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Improving health outcomes is the goal of every practitioner. Finding the solutions for challenging chronic conditions often requires precious time, extensive research, and sometimes even trial and error. Join Rob Lutz, the host and founder of Today’s Practitioner, as he interviews recognized experts and shares their knowledge and proven treatment protocols. Peer to peer guidance can be the most direct path to finding effective solutions for the conditions impacting your patients.
Rob Lutz 00:02
Hello and welcome to the OneMedicine Podcast with Today's Practitioner. In each episode, we share the expertise of a respected thought leader, some you will know and others you'll probably meet for the first time. We cover topics important to you, always with a focus on improving the health outcomes of the patients you treat, while expanding your understanding of the many healing modalities being used today.
Rob Lutz 00:24
Okay, welcome to the OneMedicine Podcast. I'm Rob Lutz, your host and with me today is KP Khalsa. We'll be discussing the use of natural methods for neurological conditions. KP is an herbalist, nutritionist, yoga teacher, and educator who has been making holistic approaches palatable to the modern mind for over 50 years. He was the first person to be professionally certified in both herbalism and Ayurveda in the US. He is President Emeritus of the American Herbalist Guild and Director Emeritus of the National Ayurvedic Medical Association. Thank you, and welcome to the podcast, KP. I do have a couple of questions that I typically like to ask before we dive into the topic, just so our listeners get a little more context and a little bit more about you perhaps. And it's just a little bit more interesting that way, I think. And so these are three questions I ask most of my guests. So first is: How did you find your way to herbalism and Ayurveda? What was your path? Why that direction?
KP Singh Khalsa 01:20
Thanks for having me, Rob. This goes way back to the hippie era, and people were experimenting with all sorts of new ideas, philosophies, theories, lifestyles, things like that. I was the mythic, all that. So these things just seemed fascinating to me on their face, and I began to experiment. Now in those days, of course, a health food store had on one shelf a bag of wheat germ, and on the other shelf a bottle of alfalfa pills, and that was about it. So there wasn't that much that we had available at that time. But gradually as we began to learn, things evolved. Now, alongside of that, I have a kind of a typical wounded healer story. I was diagnosed with a terminal illness when I was age 10; it was a slow developing kind of thing. I was told that nobody ever makes it past age 40. I went to an army of physicians; there was nothing anybody could do. They just said, "Don't get addicted to morphine too early, because you're going to need a lot later." When you're 10 years old, that doesn't really sink in very well, you know, so I lived my life the best I could, although I was in more and more pain every year. But gradually then, I began to experiment with these kinds of things that we're talking about, and I got some relief. And over time, more and more relief. Then finally, by the time I was about 20, I was completely out of pain. And note, the medical tests were now all normalized. Now, obviously, I'm way past 40. There's no sign of the illness now. So, I wasn't thinking about it for myself really at the time, because initially I was told there's nothing that can be done about it. But I think subconsciously, that was a motivation. So I had great results with it. I took a yoga class one day when I was about 18 years old; it brought me a tremendous relief from the pain for about five minutes, and I thought: Well if there's something there, there must be other things. And so that led to my interest in Ayurveda. I got to Ayurveda through yoga, but also I had been studying nutrition and herbalism as well, and those paths all just kind of joined.
Rob Lutz 03:11
Yeah, that's interesting. And if you don't mind me asking, what was the condition that you were diagnosed when you were 10?
KP Singh Khalsa 03:17
It's called Scheuermann's Disease; it's a diagnosis that's not very often given in the United States. It was diagnosed by a German orthopedist who was familiar with that diagnosis. It's a gradual degeneration of the spine, basically.
Rob Lutz 03:31
Oh, wow.
KP Singh Khalsa 03:32
My vertebrae eventually look like Swiss cheese. The typical kind of scenario was that gradually, as those vertebrae collapse, the spinal nerves are shot. And gradually, you get to the point where you have no feeling in your body from those spinal nerves. I actually met somebody who was in the hospital in their last stage of that disease, and a chill wind blew across my forehead; that could have been me. So, who knows how correct that diagnosis really was; it was kind of obscure. But the point is: 60 years ago, they didn't have anything they could do for it anyway.
Rob Lutz 04:06
So you're still doing yoga now, and you're really kind of pain-free, and so forth?
KP Singh Khalsa 04:12
I've been pain-free for 50 years. I still do yoga and practice yoga or Ayurveda type lifestyle.
Rob Lutz 04:20
That's interesting. I find that honestly, all the guests that I've had on, there's something that happened in their life that really brought them to the path that they're on right now. And then they wanted to share that or how it helped them. It's that altruistic intent to help others. I always like that. I think I probably know the answer to this question, but I do like to ask: What form of medicine or school of medicine do you feel most aligned with, and maybe share three or four of the key attributes of that?
