A Brief on Safely Using Chinese Herbs

While using herbal extracts and formulas is typically quite safe, it is important to be aware of common mistakes such as overdosing or following unreasonable treatment courses. For example, some patients have taken Long Dan Xie Gan Tang for more than 10 years, far exceeding clinical recommendations. Prolonged use at high doses increases the risk of side effects. Even non-toxic herbs like Gan Cao (Licorice) can cause edema, high blood pressure, sodium retention, low potassium levels, and limb weakness if used for an extended amount of time. Large doses and long-term use of herbs can lead to their accumulation in the body, surpassing the body's tolerance for their chemical constituents and can result in adverse reactions.  

Effectiveness and safety are critical factors in the use of TCM, and ensuring the proper use of Chinese herbs ought to be a key concern for every TCM practitioner. Safely using TCM requires special attention to the following details:

Consider Both Efficacy and Side Effects: Practitioners should review the potential side effects of each herbal treatment and avoid solely focusing on its clinical effectiveness. 

Ensure Formula Compatibility: Compatibility has been a crucial method for reducing the likelihood of adverse reactions to TCM herbs since ancient times, and it remains the foundation of formula prescriptions. Combining two or more ingredients according to specific principles can produce different effects based on their compatibility. The same herb can have both therapeutic and detrimental properties. If used improperly, they may cause toxic and side effects; however, when used correctly, they can achieve remarkable results for complex conditions.

Use Syndrome Differentiation to Inform Treatment: Proper syndrome differentiation is essential to avoid problems such as incorrect diagnosis and inappropriate formulation in practice. 

Control Dosage and Timing: The dosage and timing of herbal treatment should be appropriate. For herbs with known toxicity or side effects, dosage and duration must be strictly controlled to prevent overdose and prolonged use. In cases where long-term use is necessary, taking regular breaks can help reduce the burden on the liver and kidneys and avoid toxicity.

Understand Herb Function and Mechanism: It is crucial to fully understand the functions and mechanisms of herbs, particularly those with side/toxic effects. During treatment with these particular herbs, provide patients with careful observation and guidance.

Dr. Wang, founder of Treasure of the East and herbal expert, has summarized the herbs that require special attention in dosage control and the length of clinical use, which is provided here for your reference. 

Herb Name   Raw Herb Daily Dosage 5:1 Concentrated Extract Daily Dosage
Qian Niu Zi 牵牛子 10g 2g
Bai Guo 白果 5g 1g
(Ku) Xing Ren 苦杏仁 10g 2g
Cang Er Zi 苍耳子 10g 2g
Chuan Lian Zi 川楝子 10g 2g
(Fa) Ban Xia 法半夏 6g 1.2g
Guan Zhong 贯众 15g 3g
(Chao) Bai Ji Li 炒白蒺藜 10g 2g
(Jiang) Ban Xia 姜半夏 6g 1.2g
Quan Xie 全蝎 3g 0.6g
Shan Dou Gen 山豆根 10g 2g
She Chuang Zi 蛇床子 10g 2g
Shui Zhi 水蛭 3g 0.6g
Tu Bie Chong 土鳖虫 10g 2g
Tu Jing Pi 土荆皮 10g 2g
Wu Zhu Yu 吴茱萸 3g 0.6g
Wu Gong 蜈蚣 1g 0.2g
Xian Mao 仙茅 10g 2g
Nan Xing (Zhi) 制南星 6g 1.2g
Chong Lou 重楼 10g 2g

 

This article is provided only as an educational resource - it is not intended or implied to be a substitute for professional medical advice, and the herbs and/or formulas within are not intended to diagnose, treat, cure, or prevent any diseases. The statements regarding Traditional Chinese Medicine and herbal formulas have not been evaluated by the Food and Drug Administration (FDA). This information is intended only for licensed healthcare practitioners.