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Customizing Herbal Formulas

I have a patient with well-controlled type 2 diabetes, but persistent slightly high WBC count & trace of blood in urine. I am using one of your formulas for one week per month for a few months. What dosage? fairly high because trying to knock out infection? or caution because it’s so cold. any advice?
huang lian 10gm, huang qin 10, huang bai 10
shan zhi zi 10, mu tong 5, hua shi 5
che qian zi 5, qu mai 5, bian xu 5
da huang 5, deng xin cao 5
gan cao 5, xiao ji 5
bai mao gen 5

West Berkeley Acupuncturist

Dear West Berkeley Acupuncturist,
Great questions! The advantage of making custom formulas is in making them specific for branch,while effectively treating the root of the condition. A good example is the Da Huang.  If there is diarrhea or loose stools, especially if not much intestinal heat, I might leave it out entirely.  If any problem of low fecal output or constipation, or intestinal heat, I might use up to 20g of Da Huang. Then, depending on where the highest level of damp heat is located, I might adjust the levels of huang lian, huang bai, huang qin, or shan zhi zi for the appropriate of the three jiao that needs to be treated.  In this case I might double the huang bai dosage since the problem is primarily lower jiao.

I would pulse at moderately high dose for 7-10 days every month.  Low dose increases the likelihood of developing bacterial resistance; long term would damage the spleen qi. I might think 8-10 grams of 5:1 extract , which would equal 50 grams of raw herbs.

So, use the 10-20 grams that are uncertain to go to the root of the problem.

I would add probiotics or fermented foods to balance the antibiotic herbs.  I would recommend a d-mannose or a non sweetened cranberry extract to clear residual bacteria in the kidneys and bladder.

These are the questions, whether internal or external, that make the critical difference in herbal care.  It is why a great herbalist will always get better results than those who use use “rote” formulas.

Be Happy!

Dr. John Nieters, L.Ac. DAOM

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