Eric Brand is a graduate of the Pacific College of Oriental Medicine and a fluent Chinese speaker. He is the author of A Clinician’s Guide to the Use of Granule Extracts and the co-author of the text Concise Chinese Materia Medica. Eric has a particular passion for Chinese herbal processing, authentication and quality discernment. He recently completed a PhD in pharmacognosy at the School of Chinese Medicine in Hong Kong. He is the owner of the granule company Legendary Herbs, He is a Chinese medicine advisor to the American Herbal Pharmacopoeia and currently serves as the U.S. Chair for the ISO TC 249 committee on international standards in Traditional Chinese Medicine.
Greg: Hello and welcome to the Pacific Center Podcast. My name is Dr. Greg Lane and I will be your host as we explore many interesting topics with many amazing people from a variety of professional backgrounds over the months and years ahead. The focus of this podcast will be the intersection of the traditional healthcare practices of various cultures and the modern scientific research on peak physical and cognitive performance. The show will be delivered in an interview format. Quick disclaimer: while we may be discussing some health-related issues and therapies, in no way will things be construed as medical advice. As always, if you are seeking information or treatment for a medical condition, please consult with a licensed healthcare provider. So our guest today is Eric Brand. Eric is a graduate of the Pacific College of Oriental Medicine and a fluent Chinese speaker. Eric has pursued extensive academic and clinical opportunities in mainland China, Hong Kong, and Taiwan. Following a prolonged internship at Chenggong Memorial Hospital in Taiwan, Eric became immersed in numerous projects related to Chinese medical translation and herbal research. He is the author of A Clinician’s Guide to Using Granule Extracts, and the co-author of the text Concise Chinese Materia Medica, and he has edited a variety of modern and classical texts. Eric has a particular passion for Chinese herbal processing, herbal authentication, and quality discernment. He serves as a TCM advisor to the American Herbal Pharmacopoeia and is a US delegate for the ISO Technical Committee on TCM standards. We’re going to be speaking with Eric from his home office in Boulder, Colorado. Eric, welcome, it’s so great to see you virtually and have you here. It’s been a while since I’ve seen you, we had nice lunch here last time you were in San Diego. We’re in for a real treat today, to pick your brain on something that I know you’re extremely passionate about. Before I begin, I want to read this brief passage from the classic Chinese medical text, the Nei Jing Su Wen, that will springboard us nicely into our discussion of the vast and fascinating subject of herbal medicine. “Those who strive to go beyond normal human limits will remain light and strong. And although they grow old in years, they will remain able-bodied and flourishing.” So, Eric, take us back, if you will, to the first known uses of herbs in China, and in India, and ancient Greece. And western travelers, you know, Marco Polo and the like. Or, just kick us off here, buddy.
Eric: Well, that’s a very big and broad topic but the roots of herbal medicine and all cultures go back for thousands of years. So, many of the early formative texts in Chinese medicine emerged around the same time, actually, as some of the early Greek texts of herbal medicine. And so, you have, actually, a lot of interaction between China and the Arabic world and within south Asia, as well as within Europe. So throughout the history of Chinese medicine, there’s been a long assimilation of new Chinese herbal medicine, new herbal medicines, new ideas, new concepts. And then, a lot of transport of herbal medicines along the Silk Road going across central Asia to connect the East with Europe, as well. After the age of exploration, you had a lot of further development of the – what they call – the “Maritime Silk Road,” where basically the trade of spices, herbal medicines, exotic materials from South East Asia and India by sea, traveling through China. So China has a very long history of absorbing foreign medicines, in terms of its earliest recorded knowledge. Essentially, there’s kind of – it starts with a myth, the myth of Shennong, and the first materia medica text in Chinese medicine that largely survived to the present day, the Shennong Bencao. Bencao Jing is ascribed to this mythological figure, Shennong. According to the myth of Shennong, he tasted many different herbs, discerned which items were poisons, which items were medicines, which items were food. He helped – he’s sort of a mythical figure that honors the countless people that died in the experimentation for what is food, what is medicine. He’s the figure of, sort of, regarded as the mythological founder of Chinese agriculture animal husbandry and herbal medicine. And, sort of, the myth of Shennong is that one day we’ll try to discern which items were food, which items were medicine. He ingested a poisonous substance and died. This myth largely, in a sense, thanks all of the countless unnamed ancestors that came before. As human society developed and people learned which things were edible, which were poisonous in their own regional areas. And from that shenanigan, you basically had a long history of materia medica