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Traditional Chinese Medicine Herbal Formulas

What are Traditional Chinese Medicine (TCM) herbs?

Traditional Chinese Medicine (TCM) uses over 1000 herbs (approximately 350 herbs in everyday use), whose complex properties are recorded in materia medica books dating back thousands of years.

It’s one of the most widely-used herbal traditions in the world, prescribed in hundreds of hospitals across East and Southeast Asia, and even some in Europe and the USA now. Our knowledge of herbal properties is constantly updated through clinical experience, professional collaboration, and scientific research.

‘Most herbs are plants or fungi (e.g. ginseng, astragalus, licorice root, cinnamon bark, reishi mushroom, and more), while a few are tree resins, minerals, or animal products (e.g. frankincense, oyster shell, etc.). Some of the herbs are common kitchen herbs (cinnamon, clove, turmeric, mint, ginger, etc.), but the vast majority are herbs you’ve probably never heard of (e.g. bupleurum, atractylodis, prunella, etc).

The herbs are prescribed in formulas that include anywhere from 4 to 20 herbs, that are customized to the individual patient.

What conditions are TCM herbs good for?

Chinese herbs (or Japanese Kampo or Korean herbal medicine) are used in all departments of hospitals throughout East and Southeast Asia. They can contribute to effective treatment in all fields of medicine, including internal medicine, pediatrics, oncology, rhematology, respiratory, neurology, gynecology, andrology, orthopedic, and more. Herbs can be used internally (e.g. for digestion, infertility, coughs, fatigue, etc.) and externally (e.g. skin conditions).

In oncology, herbal medicine is particularly good for fatigue, digestive difficulties, low immunity, insomnia, dry mouth, and much more. External herbs are helpful to prevent radiation dermatitis, and oral herbal rinses help such issues as with mouth ulcers, oral mucositis, and xerostomia (dry mouth). In China, cancer patients often take custom herbal formulas for 3 years after completing their cancer treatment, to consolidate their recovery, support immunity, and help prevent recurrence. Several studies show improved outcomes when herbs are used alongside conventional cancer treatment.

Why are there so many herbs in the formula?

Unlike some other herbal traditions, TCM primarily treats using combinations of herbs, not individual herbs. Our medical tradition includes thousands of classical formulas that were developed by herbal masters over the past centuries, many of which are still popular and effective today.

This is because each herb has multiple actions and qualities; it may act one way in combination with a certain pairing, and another way in a different combination. Some of the qualities include the herb’s thermal nature (hot, warm, neutral, cool, cold), taste (sweet, salty, pungent, bitter or sour), it’s direction of action in the body (up, down, etc), the level on which it acts (Qi, Blood, Yang, Yin, body fluid, etc.), the meridians it acts on (Liver meridian, Stomach meridian, etc.), and specific empirical actions it’s known for (e.g. stop cough, stop pain, etc.)

The herbs in the formula act synergistically (enhancing each others’ effects), may address various aspects of your condition, may assist in digestion or metabolism of other herbs, or may temper each others’ effects (to reduce side effects, for example).

On what basis are Traditional Chinese Medicine (TCM) herbs prescribed?

To choose and modify your formula, your practitioner has been trained to consider many factors, including:

  • your primary complaint(s) or health goal
  • your specific combination of signs and symptoms (known as your ‘TCM pattern’)
  • your body type or ‘constitution’
  • the state of your digestive system
  • your biomedical diagnoses or diseases, and any known issues with them (e.g. hormone sensitive cancers, blood-thinners, liver disease, etc.)
  • your other medications and supplements (including chemotherapy drugs)
  • your other treatments (e.g. upcoming or recent radiation or surgery)
  • your allergies, nutritional sensitivities or dietary restrictions (e.g. veganism, celiac disease, etc.)
  • balancing the tastes, thermal nature, and directions of the herbs to suit you

It can be difficult to fully explain the basis of the formula to those who don’t have a basic understanding of Chinese medicine theory. We will try our best, but Chinese medicine uses its own traditional diagnostic system which is quite complex (hence requiring at least 4 years of full time post-secondary study to become a TCM herbalist).

What can I expect when I agree to try TCM herbal medicine?

Typically we start a patient on a 7-14 day trial of herbs. We check in after you have tried it for at least 5-7 days, to ensure that you don’t have any allergic reaction or digestive upset from the herbs. This does not mean that your health condition will show significant improvement after 1 week, depending on how chronic your condition has been. The one-week trial is to make sure that you don’t have a negative reaction to the herbs.

