There is no simple answer to this question. It depends on the individual’s health situation, if the drugs are necessary, and how much personal health work is willing to be performed.

Let me briefly list the main pharmaceutical-load categories, as they apply to this issue. The following is a generalization. There are exceptions.

1. The individual who needs the pharmaceutical/s to live, i.e. type-1 diabetic, anti-rejection medication, chemotherapy, etc. There is no herbal replacement for very profound conventional treatments.
   
   Bringing in herbal medicine to address a non-serious secondary issue (sore throat, indigestion, anxiety, etc.) should be OK…but it may be tricky due the body’s already highly-manipulated state. Relatedly, many times, these lesser secondary issues are a drug side effect.
   
   As far as the application of constitutional herbal medicine, this individual is often beyond its reach. These applications are subtle in their effects. This means that the pharmaceuticals will overpower most things herbal (constitutional and otherwise). An additional factor is – what occurs after adding another set of chemicals to a complicated pharmacological internal state? It is anyone’s guess.
   
   
2. The individual who is highly medicated but the drugs are not essential (many seniors fall into this category). One pharmaceutical leads to another, and so on. Much of the first category applies here. The difference however is many of the drugs can be eliminated, very slowly. This takes willingness (most important) on the part of the client, patience, and health work (diet/exercise/lifestyle/etc.). Once the physical ‘slate’ has been de-cluttered, herbal medicine has a good chance of making a positive difference.
   
   
3. The individual who is taking just one to two pharmaceutics for non-life-threatening health complaints. Mild to moderate GERD, anxiety, sleeplessness, joint inflammation, and list goes on. Herbs probably could have been employed from the start, but for whatever reason, that didn’t happen. The simplest cases are a this-for-that switch. But sometimes there needs to be a slow tapering of the pharmaceutical while the herb is incrementally increased.
   
   
4. The person who is pharmaceutical free is the ideal candidate for herbal medicine. However, these people are rare.

In summation, the longer, more of, and profound an individual’s pharmaceutical use is, the less positive influence herbal medicine will initially have. But that doesn’t mean that all hope is lost. If you’re able to put in the hard work (diet/exercise/lifestyle changes) and declutter extraneous pharmaceuticals, there is much herbal application has to offer.

*I am not advocating for the discontinuation of anyone’s pharmaceutical use without a doctor’s consent.*

Certain pre-appointment questions come up more than others. Here’s a list of some of the more common ones.

• Are you accepting new clients?
• How long will it take for me to see a difference with my situation?
• I’m receiving care from other branches of medicine (or self-care), do you coordinate your recommendations?
• I’m taking an herbal formula from another herbalist (or a store-bought herbal supplement) and it seems to be effective. Can you duplicate it and provide me with the same herbal formula?
• I want my spouse/significant other/family member to come in for an appointment. Can I schedule it for him?
• I want to bring someone or a pet to the appointment. Possible?
• What’s your opinion of medicinal-Marijuana?
• Are you a retail herb shop?
• Do you formulate without alcohol?
• Do you email/phone/video chat consult?
• Do you make house calls?
• What forms of payment do you accept? Insurance?
• Can I barter or trade for your services?
• What is your sliding scale policy?
• What is your therapeutic overlay? Western, eastern, metaphysical, etc.?
• I’m a visiting herbalist/student and would like to pick your brain. Possible?

Are you accepting new clients?

Yes, with some limits. The practice is at an ideal level of activity, however, in any given 1-2 week period I can usually take on a new client. But I am picky. What this means is, if I get the sense in the preliminary contact that my services are not going to be sufficiently valued, I’ll politely refer the individual to another practitioner. It’s better that way for both parties. My time is limited, so it’s best that I apply my attention to people who really what my assistance.  [Top]

How long will it take for me to see a difference with my situation?

As long as the situation is within herbal medicine’s scope and the correct herb or combination is given (correct being the operative word), one day to one week, depending on the situation. Nervous system, gastrointestinal, and skin-oriented conditions usually respond (not resolve, but begin to respond) within a day or two. Long-standing vascular, metabolic, reproductive, or inflammatory-immune issues often take longer. A general rule-of-thumb is: the longer the disfunction has existed, the greater the length of time needed to see herbal results. [Top]

I’m receiving care from other branches of medicine (or self-care), do you coordinate your recommendations?

