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Herbal Formulation--How To Achieve Synergism with Multiple Ingredients

Herbal Formulation--How To Achieve Synergism with Multiple Ingredients
by Dr. John Chen, Ph.D.

The 'magic bullet' approach of attempting to cure complicated illnesses with a single pharmacological agent has long been the aim of contemporary conventional medicine in the West. While this approach may work to treat the "disease," it is often not sufficient to treat the "patient." Optimal healing requires treatment of the symptoms, the cause, and the complications in order to restore the patient to health. Accomplishing this goal is often beyond the reach of the single-agent approach, but can be achieved by using a balanced combination or 'formula' that maximizes the desired therapeutic effect and minimizes the side effects.

In the past 20 years, western medicine has recognized the benefit of administering drugs in combination rather than singly. There are now numerous examples of such products:

Antibiotics: Faced with increased bacterial resistance to and tolerance of antibiotics, pharmaceutical companies have developed drug combinations to potentate therapeutic effects. Bactrim is an antibiotic containing sulfamethoxazole and trimethoprim. This combination is extremely effective: sulfamethoxazole kills bacteria, and trimethoprim inhibits the growth and multiplication of bacteria. The combination of these two agents enables the final product to achieve far more than what each is able to accomplish individually.

Pain Killers: Aspirin alone is an effective pain medication, but is notorious for causing stomach irritation. Therefore, to maximize positive effects and minimize unwanted side effects, aspirin is commonly combined with antacids or covered with an enteric coating to protect the stomach.

Hypertension therapies: Dyazide, a drug commonly prescribed to treat hypertension, contains two diuretics that balance one another's side effects. Triamterene eliminates water but retains excessive potassium in the body, while hydrochlorothiazide eliminates water and lowers potassium levels in the body. Neither ingredient is an ideal diuretic if used individually. However, when formulated together, excellent efficacy with few side effects is achieved.

While the fundamental concept of using synergism is the same whether applied in western medicine or in Traditional Chinese Medicine, the formulation of herbal products is often more challenging and complex than that of current pharmaceutical products. In Traditional Chinese Medicine, many herbs are prepared with special and specific protocols to minimize side effects, and multiple-herb formulas are combined carefully to maximize therapeutic effects.

For example, Radix Polygoni Multiflori (He Shou Wu) is an herb commonly used for treatment of premature gray hair and hair loss. In its normal state, it contains emodin and sennoside, which are known to cause diarrhea. Therefore, Radix Polygoni Multiflori (He Shou Wu) must undergo a black bean curing process prior to consumption to avoid diarrhea.

In addition to proper preparation, herbs are almost always prescribed in combinations, or 'formulas' according to Traditional Chinese Medicine. This goes beyond treating the disease solely on the molecular level, advancing to treating the patient as a whole person. In most cases, it is unrealistic and impossible to assume that the illness is caused specifically by one enzyme, one receptor, or one protein. Instead, an illness is often caused by a number of factors, leading to multiple symptoms and complications. Therefore, a treatment protocol that emphasizes treating the cause, and the symptoms and the complications, will often achieve wonderful results.

Despite the current fad surrounding Radix Ginseng (Ren Shen), one of the oldest and most commonly used herbs worldwide, many new advocates of this herb do not understand that it is rarely recommended for use as a single agent. It is often combined with Rhizoma Atractylodis Macrocephalae (Bai Zhu) to improve energy, with Arillus Longanae Euphoriae (Long Yan Rou) to improve memory, and with Radix Rehmanniae Glutinosae Conquitae (Shu Di Huang) to treat impotence.

Use of Radix Ginseng (Ren Shen) by itself is associated with a higher incidence of side effects, all of which can be neutralized by the addition of other herbs. For example, bloating sensations may be relieved by combining Radix Ginseng (Ren Shen) with Pericarpium Citri Reticulatae (Chen Pi) or Fructus Amomi (Sha Ren). The increase in thirst and body temperature may be relieved with the addition of Radix Rehmanniae Glutinosae (Sheng Di Huang), and edema may be alleviated with Sclerotium Poriae Cocos (Fu Ling) or Rhizoma Alismatis Orientalis (Ze Xie).

Some herbs are essentially ineffective unless combined with others but gain unique potency when formulated, so long as the appropriate methodologies are performed.

While some herbs may be used as individual entities, most of them require precise formulation to achieve the desired effects. Traditional Chinese Medicine is an art of medicine perfected thorough thousands of years of practical, recorded experience. The practice of synergism through herbal formulations has been documented since the dawn of herbal medicine, and the same principle is now gradually being utilized in the pharmaceutical industry.

If you want your herbal products to have lasting success, make sure they are correctly formulated with properly cured herbs in order to ensure its efficacy and eliminate unwanted side effects.

Note: The art of formulation is both sophisticated and complex, requiring years of education and experience. Inappropriate formulation may render the product ineffective, and perhaps cause adverse reactions. Expert Chinese herbalists must have an advanced degree in Traditional Chinese Medicine, which requires a minimum of four years of post-graduate training in accredited universities and colleges.

Dr. John Chen, Ph.D, Pharm.D., O.M.D., L.Ac. is a recognized authority on Chinese Herbal Medicine and Western Pharmacology. He is a member of the Herbal Medicine Committee for the American Association of Oriental Medicine (AAOM) and an herbal consultant for the California Association of Acupuncture and Oriental Medicine (CAAOM). He can be reached for consultation at (626) 916-1020.

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