texts where original knowledge was often supplemented or added to. Around the 5th century, you had Tao Hongjing’s work that was an annotated addition to the Shennong Bencao. The original Shennong Bencao contained 365 medicinals and Tao Hongjing made further additions to it and further commentary on it. And he, sort of, established a pattern of scholarship that the example that was exemplified throughout the later Chinese literature where the original texts, the knowledge that had come before that was being transcribed in this book, was printed – was written – with one color ink and then his own annotations were written with a different colored ink. And as printing developed, they used – they maintained – that difference by using different type sizes. And so, Chinese medicine accumulated a long history of scholarship where it would preserve the previous works that came before it while adding new ideas, adding new comments, clarifying confusion. And that really reached a pinnacle in the Ming dynasty with Li Shizhen the author of Ben Cao Gang Mu and 1892 Substances. It was sort of using materia medica Chinese medicine theory as a lens to classify the natural world as a whole. Li Shizhen made a, sort of, a novel classification system of all different items throughout nature and he used the Chinese medicine theory to evaluate those substances. And so, he kind of embodied that classical scholarship while also incorporating field research and leisure. Li Shizhen not only combined traveling in the field, acquiring new knowledge, and reading the classical text, but Li Shizhen was very much a critical thinker and reevaluated material that came before. He was constantly trying to make corrections and improvements and leisure. Li Shizhen was a renaissance figure, in fact, this is the 500th anniversary of Li Shizhen birth this year. There’s a very large celebration in his hometown in China coming up on May 26 to celebrate him. But in Europe, what was going on around the same time period, was a flourishing of herbal medicine that started to happen also in the Renaissance period. Before the Renaissance, actually, much of herbal medicine knowledge in Europe was very closely rooted in diascorea, which was one of the earliest fundamental Greek texts around 2000 years ago. A similar time period is like the Shennong Ben Cao Jing and the Huang Di Nei Jing of Chinese medicine were sort of a constant stable text that was extensively used throughout earlier herbal medicine. And then during the Middle Ages, European herbal medicine sort of fell into a period of time that was affected by the Dark Ages. A lot of European knowledge ended up being preserved in the Arabic world and then brought back from the Arabic world back into Europe. And around the Renaissance period, you started having different authors using languages other than Latin, using the – what were considered at the time – German, English, the common spoken languages of the people to recordable medicine knowledge. And that started to produce a big flourishing in the Renaissance. So from, pretty much, the Renaissance period of time afterwards, the material medical literature in both cultures was was quite developed and there was a lot of exchange of medicinal materials between the cultures.
Greg: And you also had the third pillar, I guess, which would have been India. Or was that included in the, what you just said?
Eric: Well, historically, a lot of the trade between India and Europe was linked through the Arabic traders. And in a similar situation, the Arabic traders were also a key link between the trade, between China and Europe. And so, the Silk Road trade incorporated, to some degree, both Indian goods as well as Chinese goods. But the Silk Road was especially like a route of trade between China across to the Middle East. India and China directly, they had – even though they’re very close geographically – historically, the Himalayas were a very significant barrier. So when you think about when Buddhism went from India to China, one of the first people in the Tang dynasty to bring a lot of those original fundamental Indian sutras over from India to China, it took him 27 years to make the journey. And it was very difficult journey to cover, to cross the Himalayas directly. So a lot of the items from India enter Chinese medicine via sea. So a lot of the things that we see in Chinese medicine, some of the things that were traditionally called, for example, guan mu xiang, the mu xiang aucklandia or saussurea, was traditionally a medicine that came from India and was imported from India into China via sea. And so, the Chinese called it guan mu xiang because it came from the southern trading hub of Guangzhou. Nowadays, when we talk about mu xiang, we call it yun mu xiang because that plant was successfully cultivated in Yunnan province in China. And now, Yunnan province is the major production area for mu xiang. But you have many examples of items that definitely traveled from India to China and there was definitely an exchange of medical ideas. But oftentimes, you find that in, you know, in India, they think a lot of exchange of medical ideas are from India to China. And China, I think, a lot of exchange of medical ideas from China to India. I think both cultures were constantly interacting and from an early time, but only with the relatively small number of individuals that actually made the journey.
