The professional, responsible, kind of boilerplate answer is, of course, to find an acupuncturist trained in herbs or an herbalist, and work with her or him. And that is, generally, the way to get the best results and minimize the chances of taking the wrong thing--or too much of a good thing. It’s also important, I would think, to make sure there are no potential interactions with other meds or foods or supplements you might be taking. From what I have seen with this particular formula, however, the only real caveat is to (just to be safe) take the herbs at a different time of day (at least 2 hours away) from one’s meds. And, even though no one has yet provided me with an explanation why, the standard for taking herbs is to divide them into two (classically, it is three!!) doses and take them throughout the day. It seems that twice a day is becoming more and more common-- but I have not yet seen much once a day dosing.

Most herbal formula companies will have Bu Zhong Yi Qi Tang-- although as someone pointed out earlier, sometimes the Tang (which just means “decoction”) part is omitted and  they might use Pian (tablet) or Wan (pill) instead. Customized powders and liquids are always the most effective but will cost a minimum of $35-45 (or more if it contains real ginseng (as opposed to the ginseng stand-in, Dang Shen (Codonopsis root)); more still if it contains high quality ginseng*) for a week’s supply. If you have a Chinatown or Koreatown near you, you might be able to get them direct for less. But some of these herbal pharmacies will also only sell to licensed herbalists. (Then again, they never seem to ask for any proof of this.)

Hypertension needs to be considered in anyone considering taking Bu Zhong Yi Qi Tang. Remember, I am only 18 months into this whole Alice in the Rabbit Hole program, but so far I very much appreciate Dr. Sun’s understated proclamation from Formulas II class this quarter that, “Hypertension is complicated.” (In TCM there are various explanations and possible causes of high blood pressure.) There is reason to believe that qi (as well as many if not most Yang) tonics--Huang Qi (astragalus root) in particular--might exacerbate hypertension. Still, there are apparently other studies that show it to ameliorate the condition. Generally, I am told, studies that used a high dose of Huang Qi (more than 15 g/day) reported a beneficial effect while studies that used lower doses (probably 9 grams a day or less) supported the more common opinion that Huang Qi can increase blood pressure. So if hypertension (or so-called pre-hypertension) is an issue for you, please bear this in mind.

The only source of “patent medicines” (the aforementioned pills and tablets) that sells directly to public (as opposed to licensed herbalists and, in some cases, naturopaths, osteopaths, chiropractors and the like) is a place in San Diego called ActiveHerb.

(Please, do not do their $40 online consultation. They might mean well, but these things cannot be done via email or post. They have you mail in a snapshot of your tongue! I tried it for my father a year or so ago. (He is back in Midwest, and I am on West coast.) They wrote back that he had Spleen Qi Deficiency. Guess what? Newsflash: Just about everyone (at least in U.S.) has "Spleen Qi Deficiency“ (along with ”Liver Qi Stagnation"). So that was not at all helpful--and a waste of forty bucks. Live and learn. I wouldn’t even buy the Guang Ci Tang products if it weren’t for the fact that all of the TCM school clinics here in LA stock them--and only them--in their pharmacies. I still don’t quite understand why, as I suspect that the vast majority of patients taking them are getting subtherapeutic doses.)

The problem with Active Herb as a source, however, is that they sell (as do others) these baby aspirin sized “tea pills,” and you would have to take 2 or 3 times their recommended dose in order to get anywhere near a therapeutic quantity of herbs.

To complicate things further, the Guang Ci Tang folks who prepare these formulas, in Taiwan, don’t tell you how much of each herb is in the formula. So it’s virtually impossible to know how much you are getting. This has been my biggest frustration with Guang Ci Tang.

If anyone out there knows of something I am missing, please let me know.

*Please note that what we call ginseng in the United States is often not the ginseng spoken about when herbologists speak of Ren Shen. Ren Shen is, in the Latin, Radix et Rhizome Ginseng, and refers to the ginsengs grown in China, Korea and Japan. The ginseng grown in the United States (principally Wisconsin) and Canada is Radix Panacis Quinquefolii and actually a totally different herb altogether in Chinese medicine: Xi Yang Shen. Where Ren Shen is “slightly warm” in Chinese medicine, Xi Yang Shen is “slightly cold.” Ren Shen enters the Spleen and Lung channels’ Xi Yang Shen enters Heart, Lung and Kidney. Xi Yang Shen is more for “clearing heat, nourishing yin and tonifying qi” whereas Ren Shen “strongly tonifies ’basal’ qi, strengthens the Spleen, tonifies the Lung, generates fluid, benefits Heart qi, and calms the Spirit.” There is also a caution to avoid eating turnips (!!) when taking Ren Shen as it is said to reduce its potency. Now that’s a research paper I would like to look up.

Mike Barr is a board certified acupuncturist and herbalist and can be reached at Turning Point Acupuncture (just off Columbus Circle across from the Mandarin Oriental hotel) and at Suite 904 in the Flatiron District. His interests and experience include sports acupuncture, pain syndromes, liver health, immunological support, herbal and acupuncture approaches to getting off/putting off prescription medications of unsatisfactory or unclear benefit, and in helping to manage the side-effects of other necessary and life-saving biomedical interventions. He has also been busy exploring the application of Chinese herbal therapies, and specific acupuncture protocols, for all aspects of sexual health and anti-senescence.