KP Singh Khalsa 04:49
Well, gosh, I'm probably most well known out there in the natural healing world as an Ayurveda guy, but that's really mostly because I got into it so early that in any group of people I was the only one that knew anything about it. So, I would be invited to speak at herb conferences and they would say: Well, we need a token Ayurveda guy; you're it. So, I feel equally competent in all the big three: Western, Ayurveda, and Chinese medicine, and I use them in a way where they're mixed. So I'm most aligned with Ayurveda probably, just because that is the sister science of yoga, which is my lifestyle. And so, Ayurveda is a complete natural healing system, the ancient healing system of India. It's the side of the coin of yoga. So, it comes from the same roots, has the same basic theory and structure behind it. And the idea is that we want to treat physical, mental, and spiritual causes for disease and use a wide variety of techniques to manage our day-to-day life, and take it back to a state of balance where all the energies in our body are brought to neutral, basically, so you're not too cold, not too heavy, not too light, that kind of thing, and then figure out ways to sustain that. Ayurveda very much relies on herbal medicine; it's the the main treatment that you would expect. But then every other thing you could imagine is involved--all kinds of cleansing procedures, topical procedures, diet, psychology, everything. So it's a very complete system, and I just find it to work very, very well.
Rob Lutz 06:20
Awesome. John Douillard is someone that I've followed for a long time, and where I really first got introduced to Ayurveda. And what I've always felt is traditional Chinese medicine, Ayurveda, these are healing modalities--for lack of a better word--that didn't have a billion dollar marketing campaign behind them. And this is stuff that has worked for, I guess, thousands of years, right?
KP Singh Khalsa 06:42
Yeah, absolutely.
Rob Lutz 06:42
I find that really interesting. So, there are many modalities being practiced and it sounds like you're integrating quite a few of those yourself. Do you think there's one underlying or universal principle that connects all of them together? Is there one thing that all these different healing modalities have in common, do you think?
KP Singh Khalsa 07:02
Just the idea that you should be in that neutral zone; in Ayurveda, we call it the Zone of Dynamic Balance. You have a little bit of wiggle room, you want to stay in the middle of the freeway, you don't want to veer off into the ditch. It's not being excessive with any given thing. You mentioned Chinese medicine also. Ayurveda and Chinese medicine are 90% identical; they came from the same root. There's a difference in vocabulary, of course; the pharmacopoeia is a bit different. But when you get down to it, they're essentially identical. So if you know one it's easy to learn the other. And both of them emphasize that idea of a balance. You don't have to be perfect, but you want to be more or less in the middle. It takes a while to get back to that place if you live like the average North American has up to this point. And Western herbalism--or Western natural healing--had a system of energetics like that. If we go back to about, let's say, 2300 years ago, there was a pan-Eurasian system of medicine that everybody was practicing. That's about when Hippocrates was practicing, and Hippocrates practiced an energetic system of herbal medicine that probably was rooted in Ayurvedic ideas. We don't really know where these ideas came from, but by that time, they had already come to their optimized point, and people were practicing in a very similar way. Western natural medicine lost its system of energetics during the Dark Ages in Europe, and then when the Renaissance came, it wasn't picked back up again. So the Western practitioners don't think about those kinds of things like hot or cold, heavy or light, but they were part of the system originally.
Rob Lutz 08:37
You mentioned energetics. Can you just expand on that a little bit?
KP Singh Khalsa 08:42
That's a term that we use today to describe this idea that things that you can experience in your own being are the things that we want to be aware of. So it doesn't take any kind of fancy equipment or gizmos or blood tests or X-rays. If an herb makes you feel hotter, than we call it a hot herb. Out into the environment, if the weather is dry, you get drier. The environment affects you. Like increases like. You eat a bunch of wet food, you're going to get wetter. So, we look at mainly temperature, moisture, and weight, but there are other more subtle kinds of circumstances. Not only the chemical action of any particular remedy and how it may affect a particular symptom, but how it affects your entire body. If we would take, for example, garlic versus goldenseal, those are both antimicrobial herbs, and they could kill the bacteria in any given case. But garlic is hot and goldenseal is cold. Depending on the person and their underlying state of energetics, we could either bring them in general--in addition to the infection--more back into balance, or we could push them further out of balance by choosing the correct one or the wrong one.
Rob Lutz 09:55
So are you choosing the correct one based on their dosha or how they are presenting at that time, or is it both really?
