With so many herbal products on the market, it’s important to distinguish between different preparations and to select one whose strengths harmonize with one’s personal approach to healing. Within the practice of herbalism, there are widely varying dosing strategies that correspond to the many different ways an individual practitioner chooses to use herbs, and not all products are suited to every approach. Due to variation in factors like strength, plant parts used, and unique aspects of preparation, one brand’s Echinacea product may not be the same as another. Even two brands of Echinacea tincture may differ significantly with respect to the extent that one may work better for a given practitioner than another. And this is not because stronger is always better: beyond factors like whether the extract captures the full spectrum of plant constituents as opposed to concentrating a few actives, different schools of herbal medicine disagree on what an ideal dose actually is and how far the individual constituents matter as opposed to the essence of a plant.
In botanical medicine, a broad distinction can be made between the so-called “high-dose” and “low-dose” schools of herbalism, whose proponents are often at odds with one another. It is wrong to say that one approach is better than the other, because each has its own merits in different situations, and yet most practitioners approach healing in a way that clearly favors one or the other, which has in fact become a source of contention and controversy in alternative healing. Proponents of the high-dose school often accuse low-dose herbalists of ignoring modern science and continuing to use many plants in ways that are entirely unsupported or even contradicted by evidence-based medicine. Proponents of the low-dose school, on the other hand, accuse their opponents of practicing “green allopathy,” essentially using standardized extracts of herbs as pharmaceutical drugs that only treat symptoms without actually healing, due to ignoring the subtle energetics of plant medicines.
In reality, the ideal dosing strategy will vary depending on the herb used, and even for the same herb, for what purpose it is being used. Part of what makes herbs such useful and versatile health-promoting allies is their panoply of constituents and mechanisms of action, allowing the same herb to be used for different things. But depending on the application, the best approach to dosing an herb and therefore, the best form of herbal product to use will vary, especially based on a practitioner’s own school of training and personal philosophy. The below summary, which details the most common dosing strategies, can be seen as a spectrum, representing the furthest extremes of the high-dose and low-dose perspectives. As will be seen, each has its own separate merits and disadvantages.
- Standardized Extract: in terms of delivering a specific active constituent, a standardized extract would be considered the most efficient. They are also preferable if a specific dose is desired, as standardization can overcome the naturally occurring variation in the actives of many herbs. This is especially important if the constituent can become toxic in too high a dose, though standardized extracts are more commonly used to ensure an adequate content of beneficial constituents, often in amounts supported by research. One disadvantage of using standardized extracts is that by focusing on obtaining and concentrating one active constituent, they neglect to consider the full spectrum of the plant’s activity. They may even be focusing on the wrong constituents, if presumptions about some proposed mechanism of action are wrong.
- Medicinal Food: Herbs like Dandelion, Maca, Ginger, and Dong Quai have all been at one time or continue to be eaten as foods in various cultures, because they often work best when taken in larger quantities than what capsules and tinctures can deliver. What determines a medicinal food is not whether one can typically find it in a grocery store, but rather that it is to be consumed whole in amounts similar to a serving of vegetables. This distinguishes it from a standardized extract, which can offer similarly high doses of a constituent by leaving most of the plant out. A great example of a medicinal food would be using broccoli to support gut health. Not only is broccoli rich in sulforaphane, a constituent shown to support a healthy microbiome, it’s also a good source of soluble fiber, providing further benefits that a sulforaphane supplement would lack. Possible disadvantages of medicinal foods include taste and the presence of other constituents which may not be desired. Besides sulforaphane, broccoli contains goitrogens which can lower thyroid activity. For a patient with hypothyroidism who hates the taste of broccoli, a standardized sulforaphane supplement would clearly be preferable.
- High-Dose Tincture: this is probably the most common method of dosing herbs within a clinical setting. For most tinctures, a “high dose” would be considered a full dropper (about 20 drops) 3-4 times per day. While tinctures will not typically provide as many active constituents as a standardized extract, they may compensate by offering a broader range of constituents. This is especially important when the herb’s actives are multiple or not well-characterized. As scientific knowledge of herbal medicine expands, and more herbal constituents become identified and characterized, it seems that high-dose tinctures are losing popularity in favor of standardized extracts. An example of this is the herb hawthorn, which is believed to benefit the heart through its proanthocyanidin content. Due to its relative safety and the high dosages demonstrated to be effective in research, it was not uncommon to use hawthorn tincture in doses up to a teaspoon 3-4 times per day. It is also becoming more common today to use standardized extracts of hawthorn instead, to ensure a clinically relevant dose of oligomeric proanthocyanidins.
