Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Hi, does anyone know of a good place to order individual granules in the US? Specifically I am looking for Lu Jiao Jiao. I usually go through KPC or May Way, but neither have it. Its such a key herb in several of my patients formulas...and I'm running out! Help! May Way does have it in raw herbs, so if I have to I could figure out a way to make it into a granule...but first I'd have to figure that out...(any simple ideas?). Thanks, Laura Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Evergreen has a Lu Jiao Shuang. On Dec 20, 2007 8:16 PM, heylaurag <heylaurag wrote: > Hi, does anyone know of a good place to order individual granules in > the US? Specifically I am looking for Lu Jiao Jiao. I usually go > through KPC or May Way, but neither have it. Its such a key herb in > several of my patients formulas...and I'm running out! Help! > -- , DAOM Pain is inevitable, suffering is optional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 As far as I can tell making a granule will be near impossible since it has to be dissolved for it to be effective. I remember trying to put E Jiao through a grinder. It melted inside with the heat of the grinding and it took several days to scrape the dried goop out. Doug , " heylaurag " <heylaurag wrote: >unning out! Help! > > May Way does have it in raw herbs, so if I have to I could figure out > a way to make it into a granule...but first I'd have to figure that > out...(any simple ideas?). > > Thanks, > > Laura > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2007 Report Share Posted December 20, 2007 Have you tried Bioessence. That's where I've purchased it in the past. _____ On Behalf Of Al Stone Thursday, December 20, 2007 9:00 PM Re: Granules--Help! Evergreen has a Lu Jiao Shuang. On Dec 20, 2007 8:16 PM, heylaurag <heylaurag (AT) hotmail (DOT) <heylaurag%40hotmail.com> com> wrote: > Hi, does anyone know of a good place to order individual granules in > the US? Specifically I am looking for Lu Jiao Jiao. I usually go > through KPC or May Way, but neither have it. Its such a key herb in > several of my patients formulas...and I'm running out! Help! > -- , DAOM Pain is inevitable, suffering is optional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2007 Report Share Posted December 21, 2007 Hi, does anyone know of a good place to order individual granules in the US? Specifically I am looking for Lu Jiao Jiao. I usually go through KPC or May Way, but neither have it. Its such a key herb in several of my patients formulas...and I'm running out! Help! May Way does have it in raw herbs, so if I have to I could figure out a way to make it into a granule...but first I'd have to figure that out...(any simple ideas?). Thanks, Laura Hi Laura, As far as I know, the granules of this you can purchase are just the ground up gelatin and are not further processed anyway. What we do is order the Gelatins powdered from Kamwo in New York: http://www.kamwo.com/mambo/ We use this powder in our raw herb formulas as well as with our powder (KPC) formulas. As for proportions, we use it as if it were an extract. It works great. Best Sharon Sharon Weizenbaum 86 Henry Street Amherst, MA 01002 413-549-4021 sweiz www.whitepinehealingarts.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2007 Report Share Posted December 21, 2007 Crane Herb Co. has Lu Jiao Jiao and Lu Jiao Shuang from KPC and Spring Wind. It was not available (per FDA) for some time. Happy Holidays, Bill Egloff On 12/20/07 11:16 PM, " heylaurag " <heylaurag wrote: > > > > > Hi, does anyone know of a good place to order individual granules in > the US? Specifically I am looking for Lu Jiao Jiao. I usually go > through KPC or May Way, but neither have it. Its such a key herb in > several of my patients formulas...and I'm running out! Help! > > May Way does have it in raw herbs, so if I have to I could figure out > a way to make it into a granule...but first I'd have to figure that > out...(any simple ideas?). > > Thanks, > > Laura Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2007 Report Share Posted December 21, 2007 health source products aka e-fong has both lu jiao jiao and lu jiao shuang Jack Schaefer Mountain West Wellness Louisville, CO Please note: message attached ___________ Discount Online Trading - Click Now! http://thirdpartyoffers.juno.com/TGL2121/fc/Ioyw6i3mJ8XwYNLWxcUNjrlcvWeAgnKHAYad\ pxNWNNlbLa2G5Hh71J/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2007 Report Share Posted December 21, 2007 , sharon weizenbaum <sweiz wrote: > > Hi, does anyone know of a good place to order individual granules in > the US? Specifically I am looking for Lu Jiao Jiao. I usually go > through KPC or May Way, but neither have it. Its such a key herb in > several of my patients formulas...and I'm running out! Help! Actually, the gelatin products in granule form are not actually concentrated extracts, they are just finely ground powders. As I understand it (based on discussions with granule producers at some of the major factories), the gelatins cannot be further concentrated, as the gelatin itself is already the water-soluble extract of the crude drug, and the gelatin will just turn into gunk that sticks to all of the equipment if one tries to cook it again. Consequently, gelatins are the same in the bulk and the granule form, the only difference is in the consistency of the even, fine powder. The same is true for mineral products. This issue has been discussed on CHA in the past, and the discussion would be completely unnecessary if the granule companies didn't obscure their concentration ratios when they are re-labeled for the US market. Of course, the problem lies more with the consumers than the pharmaceutical companies, since it is lack of practitioner knowledge of dose and lack of practitioner demand for transparency that is the problem, but these issues and the myth of 5:1 have been discussed on CHA before and don't need to be repeated here. If you buy your lu jiao jiao from a bulk herb supplier and need to powder it, the most common technique is to bake the gelatin with clamshell powder or hai piao xiao powder. This causes the gelatin to puff up (commonly seen with e jiao when making e jiao zhu), and the resulting product is easy to grind and use. To my mind, using lu jiao shuang (degelatinated deer horn) as a substitute for lu jiao jiao (deer horn gelatin) wouldn't make sense. The two substances have significantly different natures and uses. Lu jiao shuang has a very weak supplementing effect