California Acupuncture Board Decreases Herb Portion of Exam

August 1, 2009

Karen,

Of course it may be the starch (etc.), that is the point. Many companies do

not disclose honestly what fillers they use.

Also, as stated before, compliance is most of the time not an issue when the

patient gets results. Often I have found that when patients start to become

noncompliant it is because they do not feel like they are getting the

benefit.

-Jason

On Behalf Of

creationsgarden1

Saturday, August 01, 2009 8:52 AM

Re: California Acupuncture Board Decreases Herb Portion of

Exam

Jason,

Your client may be reacting to the excipient in granulars, many of which

contain various starches.? I have one who is quite gluten sensitive and can

only use granulars when the herb itself is the excipient.?

Generally I find that compliance is far better with granulars, and I've been

known to burn the herbs myself while decocting.

Karen Vaughan

August 1, 2009

I do see some stomach upset with granulars, but no more than I see with bulk

herbs. In both cases, it's fairly infrequent, and I give large doses of

granulars. The brand I use doesn't contain excipients, though.

In the cases of external invasion or infections, I agree that bulk herbs are far

more reliable. I usually give them granulars to start out, and switch them to

bulk if they aren't improving within 24 hours. If their symptoms are already

severe, bulk is almost always the only way to get fast results. If they have a

bacterial infection on the verge of needing antibiotics, I won't give them herbs

unless they agree to use bulk three times per day for at least a week.

Why don't I use bulk all the time? When I started practicing, I did house calls

for the first three years. I frequently saw a dozen unused bags of bulk herbs

sitting on top of the refrigerator. Compliance is much better with granulars. In

the cases where they can't handle the flavor of granulars, I put them in

capsules. For chronic conditions, very few patients will make decoctions for

months on end. I do agree that the attitude of the practitioner makes a big

difference. I have seen students offer bulk herbs to patients, saying " these

taste really bad " , while making a face. Of course, they don't want it then. On

the other hand, it's important to warn new patients that this isn't some kind of

sweet " sipping tea " .

- Bill

, " " wrote:

>

> Karen,

>

> Of course it may be the starch (etc.), that is the point. Many companies do

> not disclose honestly what fillers they use.

>

> Also, as stated before, compliance is most of the time not an issue when the

> patient gets results. Often I have found that when patients start to become

> noncompliant it is because they do not feel like they are getting the

> benefit.

>

> -Jason

>

> On Behalf Of

> creationsgarden1

> Saturday, August 01, 2009 8:52 AM

>

> Re: California Acupuncture Board Decreases Herb Portion of

> Exam

>

> Jason,

>

> Your client may be reacting to the excipient in granulars, many of which

> contain various starches.? I have one who is quite gluten sensitive and can

> only use granulars when the herb itself is the excipient.?

>

> Generally I find that compliance is far better with granulars, and I've been

> known to burn the herbs myself while decocting.

>

> Karen Vaughan

>

August 1, 2009

Bill,

I like this idea.

-Jason

On Behalf Of bill_schoenbart

If they have a bacterial infection on the verge of needing antibiotics, I

won't give them herbs unless they agree to use bulk three times per day for

at least a week.

- Bill

August 1, 2009

" Many companies do not disclose honestly what fillers they use. "

As a group, we shouldn't do business with companies that either do not disclose

ingredients (and their amounts) or do so dishonestly. This is medicine after

all. As long as we keep buying from these companies, they have no incentive to

change. We must pressure these companies to play by the rules here in N.America.

For instance, many companies' labels do not meet current FDA requirements. Take

Mayway for example. This should just not be acceptable to the profession.

The problem is that, as a group, we are so naive about all this.

In the UK, the Register of Chinese Herbal Medicine has an approved list of

suppliers which they promote to their members. These are the companies who meet

the standards of quality, including disclosure, set by the RCHM. We should have

something like that here. Several times in the past, we've tried to form a

Chinese herb trade association, but every time we do, the Asian-owned companies

won't play along. It's unfortunate that this all plays out along ethnic lines,

but it does.