After that, we typically update a formula every 2 weeks for awhile, while you are in the “relief” phase of treatment (when you’re still trying to get relief from a certain condition). We take so many factors into account with your formula, including subtle changes in your sweating, sleep, mood, digestion, bowel movements, energy levels, headaches, menstrual cycle details, hot flashes, pain, etc. Many complex health conditions require working for awhile in one direction, and then as one or two major symptoms start to clear up with need to redirect your formula in another way. As your health recovers and improves, your body shifts in subtle ways and we have to continue to fine-tune your formula. 

If you’re in a more stable or “maintenance” phase, we may need to check in less often to tweak and update the formula, e.g. around 3-6 weeks between check-ins. After you achieve your health goals, you may be able to wean off the formula entirely. Alternatively, if you find it helpful for long-term maintenance, we may suggest you take it only some days of the week (say, 5 days on, 2 days off; or, only during some periods in the month). We may also switch up the herbs every now and then, as some herbs are not suitable for long-term use. 

How fast can I expect the results to appear?

Generally, the longer you have had a condition, the longer it will take to heal from it. It will also depend on your particular condition and your health goals. An acute condition such as a recent cold or cough can shift in as little as a week, whereas if you have had insomnia and exhaustion (or another chronic complex condition) for 15 years, it may take several months to shift you permanently into sleeping consistently and having abundant energy during the day. You can assist with the process through implementing the acupuncture, acupressure, home self-care routines, and dietary changes we recommend.

Who can prescribe Traditional Chinese Herbal Medicine?

In Ontario, TCM Herbalists must be Registered Traditional Chinese Medicine Practitioners (R.TCMP) with the College of Traditional Chinese Medicine Practitioner and Acupuncturists of Ontario (CTCMPAO). Only professionals registered in the CTCMPAO are allowed to give a TCM Diagnosis (despite members of some other professions claiming to have a background in TCM).  R.TCMPs need to complete 4 full-time years of post-secondary TCM education, including at least 500 hours of direct patient contact, to qualify to write the board exams.

This means that those who only have Registered Acupuncturist (R.Ac.) designations, and those who are NOT registered with the CTCMPAO (for example most chiropractors and naturopaths) are not technically supposed to be composing Traditional Chinese herbal formulas. The reason is the length of education and training expected to meet international standards for Chinese herbalists, which is a time-honoured tradition of medical professionals.

Does Traditional Chinese Medicine (TCM) use endangered animal products?

There are some animal products previously used in TCM that still make the news (e.g. rhinoceros horn, tiger bone, bear bile, pangolin scales, etc.) These are actually not used nowadays in reputable environmentally-conscious TCM practices. Please feel free to ask us for more details. We are a transparent practice that always provides labelled formulas so you know exactly what is in the bottle.

Are Chinese herbs the same as supplements?

Supplements that you find in a health food store may include anything from vitamins, minerals, probiotics, or yes, herbs as well. Often supplements will include single herbs, small combinations, or extracts, and most professional Chinese herbal formulas are not available in health food stores. TCM herbs are not over-the-counter products, but are uniquely prescribed for you alone, based on an extensive Traditional Chinese Medicine intake and individual diagnosis. 

Are there any side effects?

Chinese herbs typically use the entire plant (or mineral, fungi, etc.) which has multiple active ingredients naturally occurring together. This often means the effects are arguably more balanced than using an extracted single active ingredient. In addition, we use multiple herbs in one formula to balance each other out. At the same time, there can still be side effects to herbal formulas. This is one of the reasons that as professional herbalists, it is our responsibility to check in on your reactions to the herbal prescription, and ensure it is rebalanced regularly to suit you.  For those on long-term formulas, we recommend regular check ups with your family physician to ensure maintenance of optimal liver and kidney function.

What form do the herbs come in? What is the cost?

We’ve written a whole other blog post about this!  Chinese herbs now come in dried raw form, in granules that can be dissolved in hot water to make a tea, in pills, tablets, capsules, tinctures, as external washes, compresses, or salves, and as mouthwashes and suppositories. Please click here to read How to Choose What Type of Chinese Herbal Medicine to Take for an overview of the most common types of oral herbs we prescribe.


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