When treatment doesn’t go to plan…
This should have been easy.
A middle-aged woman, not really ill, but more wanting better health after a long run of minor infections. Mrs W was an articulate, intelligent woman who knew that three months of antibiotic treatment would compromise her gut health. She was asking for herbs and dietary advice to keep the lining of the gut healthy and feed her microbiome.
Quite simply, this sort of thing is my bread and butter [rye bread and organic butter is my preference].
At her first appointment I prescribed a gentle herb tea for two weeks, during which time I would go over her notes and have a think about her constitution etc. and tweak her mix at her next appointment.
Her tea mix was simple, but efficacious:
Calendula [promotes tissue repair, anti-inflammatory]
Meadowsweet [soothing for reflux, astringent on small intestine surface]
Ribwort [anti-inflammatory, mucous membrane tonic for the gut]
Marshmallow [supports gut lining integrity]
She was asked to drink 2 cups a day after steeping for 10 minutes. This is medicinal tea, remember – not Tetley’s.
I also gave her specific dietary guidelines which she was happy to try.
At her next appointment she reported an improved feeling of well-being, but which reduced in the second week as dietary changes were not easy to maintain, and she had regressed to her old eating habits. However, we did feel that there was a positive indication that dietary change could provide a real benefit.
But then, in addition to her tea I prescribed a tincture. This tincture was to address a chronic structural problem she was suffering from:
Horsetail, Solomon’s Seal, Witch Hazel, Astragalus, Cleavers, Ginger
400mls take 5mls 3x day with water after food
I was quite happy with this mix and confident that she should start to see some improvements in her general condition.
How wrong I was.
The first email came the very next day, and was along the lines of ‘I’ve developed a sore throat. Is it the tincture?’
Sometimes patients blame their mix if they develop symptoms after starting herbal medicine, it is the easiest thing to blame. I have never, ever experienced that a mix I have prescribed has made a patient worse. They may not have liked the taste, but still…
I asked her if she was diluting the dose as per instructions. It would have been possible for the small amount of weak alcohol to irritate her throat if knocked down neat.
She was diluting the dose.
I looked through her tincture. I scratched my head. None of these herbs had irritated anybody’s throat before.
Was she coming down with a cold which collided with her first dose of tincture? I waited a few days and asked her if she was experiencing any other symptoms. Hopefully she would have started to sneeze…
Apparently not. She had stopped all of her herbal mixes and the next day she was fine. She started the tea again and her throat became ‘like glass’ by the afternoon.
Just with the tea? The tea that was fine two weeks ago? What was going on? This wasn’t going to be quite so simple as I had presumed.
If she had developed problems with her throat just with the tea, I couldn’t blame the tincture. It must be the tea. Was it exactly the same as before? I checked, and realised that I had added some Ladies Mantle. This is a gentle herb, but odd reactions can sometimes happen to anything. Could Ladies Mantle leaf irritate the throat?
Ironically, Ladies Mantle [Alchemilla vulgaris] can be used to treat sore throat, oral problems and coughs and colds. Logically, it shouldn’t affect the throat adversely, but people are individuals.
I am seeing her again in a week when I shall ask her more questions. Maybe I shall find something out that will inform my practice and make me a better herbalist. Or maybe it is a conundrum.
Hopefully our next meeting will resolve the issue, and she won’t leave feeling that she has just been with a charlatan.