because all of the lu jiao jiao has been cooked out of it; lu jiao shuang is mostly used for its astringent effect in gynecology. Lu jiao jiao is mostly used for supplementing yin-blood with its rich nature, so to my mind a more comparable substitute would be gui ban jiao (if using it for yin-blood) or lu rong (if using it for yang, blood, and essence). Eric Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2007 Report Share Posted December 21, 2007 Thanks for all the great ideas everyone. Eric, I agree with you about Lu Jiao Jiao being completely different from Lu Jiao Shuang. And because its milder than Lu Rong it doesn't seem to run the risk of liver yang rising from it. I think its a great herb, so I'm hoping I can find it. So, Eric, do you use the same amount of grams in a formula that you would use if it was a concentrated granule? , " Eric Brand " <smilinglotus wrote: > > , sharon weizenbaum > <sweiz@> wrote: > > > > Hi, does anyone know of a good place to order individual granules in > > the US? Specifically I am looking for Lu Jiao Jiao. I usually go > > through KPC or May Way, but neither have it. Its such a key herb in > > several of my patients formulas...and I'm running out! Help! > > Actually, the gelatin products in granule form are not actually > concentrated extracts, they are just finely ground powders. As I > understand it (based on discussions with granule producers at some of > the major factories), the gelatins cannot be further concentrated, as > the gelatin itself is already the water-soluble extract of the crude > drug, and the gelatin will just turn into gunk that sticks to all of > the equipment if one tries to cook it again. > > Consequently, gelatins are the same in the bulk and the granule form, > the only difference is in the consistency of the even, fine powder. > The same is true for mineral products. This issue has been discussed > on CHA in the past, and the discussion would be completely unnecessary > if the granule companies didn't obscure their concentration ratios > when they are re-labeled for the US market. Of course, the problem > lies more with the consumers than the pharmaceutical companies, since > it is lack of practitioner knowledge of dose and lack of practitioner > demand for transparency that is the problem, but these issues and the > myth of 5:1 have been discussed on CHA before and don't need to be > repeated here. > > If you buy your lu jiao jiao from a bulk herb supplier and need to > powder it, the most common technique is to bake the gelatin with > clamshell powder or hai piao xiao powder. This causes the gelatin to > puff up (commonly seen with e jiao when making e jiao zhu), and the > resulting product is easy to grind and use. > > To my mind, using lu jiao shuang (degelatinated deer horn) as a > substitute for lu jiao jiao (deer horn gelatin) wouldn't make sense. > The two substances have significantly different natures and uses. Lu > jiao shuang has a very weak supplementing effect because all of the lu > jiao jiao has been cooked out of it; lu jiao shuang is mostly used for > its astringent effect in gynecology. Lu jiao jiao is mostly used for > supplementing yin-blood with its rich nature, so to my mind a more > comparable substitute would be gui ban jiao (if using it for > yin-blood) or lu rong (if using it for yang, blood, and essence). > > Eric > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2007 Report Share Posted December 21, 2007 Eric- I read your article in the acupuncture almanac on this subject and really liked it. How do you end up dosing granules of these medicinals that do not concentrate? Also, have you a list of the concentrations of various herbs? Thanks. -Steve " Eric Brand " <smilinglotus 12/21/2007 2:12 PM Re:Granules--Help! , sharon weizenbaum <sweiz wrote: > > Hi, does anyone know of a good place to order individual granules in > the US? Specifically I am looking for Lu Jiao Jiao. I usually go > through KPC or May Way, but neither have it. Its such a key herb in > several of my patients formulas...and I'm running out! Help! Actually, the gelatin products in granule form are not actually concentrated extracts, they are just finely ground powders. As I understand it (based on discussions with granule producers at some of the major factories), the gelatins cannot be further concentrated, as the gelatin itself is already the water-soluble extract of the crude drug, and the gelatin will just turn into gunk that sticks to all of the equipment if one tries to cook it again. Consequently, gelatins are the same in the bulk and the granule form, the only difference is in the consistency of the even, fine powder. The same is true for mineral products. This issue has been discussed on CHA in the past, and the discussion would be completely unnecessary if the granule companies didn't obscure their concentration ratios when they are re-labeled for the US market. Of course, the problem [truncated by sender] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2007 Report Share Posted December 21, 2007 , " heylaurag " <heylaurag wrote: > > Thanks for all the great ideas everyone. Eric, I agree with you about > Lu Jiao Jiao being completely different from Lu Jiao Shuang. And > because its milder than Lu Rong it doesn't seem to run the risk of > liver yang rising from it. I think its a great herb, so I'm hoping I > can find it. So, Eric, do you use the same amount of grams in a > formula that you would use if it was a concentrated granule? All of the deer antler products have unique advantages and drawbacks, no doubt about it. As for dosage, it depends on the situation. If I am using raw herbs by decoction, I use a standard dose of lu jiao jiao, melted into the strained decoction. If I am using granules instead of decoctions, I just use the granule form of lu jiao jiao, mixed with the other granules in the prescription. Ideally, the dosage of lu jiao jiao for the two forms should be basically the same, but there are often other concerns that affect my decision. Expense and ratios are the biggest factors that shape granule dosing for me. With granule prescriptions containing lu jiao jiao, the issues that arise are largely parallel to the challenges posed by other products that are weak in medicinal strength by weight, such as qian shi, yi yi ren, and shan yao. I spent a long time in Taiwan observing doctors using granules, and there are a few issues that are hard to resolve completely, particularly when mild medicinals, minerals, and gelatins are indicated. However, despite these