me, most western herbs in the U.S. actually come from other countries! According to Roy Upton, executive director and editor of the American Herbal Pharmacopoeia® and director of Planetary Formulas, probably close to 90% in weight of herbs in the States come from elsewhere. His colleague, Josef Brinckmann, who routinely watches the international plant market, confirms that the overwhelming majority of herbs by volume used in the U.S. are imported form other countries.

Of the "big 10" U.S. sellers – cranberry, saw palmetto, soy, garlic, ginkgo, Echinacea, milk thistle, black cohosh, St. John’s Wort, and ginseng – only cranberry, saw palmetto, echinacea and black cohosh are native North American botanicals, and of these four, black cohosh extract is adulterated with Chinese material and the most widely used echinacea extract, or E. purpurea, is cultivated in Europe. This means that only two of the top selling herbs in the U.S. – cranberry and saw palmetto – are actually sourced from North America!

So what is the real problem behind shunning non-"western" herbs?

Could it be that people think they first need to learn a complicated system before using Chinese or Ayurvedic herbs? If this is the case, it’ s not actually so. One just needs to understand herbal energetics, and frankly, this is true for any herb chosen no matter what part of the world it comes from, East or West. It’s necessary to know an herb’s cooling or heating energy, flavors, direction, properties and actions according to a specific system in order to use it appropriately. This is how herbalism works. Thankfully, there are many books, teachers, and other resources available that easily provide such information.

In truth, many people don’t know that they’re already using Chinese and Ayurvedic herbs. Such herbs are valuable to all systems of herbal medicine. Licorice, mint, ginger, garlic, cardamom, and dandelion are all widely used in China and India along with dozens of other examples, though some are different species. Then there’s the opposite situation where our own unused American ginseng tonic is bought by the Chinese and then sold back to us. The Chinese don’t shun this herb because it doesn’t come from China; rather, they see it as an important plant that is irreplaceable in their pharmacopeia.

Here is a list of herbs now common to Western, Chinese, and Ayurvedic herbalism:

Ginger, garlic, scallions, horny goat weed, asafetida, aloe gel, angelica, barberry, black pepper, calamus, aster, cinnamon, fenugreek, gentian, hibiscus, juniper, gotu kola, mugwort, myrrh, mint, rose, rhubarb, turmeric, valerian, horsetail, kudzu root, black cohosh, self heal, figwort, honeysuckle, isatis, violet, andrographis, anemone, mung beans, sweet Annie, malva, plantain, aduki beans, corn silk, loquat, jack-in-the-pulpit, hawthorn, citrus peel, cattail pollen, agrimony, madder root, galangal, frankincense, motherwort, safflower, ginkgo, albizzia.

When I think about desiring only local herbs, I think of ease, convenience, and knowing what I am getting. I understand such desires. It is still much easier to obtain "western" herbs than Chinese and Ayurvedic plants. Also, Chinese herbs are becoming quite expensive. With the growing free enterprise in China, prices have at least doubled or even quadrupled in some cases, particularly with patent medicines. Other herbs are being illegally hoarded, making them unavailable.

And yet, what if what you need isn’t available locally or as a western herb? Then what do you do?

First, know your sources. Look for Chinese dao di herbs that come from their authentic natural locations in remote mountains or other wild spaces where they’ve been cultivated, harvested, and processed since the Tong Dynasty (618-907 C.E.) with certain techniques to yield superior effects. These herbs have different constituents because of their interaction between a specific natural location and their genetics. Such herbs have an enduring reputation for high quality and excellent treatment effects. They are not polluted and some herb companies specialize in obtaining and selling them. This is like saying the best feta cheese comes from Greece, and the best Gruyere comes from Gruyere, or that Napa wine is better than Nebraska wine.

Along with such geo-specific and geo-authentic plants, it’s also important to purchase herbs from companies that test their products for authenticity, potency, and purity (this should ideally be the practice of all western herb companies) as well as follow GMPs (Good Manufacturing Practices, the standards set for safe products).

Next, realize that your health and healing requirements may not fully be met if you only use western herbs. The plants you need may not grow in your local ecosystem or even be available in the West. For example, true tonics are restoratives and adaptogens and most of these come from the eastern mountains of Russia or from South America, China and India. The idea of "tonics" in western herbalism is quite different than that in Chinese and Ayurvedic medicines. What Western herbalists believe is tonifying, such as a bitter tonic or blood tonic, is either a detoxifier, a stimulant to organ function, or provides needed minerals.

For example, western blood "tonics" are bitter and cooling in nature, like yellow dock. However, blood itself is warm and moist, the exact opposite of yellow dock’s energies. This means that bitter and cooling yellow dock, although high in iron, actually dries and depletes blood rather than builds it. However, if molasses is combined with yellow dock, a warming and moistening medicinal also high in iron, the herb’s negative effects are neutralized and it then builds blood.

True tonics In Chinese medicine have a different definition and function. By nature, most tonics are sweet in flavor, which builds, slows, and harmonizes (this is a complex and not simple sugary sweet). Such tonics boost, benefit, help and/or repair. This is very different than the bitter flavor, which drains, dries, and makes firm.

Until we identify more tonic herbs in the West, we must continue to obtain them from other countries. This means using some non-western herbs if you are depleted and need to build and strengthen your body and health.

The bottom line in using Western versus Chinese or Ayurvedic herbs, however, is that no herb can really substitute for another. Even the same exact herb grown in different locations has unique properties not found when grown in another area. This is why many Chinese only use dao di herbs since they grow in optimal locations to stimulate the development of specific properties.

The pinch today is that some of the most effective Chinese herbs are no longer allowed or have limited availability to non-practitioners.  So what do we use instead?

The writing is on the wall and we are almost being forced into finding western substitutes as best we can for those lost valuable herbs. This need has long intrigued me and finally I am looking at it in depth. Yet, it is a complicated study that involves many factors. These I will begin to address in my next blog!

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