The naturopathic medical education has a robust curriculum in botanical (herbal) medicine, and is one of the aspects that sets it apart from other integrative medical disciplines. Our education qualifies us to apply for registered herbalist status through the American Herbalist Guild RH(AHG), the foremost certification in the field requiring 800 hours of botanical medicine education and 400 hours of applied clinical practice. As a lay person, before this education, I liked the idea of herbal medicine but didn’t quite trust or believe in it. I now understand this was because I was naïve to the breadth of its uses and the compendium of information and science surrounding it. There is also an art to botanical medicine that has been lost in its misconstrued claims by supplement companies and, too often, careless recommendations by untrained providers and laypersons. Botanical medicine can be very powerful when used properly but is often not dosed accurately (often too little or, worse, too much), not presented in the best form, not indicated for its claims, or simply not the right choice for the individual using it. We’ll get into some of these nuances below.
Botanical medicine is both deeply traditional and scientific. There has been an incredible amount of chemical and biochemical research into herbal medicine in recent decades that continues to validate millennia of traditional botanical medicine practices. As you begin to dive into this world you realize we are surrounded by medicine in nature. All plants are filled with nutrients and a multitude of organic chemicals with medicinal properites, some more than others, from the weed in the sidewalk to a tree in your back yard. Plants have needed to grow in harsh, changing environments and are not without threat of bacteria, viral, fungal, or parasitic infections. In their evolution to survive these challenges they have amassed chemicals with a range of actions including antimicrobial properties, compounds that attract and deter insects and animals, chemicals that cross-communicate with other plants, nutritive properties, and more. There are over 100,000 different chemical compounds that have been identified within plants with nearly 3,000 new molecules being isolated and characterized each year (1). These chemicals include carbohydrates, lipids, glycosides, terpenes, phenolics, alkaloids, and many subsets of these categories. We have evolved with plants and thus these plant compounds are compatible with us in numerous ways. What sustains plant life also helps to sustain us, not only in providing nutrition but also in the same ways the plant is protected – those antimicrobial properties can do the same for us. Plant constituents also have effects on all aspects of our functioning including the digestive system, immune system, nervous system, endocrine system, etc. Before the modern medical movement that brought us to where we are today, botanical medicine was an active part of medical care. We have since forgotten these roots and, with it, an understanding and trust in a safe and effective option for our health.
A few medicinal actions of botanicals:
- Adaptogen: adrenal/HPA axis support
- Antimicrobial: antibacterial, antiviral, antifungal, antiparasitic
- Carminitive: anti-bloat
- Diuretic: increases urine output
- Immune-modulating: affects immune system
- Nervine: calming, anti-anxiety
- Nutritive: supplyies vitamins and minerals
- Sedative: sleeping aid
- Spasmolytic: releases smooth muscle and skeletal muscle tension
- Stimulant: energizing
Traditional applications of plants and herbs often use the whole-plant or parts of the whole plant, extracting medicinal properties from dried or fresh preparations through water (tea, anyone?), vinegar, oil, glycerin, and alcohol. Chemicals extracted may vary depending on the solubility of the compounds in these solvents (chemistry!) and thus certain forms of extraction may be more beneficial for some plants over others (i.e. a plant may be more potent medicinally as a tea vs. alcohol-based extraction depending on the chemicals present). The chemical compounds within plants also work synergistically, balancing their properties. Because of this, whole-plant applications are often the most gentle for the body as we are using the plant in its balanced form. Contrast this to more modern uses of botanical medicine where we can extract specific chemicals from the plants. This is done where studies have isolated the main chemical of therapeutic value in a plant (and I find this to be a very reductionist view of plant medicine). Berberine is an example of this, a common plant alkaloid with antimicrobial and antidiabetic effects found in well-known medicinal botanicals like Oregon Grape Root and Goldenseal. In another example, salicylic acid is the chemical constituent of willow bark that was isolated and eventually made into aspirin (now synthetically derived). The salicylic acid content in aspirin is multifold higher than that found in willow bark and the sole ingredient. While it may offer superior analgesic effects in this form, the high concentration of this single ingredient is known to damage the mucosal lining of the stomach, often causing ulcers. While the whole plant extract of willow bark has a fraction of the salicylic acid content, it is complimented by additional chemicals that can provide similar benefit as aspirin but through broader mechanism of action, and does not cause stomach irritation or ulceration (2).
There is so much more to discuss when it comes to botanical medicine but the final aspect I will discuss is that of energetics. Prior to the diagnostic tools we have now, plant medicines were chosen not only by the issue at hand but by matching the energetic needs of the person to the energetics of the plant. As a very elementary example, ginger and cayenne create heat in the body and are known to be warming and stimulating herbs. You can imagine that a person who already runs physically hot or who presents to you agitated and unable to sit still might be aggravated by these properties; an herb that has more cooling energetics would be the better choice for them. These plants tend to not only impart cooling sensations (think mint family) but also more calming effects. Plants can also have moist and dry properties and be chosen based on these attributes depending how a patient presents. These subtleties of practice are part of the lost art of herbal medicine, and I think there is something to be learned from this. This level of individual attention and detail in treatment is nearly devoid in today’s medical paradigm and, I feel, is a detriment to overall care. Botanical medicine is real and does indeed work, but I think its major successes come from respecting the plants and their nuanced applications, which is unfortunately rarely being done today.
1 Hoffmann, David. Medical Herbalism: The Science and Practice of Herbal Medicine. Rochester, Vt. Health Arts Press. (2003).
2 Annemarie Lippert, Bertold Renner, Herb–Drug Interaction in Inflammatory Diseases: Review of Phytomedicine and Herbal Supplements, Journal of Clinical Medicine. (2022)