challenges, granules are extremely effective and convenient, and I feel that in many ways granules are the most promising modern form of Chinese herbal medicine. Certainly they offer the greatest flexibility and the highest potency per dollar compared to everything except raw herbs. For Taiwanese doctors, the issue is mostly an issue of ratios, because the government insurance only covers granules up to 6 gram doses (generally these 6 g doses are given 3 times a day). When the total quantity of granules is limited by government regulations, cost, or compliance in terms of how much powder the patient will ingest, the ratio of potent to weak ingredients becomes important. In the example of lu jiao jiao, if a Taiwanese doctor is giving a prescription with 18 grams of total granules per day (their typical standard for adults), they need to consider how much lu jiao jiao should be included for the maximum overall therapeutic effect. If they were prescribing raw herbs, perhaps they would use 9 grams of lu jiao jiao, to be taken dissolved into the strained decoction. In this situation, the 9 g of lu jiao jiao is maybe 10% of the total medicine in the pack, assuming a standard pack with about 90 grams of total crude medicinals. Now, if they are using granules, to get that same 9 grams of lu jiao jiao, they have to have 9 grams out of the total 18 grams representing just one ingredient (50% LJJ instead of 10% LJJ). In most cases, doctors prefer to use a smaller amount of lu jiao jiao so that it doesn't take up half of the total prescription, thus diluting the other ingredients. If the LJJ is done at its ideal dose, the other ingredients are pushed to a dose that is lower than their ideal. The same is true for something mild by weight like yi yi ren. If you would normally use 30 grams of crude yi yi ren in a raw prescription, and you achieve a 5:1 concentration with the granule extract, you still require 6 grams of the yi yi ren concentrate to achieve the same dose that you get with raw herbs. However, if 6 grams of the total 18 gram prescription is just yi yi ren, it takes up a third of the space, giving you less room for more potent ingredients like ren shen, bai zhu, etc. I see patients at the PCOM clinic in San Diego, and our limitation there tends to revolve around price rather than gov't insurance dosage limits. However, the same issue applies. A 12 gram daily granule dose at the PCOM clinic costs the patient about $3, and often the doses that I use represent a balance between acceptable cost and acceptable dose ranges from the medical perspective. If I am prescribing a 12 g total dose, I usually don't want half of it to be only yi yi ren or lu jiao jiao. If I was using raw herbs, adding 30 grams of yi yi ren wouldn't have any effect on the amount of ren shen and bai zhu or whatever that can go into the same daily pack. However, if I am using granules and the dosage is capped by outside limitations such as the clinic's pricing structure, the amount of yi yi ren that goes into the daily dose affects the amount of ren shen and bai zhu that they consume. In these examples, I will tend to use a smaller amount of yi yi ren or lu jiao jiao than I would if these outside limitations did not exist. Does that make sense? Interestingly, very few practitioners in a granule-heavy medical environment like Taiwan mix their granule formulas from scratch based on single herbs. Most doctors there use whole granule formulas that have been cooked together, augmented with single herb extracts. This is my preference also. I hope that helps answer your question! Granules are a new ball game for many of us, and most Western and mainland Chinese practitioners don't have much training in their use. Granules are very effective and I have very positive sentiments towards their use, but they do pose a few unique challenges and it is best for us to be as aware of these issues as possible. Eric Brand Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2007 Report Share Posted December 21, 2007 Hi Eric, you said that all the deer antler products have draw backs, I'm curious to hear what kind of problems you see with Lu Jiao Jiao? Are you referring to the potential for liver yang rising? I never felt like I have found a source for good information for how to take a classical formula and make it into a granule formula with the right dosages. So I've instead just watched responses and learned. I sure wish I had a good source though because I don't like having to learn from mistakes with patients! I only use granules, so that's what I'm working with. One thing I've learned is that herbs like Chen Pi and Ze Xie do not seem to require as high of a dose. I generally use a very small dose of both those herbs in a formula and it works, whereas if I used the same proportion as I see in a classical formula it would be way too much. For these reasons I too prefer to start with a classic formula and modify from there. But it sure would be nice to feel like I fully understood how to make them myself. Anyone have a good source for this information? Anyone have a basic set of rules that you go by with granules that you could share? , " Eric Brand " <smilinglotus wrote: > > , " heylaurag " <heylaurag@> > wrote: > > > > Thanks for all the great ideas everyone. Eric, I agree with you about > > Lu Jiao Jiao being completely different from Lu Jiao Shuang. And > > because its milder than Lu Rong it doesn't seem to run the risk of > > liver yang rising from it. I think its a great herb, so I'm hoping I > > can find it. So, Eric, do you use the same amount of grams in a > > formula that you would use if it was a concentrated granule? > > All of the deer antler products have unique advantages and drawbacks, > no doubt about it. As for dosage, it depends on the situation. If I > am using raw herbs by decoction, I use a standard dose of lu jiao > jiao, melted into the strained decoction. If I am using granules > instead of decoctions, I just use the granule form of lu jiao jiao, > mixed with the other granules in the prescription. Ideally, the > dosage of lu jiao jiao for the two forms should be basically the same, > but there are often other concerns that affect my decision. > > Expense and ratios are the biggest factors that shape granule dosing > for me. With granule prescriptions containing lu jiao jiao, the > issues that arise are largely parallel to the challenges posed by > other products that are weak in medicinal strength by weight, such as > qian shi, yi yi ren, and shan yao. > > I spent a long time