August 2, 2009

, " bill_schoenbart " <plantmed2

wrote:

>

> I do see some stomach upset with granulars, but no more than I see with bulk

herbs. In both cases, it's fairly infrequent, and I give large doses of

granulars. The brand I use doesn't contain excipients, though.

Something doesn't mesh here. I assume that the brand that you use is packaged

as a loose powder in 100 gram bottles. If that is the case, it will contain

excipients. If your supplier tells you that there are no excipients but the

product can be exposed to air without rapidly clumping together, the supplier is

probably lying about the lack of excipients. The only way that excipients are

not required is if the granules are packed into gelcaps or packaged in single

dose foil packs. Even then, most foil packs contain large-kernel granules (ke

li), which do contain a small amount of dextrin as an excipient.

There are a few individual products that don't require an excipient to prevent

clumping, but most items will clump rapidly if no excipient is used.

We have a few articles on granules, excipients, and the importance of

transparency in labeling at the Blue Poppy blog. For example:

http://www.bluepoppy.com/blog/blogs/blog1.php/2009/07/22/the-virtues-of-transpar\

ency

http://www.bluepoppy.com/blog/blogs/blog1.php/2009/04/23/dextrin-vs-starch-in-gr\

anules

http://www.bluepoppy.com/blog/blogs/blog1.php/2009/07/29/dosage-in-granule-presc\

riptions

The current lack of transparency is an ethical and legal time bomb just waiting

to go off. The average practitioner has no idea that most of the products on

the shelf contain 50% inert filler, and most practitioners honestly have no clue

about how much medicine they are prescribing to their patients. Newer

technology allows for dramatically lower amounts of filler, but there is little

incentive for companies to use less filler or provide greater transparency

because most practitioners remain in the dark about the entire issue.

As a group, the TCM crowd often bemoans the ethical practices of big pharma.

However, big pharma at least tells doctors how much ibuprofen is in the tablet,

and it lists the excipients clearly on the label. I only hope that we clean up

our act before some big news outlet runs an article exposing how poorly

self-policed our industry is.

Eric Brand

August 2, 2009

I am just curious, how does Mayway / plum flower make their tea pills? Are

these extracts? Raw herbs made into pills?

-Jason

August 2, 2009

The information is transparent and is available on their website:

http://www.mayway.com/store/qa_chinese_medicine_quality_main.jsp

" Teapill Manufacturing

To produce teapills, an herbal “dough” must be formed from this concentrated

paste. We avoid adding inert fillers by powdering one or more raw herbs from

the original formula and adding them to create a highly concentrated paste.

The dough is rolled out and machine cut into small round pieces that are

then spun into our superior quality teapills.

In the final stage, a tiny amount of talcum (hua shi) and activated carbon

is added for smoothness. The teapills are coated with a fine layer of

botanical wax to provide for easier swallowing and to help naturally

preserve freshness. These excipients combined make up less than 1% of the

pill.

Finished batches of teapills are tested for various quality assurance

parameters including active ingredient constituents, moisture content,

disintegration time, heavy metals (lead, arsenic, mercury, cadmium) and

microbial contamination. These tests are performed on every batch of

finished product. Following extensive in–house testing, heavy metal testing

is conducted again at third party accredited labs to confirm results and to

ensure that our standards of purity and safety are met. "

K

On Sun, Aug 2, 2009 at 8:17 AM, <

> wrote:

>

> I am just curious, how does Mayway / plum flower make their tea pills? Are

> these extracts? Raw herbs made into pills?

>

> -Jason

>

August 2, 2009

The brand is Mayway. If you leave the bottle open, it turns into a rock-like

lump very quickly. Occasionally, this will happen when the bottle is closed,

especially when there is a lot of Gou Qi Zi.

