Herbal FAQs

Who can use Herbal Medicine? Is it safe? 

Under the guidance of a qualified herbalist, herbal medicine can safely be used by almost everyone. In fact, many individuals choose herbal medicine as their primary form of healthcare, or use it alongside other treatment programs including conventional medicine.

There are, however, some clear instances where caution around the use of herbal medicine is advisable including:

• Individuals taking prescription or over-the-counter medications (potential drug-herbal interactions)
• Pregnant or nursing women
• Newborns and very young infants
• The elderly
• Severely ill or immunocompromised patients

During pregnancy, it is generally preferable to avoid taking any herbs, especially prior to the third trimester. There are some exceptions, including raspberry leaf, nettles, alfalfa, lemon balm, and partridge berry, which may be taken freely as tea during the entire pregnancy. Other herbs may also be appropriate; however, they should be used under the guidance of a qualified herbalist or midwife.

Nursing women require special consideration, as some herbal constituents can pass into the breast milk. This may be a desirable feature; for example, the carminative properties of fennel can aid in colic. Some herbs can be used to promote the production and flow of breast milk (collectively known as ‘galactagogues’) including the aforementioned fennel, along with fenugreek, goat’s rue, and hops.

What can Herbal Medicine be used for?

• Maintaining health and wellness
• Supporting healthy aging
• Enhancing mental clarity and cognition
• Chronic degenerative conditions including arthritis, diabetes, high blood pressure, high cholesterol
• Women’s health: hormonal balance, fertility, PMS, perimenopause, menopause, sexual vitality
• Men’s health: sexual vitality, fertility issues, prostate support
• Energy enhancement
• Immune support
• Allergies (food, environmental)
• Digestive problems including celiac, irritable bowel, heartburn, Crohns
• Complementary therapy alongside conventional medical treatment

What are “Herbal Extracts”?

Liquid herbal extracts are preparations which utilise a solvent, usually a water-alcohol combination, to extract soluble medicinal constituents from plant material. The most common solvent is grain alcohol, although other solvents including vinegar, wine, or glycerite can also be used. The plant material used for extraction may include the root, bark, aerial parts, resin/gum, flower, fruit, or seed.

Sophisticated modern extraction techniques include supercritical CO2, ultrasound and microwave-assisted methods, as well as vacuum-extraction and freeze-drying techniques. Some manufacturers may employ undesirable chemical solvents to extract plant material, especially when preparing standardized extracts, so be sure to inquire as to the nature of the extraction process.

The liquid preparation obtained from solvent extraction is called a tincture (technically, the ‘menstruum’). Tinctures contain dissolved or suspended plant constituents and can be prepared to various desired strengths. Most tinctures are in the range of 1:3 to 1:5 (1 gram of herb per 3 or 5 mL of solvent, respectively). Fluid extracts are simply strong tinctures made to a 1:1 strength, representing the equivalent of 1 gram of herb per 1 mL of solvent.

The strength of alcohol used may range up to 90%, and is dependent upon several factors, including the nature of the plant material (fresh vs. dried), the plant part (root vs. bark vs. flower, etc.), and the chemical composition of the desired constituents being extracted (alkaloids, saponins, resins, etc.). A minimum of 22% alcohol (v/v) is required in the finished product to ensure sterility.

A tincture can be prepared as a simple maceration wherein the herb ‘infuses’ in the water-alcohol solution for a period of time. This may take up to several weeks, depending on the constituent(s) being extracted. Tinctures may also be prepared by the percolation method, which involves passage of the solvent through a column holding packed (powdered) herb. Both methods have their advantages and disadvantages: percolations can be completed within 24 hours (or less), unlike macerations which take much longer; however, fresh material (i.e., not dried) cannot be percolated. Some herbs must be used in their fresh state as drying damages their medicinal properties; other herbs must be used dried, or even aged (e.g., cascara sagrada bark should be aged for a minimum of one year prior to use).

Full-spectrum vs Standardized Extracts

Extracts may be full-spectrum or standardized. Standardized extracts provide an established minimum level of a particular ‘marker’ constituent (or several) which is often considered to be the “active principle.” However, this is not always the case. For example, hypericin in St. John’s wort was originally thought to be its “active ingredient.” It was subsequently determined, however, that hyperforin, along with other constituents, are equally if not more “active” than hypericin.

Standardized extracts often require additional processing, including the blending of several different batches to attain a guaranteed level of a given marker in the finished product. Some standardized extracts may also use undesirable organic (chemical) solvents which may remain in trace amounts in the final product.

The attempt to isolate and identify one constituent, or even several as the “active principle” in a herb, is a quasi-pharmaceutical approach to herbal medicine. This is not necessarily a bad thing; in some instances, there is credible evidence demonstrating that a particular constituent is primarily associated with a given therapeutic effect. Some innovative manufacturers bring us the “best of both worlds”: a guaranteed minimum of a constituent associated with a desired effect, in a full-spectrum base. Full-spectrum extracts retain the inherent synergy of a plant’s myriad constituents and provide “a whole that is greater than the sum of the parts.”

Tinctures , Tablets, Teas?

The advantage of tinctures over tablets, capsules, or teas is their improved assimilation (and, therefore, effectiveness) in the body. They “get to work” faster and more reliably, as tinctures are essentially predigested – the solvent used in preparation makes the plant’s constituents readily available for absorption. If an individual’s digestion is compromised (often the case), it will be difficult to obtain the full therapeutic benefit of a herb from its solid form. With a tincture extract, the herbal constituents are absorbed from the stomach and small intestine into the bloodstream within minutes of ingesting.

If an individual has a sensitivity to alcohol, or if alcohol must be avoided, then glycerites and capsules/tablets may be considered, as well as herbal teas.

Hot water used in preparing teas (either as infusions or decoctions, or a combination of both) serves to extract out water-soluble constituents. The disadvantage of this method is that many of the medicinal constituents will remain ‘trapped’ within the herb material, as they are not water soluble. Conversely, with tinctures, some constituents will precipitate out of solution at higher alcohol concentrations. An example of this is the immunomodulating polysaccharides found in echinacea. However, there are other immunomodulating components in echinacea which require alcohol to be extracted out. In instances like this, it may be beneficial to take both a tincture and a tea (or capsules). Teas will provide the added benefit of hydration to the body; however, tinctures are still the preferred medicinal form, overall, for their therapeutic efficacy.

How long will it take before I notice anything?

Reestablishing health and wellbeing will depend upon a number of factors including the nature of the condition, how chronic it may be, one’s underlying health status, and, to a great extent, the level of commitment one makes to their own recovery. Benefits may be felt within as little as 1 to 2 weeks; however, often more time is required to realize the full benefits of herbal medicine and to effect lasting change.

How much does herbal medicine cost? Is it covered by insurance?

The cost of herbal remedies depends upon the type of preparation (tea, tincture, capsules), quantity needed, and the quality of the herbs used (certified organic, conventional cultivation, ethically wild-harvested, etc.).

Complementary medicine is generally not covered by provincial or state medical healthcare plans. Please check with your extended benefits provider, if applicable.

Professional membership in a recognized herbal association such as the American Herbalists Guild (AHG), Canadian Herbalists Association of BC (CHABC), or the National Institute of Medical Herbalists (NIMH) is your assurance that a herbal practitioner has fulfilled stringent educational and practice standards.