in Taiwan observing doctors using granules, and > there are a few issues that are hard to resolve completely, > particularly when mild medicinals, minerals, and gelatins are > indicated. However, despite these challenges, granules are extremely > effective and convenient, and I feel that in many ways granules are > the most promising modern form of Chinese herbal medicine. Certainly > they offer the greatest flexibility and the highest potency per dollar > compared to everything except raw herbs. > > For Taiwanese doctors, the issue is mostly an issue of ratios, because > the government insurance only covers granules up to 6 gram doses > (generally these 6 g doses are given 3 times a day). When the total > quantity of granules is limited by government regulations, cost, or > compliance in terms of how much powder the patient will ingest, the > ratio of potent to weak ingredients becomes important. > > In the example of lu jiao jiao, if a Taiwanese doctor is giving a > prescription with 18 grams of total granules per day (their typical > standard for adults), they need to consider how much lu jiao jiao > should be included for the maximum overall therapeutic effect. If > they were prescribing raw herbs, perhaps they would use 9 grams of lu > jiao jiao, to be taken dissolved into the strained decoction. In this > situation, the 9 g of lu jiao jiao is maybe 10% of the total medicine > in the pack, assuming a standard pack with about 90 grams of total > crude medicinals. Now, if they are using granules, to get that same 9 > grams of lu jiao jiao, they have to have 9 grams out of the total 18 > grams representing just one ingredient (50% LJJ instead of 10% LJJ). > In most cases, doctors prefer to use a smaller amount of lu jiao jiao > so that it doesn't take up half of the total prescription, thus > diluting the other ingredients. If the LJJ is done at its ideal dose, > the other ingredients are pushed to a dose that is lower than their > ideal. > > The same is true for something mild by weight like yi yi ren. If you > would normally use 30 grams of crude yi yi ren in a raw prescription, > and you achieve a 5:1 concentration with the granule extract, you > still require 6 grams of the yi yi ren concentrate to achieve the same > dose that you get with raw herbs. However, if 6 grams of the total 18 > gram prescription is just yi yi ren, it takes up a third of the space, > giving you less room for more potent ingredients like ren shen, bai > zhu, etc. > > I see patients at the PCOM clinic in San Diego, and our limitation > there tends to revolve around price rather than gov't insurance dosage > limits. However, the same issue applies. A 12 gram daily granule > dose at the PCOM clinic costs the patient about $3, and often the > doses that I use represent a balance between acceptable cost and > acceptable dose ranges from the medical perspective. If I am > prescribing a 12 g total dose, I usually don't want half of it to be > only yi yi ren or lu jiao jiao. If I was using raw herbs, adding 30 > grams of yi yi ren wouldn't have any effect on the amount of ren shen > and bai zhu or whatever that can go into the same daily pack. > However, if I am using granules and the dosage is capped by outside > limitations such as the clinic's pricing structure, the amount of yi > yi ren that goes into the daily dose affects the amount of ren shen > and bai zhu that they consume. In these examples, I will tend to use > a smaller amount of yi yi ren or lu jiao jiao than I would if these > outside limitations did not exist. Does that make sense? > > Interestingly, very few practitioners in a granule-heavy medical > environment like Taiwan mix their granule formulas from scratch based > on single herbs. Most doctors there use whole granule formulas that > have been cooked together, augmented with single herb extracts. This > is my preference also. > > I hope that helps answer your question! Granules are a new ball game > for many of us, and most Western and mainland Chinese practitioners > don't have much training in their use. Granules are very effective > and I have very positive sentiments towards their use, but they do > pose a few unique challenges and it is best for us to be as aware of > these issues as possible. > > Eric Brand > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2007 Report Share Posted December 21, 2007 , stephenbonzak wrote: > > Eric- > > I read your article in the acupuncture almanac on this subject and really liked it. How do you end up dosing granules of these medicinals that do not concentrate? Also, have you a list of the concentrations of various herbs? Thanks. Hi Stephen, Whew! Big questions! Hopefully I just answered some elements of the dosing question in my most recent post, but let me know if there are more specific questions and I can try to give you a better answer. In short, it depends on which medicinal is in question, how important it is in the formula, how safe it is in a crude state, and how much outside variables like cost and pricing structures intrude on my decision. Most of my teachers in Taiwan tended to use lower doses of weak substances and minerals in granule form than they would if they were prescribing raw herbs, so that more potent medicinals would not be diluted and so that the unknowns of ingesting straight minerals in large amounts are minimized. Nearly all preferred to use whole formulas rather than singles whenever possible. Doctors there prefer to give the whole formula ma xing shi gan tang vs. mixing ma huang, xing ren, shi gao, and gan cao together as singles, for example. As for a list of concentrations, that is a big task. With more than 5 main Taiwanese producers, each with about 500+ products, comparing the concentration ratios would require data entry of 2500+ products. Just buying the 2500 products in Taiwan so that you can type up their labels is daunting, much less the data entry component itself. The producers use different quantities of filler, and the concentration ratio varies from product to product and company to company. Below is a small comparison of a handful of products that I have posted on CHA in the past. If you have any specific requests, let me know and I can research the individual products for you. I am not associated with any of the companies, and I respect them all. Therefore, I will not name any companies or their concentration ratios on the internet because I don't want these discussions to involve commercial product comparisons and the resulting praise or critiques of any companies involved. Eric Brand Ma zi ren wan (Brand A) Two parts of 5.5:1 concentrate and one part starch. 