Yesterday I received an email from someone in Spain with the following question, copied here with permission:
“I was searching for Chinese herbs, low doses and sensitivity and found your website. I would love if you could tell me how low one can go for it to still work. After feeling bad on the prescribed dosage from the practitioner (diarrhea and exhaustion) I took a micro dose and actually felt much better, so out of that come my curiosity. And of course due to being super sensitive lately to all meds and other treatments. The practitioner says she can’t really help me if I’m not taking what she’s prescribed.”
I think this is a common situation and predicament for people using Chinese herbs. I have previously written about herb sensitivity in the article Chinese Herbal Medicine for Highly Sensitive People. Here I will address the specific issue of effective dosage.
Chinese herbs are typically prescribed at high dosages, even much higher than what is commonly prescribed by most practitioners. Here is an example of a medium-sized Chinese herbal formula:
Chai hu – 6 grams
Ban xia – 9 grams
Huang qin – 6 grams
Dang shen – 9 grams
Zhi gan cao – 6 grams
Sheng jiang – 6 grams
Da zao – 6 grams
Hou po – 9 grams
Fu ling – 6 grams
Chuan xiong – 6 grams
Zi su ye – 6 grams
Bai zhu – 12 grams
Dang gui – 12 grams
Bai shao – 9 grams
Bo he – 3 grams
This formula is a mix of xiao chai hu tang (minor bupleurum decoction), xiao yao san (rambling powder) and ban xia hou po tang (pinellia and magnolia decoction). The total dose of the formula is 111 grams, which is intended to be consumed in one day. This would equate to: 2 cups of bulk herbal decoction, 15 level scoops of granules, 45 capsules, or 178 small teapills. In terms of bulk decoction or granules, the amount is relatively manageable for most people. However, it is still much more than people are accustomed to consuming.
For people who are sensitive, this quantity of medicine is simply too much. The issue raised in the email is this: will herbs still work if taken at a lower dose. The answer is yes. The most important consideration when taking Chinese herbal medicine is having the right formula; dosage is a variable and secondary consideration. This due to the principle of resonance. If the formula matches the patient, it will act and have beneficial effect, regardless of dose.
For some people, a small dose is all that is needed. In many cases however, acclimating to a small dose allows for gradual increase in dosage. I have seen many people work their way up from very small doses to a full, large dose over the course of many months. Sometimes this also requires fine adjustments in the formula itself.
Understanding sensitivity, response and dose is the responsibility of the practitioner. There is no standard to which the patient is expected to comply or achieve. The beauty of Chinese medicine is its capacity for finely tuned, individualized treatment, including dosage.