, " Eric Brand " <smilinglotus

wrote:

>

> , " bill_schoenbart " <plantmed2@>

wrote:

> >

> > I do see some stomach upset with granulars, but no more than I see with bulk

herbs. In both cases, it's fairly infrequent, and I give large doses of

granulars. The brand I use doesn't contain excipients, though.

>

> Something doesn't mesh here. I assume that the brand that you use is packaged

as a loose powder in 100 gram bottles. If that is the case, it will contain

excipients. If your supplier tells you that there are no excipients but the

product can be exposed to air without rapidly clumping together, the supplier is

probably lying about the lack of excipients. The only way that excipients are

not required is if the granules are packed into gelcaps or packaged in single

dose foil packs. Even then, most foil packs contain large-kernel granules (ke

li), which do contain a small amount of dextrin as an excipient.

>

> There are a few individual products that don't require an excipient to prevent

clumping, but most items will clump rapidly if no excipient is used.

>

> We have a few articles on granules, excipients, and the importance of

transparency in labeling at the Blue Poppy blog. For example:

>

http://www.bluepoppy.com/blog/blogs/blog1.php/2009/07/22/the-virtues-of-transpar\

ency

>

http://www.bluepoppy.com/blog/blogs/blog1.php/2009/04/23/dextrin-vs-starch-in-gr\

anules

>

http://www.bluepoppy.com/blog/blogs/blog1.php/2009/07/29/dosage-in-granule-presc\

riptions

>

> The current lack of transparency is an ethical and legal time bomb just

waiting to go off. The average practitioner has no idea that most of the

products on the shelf contain 50% inert filler, and most practitioners honestly

have no clue about how much medicine they are prescribing to their patients.

Newer technology allows for dramatically lower amounts of filler, but there is

little incentive for companies to use less filler or provide greater

transparency because most practitioners remain in the dark about the entire

issue.

>

> As a group, the TCM crowd often bemoans the ethical practices of big pharma.

However, big pharma at least tells doctors how much ibuprofen is in the tablet,

and it lists the excipients clearly on the label. I only hope that we clean up

our act before some big news outlet runs an article exposing how poorly

self-policed our industry is.

>

> Eric Brand

>

August 2, 2009

They are extracts.

, " " wrote:

>

> I am just curious, how does Mayway / plum flower make their tea pills? Are

> these extracts? Raw herbs made into pills?

>

> -Jason

>

August 2, 2009

Bill,

Mayway states on their website that their single herb extract powders use

dextrin (and other unspecified ingredients) for fillers for an unknown

amount of their granulars. Also as Eric stated, sometimes this is up to 50%.

This is corn based and hence can be problematic for many patients.

-Jason

On Behalf Of bill_schoenbart

Sunday, August 02, 2009 10:01 AM

Re: California Acupuncture Board Decreases Herb Portion of

Exam

The brand is Mayway. If you leave the bottle open, it turns into a rock-like

lump very quickly. Occasionally, this will happen when the bottle is closed,

especially when there is a lot of Gou Qi Zi.

August 2, 2009

John K,

Thanks for the link. Does anyone have an idea what kind of extraction ratio

these pills are? Or how much raw herb goes into each bottle of pills. This

is not on their website (at least that I saw.)

-Jason

On Behalf Of

Sunday, August 02, 2009 9:40 AM

Re: Re: California Acupuncture Board Decreases Herb Portion

of Exam

The information is transparent and is available on their website:

http://www.mayway.com/store/qa_chinese_medicine_quality_main.jsp

August 2, 2009

Jason,

the dextrin is maltose dextrin and is not corn-based.

Mayway definitely keeps their fillers to a minimum, hence the clumping

issue.

I think we should actually get official/ professional statements when

talking about herb companies,

since there are many vested interests in this discussion, from people who

are on the payroll of several companies.

The best way to understand the products from various companies is to try

them out for ourselves.