- Low-Dose Tincture: the effect of most medicinal herbs is gentle compared to pharmaceutical drugs, and as such large doses are not always required to deliver their subtle healing effects. For this reason, many traditional herbalists use tinctures in comparatively low doses, especially when viewed in terms of delivering quantities of active constituents. This method is especially popular for dosing tonic herbs, considered to have a broadly supportive effect which transcends individual active constituents. This is especially true for herbs whose active constituents remain a mystery, like Solomon’s Seal which supports connective tissues throughout the body despite having no identified mechanism of action. Obviously, healing herbs that can be toxic in high doses are typically given this way as well, but there are many non-toxic herbs with energetic effects that seem to work as well if not better in smaller quantities, such as one dropper once per day or 5-10 drops three times per day.
- Drop Dose Tincture: at the extreme end of practitioners who work with plant energetics are the drop-dose herbalists, who will not uncommonly dose herbs a drop at a time. Using a vitalist approach, plants are studied not as a bundle of constituents but as individual entities, sometimes with the aid of meditation or spiritual techniques, to be used as teachers or spiritual allies against illness in single drop doses. This approach requires deemphasizing a patient’s diagnosis and prescribing instead on constitutional indications, similar to homeopathy with which it in fact overlaps significantly. Many classical homeopaths like Boericke and Burnett in fact prescribed certain remedies not in dilution, but as drop doses of the mother tincture, and obtained good results even when selecting the herb on homeopathic indications.
- Homeopathic Dilution, Low Potency: although some would draw a distinction between herbalism and homeopathy, many homeopaths today use low potencies in a manner more akin to classical herbalists than the teachings of Samuel Hahnemann. Often referred to as “drainage” remedies, many of the same herbs used commonly in botanical medicine make their way into homeopathic formulations in potencies ranging 1X and 6X. A homeopathic formulation for fever might include Echinacea 3X to stimulate the immune system, alongside more classically indicated remedies for fever at higher potencies. Although a dilution of Echinacea 3X would contain some active plant constituents, this blurring of energetic herbalism with homeopathy underscores that the pharmacological and vitalist principles of many herbs, while overlapping, are distinct and can lead to different uses. Barberry, for example, can be standardized for berberine content and used to support healthy blood sugar, or diluted homeopathically and used to relieve back pain, but neither preparation is likely to be effective for both.
- Homeopathic Dilution, High Potency: the technical cutoff between low and high potency in homeopathy is 12C/24X, the dilution beyond which Avogadro’s limit predicts there would be no molecules of the starting substance present. In actual practice, any herbal dilution beyond 6X is unlikely to have enough meaningful constituents to affect the body on a purely physical level. And yet, it is well-known in homeopathy that certain herbs can be used in high potency for the same indications they would be given as tinctures. An example is chamomile, which can have the same soothing effect in 200C dilution as when given as a tea. In homeopathic terms, the main advantage of using high potency over low is that it will often act more rapidly and need to be repeated less often. The disadvantages of high potencies are they are more likely to do nothing at all if the remedy is not well-selected, and any proving symptoms will be more intense and long-lasting. For these reasons, it makes little sense to use homeopathy in high potency unless one is very confident in the prescription.
Where do Energique’s Spagyric herbal extracts fit into the above scheme? The spagyric extraction process captures the broadest spectrum of plant constituents, including insoluble components and trace minerals, while at the same time enhancing the bioavailability of many active constituents. Although time consuming, the gentleness of the initial extraction steps also helps preserve elements which might otherwise be degraded by harsher techniques focused on maximizing certain constituents. With its roots in alchemy, the spagyric process is ideally suited to capturing the true essence of the plant, and so spagyric extracts work well within the energetic approaches of the low-dose school while still paying deference to the delivery of active constituents as favored by the high-dose school. They perhaps work best when used as low-dose tinctures, prescribed on the holistic indications of traditional herbalism.