KP Singh Khalsa 10:01
When you say dosha, I think what you're talking about is the constitution, which is a common misunderstanding. So doshas are combinations of those energetic characteristics. There are three of them, and they are primal metabolic forces that run our entire bodies. So we're made of our doshas; everybody has all three doshas. From the Ayurvedic point of view, that's what we're trying to bring back into balance. But those are just code words for combinations of these energetics. So we look at the dosha balance in two ways: One is the constitution or the underlying blueprint for your body, the way your body is supposed to work, and that's a little bit different for everybody. There's, again, within this zone of dynamic balance, some people naturally run a little hotter or colder, a little wetter or drier, but it's all within a zone of neutrality. You have a tendency, then for that particular constitution to manifest throughout your entire life. That's what we're trying to get back to. The current energy balance is what's going on at the moment. For many people, it's quite similar to their constitution, but it can be any different thing. So you can be a person who has been dry most of your life, a dry constitution, and then you did something through lifestyle or food choices that caused you to retain water or get slimier, more lubricated, overly lubricated. And so we would want to treat that wet or slimy aspect of your being, your energy balance, until we brought it back to the middle there, to that slightly dry person that you are programmed to be and then sustain it through the rest of life.
Rob Lutz 11:40
I see; that's great. Thank you for answering those questions. Again, I think gives a little more context and kind of sets us up for what we're going to talk about today, which is using natural methods for neurological conditions. Again, what I'd like to do is really just hand it over to you; where would you like to start? What do you want our listeners to walk away with today? But I'd like for you to just take it in whatever direction you like. I've got a few questions I'll ask along the way, but where would you like to start?
KP Singh Khalsa 12:09
My interest in neurology started not with any grand plan, I was requested to teach a class on holistic neurology at a school of pharmacy. And so as I pulled everything frantically together that I knew for this class, I said: "Hey, this is something that's really fascinating, something that most people don't know a lot about." I think a lot of our audience has never really delved into the neurological side of things with natural medicine. And it turns out that we can do some really great things. So we've been working on these ideas for about 50 years as we have worked to restore natural medicine in North America. So there's great thoughts that we're in now. And I was in that small group of people that began to start this whole thing to get it back to where it is now. And of course, now we've accomplished that; we have schools and books and credentials and trainings of any kind. I became fascinated by these neurological conditions and ended up just sort of slowly sliding into that direction. Now, it's most of what I do. So it's an area that I think people appreciate being able to benefit from, because most people are not very satisfied with their conventional treatment of their neurological condition, whether it's migraine, or seizure disorders, or cognitive issues. We can do a lot of good with very few side effects or problems. And over the last, let's say, 20 years, there have been a lot of discoveries about how to merge these major healing systems in a way that allows us to use the best from all over and really get great results with these conditions.
Rob Lutz 13:41
That's great. So you mentioned a few of the neurological conditions. Are there others that fall into this category that seem to be you're most successful with a natural approach, any of those neurological conditions?
KP Singh Khalsa 13:55
I mentioned seizure disorders, migraine, and cognitive kinds of issues, but facial pain like trigeminal neuralgia, multiple sclerosis. I probably deal with more multiple sclerosis--there are probably two of us that deal with that the most. That's a thing that if you'd asked me 20 years ago, how well we could do with that, I'd say: "Well, you know, we can slow it down, we can make some progress." Now, I would say we can completely conquer it with the discoveries that have been made in natural medicine from all these systems. And that includes modern things like supplements and ancient treatments like herbal medicine or dietary change. Neuropathy would be another one. Now one that we're really digging into now is Parkinson's. I've dealt with very little Parkinson's because it's a disease of elders as opposed to, let's say, migraine or MS that hits earlier. So the generation before my generation, the Baby Boomers, had no interest in natural medicine, so we couldn't work with it in practice on that, but now the Baby Boomers are of an age that they're starting to develop Parkinson's, and they are interested in natural medicine, and so they're seeking us out for those kinds of ideas. I would say that we don't have it nailed down yet; I think there are a lot of very promising things. We can treat symptoms pretty well with natural medicines. We can make good progress on the number of people who are symptom-free, but we just don't know how well that's going to progress over time, because we haven't had a whole generation of that. So that one's right on the cusp; I think we're going to do very well with it. But anyway, a wide variety of these things that medicine deals with, but has a lot of disadvantages. And so we can get both. Yeah.
Rob Lutz 15:39
And by disadvantages, you probably mean side effects of the medications that are being prescribed. I know migraines; my daughter has migraines. And her practitioner said--she's now seeing a functional medicine doctor and she's been much, much better. But before that: "Here's a drug. If this doesn't work, we've got 30 others we'll try." And quality of life dropped off dramatically when she takes those things. Headache might go away, but--anyway, it's not a not a sustainable model, I think, for her. So she's felt good about her progress that she's made with a more functional medicine doctor.
KP Singh Khalsa 16:15
Excellent.