With the sight, smell, taste and feel tests, as well as reading their

professional literature.

Otherwise, as many people know, there are many opinions, agendas and

commercial interests that can be sown.

K

On Sun, Aug 2, 2009 at 9:40 AM, <

> wrote:

>

> Bill,

>

> Mayway states on their website that their single herb extract powders use

> dextrin (and other unspecified ingredients) for fillers for an unknown

> amount of their granulars. Also as Eric stated, sometimes this is up to

> 50%.

> This is corn based and hence can be problematic for many patients.

>

> -Jason

>

> <%40>

>

[ <%40>\

]

> On Behalf Of bill_schoenbart

> Sunday, August 02, 2009 10:01 AM

> <%40>

> Re: California Acupuncture Board Decreases Herb Portion of

> Exam

>

> The brand is Mayway. If you leave the bottle open, it turns into a

> rock-like

> lump very quickly. Occasionally, this will happen when the bottle is

> closed,

> especially when there is a lot of Gou Qi Zi.

>

August 2, 2009

Interesting. I use mostly their formulas, usually 2 or three at a time, but I do

use their single herb extracts to make custom formulas.

, " " wrote:

>

> Bill,

>

> Mayway states on their website that their single herb extract powders use

> dextrin (and other unspecified ingredients) for fillers for an unknown

> amount of their granulars. Also as Eric stated, sometimes this is up to 50%.

> This is corn based and hence can be problematic for many patients.

>

> -Jason

>

> On Behalf Of bill_schoenbart

> Sunday, August 02, 2009 10:01 AM

>

> Re: California Acupuncture Board Decreases Herb Portion of

> Exam

>

> The brand is Mayway. If you leave the bottle open, it turns into a rock-like

> lump very quickly. Occasionally, this will happen when the bottle is closed,

> especially when there is a lot of Gou Qi Zi.

>

August 2, 2009

Jason,

The extraction ratio for the pills range from 5:1 to 8:1 generally.

One can do a potency taste test by boiling 8 pills for 5 minutes.

I've done this with several companies to see the efficacy.

As people on this list know, the proof is in the pudding.

K

On Sun, Aug 2, 2009 at 9:42 AM, <

> wrote:

>

> John K,

>

> Thanks for the link. Does anyone have an idea what kind of extraction ratio

> these pills are? Or how much raw herb goes into each bottle of pills. This

> is not on their website (at least that I saw.)

>

> -Jason

>

> <%40>

>

[ <%40>\

]

> On Behalf Of

> Sunday, August 02, 2009 9:40 AM

> <%40>

> Re: Re: California Acupuncture Board Decreases Herb Portion

> of Exam

>

> The information is transparent and is available on their website:

> http://www.mayway.com/store/qa_chinese_medicine_quality_main.jsp

>

--

Turtle Island Integrative Health

TCM Review director

CA State Board Prep Courses

www.tcmreview.com

August 2, 2009

Jason,

Mayway extracts raw herbs in a decoction and creates the teapills. They have an

explanation on their website.

http://www.mayway.com/store/qa_chinese_medicine_quality.jsp

Sincerely,

Miles

, " " wrote:

>

> I am just curious, how does Mayway / plum flower make their tea pills? Are

> these extracts? Raw herbs made into pills?

>

> -Jason

>

August 2, 2009

John,

I see no problem discussing these issues in a public forum. As for my input

it straight from their website.

Mayway says, " The dextrin used is 100% corn based (derived from corn

starch) pharmaceutical grade material. "

The website also states that if one of their single herb extracts comes out

to a 10:1 ratio they will add 100% dextrin (to it) to bring it to a 5:1

ratio this is essentially a 50% filler.

For the record, I have no agenda, and have no vested interest in any

company.

-Jason

On Behalf Of

Sunday, August 02, 2009 10:52 AM

Re: Re: California Acupuncture Board Decreases Herb Portion

of Exam

Jason,

the dextrin is maltose dextrin and is not corn-based.