4.5g of the final powder contains the equivalent of 4g huo ma ren, 2g bai shao, 2g zhi shi, 2g hou po, 2.5 xing ren, and 4g da huang. Ma zi ren wan (Brand B) one part 4.25:1 concentrate and one part starch. 4.0g of the final powder contains the equivalent of 2.5g huo ma ren, 1g bai shao, 1g zhi shi, 2g da huang, 1g hou po, and 1g xing ren. As you can see, these two formulas have very different concentrations. One is nearly twice as strong as the other. Oddly enough, the stronger one is cheaper at the store. Note that neither is 5:1 in its final stage. Brand B is 2.15:1. Brand A is 3.66:1. Now just a random survey of other formulas: Yin qiao san= Two parts of 7.5g concentrate to one part filler. About 4.95:1 at the end, very close to 5:1. 6g of final product contains 5g jin yin hua, 5g lian qiao, 2g dan zhu ye, 2g jing jie, 2g lu gen, 3g jie geng, 3g niu bang zi, 3g ze xie, 3g bo he, 2.5 gan cao, 2.5g dan dou chi. Yi guan jian= One part 4.33g extract mixed with one part filler. About 2.17:1 at the end, close to only 2:1. Xiao Feng San= One part 5:1 extract mixed with one part filler. About 2.5:1 at the end. Huo Xiang Zheng Qi San= One part 6.7:1 extract mixed with one part filler. About 3.35:1 at the end. Xiao Yao San= 10.5g contains 5.9g of 4.7:1 concentrate mixed with 4.6g starch. About 2.6:1 at the end. Si Wu Tang= One part 5:1 extract mixed with one part filler. About 2.5:1 at the end. Gui Pi Tang= One part 5.2:1 extract mixed with one part filler. About 2.6:1 at the end. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2007 Report Share Posted December 21, 2007 , " heylaurag " <heylaurag wrote: > > Hi Eric, you said that all the deer antler products have draw backs, > I'm curious to hear what kind of problems you see with Lu Jiao Jiao? > Are you referring to the potential for liver yang rising? Dear Heylaurag (???), I'm not referring to liver yang rising per se. Although all of the deer antler products share a common source and general nature, each has particular actions that are relatively distinct, and their supplementing effect is dramatically different. For example, lu rong is potent for supplementing yang, while lu jiao jiao is weak for supplementing yang but stronger for supplementing essence and blood. Lu jiao jiao has the drawback of being richer and stickier; it is more of a " zi bu " type of substance ( " enriching, " which has a connotation of being rich and nourishing but potentially cloying, a quality seen in herbs like shu di). This is a drawback in some ways but it is the same thing that allows it to be so good for building essence and blood. It is a comparatively yin substance that is used in relatively high quantities and it additionally has an action of stopping bleeding. By contrast, lu rong is used in smaller doses and it has a more yang nature; it is much more effective for supplementing yang, but this same nature gives it the drawback of causing upbearing of yang and stirring of blood when it is taken inappropriately. Lu jiao (mature antlers) has similar actions as lu rong, but it is much weaker. Its distinct characteristic is that it also moves the blood and disperses swelling, but lu jiao is generally used much less than the other deer antler products. Lu jiao shuang is distinguished by its weak supplementing effects but its additional astringent action; its use for uterine bleeding and vaginal discharge makes it a relatively common medicinal in gynecology. Eric Brand Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2007 Report Share Posted December 22, 2007 FYI- I have been waiting for lu jiao jiao as well from Crane herb and just finally was able to order it about 2 weeks ago!!! , " Eric Brand " <smilinglotus wrote: > > , " heylaurag " <heylaurag@> > wrote: > > > > Hi Eric, you said that all the deer antler products have draw backs, > > I'm curious to hear what kind of problems you see with Lu Jiao Jiao? > > Are you referring to the potential for liver yang rising? > > Dear Heylaurag (???), > > I'm not referring to liver yang rising per se. Although all of the > deer antler products share a common source and general nature, each > has particular actions that are relatively distinct, and their > supplementing effect is dramatically different. > > For example, lu rong is potent for supplementing yang, while lu jiao > jiao is weak for supplementing yang but stronger for supplementing > essence and blood. Lu jiao jiao has the drawback of being richer and > stickier; it is more of a " zi bu " type of substance ( " enriching, " > which has a connotation of being rich and nourishing but potentially > cloying, a quality seen in herbs like shu di). This is a drawback in > some ways but it is the same thing that allows it to be so good for > building essence and blood. It is a comparatively yin substance that > is used in relatively high quantities and it additionally has an > action of stopping bleeding. By contrast, lu rong is used in smaller > doses and it has a more yang nature; it is much more effective for > supplementing yang, but this same nature gives it the drawback of > causing upbearing of yang and stirring of blood when it is taken > inappropriately. > > Lu jiao (mature antlers) has similar actions as lu rong, but it is > much weaker. Its distinct characteristic is that it also moves the > blood and disperses swelling, but lu jiao is generally used much less > than the other deer antler products. Lu jiao shuang is distinguished > by its weak supplementing effects but its additional astringent > action; its use for uterine bleeding and vaginal discharge makes it a > relatively common medicinal in gynecology. > > Eric Brand > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2007 Report Share Posted December 22, 2007 Thanks Eric- Great info. How have you seen single mineral substances dosed in granule combinations? I usually use minerals decocted with the granule formula, not as an addition. Aside from cost considerations, how much should you give of mu li, let's say, if you want to get a similar effect in a granule combo of a 30 g raw dose? Thanks. -Steve " Eric Brand " <smilinglotus 12/21/2007 10:23 PM Re:Granules--Help! , stephenbonzak wrote: > > Eric- > > I read your article in the acupuncture almanac on this subject and really liked it. How do you end up dosing granules of these medicinals that do not concentrate? Also, have you a list of the concentrations of various herbs? Thanks. Hi Stephen, Whew! Big