Rob Lutz 16:16
So maybe let's just talk about one of those conditions to start with. I know migraines are, obviously, because I've known lots of women who have migraines, a lot of folks on my side. So what would your approach be if a young woman came in and says: "Gosh, I get migraines a couple of times a week?"
KP Singh Khalsa 16:33
This is a great example, because we've been working on this for a long time now and we've nailed it. We have very good treatments that will abort and attack, treatments that will prevent migraine from ever happening. You take the remedies for two or three days, you get them saturated in your body, and then you never have another migraine, and then long-term cure or stabilization of the situation. It's about 99% resolvable all the way along. So usually I would expect to begin to give people some tools to abort and attack if they have an attack sometime in the near future, but also get going with preventive kinds of things--which again, within a week, usually we can find some combination of things that will prevent it quickly--and then over the long run, work on the underlying causes. And that might take a year to get everything regulated.
Rob Lutz 17:24
My guess is these are not something that a patient consumer can say: "Oh, I read this story on some website about herbs I can take to stop my migraines." It's really probably--is it more involved with the practitioner and really understanding what's going on and then essentially prescribing dosages and certain botanicals to help with that migraine?
KP Singh Khalsa 17:49
Usually that's the situation. The internet is just such a swamp of misinformation. And also this idea that there are miracle cures and if you just do this one thing that you buy from the writer of the Ogg or whatever, that it's going to work. Migraine is quite complicated, and sometimes people hit the bullseye immediately. But what we see is that we know there are many remedies that have shown some benefit for migraine in the science, 20 of them natural remedies. And so what usually happens is that all 20 of those go into a pill in some small amount. And it's kind of a bell curve formula, and it will work occasionally for some people, but for most people, there's not enough of any of those things to do the job. And probably your audience has heard of a lot of those things. But whether or not they've figured out the nuances of putting them together with an individual client is another matter.
Rob Lutz 18:42
So that would take obviously significant training for them to get versed enough to be able to do that. Where would they go to get that kind of training in your mind?
KP Singh Khalsa 18:53
Certainly my school offers many trainings at a professional level. And for laypeople, you could learn enough in a weekend to be able to do pretty well if you were just focusing on migraine only. Otherwise, it's going to be thrashing around, as you said, with a bunch of possibilities. Fortunately, the natural methods don't have much in the way of side effects. So it's just a function of if they don't work, you can try something else. Yeah, so there's going to be all kinds of various herb schools. Naturopathic physicians would be trained to deal with this sort of thing; I teach botanical medicine in two naturopathic universities. Frankly, migraine is not something that's emphasized in that curriculum, and there are just so many things to to deal with in that curriculum and so many modalities to learn that often the herbal training ends up being kind of superficial. So naturopathic students don't focus on that particular modality and take other additional courses or specialize after they graduate. Usually their understanding is pretty, again, superficial but yeah, that's a place where you could learn about it.
Rob Lutz 20:07
We have quite a few conventional practitioners--nurse practitioners and MDs and so forth--that obviously didn't get that kind of training where they went to school, I will include a link to your school, for them to look a little bit deeper if they want to learn more about how to incorporate herbal medicine into their practice. Sounds like you offer plenty of courses that would be applicable to a practitioner as well.
KP Singh Khalsa 20:30
Oh, absolutely.
Rob Lutz 20:31
Great. So we touched a little bit on this, but: why use natural methods? What, in your opinion--why natural as opposed to just the conventional medications or approaches that are out there?
KP Singh Khalsa 20:45
Pretty much what you were saying was that the side effects are pretty grim for a lot of these things. And so cycling through, exactly as you said, 20 other different possibilities is really tedious for people. Sometimes they work, sometimes they don't, often there are side effects. So there's just a general dissatisfaction with people, whereas we usually hit the bullseye pretty quickly with natural medicine, and side effects are generally not there at all. So, it's a nice combination of results plus lack of problems. Also, some of those drugs have only been around for a very short time; we don't really know what the long term is going to be. So if a person has migraines, and they're 20 years old, and they're taking some drug that's going to have to last them till they're 90. Now, maybe we'll all have brain implants in 20 years, and there won't be an issue. But these drugs need to last a long time. And it's pretty likely that some of them are going to have significant side effects over time. The things that we're using? Very unlikely.
Rob Lutz 21:46
I think about adults who have been on ADHD drugs for years.
KP Singh Khalsa 21:52
Good example.
Rob Lutz 21:53
How are they ever going to get themselves off of those, because they feel the effects of not being on it. That just seems like a really tough one for folks. Any medication you're going to have to take for a long, long time, there's no free lunch. There's got to be a side effect or depletion.
KP Singh Khalsa 22:12
Agreed.
Rob Lutz 22:13
So how would you recommend, let's say, someone who was on an ADHD medication, to resolve that and get off of those medications and alleviate the symptoms?
