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Q: I feel like treating pediatric patients is challenging because I can use so few modalities. Are there ways to increase my success rate and compliance with kids?
A: The majority of herbs in clinical use in adults are also applicable to children. By grinding up tablets and placing the appropriately calculated (for size and age) dose in each compartment of an ice cube tray, you can follow directions on a
gelatin package and make tasty jello snacks that pack a herbal punch. Consider Astragalus Combo for back to school, 5 Mushroom Formula for immune support or Eyebright Complex for allergy season. Don't let the fact that they are kids get in the
way of helping your patients!
Q: What should I consider as a new ND graduate? (Answers from Dr. Katie Yash ND)
Q: I love MediHerb products but worry about prescribing them in my pregnant patients. Are there any herbs that are safe for use in pregnancy?
A: New research has shown that if infertility or menstrual irregularity is due to a short luteal phase, corpus luteal insufficiency or low progesterone Chaste Tree can be used to help regulate cycles and is useful in the first trimester to maintain the
pregnancy and reduce chance of miscarriage. While many herbs can be very useful to treat symptoms in pregnancy, they are usually reserved for the second half (20 weeks and beyond) when all of the organ systems are formed and the fetus is simply
getting bigger. Bilberry for hemorrhoids, Echinacea Premium for immune support and Withania tincture for anxiety are all safe and effective tools for treating the pregnant woman.
Q: I've got a lot of older patients who would like to stay young and vibrant without being on a tonne of pills. How can I target cardiovascular, memory and joint health without drastically adding to their pill regime?
A: When you break it down, the causes of aging are simple: decreased microcirculation and increased oxidation are at the root of most of the diseases associated with aging. Providing your patients with the tools to increase circulation and cognition,
like Ginkgo, and to reduce reactive oxygen species, like the antioxidant powerhouses in Vitanox (turmeric, resveratol, rosemary and green tea) can give them a daily way to slow the aging process. Doses as low as 1-2 tablets per day can provide
an incredible advantage over the ravages of time, with research showing enhanced memory, reduced tissue oxidation and better cardiovascular health.
Q: Why should SON Formula (MAP) be used in your practice?
Q: I am curious about how often a patient can dose when having extreme anxiety ,that they would normally treat with ativan. I've been using a herbal tincture and the herbalist told me a patient can take 1 tsp every few minutes until they calm; is there a recommended dosing of the tablet in this way? The tablet is obviously much stronger than a liquid but how often could they take it in extreme acute anxiety? I've also heard that they could chew the tablet for faster effect?
A:Chewing a tablet generates more surface area and contact with the sublingual capillaries which will allow for the kavalactones to enter the body. Peak absorption is usually achieved in 10-15 minutes compared to oral ingestion. Oral route has
several factors that effect the absorption time - the liver's efficiency, gastric emptying (usually the slowest of steps), presence of food type (fatty = slower).
The most important part is that the patient has to hold the kava (powdered, see below) in ones mouth for at least 60 seconds before absorption can be initiated. kava will cause the mouth to feel prickly, slightly numb - a sensation that some
patients will not enjoy. Be sure to check first. I would recommend buying a grinder as an alternative to chewing a tablet. Chewing tablets can create pits within the molars.
If you use Kava liquid instead , be certain that Kava liquid is not mixed with ethanol. Kava + ethanol can increase liver enzymes and it can also increase the likeliness that hepatotoxicity will occur. This is the reason MediHerb produces their Kava through hot-water extraction, and then quickly presses it into a tablet. This preserves the maximum effect of the kavalactones without the danger of hepatotoxicity.
Comparing the tincture to the tablet - use this as a rule of thumb: Do not take more than 2-3 tablets in an hour (every 20 minutes) and not more than 5 tablets in a day. The key to help most patients with anxiety is to give Kava at regular intervals
each day over a period of 4 weeks. Significant reduction of anxiety and even depression can be measured using such a test as the Hamilton Anxiety Rating Scale. The difference can be seen even after 1 week.
Q: Have you or how frequently have you seen anxiety occur with Saint John's Wort instigation?
A: No, I haven't observed this, but it is possible. Are you using the SJW in a patient with Major Depressive Disorder or a patient with General Anxiety Disorder? This reaction is observed with SSRI and SNRI medications that are used to treat anxiety.
This is why allopaths will prescribe a short course benzodiazepine to take the edge off while the other agents have their window to ramp up and be effective.
Q: If you've seen this occur, what course of action is recommended?
A: You'd give an anxiolytic like Kava or GABA short course until the SJW was having an effect.
Q: Does it subside?
A: Yes, it does. It is usually related to the serotonergic agent not yet being effective.
Q: Is it dose dependant?
A: It would only be dose dependent if you weren't reaching a physiological dose for the case and the SJW wasn't working due to this.
BOTANICAL BOOTCAMP: Q&A’S