questions! Hopefully I just answered some elements of the dosing question in my most recent post, but let me know if there are more specific questions and I can try to give you a better answer. In short, it depends on which medicinal is in question, how important it is in the formula, how safe it is in a crude state, and how much outside variables like cost and pricing structures intrude on my decision. Most of my teachers in Taiwan tended to use lower doses of weak substances and minerals in granule form than they would if they were prescribing raw herbs, so that more potent medicinals would not be diluted and so that the unknowns of ingesting straight minerals in large amounts are minimized. Nearly all preferred to use whole formulas rather than singles whenever possible. Doctors there prefer to give the whole formula ma xing shi gan tang vs. mixing ma huang, xing ren, shi gao, and gan cao together as singles, for example. As for a list of concentrations, that is a big task. With more than 5 main Taiwanese producers, each with about 500+ products, comparing the concentration ratios would require data entry of 2500+ products. Just buying the 2500 products in Taiwan so that you can type up their labels is daunting, much less the data entry component itself. The producers use different quantities of filler, and the concentration ratio varies from product to product and company to company. Below is a small comparison of a handful of products that I have posted on CHA in the past. If you have any specific requests, let me know and I can research the individual products for you. I am not associated with any of the companies, and I respect them all. Therefore, I will not name any companies or their concentration ratios on the internet because I don't want these discussions to involve commercial product comparisons and the resulting praise or critiques of any companies involved. Eric Brand Ma zi ren wan (Brand A) Two parts of 5.5:1 concentrate and one part starch. 4.5g of the final powder contains the equivalent of 4g huo ma ren, 2g bai shao, 2g zhi shi, 2g hou po, 2.5 xing ren, and 4g da huang. Ma zi ren wan (Brand B) one part 4.25:1 concentrate and one part starch. 4.0g of the final powder contains the equivalent of 2.5g huo ma ren, 1g bai shao, 1g zhi shi, 2g da huang, 1g hou po, and 1g xing ren. As you can see, these two formulas have very different concentrations. One is nearly twice as strong as the other. Oddly enough, the stronger one is cheaper at the store. Note that neither is 5:1 in its final stage. Brand B is 2.15:1. Brand A is 3.66:1. Now just a random survey of other formulas: Yin qiao san= Two parts of 7.5g concentrate to one part filler. About 4.95:1 at the end, very close to 5:1. 6g of final product contains 5g jin yin hua, 5g lian qiao, 2g dan zhu ye, 2g jing jie, 2g lu gen, 3g jie geng, 3g niu bang zi, 3g ze xie, 3g bo he, 2.5 gan cao, 2.5g dan dou chi. Yi guan jian= One part 4.33g extract mixed with one part filler. About 2.17:1 at the end, close to only 2:1. Xiao Feng San= One part 5:1 extract mixed with one part filler. About 2.5:1 at the end. Huo Xiang Zheng Qi San= One part 6.7:1 extract mixed with one part filler. About 3.35:1 at the end. Xiao Yao San= 10.5g contains 5.9g of 4.7:1 concentrate mixed with 4.6g starch. About 2.6:1 at the end. Si Wu Tang= One part 5:1 extract mixed with one part filler. About 2.5:1 at the end. Gui Pi Tang= One part 5.2:1 extract mixed with one part filler. About 2.6:1 at the end. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2007 Report Share Posted December 22, 2007 , stephenbonzak wrote: > > Thanks Eric- > > Great info. How have you seen single mineral substances dosed in granule combinations? I usually use minerals decocted with the granule formula, not as an addition. Aside from cost considerations, how much should you give of mu li, let's say, if you want to get a similar effect in a granule combo of a 30 g raw dose? Thanks. Hi Steve, That's the million-dollar question right there! There is no one answer, and there is no source text that elucidates it, even in Chinese. I've talked to several doctors in the top of the field, and none of them have any final answer, though they all love to discuss the issue and the challenge it poses. The truth of the matter is that people watch their teachers and imitate what their teachers do. In parallel CHA discussions, we see people debating the merits of new delivery methods of herbal medicine that are largely unique to the West- like the granules, they are a new field with no past history of use. Granules do attempt to replicate traditional methods and formulas, and granules do have a longer track record of patient use than the other " new " forms of Chinese medicine that we have on the US market, easily surpassing other new methods by at least 10-20 million patients, I'd estimate. However, at the end of the day, the phenomenon is the same- new delivery method appears, some attempt to use it, some users are satisfied with their results, students see teachers they trust get satisfying results, and students imitate the teachers for the next generation of patients. Really this process is just the history of Chinese medicine overall, the variables are only a question of how long each method has been in use and how many millions of patients have been used to test it. I've had some great teachers that I respect a lot from the hospital in Taiwan who use granules every day. My teacher Feng Ye sees about 3000 patients per month, and he uses granules for at least 2500 of them, I'd estimate. His teacher, Vice Superintendent Chang Hen-Hong, has the luxury of longer patient visits and lower patient numbers (good to be the boss!), but he uses granules for dozens of cases every shift. Xie Jia-Rong, the head of the GYN dept, sees about 120-140 patients per shift, and she uses granules for 80% plus, at least. All of them prefer to use raw herbs, but all feel that they also get consistent (if slower) results with granules. Their patients largely receive granules because they are virtually free with insurance, whereas raw herbs are quite expensive, costing at least as much as in the US. Having been fortunate to have some good teachers, I basically just imitate their style because they all have far more experience than I have. With regard to minerals, they prefer to use them integrated into whole pre-cooked formulas (like chai hu jia long gu mu li tang, ma xing shi gan tang, etc), but I have also seen them add minerals in as single medicinals. The limitation of the hospital environment