Mayway definitely keeps their fillers to a minimum, hence the clumping

issue.

August 2, 2009

, " Eric Brand " <smilinglotus

wrote:

>

> As a group, the TCM crowd often bemoans the ethical practices of big pharma.

However, big pharma at least tells doctors how much ibuprofen is in the tablet,

and it lists the excipients clearly on the label. I only hope that we clean up

our act before some big news outlet runs an article exposing how poorly

self-policed our industry is.

>

> Eric Brand

>

Eric, Thanks for sharing your knowledge on this subject. I believe your 100%

correct in your assessment about most practitioners having no knowledge about

the amount of inert filler in the products they are prescribing. Whether it is

due to the lack of education from our schools or lack of transparency from our

suppliers, clearly it's time for a change. As practitioners we should only

support the herbal companies that provide full disclosure on their labels. Hope

that legal time bomb you describe, doesn't go off before we clean up our act.

What's the best way to get the word out?

August 2, 2009

, " bill_schoenbart " <plantmed2

wrote:

>

> The brand is Mayway. If you leave the bottle open, it turns into a rock-like

lump very quickly. Occasionally, this will happen when the bottle is closed,

especially when there is a lot of Gou Qi Zi.

Ah yes. I don't know their exact process, but I think that this phenomenon is

due to a difference in the final stage of the granule manufacturing process.

When a company makes granules, they essentially boil the herbs in something

similar to an enormous steel pressure cooker. The extract then goes into a

machine that evaporates the water in a low-temp, low pressure environment. The

herbal concentrate then becomes a gooey, sticky mass.

From there, the viscous goo can then be sprayed onto particles of starch, which

fall through a chamber of forced air. This forms a fine granule. This method

is used in Taiwan, and the Taiwanese domestic market also has a honey pill

product that is made by using honey as an excipient instead of starch.

In China, the method most commonly used at the end goes basically like this: The

viscous extract goo is sprayed through a drying chamber, and the dry extract is

collected. It can then be ground and sieved to make a fine powder. This fine

powder (called qing gao fen in Chinese) can be used directly, by packaging it in

foil packs or gelcaps. Blue Poppy's extracts are basically this, pure dry

extract without excipients. The largest supplier of China's hospitals,

Tianjiang Pharmaceutical, also used this process to produce foil packs for the

Chinese domestic market for many years (I hear that now they have switched to Ke

Li, which are ever-so-slightly different, as below).

Based on its characteristics and its marketing, I suspect that the product

Mayway uses is basically this qing gao fen, dry extract with minimal or no

excipient. I am also under the impression that they work a lot with the

nutriceutical industry, where the issue of clumping is generally not a problem

because the finished product is a capsule or tablet. The advantage of this

method is the minimal use of excipients, the disadvantage is that it tends to

clump and become difficult to work with. As an aside, I suspect that their tea

pills also start from the same extract, but utilize additional excipients and

pressing/shaping techniques.

In China, there is one other method that is prominent: Ke Li, large kernel

granules, for lack of a better common English term. These are made by taking

the qing gao fen (dry concentrated extract powder) and adding a small amount of

water and dextrin. This makes it a workable paste, which is then pressed and

cut into large particles. The particles are sieved and dried a second time to

form the final Ke Li (large granule). This product is common on the Chinese

domestic market.

By nature, the extraction ratio of each herb is different. To make an even 5:1

extract, additional dextrin is typically added to dilute the extracts that

naturally come out stronger than 5:1. A few products cannot achieve 5:1,

although most can achieve 5:1 or more.

The method used will require different quantities of excipient. The dextrin

method of making Ke Li tends to require less excipient than the starch or raw

herb excipient approach, but 5:1 Ke Li tend to have more dextrin than Ke Li that

are packaged in foil packs.