KP Singh Khalsa 22:25
Well, we use a cross taper for all these things. And thanks for mentioning ADHD, because that's one of the conditions that falls in this category. And generally, we do very well with it. So anytime anybody is taking some kind of a psychoactive medication or neurological medication, we use a cross taper so they gradually begin to reduce the dose of the drug, as we gradually begin to increase the dose of the remedy that we're talking about. Usually a 10% taper is pretty good. Usually, you're not risking symptoms coming back for people, and you're not risking doing too much or too little of something. So that would take 10 months, let's say 10% per month over 10 months, the taper would be complete. An example of an herb we might use for ADHD is the herb calamus. And in fact, that's a very general remedy for a lot of neurological issues. Great for seizure disorder and migraine, in fact, as we were talking about. Calamus is an herb that is a root and its grows all across Eurasia, but mainly focus on its benefit in Ayurveda, Chinese medicine uses it exactly the same way, so this is a very effective brain regulator, let's call it. It promotes circulation into the brain, and just helps in ways that we don't even really understand, many different neurological kinds of conditions. But I recommend Calamus when I'm teaching to my medical students, because they're having a lot of difficulty with memorization, and that kind of thing; just overwhelmed. And then by the end of the year, everybody in the school is taking it because it works so well that they told their friends and yeah, so they can stay up till you know two in the morning, memorizing things, and they don't have that "Oh, I just read a page, but I can't remember anything" kind of deal. So it enhances cognition, awareness. Traditionally, it's said to enhance speech or the ability to express yourself, the connection between the brain and speech. And I've seen some really dramatic kinds of things with that. I've used it with a number of nonverbal people with autism.
Rob Lutz 24:29
Interesting.
KP Singh Khalsa 24:29
Astounding. It just flips a switch and all that was in there, but they just couldn't organize it to get it out of their mouth. And you know, 2, 3, 4 weeks later, they're talking like crazy.
Rob Lutz 24:39
That's amazing. And I've never heard of that. Does it go by any other names?
KP Singh Khalsa 24:45
Well, the Ayurvedic name is vacha, V-A-C-H-A, which actually does literally mean "speech." Calamus is the scientific name, and usually that's what people use as the common name as well. Now one tricky thing about it is that it's extremely nauseating. So I need to say that again. Most people can't tolerate more than about 4g, but it's a very potent herb so you don't need more than that. Typically, you'd want to start with about 250mg and work up in 250mg increments--divided doses with food--just to make sure. And if you get up to the results that you want, great. I never have any nausea problems with my clients because we do that sort of incremental dose increases and we don't get up to the place where it's a problem. But if you or I swallowed 4g of calamus right now on an empty stomach, we'd be puking all over the place. You have to be careful with it.
Rob Lutz 25:39
Is there a preferred delivery of botanicals? Do you like the tinctures? Do you like the whole herb in a tea or something like that?
KP Singh Khalsa 25:47
That is a great question and one of the most misunderstood areas of natural medicine. And I think frankly, a lot of practitioners listening to this are confused about that. So generally speaking, I recommend using things in the form that they've been used traditionally. Chinese medicine decocts everything. They make a soup out of it, and you drink that. That has advantages and disadvantages. Tinctures are typical in Europe. Ayurveda has many preparations, but mainly powder. So you stir the powder into something mushy, like ghee, or warm milk or something and get it down in that way. So all these cultures have experimented with ways of using these things over thousands of years. And they have figured out which things work. So, for example: Ashwagandha--an herb that everybody, I'm sure, has heard of--the active ingredients are not very water-soluble, so it's not very often used as a tea in Ayurveda, mostly as a powder. And in modern times, that would be a capsule or a tablet. With tinctures, the active ingredient has to be alcohol-soluble. So you can't just take any old herb, throw it in a bucket with a bunch of vodka and expect that you've made a tincture. So we have to know about the solubility of the active ingredients. Some of that can be determined scientifically to some extent. But all these things have been worked out traditionally, and if we use it in the form it was used traditionally, then we know it's going to work, then we can experiment with other ways of using it and you know, maybe it will or won't. So I use all those preparations, plus many more: Medicated wines, things that go up your nose, gargles, topical things, things you put in your eye, so many different kinds of preparations depending, so we can't just pick one and have a preference for it because the client likes it or I like it.
25:47
Right. I like that. So, what would you say to a conventional MD who's listening to this, who doesn't have a background in herbal medicine, and they're like: "Well, I want to see the studies. I want to see the double-blind placebo-controlled studies." Again, I think I know where your your answer will go, but I'd like to hear: How do you address that concern or skepticism with someone who's more conventional looking at some of these things?