is that the constant stream of patients gives only small windows for questions on each individual case- we'll be seeing 100+ patients in a four-hour slot and I am just trying to keep up with the constant flood of doctor-patient interaction in Mandarin, looking over the shoulder of the doctor to watch the herbs that get entered into the computer. There will be a brief pause and I will slip in as many good questions as possible, but honestly I invariably feel as though I have more questions than answers by the end of the shift. So please understand my limitations and take my opinions with a grain of salt; I am no master by any means, I just try to watch far smarter people than me practice their art and I try to pay attention. I've had some good chances to ask these doctors and many others about their approach, but I always feel like there is so much more to learn. In fact, I am planning another trip to Taiwan soon just so that I can interview doctors about their granule styles; I want to tape the interviews so that I can continue to learn more about it and compare opinions. It's a fascinating topic, and hardly anyone in the US knows much about it. Even in Taiwan, there are no books and no ultimate authorities on the issue- the approach was pioneered about 30-40 years ago, and the current generation largely follows the style that they learned from watching their teachers. This produces Taiwan's distinct approach of mixing whole formulas and adding singles, using about 18 grams per day, or about 9-15 grams or so for mild cases or kids. Because 18 grams of granules is less total crude drug than a standard pack of raw herbs, whole granule formulas are used together because they are thought to get more mileage than just single herbs combined together. This introduces another unknown variable, because no other generations have tried mixing so many ingredients together before. So there are a couple new variables and there is a general consensus that there are a lot of unknowns in this evolving science. However, there is one fact that is quite clear- practitioners continue to get great results with the granule approach. Not as good as with the traditional raw approach, but still acceptable, and the overall system is far more convenient for accountability, research, patient compliance, safety, and insurance purposes. The doctors that I mentioned above all tend to use mineral products in modest doses. For example, they add in about 1-1.5 g per day of whichever given mineral they want to use. This does not necessarily mean that they believe this dose to be correct, however. It just means that they think it is the best choice for the patient under the circumstances. If the patient is paying out of pocket and is willing to cook raw herbs, raw herbs are always used, and the normal dose of 15 grams of mu li or whatever is used. However, if the patient is an insurance patient or wants more convenient medicine, they have to sacrifice the medical ideal to match the scenario so that they can best help the patient. This often means retaining the theory or the qi of the target medicinal (such as mu li) by including it in the prescription, but they use it in a lower dose than it would be used in a raw state. Remember also that the granule form is taken directly and it is finely ground with a high surface area, so a smaller quantity still represents more strength than the same small quantity in a raw formula. But is 1.5 grams of straight mu li weaker or stronger than 15 grams of decocted mu li? Now, that is the million-dollar question. My teachers don't have the answer to that question, although they know enough to know that the question must be posed. They use the lower dose of mu li in granule form because they are making a compromise to give the patient a convenient and inexpensive form of medicine to begin with, and they want to make sure that the overall granule formula has its required potency- it wouldn't do to give a patient 12 grams of mu li and only 6 grams of everything else, and they are operating with the 18 gram total limit or else they aren't using granules at all. So their experience is based on different limitations and considerations than we have in California. On the one hand, you have the variable that giving 1.5 grams of mu li may not have the strength of giving 15 grams of mu li in decoction, yet on the flip side giving 15 grams of straight granule mu li introduces a new variable because it would be more mu li than you'd get if you decocted that same 15 gram dose. It's a quandary, and no matter who tries to say they know the answer, no one does. There is no one answer, and we can only make educated guesses based on 1000s of patients' experiences. One thing is definitely true, and that is that the minerals should be considered individually, based on their toxicity, solubility, and traditional method of use. A mineral salt like mang xiao that is highly water soluble (and taken in the strained decoction) should be used in a high dose in the granule form, because the granule is not very different from the use of the crude product. If we use 10 grams of mang xiao as a crude drug, we probably should use a similar amount as a granule, because in the case of mang xiao, the crude drug is generally ingested completely. However, if the substance is not very water soluble, the granule dose should be much lower because the original water decoction wouldn't dissolve much of the mineral. If the mineral has toxicity, the dose should be carefully considered, especially for prolonged use (for example, dai zhe shi, hematite, has traces of arsenic and poses a greater risk when ingested straight than it would if it was decocted). By contrast, a mineral like mu li is basically calcium, and is probably safe within a wider range of use. These are my thoughts, which in turn are basically entirely shaped from the experiences and thoughts of my teachers. I'd be fascinated to learn more about the experiences of others, collectively we have seen a lot of patient responses. Getting more of this information into our educational system would help prepare the next generation for the realities of modern clinical practice, but I find that so few teachers know much about granule dosing that it is hard for students to get a clear message during their clinical training at present. Stephen, I love your method of decocting the minerals at home! I apologize to the group for all the long posts of late. Eric Brand Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 23, 2007 Report Share