Absolutely. Relatedly, an important question to ask about a therapy, whatever modality – is it helping? It may seem like an obvious comparison, but there’s a big difference between a supplement, herb, drug, or otherwise, helping, versus, supposing to help. I’m of the opinion that ‘less is more’; so if the job can get done with one or two approaches, rather than a half-dozen, then I’m all for streamlining. However, if the pharmaceutical, supplement, iv-drip therapy, etc. is having a net-beneficial effect, then I’ll be the first to say – stay the course. [Top]

I’m taking an herbal formula from another herbalist (or a store-bought herbal supplement) and it seems to be effective. Can you duplicate it and provide me with the same herbal formula?

As long as you come in for a consultation, which allows me to do my job properly, and the positive effects of the herbal formula are as described, then yes. [Top]

Note: in formula matching, knowing the herbal ratios (and the specific herbs) is important. Continuing to purchase the formula from the original source is optimal, but I’m assuming for whatever reason, that’s not an option.

I want my spouse/significant other/family member to come in for an appointment. Can I schedule it for him?

With the exception of someone who needs a parent or guardian throughout the scheduling and office visit process, the adult of concern, needs to personally put in the effort of scheduling an appointment. This demonstrates to me that they are sincerely interested and not being forced into an office visit. [Top]

I want to bring someone or a pet to the appointment. Possible?

Without getting into the reasons why a client wants to bring someone to the appointment, I can say with absolute certainty that having an extra person in the room during the consultation is not helpful. However, the extra person is welcome to say hi, then wait in the lobby. As far as pets (or “emotional support animals”)…they’re best left at home. Be strong….you can do this all by yourself! [Top]

What’s your opinion of medicinal-Marijuana?

Usually Cannabis’ several therapeutic benefits can be matched by much less risky herbal medicines. If the ‘high’ from medicinal-Marijuana is undesirable, but the spasmolytic, stomachic, or sedative effects are wanted, then most clients will find herbal medicine a better choice. [Top]

Are you a retail herb shop?

No. My services are consultation-based. I only sell herbs (mostly tailored formulas) to clients. [Top]

Do you formulate without alcohol?

If it’s called for/desired, then yes. Diabetics, children, pregnant women, and people with alcohol histories, are the main groups that usually ask for non-alcoholic preparations. [Top]

Do you email/phone/video chat consult?

No. Consultations need to be in-person. There’s no way to properly assess a client’s situation through these modes of communication. *I do make an exception for COVID related consultations. These are conducted by phone.*   [Top]

Do you make house calls?

As long as it’s in the Tucson-area, and the residence (or a room within the residence) is distraction-free, I’ll consider it. The consultation fee for a house call is $250 (pre-pay and no sliding scale for house-calls). [Top]

What forms of payment do you accept? Insurance?

Cash, check, money order, and credit/debit cards. I do not accept insurance/Medicare/Etc. [Top]

Can I barter or trade for your services?

No. But I do have sliding scale. [Top]

What is your sliding scale policy?

It’s pretty simple – if paying the $120-$160 (initial consult with herbs) means a utility bill, the rent, or another essential payment gets put off – please ask for the sliding scale.

If paying the $120-$160 means that money doesn’t go into the mutual fund this month…be proud to pay the full price! [Top]

What is your therapeutic overlay? Western, eastern, metaphysical, etc.?

Critical thinking and the application of western scientific thought have done a pretty good job of lifting Mankind out of the Dark Ages. The application of these perspectives is likewise optimal in channeling herbal potential into herbal result.

One way to look at the material versus spiritualist application of herbal medicine is this:

Herbs contain physiologically active chemicals, usually in small amounts. Pharmaceuticals contain physiologically active chemicals, in larger amounts. No intelligent person wants a doctor to write a prescription based on dreams/dowsing/astrology/intuition. Like doctors, good herbalists think (thinking is different from feeling or intuition), are oriented towards rational problem solving, and do not use the subject to further their own psychological/emotional tendencies. It’s about the client; not the herbalist. [Top]

I’m a visiting herbalist/student and would like to pick your brain. Possible?

I’m always happy to meet with visiting herbalists/students (other modalities too). Contact me using the form (Contact page), and we’ll schedule a time for you to come in to the office (gratis). Please don’t show up unannounced – I’m either not going to be there or I’ll be with a client. Thanks! [Top]

I rely upon the medicinal virtues of many native plants; some that serve as indigenous representatives to herbs in commerce (i.e. native species of Passionflower, Skullcap, St. John’s wort, etc.) and then others that are unique in activity and identification. Certainly there are non-regional herbs that I’m unable to gather (Garlic, Turmeric, Ginseng, etc.). For these I seek out quality bulk sources and then they are prepared accordingly.

