Sunday, 27 October 2019

Thinking of becoming a Medical Herbalist or making an appointment with one?

Western Herbal Medicine (WHM) appointment as personalized medicine.

If you think the role of a medical herbalist is limited to knowing what herb or even herbs are useful for your medically diagnosed condition you would be substantially misinformed. They have a lot more to offer.

Herbal medicine is a holistic system of medicine. The important word here is ‘system’. Holistic we will revisit later.

The blend of narrative medicine and clinical examination in the context of lab tests and other biomedical results offers a real-time context for considering your specific health problems. Narrative medicine is your story, especially your timeline in the context of your childhood and life-time past history, your family history, medication, values, and beliefs (including spiritual sustenance which includes but is not limited by religion). Particular consideration is given to how these have changed or fluctuated in relation to your health problems.

Herbal training includes appreciating the overall energy balance, described as the vital force, understood as the breath (pneuma), chi, prana and as many other descriptions as there are kinds of traditional medicine systems.

WHM affects the same physiology systems as drugs, but the main aim is to support healing, in addition to suppressing symptoms. Digestion and elimination are core elements of the healing response, even if this is not an obvious feature of the main presenting complaint. The herbal medicine treatment approach places different emphasis on lymph flow and fascia connections of the muscle and bone structure, which is well described by anatomy and physiology but generally not taken into account as of much importance by pharma-therapeutics.

Each herbal prescription is complex and has its own traditional profile of actions, dose range, synergistic effects and clinical indications. Most have multiple actions, and different expected effects in different patients, depending on the patient’s state of health.

Many herbs are bi-phasic i.e. they have different effects at high or low doses. Others are modulators, which can increase or decrease actions depending on the needs for restoring normal function, like an auto-pilot function in an aircraft. Others can have dual functions, opposite to each other depending on the context. With more than 250 constituents in each herb, they can be expected to have a complex range of therapeutics actions.

This is the art of blending herbs, according to tradition and training. Experience, mentoring and professional support are key to the art and science of herbal medicine.

Their low dosage and subtle but collective physiological effects explain their enviable safety profile.

Food is a major part of health and herbs are often used for nutrition for specific health systems e.g. wild oats for the nervous system. Herbalists spend a lot of time talking about food and teaching you how to change, often subtle gradual changes have the best long term health benefits. Optimum food is essential for healing.

The motivation for change is highly individual and it takes time to find the three practical manageable changes before subsequent appointments.

So a typical WHM protocol will encompass:

  • A timeline of health history

  • Family History implications

  • Medical hospital results impact assessment

  • Clinical examination

  • Food – everything about food is important

  • Smoking and alcohol

  • Movement

  • Spiritual/vital energy: is there enough for healing and enhancing the recovery by any means possible.

WHM treatment protocols typically include:

Food: Often 3 changes identified by patient

Movement: Personalised advice (can include doing less or changing the kind of exercise)

Herbal prescription: Usually oral infusion or tincture to be taken as directed. May include cream/ointment, pessaries or suppositories, inhalations, other topical preparations such as oils etc.

WHM practitioners use whole herbs, with very simple low tech processing for preservation. Using whole herbs is core to herbal medicine practice. The traditional practice of using whole herbs is central to safety reassurance.

Processed herbal extracts particularly with non-traditional doses and based purely on small scientific reports do not have the same safety profile as whole herbs used over millennia. Most reported herbal dangers are due to extraction processes, mis-identification by untrained therapists (including doctors and pharmacists) and substitutions in error or for profit.

Diseases and population conditions change e.g. we are in an epidemic of presentations of auto-immune disease and cancer and more significantly 25% of the population over 65 years are on 5 or more pharmaceuticals daily. The training of medical herbalists needs to be aware of scope of knowledge when co-prescribing herbs.

So the role of the herbalist following initial assessment is to:

Co-write an achievable action plan with you and

Write your herbal prescription in the light of your unique holistic health profile.

Outline a plan of action including time-frame and framework for care e.g. for a health assessment no further appointments would be indicated, for mild-moderate chronic health problems such as irritable bowel syndrome or chronic sinusitis 3 appointment at one month intervals and a further appointment after 3 months are likely.

This is a highly skilled professional service depending on degree of expertise, training and mentoring which is a lifelong process.

The initial interview/assessment is designed to outline the presenting problems, and sufficient relevant detail for mutual assessment as to whether herbal medicine is a ‘best fit’ medical treatment system to suit your needs. For best fit for any professional service: financial advice, legal advice or educational opportunity time is a crucial element for a personalised Best Fit solution. Herbal medicine is a treatment based solution with a large element of education, I say to my patients “it is a qualification in your own unique health, teaching you how to not need a herbalist. Instead of a certificate for your wall you get to live your life with better health”.

The assessment will offer valuable stand-alone suggestions for self-care and/or guide you other directions for treatment where indicated.

Dr Dílis Clare, GP and Medical Herbalist, MBBCh, DRCOG, BSc(Herbal Medicine), Hon. Clinical Fellow NUIG Medical School.


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