Posted December 23, 2007 Hi Eric, I have been using granules since 1996 in my own practice and ran a small pharmacy for local practitioners in Santa Cruz. I started using them in '95 when I was doing my clinical apprenticeship with Michael Tierra. I mostly used singles combined to create formulas, primarily because that is what Michael did. I also liked the versatility of creating the formula as I wanted. I started using more simple formulas, such as er chen tang, si wu tang, et al, mostly for time saving reasons, but also because I recognized that when formulas are cooked together there is a synergistically created new " product " that is different from simply mixing the single herbs together. As I went on I started using more formulas and modifying them but still the majority of the prescriptions were made up of wholly or mostly individual herbs. I write the prescription as if I were writing a raw prescription and use the proportions of the medicinals as the guide to the formula to be filled with granules. Thus, if I wanted to use 15g of muli that would be represented proportionately in the formula given to the patient. My daily dosage right range from 6 to 18g, depending on the patient, condition, compliance, etc. I have always found this to be satisfying clinically, although I will admit I don't like it nearly as much as giving raw formulas and I always recommend raw formulas. I say all that as a prelude to a some questions and observations about the use of granules. First, I am wondering how the granules are dispensed in Taiwan. The main reason I ask this question is this. There in the Sates I always gave the patients a spoon and the dose was measured by volume, not weight, although the spoon is supposed to approximate a gram. If you look at different herbs the volume can be quite different, for instance the volume of muli is significantly different than that of juhua or even renshen gram for gram (most easily seen in the 100g bottles). So, this will of course have an effect on the dosage when given by volume rather than weight, no matter how close the approximation is. What I'm getting at here is that because of the density of the the minerals if you reduce the weight in an attempt to make sure they don't dominate the formula disproportionately then using the volume (spoon) method will actually give you less of the mineral than what you wanted to give. What do yo think? If the way they dispense formula in Taiwan different? Is my thinking non-sense or does it make sense? Thomas Beijing, China www.sourcepointherbs.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 23, 2007 Report Share Posted December 23, 2007 The only way I can think my way out of the granule issue is to prescribe based on a raw formula. We know the saying, dosage changes everything, but I have to look at that as meaning percentages not volume. I tell my patients that herbs are more like foods than drugs and work through the digestive mechanisms. Taking that as a given then I stop second guessing every aspect of the granule concentrations and dosages. Doug , wrote: > > Hi Eric, > > I have been using granules since 1996 in my own practice and ran a small pharmacy for local practitioners in Santa Cruz. I started using them in '95 when I was doing my clinical apprenticeship with Michael Tierra. I mostly used singles combined to create formulas, primarily because that is what Michael did. I also liked the versatility of creating the formula as I wanted. I started using more simple formulas, such as er chen tang, si wu tang, et al, mostly for time saving reasons, but also because I recognized that when formulas are cooked together there is a synergistically created new " product " that is different from simply mixing the single herbs together. As I went on I started using more formulas and modifying them but still the majority of the prescriptions were made up of wholly or mostly individual herbs. I write the prescription as if I were writing a raw prescription and use the proportions of the medicinals as the guide to the formula to be filled with > granules. Thus, if I wanted to use 15g of muli that would be represented proportionately in the formula given to the patient. My daily dosage right range from 6 to 18g, depending on the patient, condition, compliance, etc. I have always found this to be satisfying clinically, although I will admit I don't like it nearly as much as giving raw formulas and I always recommend raw formulas. > > I say all that as a prelude to a some questions and observations about the use of granules. First, I am wondering how the granules are dispensed in Taiwan. The main reason I ask this question is this. There in the Sates I always gave the patients a spoon and the dose was measured by volume, not weight, although the spoon is supposed to approximate a gram. If you look at different herbs the volume can be quite different, for instance the volume of muli is significantly different than that of juhua or even renshen gram for gram (most easily seen in the 100g bottles). So, this will of course have an effect on the dosage when given by volume rather than weight, no matter how close the approximation is. What I'm getting at here is that because of the density of the the minerals if you reduce the weight in an attempt to make sure they don't dominate the formula disproportionately then using the volume (spoon) method will actually give you less of the mineral than what you > wanted to give. > > What do yo think? If the way they dispense formula in Taiwan different? Is my thinking non-sense or does it make sense? > > Thomas > > > > Beijing, China > > www.sourcepointherbs.org > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 24, 2007 Report Share Posted December 24, 2007 A good way to get an idea of the potency of a dosage form is to taste it in one cup of water and compare the taste to a decoction. Granules generally compare favorably in flavor to a decoction. Fluid extracts (1:1) aren't quite as strong tasting. An exception is resinous herbs like ru xiang or mo yao, which actually taste stronger in an ethanolic extract. Pills and tablets can also be ground and mixed in one cup of water. The flavor is typically quite weak. I think all the dosage forms have their time and place, but it's good to have some idea of the comparative potencies. Aside from analytical chemistry, tasting is a fairly reliable subjective method. - Bill Schoenbart Quote Link to comment Share on other sites More sharing options...
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