KP Singh Khalsa 27:58
Well, if there are such studies, then we can refer to them. And there are remarkably many more than people are aware of. So we hear just endless repetition, from conventional practitioners, that there's no scientific information on these things, which is just overtly not true. They just had been told that and they believed it, maybe in medical school or at a conference or whatever, and they didn't look for themselves. But if you go to Medline and dig into a bunch of these things, there are many more, there's much more evidence than people think. But otherwise, traditional use is what it is and you just have to decide if that's adequate for you. People have been experimenting with these things for literally thousands of years and yeah, they may have missed some things and we just have to account for that. But I think that not using them because we don't have enough scientific validation yet is a worse problem. So overwhelmingly, we see that these things tend to work very well and have very few problems. And you know, millions of people are taking these things all over the world, and we're not seeing an epidemic of problems from them. So you just have to decide how much validation you need and then decide to forge ahead or not.
Rob Lutz 29:09
Yeah, and I think the modern mind, for lack of a better term, is we're so skeptical because we see all the false claims being made to make a dollar, right? But I think traditional Chinese medicine and Ayurveda--their intent when they developed was to help people to heal people. And if something worked in this forum, using it this way, let's put it over here. We're going to remember that; we're gonna keep using that. If it didn't work, we just got rid of it. There was no motivation to: "Hey, we're gonna sell a lot more ginseng, if we tell people it does this." So I think that, to me, that's, that's why I look at some of the traditional healing modalities as something that we should really pay more attention to, and lighten our criteria that it has to have a double-blind placebo-controlled study because it's not--I'm not going to say it's not going to happen, but it's less likely. But let's stick with what works. If it's traditional in its support, there's a reason why and we should pay attention to it, especially those that have really spent so much time with it like yourself. What would you say--and we just talked about one for ADHD--but what are some natural treatments that really bring the goods for neurological conditions?
KP Singh Khalsa 30:21
I would say that my favorite herb for neurological issues is the herb gotu kola, G-O-T-U K-O-L-A. It's a very well known herb, but it's often not used correctly. So, it's a very mild herb; the doses need to be much higher than people are used to, typically 30g as tea. When we talk about tea doses in the natural healing world, we talk about the weight of the dry herb that's then going to be brewed into tea. So 30g is a heaped palmful of gotu kola, a heaped handful of gotu kola. It just seems like way more than it should be. So clients are concerned about that. It's way more than conventional practitioners have seen and, frankly, way more than most modern trained herbalists would use. Gotu kola sneaked its way into western herbalism in the 1800s and has been used there as a western herb. In fact, I learned about it as a western herb before learning about it as an Ayurvedic herb, but it's typically used at just a gram or two a day, either in tincture or a pill form. And it's just such a low dosage, it just doesn't do anything. So that one is just universally applicable for everything from everything we talked about to traumatic injury to the nerves, neurological diseases like MS. It's my pillar recommendation for MS, that's for sure. So there's one. Another one that's somewhat similar from Ayurveda is shankhpushpi. That's S-H-A-N-K-H-P-U-S-H-P-I. Shankhpushpi, a very general neurological regulator. It is a little bit sedating, whereas the gotu kola we talked about isn't. Shankhpushpi can be used at bedtime to help you sleep, but it's widely used in India for school kids to help them with their SAT scores, that kind of thing. So very good generally, neurologically.
Rob Lutz 32:10
How would that help with their SAT scores? What would be the--
KP Singh Khalsa 32:13
It increases their intellectual functioning. Yeah, it's very, very well known. I don't know if any given kid, we don't have a double-blind study about whether it's going to work there. But it's widely known. And they just cognitively function better when they're taking it.
Rob Lutz 32:28
So when you make a tea, let's say with the gotu kola, and you put the 30g, how hot should the water be?
KP Singh Khalsa 32:35
That should be infused. In terms of tea preparation, we have two kinds of tea: Infusion, which is used for more delicate parts like leaves and flowers, and decoction, which is used for rougher parts like roots and barks. So this one is going to be infused, in other words steeped. So you're going to put it into water that's just been boiled and then put the lid on, maybe wrap up the pot in a towel or something, and then infuse it for up to 24 hours. Then strain it out; you have to strain it with tremendous pressure to get all the last medicine out of the dregs. The minimum amount of water you would want to use would be 500mL, or a pint, of water. So 30g is about an ounce, so an ounce to a pint is the classic minimal amount. Otherwise, you don't get full extraction. You can use more than that if you want. If you want to use a quart, that will be fine. That will extract the constituents, but then you have to drink the whole quart.
Rob Lutz 33:30
So, no danger of reducing the efficacy of it by having such hot water. I know that can happen with some some things.