Certain items naturally come out with a high concentration ratio. For example,

zhu ru and ji xue teng can often achieve 15:1 or 20:1. Assuming no excipients

are used and the product is a fine powder, if only 5:1 is achieved, it isn't

quite as strong as it could be. If dang gui or da zao is done under the same

conditions, a 5:1 extract is not as complete as it could be (more cooking would

get out more constituents, which would bring the ratio below 5:1).

If items that have a high potential concentration ratio do not contain filler

but do not achieve high concentrations, I sometimes wonder what is going on

(maybe it is done just for marketing consistency). If items that are hard to do

at a high concentration ratio claim the same ratio as an item that is easy to

get up to a high concentration ratio, I also wonder. If an entire line is billed

as exactly the same concentration ratio, I wonder.

As I see it, the phenomenon can be essentially summed up like this: Many

practitioners aren't great with dosage, maybe because too many students are too

focused on their exams and have inadequate mentoring with dosage in clinic.

Many practitioners also don't understand the ins and outs of the granule field,

which is itself a bit of a specialized topic with Chinese medicine. The granule

companies thus attempt to market to a group that doesn't really have the

background knowledge to know what questions to ask. The market wants to hear

even 5:1 ratios and minimal filler. Many products can achieve that, true, but

the reality of the whole picture is a bit more complicated.

What we now need is better practitioner education so that the companies can

market their products exactly as they are. Right now, the companies tell us

what we want to hear. Most of us don't know enough to ask the right questions,

and we don't know what to look for. Many companies have very good reasons for

every decision they make, and a company that provides education and transparency

can generally win over an educated customer based on an intelligent explanation

of their methods and solutions, even if it is more complex than a simple 5:1.

It is often hard to find out the real answers unless one knows how to ask the

right questions. I study this stuff in depth yet I still learn new things and

correct my own misconceptions all the time. I've gone to many granule factories

in Asia, and I get down and dirty with the hardest questions I can ask. Even at

the manufacturing facility, even one-on-one with the quality control experts,

speaking their language, knowing their art, it is hard to get straight answers

to all these questions. One must visit each factory and ask all kinds of

questions, and each time one gains another piece of the puzzle. Sometimes I'll

go to a different factory, learn something new, and come back to the first

factory with a new question that solves yet another mystery. I can say first

hand that this stuff is complex. I admire the people that really have a solid

understanding of all the science that goes into making granules.

Sorry for the long reply. Bill, I really appreciate your comments here on CHA,

you invariably post extremely thoughtful and useful messages. I always scroll

through the messages looking for your name, and I read those posts first.

Eric

August 2, 2009

, " " wrote:

>

> Bill,

> Mayway states on their website that their single herb extract powders use

> dextrin (and other unspecified ingredients) for fillers for an unknown

> amount of their granulars. Also as Eric stated, sometimes this is up to 50%.

> This is corn based and hence can be problematic for many patients.

Actually, I think that dextrin is usually used in much lower amounts than

starch. Starch is generally around 50% in most products that contain it,

sometimes as low as 35%. By contrast, dextrin is often only around 5-15%, but

it can be much higher for items that naturally have a high concentration ratio

and thus need to be diluted to come down to 5:1.

That said, to my knowledge I am unsure if dextrin poses any risk of food

allergies. True, it is a corn product, but I'm under the impression that it

does not contain corn proteins, which are the allergen that triggers reactions.

I've posed this question on CHA before, but so far no chemists have chimed in to

clarify. My impression is that dextrin is not thought to be an allergen. All I

can find on pubmed about dextrin and allergies is stuff that uses dextrin in

various preparations to treat allergies. It is the most common pharmaceutical

excipient in the world- are there allergy warnings on pharmaceutical pills?

Certainly some patients could experience psychogenic symptoms, and I wouldn't be

surprised if crude corn starch itself might be problematic, but I've so far not

seen evidence that suggests that dextrin poses a risk to sensitive patients.