Many plants are best tinctured fresh (with undiluted 190% proof ethyl alcohol), particularly if that herbal medicine needs to relay physiologically complexity and/or nuance. For instance, dried Lobelia (herb) is largely an upper gastrointestinal stimulant (nauseating); however when prepared fresh, Lobelia’s subtleties remains intact. In this form it delicately influences an array of parasympathetic nervous system activity. Also, herbs that influence emotional states (depression, anxiety, etc.) tend to be better prepared fresh.

Whether it’s muting an irritating principle and/or focusing a plant’s physiological direction, at times, the drying process is important. The two techniques that best capture a dried herb’s value are the percolation and fluidextract (which is contingent upon the percolation). Both preparations begin by allowing the menstruum (an alcohol-water solvent, calculated for that particular herb) to slowly filter through the powdered/digested herb. It is then dripped at a specific rate and captured as a percolated tincture (1:5). A fluidextract is essentially a concentrated percolation (1:1) that is reduced via low heat or even better, low heat and vacuum. A maceration is a failed percolation – everything (powdered herb/menstruum) gets thrown together in a jar and is shaken daily for two weeks, strained, and bottled.

An essential oil is the fraction (mostly terpenes) that is rendered when a plant undergoes steam distillation. Essential oils are best used topically (and in some cases, internally), and nearly always diluted, for their various medicinal qualities. Consider them a concentrated botanical isolate – significant in application, but prone to toxicity if improperly dosed. I prefer to use them as an accent element in combination with other internal/external herbs.

Water-based teas need little introduction – however their best areas of influence often go undefined. It’s the where and less of the what that helps decide if a tea preparation is picked, instead of a tincture or capsule. Problems of the gastrointestinal and urinary tracts respond better to teas (as long as the herb’s constituents are water-soluble); mainly because the tea’s volume either coats (GI) or is eliminated (UR) through these two systems.

More on the nuances of caps/taps and a bevy of topical preparations, at a later date.

In essence, the label constitutional herbal medicine simply points to a type of herbal treatment that addresses an underlining tendency rather than an outward dysfunction/symptom.

The progression of tendency to dysfunction occurs thusly:

(But first: a healthy organ or unified group of tissues working in concert under normal/non-stressed conditions has an output of much less than total capacity. Let’s call this ‘steady-state’ operation. If we are fortunate enough to be born healthy and have a reasonably health-normal childhood, we start here.)

Due to a combination of every-day influences (the aging process, genetics, and long-term environmental and/or lifestyle insults) working organ/tissue effort increases in order to maintain equilibrium. That particular organ or area must work harder to complete its physiological tasks; instead of steady-state operation being achieved with only 10%-20% of total capacity, it now, for whatever reason, is called on to engage a greater percentage. Workload increases.

At moderate organ/tissue challenge (middle age or even in the healthy or young with a genetic predisposition) it’s common to approach the half to three-quarter capacity mark. But even here the body is mostly symptom free: the less efficient organ/tissue group still maintains steady-state (and routine blood work and examinations all come back normal). Enter constitutional herbal medicine: it is best used here to either stimulate or sedate an organ system or tissue group, ideally before an illness manifests.

Further along on the continuum, in response to the continued push-pull of life, dysfunction breakthrough begins to occur. This period, when symptoms of dysfunction begin to manifest and peek through an otherwise healthy, but labored internal situation, is the beginning of the transition from successful constitutional herbal application to symptomatic application. As the underlying tendency changes to definable illness, constitution herbal medicine has less sway. At this point, symptom-oriented applications will likely comprise the mainstay of an herbal treatment plan.

So basically, constitutional herbal medicine has as much to do with the what (herb) as the timing (pre-disease). By subtly targeting a particular tissue group or organ system, the premise is to head-off disease prior to its occurrence with a well-selected herb or combination thereof.

The ability to discern the relevant functional tendency, which underpins a particular symptom, is another aspect of constitutional herbal medicine. For instance – someone who is suffering from sleepless and anxiety, usually manifests one of three possible constitutional scenarios (caffeine, acute stress, etc., have been ruled out). A) Sympathetic/adrenergic excess. B) Parasympathetic/cholinergic deficiency. C) Thyroid excess. Common herbal approaches focus on A, i.e. Passiflora, Valeriana, Scutellaria, etc. Remedy for B entails stimulating parasympathetic activity, for example, with various species of Asclepias or Lobelia. Leonurus or Lycopus (small doses) are best for scenario C. Some people are unresponsive to traditional herbal sedatives. It’s not that the herb was ineffective; it’s that the wrong herb (and pattern) was decided upon.