KP Singh Khalsa 33:39
These are all individual cases, and you have to learn about those specifically. Gotu kola works perfectly fine as a tea; it has been used for thousands of years that way. We know a lot about it. In fact, there's one that has a lot of science. If you go to Medline and look that up and use the scientific name and/or the common name here, you'll find a few dozen studies on gotu kola.
Rob Lutz 33:58
Back probably 20 years ago, I worked with a group out of Boston and we published the Commission E Monographs out of Germany. Are those continued? Updated? Do they--still a thing? It was a big deal back then for us. But I'm just curious is the Commission E still producing monographs and research and things like that?
KP Singh Khalsa 34:21
The actual German Commission E might be producing things, but the book has not been updated to my knowledge ever, so it's very old information. It's good information, but it's kind of irregular in its quality. The way the German government put it together, there were a lot of voices and you end up--anything that's made by a committee--so you and I know a lot of people probably: Len Wisneski, Mark Blumenthal, people that were involved in that whole thing.
Rob Lutz 34:49
Yeah, great. Any others that really jump out at you as really bringing the goods, as you say, for neurological conditions? Any other botanicals, herbs?
KP Singh Khalsa 34:58
Yeah, sure. So there's is an herb called guggulu, which is a dried sap of a little tree from the desert, very widely used in Ayurveda for neurological conditions. You would take that as a powder. The dried sap is processed a little bit and then ground to powder. You can take it in capsules or you can swallow it just as the powder. That has a number of attributes that lend it to neurological conditions. It's deeply detoxifying, so we use that in that way. Ayurveda says that guggulu detoxifies down to every layer of the tissues of the body. They use the analogy of: It scrapes the channels. In other words, you're sort of getting an internal carwash. It's also anti-inflammatory; most of the studies on it are about its anti-inflammatory benefit. So we know that in modern understanding, a lot of the genesis of these conditions is in fact inflammation, underlying subclinical inflammation that just is cooking your brain year after year for your entire life. We know Alzheimer's is now highly associated with inflammation. So guggulu detoxifies the tissues, and in the case of the brain and nervous system, there's a bunch of detritus that our brain produces every hour that it's functioning. And during the night, a cleanup crew comes in and detoxifies all that material. So detox is a major thing we need to be aware of with the brain and inflammation. So guggulu just fits the bill perfectly there. A typical dose of that to get started might be as much as, let's say, 10g, and a maintenance dose might be just a gram or two. Which brings up another matter, along with the correct preparation we were talking about, is the idea of loading doses. When I first started with many of my mentors--when I was 18 years old, they were 80 years old, so we were working with people who had gone to natural medical school in the beginning of the 20th century--folks used loading doses like crazy. Loading doses are used in Ayurveda and Chinese medicine especially, and that's where we use a relatively high dose initially to saturate the body until we get the the signal that things are going the way we want them to go. We sustain that dose until we've solved the problem, and then we titrate down either to zero or to a maintenance dose. Gotu kola can be taken for a person's life as a preventive for neurological issues. Something like guggulu is detoxifying; we normally don't use radical detoxifiers forever. When it has done its job, we stop taking it. The idea of loading doses is completely disappearing in the natural medicine world because of the internet. So, we have self-styled experts that are writing blogs; they don't understand what a loading dose is. They only know about a maintenance dose. And still they will write in their blog: "Never take more than X amount of herb X." Our clientele reads that, and because we know that blogs just are self-replicating like a parrot and just getting repeated over and over, people will say: "Well, I looked this up on the internet and all 10 blogs that I read said: 'Never take more than a gram.'" That's the maintenance dose. That's not the therapeutic dose, the loading dose. So we're losing this drastically. I mean, I have trouble using loading doses because I get pushback from people that read the ten blogs.
Rob Lutz 38:17
Be careful where you get your information from. That's an underlying message across the board here. Go to an expert who is trained in this. That makes a lot of sense. It sounds like you've got a good list; any others that you want to mention as far as for neurological?
KP Singh Khalsa 38:33
Yeah, sure. There's a an oil combination called narayan oil, that's N-A-R-A-Y-A-N. Narayan oil, which has about 30 different ingredients that have been infused into an oil. Most people know this because it's the main joint and muscle oil used in India; every grandma has a bottle of narayan oil and uses it for her low back pain or whatever. But it can be taken internally as well. It's completely fine to take internally. And it's very beneficial for the nervous system. It's in a base of sesame oil. It doesn't taste wonderful, but you definitely can swallow it. And so one would take, let's say, a couple of teaspoons a day of narayan oil. You could maybe stir it into a cup of tea, something like that, whatever your preference, and drink that down. So that's something that has multiple beneficial effects for the nervous system. And it's something that can be used pretty casually by most people.