Just because it comes from corn doesn't mean it has the same baggage as corn,

chemistry is way more complex than that.

By the way, if anyone happens to be near Hong Kong in a few weeks, there is a

huge herbal symposium and trade show happening there. See:

http://icmcm.hktdc.com/index.htm

Eric Brand

http://bluepoppy.com/blog/blogs/index.php

August 2, 2009

Jason

Since i started studying with arnaud i only use ZZJ Rxs. I now use

about 100 herbs in total and way fewer formulas. While i have much

more experience with TCM and know the limitation much better in the

short time i have been doing this my impression that results have

improved while simplicity as increased. I am not saying this classical

approach does not take time and effort to learn, it does, but in

general it feels much more manageable the modern tcm approach. I

definitely see an advantage of learning systems that have definite

boundaries even though vast. For me the most difficult thing about

TCM is that one can take 100 roads all the time. This makes it much

more difficult to decide were to go as a student.

400 29th St. Suite 419

Oakland Ca 94609

alonmarcus

August 2, 2009

Patient psychology is very peculiar. I will see a new patient that has

seen

a few of these practitioners and they will often tell me how great their

success was. How can one not wonder, why are they coming to see me?

>>>>Wow Jason now you really sound like me

400 29th St. Suite 419

Oakland Ca 94609

alonmarcus

August 2, 2009

I rarely have a problem with them, but I am very careful about putting the lids

back on immediately and tightly. I warn all my patients about this, too.

- Bill

, <johnkokko wrote:

>

> Mayway's 5:1 powders clump up relatively quickly, because of their

> insistence in not adding more fillers.

> You can taste the potency and purity in the powders. They are dedicated to

> purity,

> but their powders do clump up quickly, which becomes impractical at times.

> It helps a lot if you keep them refrigerated, which keeps the powders

> drier.

> It is something I know they have been debating for a long time... purity vs

> practicality.

>

> K

>

> On Sun, Aug 2, 2009 at 9:00 AM, bill_schoenbart <plantmed2 wrote:

>

> >

> > The brand is Mayway. If you leave the bottle open, it turns into a

> > rock-like lump very quickly. Occasionally, this will happen when the bottle

> > is closed, especially when there is a lot of Gou Qi Zi.

> >

>

August 2, 2009

I think a lot of alternative therapies make people relax and feel

good, but to treat underlying conditions takes a great deal of skill,

effort and a systematic approach that established disciplines such as

Chinese medicine can deliver.

On Aug 2, 2009, at 1:00 PM, alon marcus wrote:

> Patient psychology is very peculiar. I will see a new patient that has

> seen

> a few of these practitioners and they will often tell me how great

> their

> success was. How can one not wonder, why are they coming to see me?

> >>>>Wow Jason now you really sound like me

>

> 400 29th St. Suite 419

> Oakland Ca 94609

>

> alonmarcus

>

August 2, 2009

Thanks Eric. I always appreciate the time you take to explain the manufacturing

process for the Chinese extracts. It's really important, and very few

practitioners have had the opportunity to visit the factories.

There is a similar situation with American and European extract manufacturers.

They standardize for a huge variety of compounds and concentration ratios. Many

of them will provide numerous ratio extracts or standardized marker compound

extracts for just one herb. Each manufacturer does it a slightly different way.

- Bill

, " Eric Brand " <smilinglotus

wrote:

>e bottle is closed, especially when there is a lot of Gou Qi Zi.

>

> Ah yes. I don't know their exact process, but I think that this phenomenon is

due to a difference in the final stage of the granule manufacturing process.

>

> When a company makes granules, they essentially boil the herbs in something

similar to an enormous steel pressure cooker. The extract then goes into a

machine that evaporates the water in a low-temp, low pressure environment. The

herbal concentrate then becomes a gooey, sticky mass.

>

> From there, the viscous goo can then be sprayed onto particles of starch,

which fall through a chamber of forced air. This forms a fine granule. This

method is used in Taiwan, and the Taiwanese domestic market also has a honey

pill product that is made by using honey as an excipient instead of starch.

>

> In China, the method most commonly used at the end goes basically like this:

The viscous extract goo is sprayed through a drying chamber, and the dry extract

is collected. It can then be ground and sieved to make a fine powder. This

fine powder (called qing gao fen in Chinese) can be used directly, by packaging

it in foil packs or gelcaps. Blue Poppy's extracts are basically this, pure dry

extract without excipients. The largest supplier of China's hospitals,

Tianjiang Pharmaceutical, also used this process to produce foil packs for the

Chinese domestic market for many years (I hear that now they have switched to Ke

Li, which are ever-so-slightly different, as below).

>

> Based on its characteristics and its marketing, I suspect that the product

Mayway uses is basically this qing gao fen, dry extract with minimal or no

excipient. I am also under the impression that they work a lot with the

nutriceutical industry, where the issue of clumping is generally not a problem

because the finished product is a capsule or tablet. The advantage of this

method is the minimal use of excipients, the disadvantage is that it tends to

clump and become difficult to work with. As an aside, I suspect that their tea

pills also start from the same extract, but utilize additional excipients and

pressing/shaping techniques.

>

> In China, there is one other method that is prominent: Ke Li, large kernel

granules, for lack of a better common English term. These are made by taking

the qing gao fen (dry concentrated extract powder) and adding a small amount of

water and dextrin. This makes it a workable paste, which is then pressed and

cut into large particles. The particles are sieved and dried a second time to

form the final Ke Li (large granule). This product is common on the Chinese

domestic market.

>

> By nature, the extraction ratio of each herb is different. To make an even

5:1 extract, additional dextrin is typically added to dilute the extracts that

naturally come out stronger than 5:1. A few products cannot achieve 5:1,

although most can achieve 5:1 or more.

>

> The method used will require different quantities of excipient. The dextrin

method of making Ke Li tends to require less excipient than the starch or raw

herb excipient approach, but 5:1 Ke Li tend to have more dextrin than Ke Li that

are packaged in foil packs.

>

> Certain items naturally come out with a high concentration ratio. For

example, zhu ru and ji xue teng can often achieve 15:1 or 20:1. Assuming no

excipients are used and the product is a fine powder, if only 5:1 is achieved,

it isn't quite as strong as it could be. If dang gui or da zao is done under

the same conditions, a 5:1 extract is not as complete as it could be (more

cooking would get out more constituents, which would bring the ratio below 5:1).

>

> If items that have a high potential concentration ratio do not contain filler

but do not achieve high concentrations, I sometimes wonder what is going on

(maybe it is done just for marketing consistency). If items that are hard to do

at a high concentration ratio claim the same ratio as an item that is easy to

get up to a high concentration ratio, I also wonder. If an entire line is billed

as exactly the same concentration ratio, I wonder.

>

> As I see it, the phenomenon can be essentially summed up like this: Many

practitioners aren't great with dosage, maybe because too many students are too

focused on their exams and have inadequate mentoring with dosage in clinic.

Many practitioners also don't understand the ins and outs of the granule field,

which is itself a bit of a specialized topic with Chinese medicine. The granule

companies thus attempt to market to a group that doesn't really have the

background knowledge to know what questions to ask. The market wants to hear

even 5:1 ratios and minimal filler. Many products can achieve that, true, but

the reality of the whole picture is a bit more complicated.

>

> What we now need is better practitioner education so that the companies can

market their products exactly as they are. Right now, the companies tell us

what we want to hear. Most of us don't know enough to ask the right questions,

and we don't know what to look for. Many companies have very good reasons for

every decision they make, and a company that provides education and transparency

can generally win over an educated customer based on an intelligent explanation

of their methods and solutions, even if it is more complex than a simple 5:1.

>

> It is often hard to find out the real answers unless one knows how to ask the