Rob Lutz 39:25
That's great. Let's see...so another question that I want to make sure that we ask you is: What are some important points to remember about treatment approaches? Kind of a broad question, but what would you like to say to that?
KP Singh Khalsa 39:40
Well, it's the right herb, the right quality, the right preparation, and the right dose. Dose, by far, is the most problematic area in natural medicine. People if they begin to experience these kinds of things will realize that Ayurveda and Chinese medicine are high-dose systems. The average dose in Chinese medicine is about 45g a day of mixed herbs--again, made into a soup that you that you drink. Ayurveda would be maybe somewhat less but similar. The average dose that's used by western natural practitioners very often are, of these botanicals, a gram or half a gram. And they're just nowhere near the dose that's really going to do anything. So we have to study that carefully, figure out what's really going to work. The whole issue with the loading dose, as we talked about, that's a factor now that's causing people to use lower and lower doses, but especially with tinctures. In Europe, tinctures are not dosed by the drop; they are dosed by the teaspoon. So a typical dose of most tinctures in Europe is a teaspoon three times a day of the tincture, but that's even only equivalent to about 3g of medicine. So when you're taking 10 drops, it's just nothing. I don't know how this all got started, but there's a mass hallucination in our culture that tinctures are somehow super powerful medicine, and you're supposed to take 10 drops. That's the dose that the manufacturer thinks won't freak you out, not the dose that actually is going to do anything. So we need to figure out that dose. When we first started getting interested in tinctures going back 45 years, we looked at the doses that were being used in Europe and Australia. And very often they were 7 to 15 times higher than the dose that people were using here. So somehow we just got stuck on this idea of selling tinctures in those 1 oz. bottles; that's a two-day dose in Europe. So some European herbalists say: "What's that? The sample? Why would you sell something in a sample size?" But it's going to cost $15 because of all the other expense: Bottling, labeling, labor, all that. In Europe, tinctures are dispensed by the liter. You take your prescription from the herbalist, go to the dispensary, they mix it up for you and send you home with a liter bottle of it, which makes it drastically less expensive. Maybe nearly 20 times less expensive. So it's affordable; you can use the doses that you need. So doses across the board--THE big issue that's causing failure in natural medicine.
Rob Lutz 42:08
Yeah, that's interesting, I think it probably was a price-point issue, because thinking about the consumer going into the health food store, and a small bottle is still fairly expensive. But if they were told: "That's a two-day dose, and you really need to take this for 30 days" or whatever it might be. I do remember getting a large bottle of the echinacea goldenseal from Zand, and yeah, it was--I took a lot of it when I felt like I was coming down with a cold and it worked.
KP Singh Khalsa 42:36
Yeah, absolutely.
Rob Lutz 42:38
Anything else that you want the listeners to be remembering or thinking about as far as this kind of a treatment approach?
KP Singh Khalsa 42:44
Nothing in particular, but just to remind everybody that neurological disorders, we've work on them for a long time, and especially if we use this idea of what I call global herbalism, the best from all over. I'm not locked into any of these systems or approaches; I'm a mixer, and now I have access to all these things, and we know how well they can work. So feel free to get involved with using these things for these otherwise very challenging things to treat. So if you want your patient to be seizure-free, investigate the possibility and realize that many of these things, we can not only abort the condition--seizures, probably we can abort those minimally. There are a few things that might work, but mainly that's going to be prevention, but then ultimately cure. So, getting serious about these things, investigating them, figuring out the right herb, the right preparation, the right dose is going to bring great results.
Rob Lutz 43:38
That's great. I think that's the pearl from today's episode is: Dig deeper, do your research. I think everyone wants to improve the health outcomes of their patients, and now there's so much good information out there of all these traditional approaches that have limited side effects, have worked for thousands of years. Find a good resource--like your school--to learn more about these things. What we'll do in the show notes, we mentioned a number of different herbs, we mentioned your school, I'll make sure that we provide some links for the listener when they come to the show notes so they can dig a little deeper on these things. This was great; I really appreciate you coming on. This was a great topic. We cover botanical medicine frequently on Today's Practitioner, and there's a lot of interest in it, and I think a lot of interest in learning more. So, I think that's a good theme here. Thank you so much for coming on today. I really enjoyed it, and I know my audience will as well.
KP Singh Khalsa 44:39
My pleasure. Nice to meet you virtually.
Rob Lutz 44:41
Thank you.
Rob Lutz 44:43
Thanks for listening to the OneMedicine Podcast. I hope you found today's episode interesting and came away with a few insights you can apply to your practice. If you're looking for the show notes, they can be found in the link below. If you want to go deeper on this topic or anything else, please visit todayspractitioner.com and consider registering for our weekly newsletter as well. Thanks again, and I hope you'll join us next time.