Greg: It’s so interesting that we, you know, I’m just listening to you talk about the different regions and thinking about the development of the cultural herbal medicines of, like, Ayurveda or Chinese medicine, or the South American herbs and how these all develop and get shared. You know, over time, that kind of brings us to where we are today. You see this cross sharing of herbal medicines – and I want to kind of get to that later – how, you know, in peak performance, how we’re seeing these being utilized with athletes and people that are just trying to enhance their lives or live longer. And that kind of brings me to the next question I have for you. You know, talking about the different classes of herbs and maybe before we even depart into that, it’s difficult to springboard forth without really talking about ginseng. And, you know, because I think most of the public knows of ginseng as being like this amazing herb. And we know it in Chinese medicine for having multiple uses but it was really, you know, maybe you can tell us a little bit about the history of ren shen in Hong Kong, bai ren shen, the different kinds of ren shen and ginseng, and how they were used. And, you know, what is it? Myth? Is it, you know, fact? I mean, we know as practitioners what they do therapeutically, but maybe share a little bit about that.
Eric: Yeah, so the question of ginseng is a very good question. Ginseng has an extremely rich cultural history behind it. And so, one of the first things that we can say about ginseng is it touches a lot on the issue of natural resources. Historically, most ginseng was wild ginseng in early formative period of Chinese medicine. And wild ginseng grows extremely slowly. And in fact, one of the ancient names for wrench and wrenching and the character for the shin that we use in wrenching – this is a word generally ascribed to medicinal roots – and ginseng, in particular. That original character was in the Bronze script, was sort of a pictograph that illustrated the fruit and the root of the ginseng. But in early texts, we find mention that the ginseng from a region that no longer produces ginseng, in modern day called Shandong, a region that was cited in Tao Hongjing’s sixth century work. He said that the best ginseng comes from this region, in what’s now modern day Shandong Shanxi. So this Shandong region, modern day Chengdu of Shanxi, this area no longer has any ginseng growing there but it was before. At one time, you could tell from the historical literature, you have botanical illustrations of the ginseng plant that clearly indicate that it was growing in that part of China. And the character “shen,” besides for being a pictograph of the ginseng plant itself, one of the alternate characters used for ginseng was a word that’s also pronounced “shen” means “very slow growing.” The “ren” in the character ginseng means “human” and that’s because it’s said that the root had a human-like shape. And so, you can find ginseng roots with a remarkable similarity to the human shape. They’re extremely rare to find, the wild Chinese ginseng roots with a human shape, anymore. To find any genuine wild ginseng at all is extremely rare. While ginseng was nearly what would have probably gone extinct in the wild in the past, had it not been for about a 200-year period of time where the Chinese emperors cut off access to the ancestral homeland, like, the natural territory of ginseng was regarded as their ancestral homeland. The Qing emperors came from Manchuria and, actually, the fall of the Ming dynasty and the rise of the Qing dynasty itself was somewhat related to ginseng because the people from the Manchurians, who became the rulers in the Qing dynasty, accumulated a tremendous amount of wealth from selling the wild ginseng to the Ming aristocrats. That was actually a factor in allowing them to have the power to overtake the entire empire of China. And it was also a ginseng collection that was also a factor in the delineation between China and what’s now North Korea. Because the area right between China and North Korea, around Chiangmai mountain, was a sacred homeland to the Manchurian people. And during the Qing dynasty, though for about 200 years, that area was cut off from the common people. So you would be executed if you went in to harvest ginseng there. And the region that basically marked that execution line ended up influencing what became the border between China and Korea. And so, there was a long time where only the emperor’s troops were allowed to go hunt for wild ginseng. And at that point in time, by the Qing dynasty, the area for wild ginseng had pretty much shrunken to only being that area around Chiangmai mountain, close to northeastern China, close to the Korean border. But from the textual evidence, the early botanical illustrations, we can see that actually ginseng existed on a larger geographic region all the way from the ancient region – it was called Shandong – over to, what they called at the time, the northeastern part of China, that encompasses Manchuria, and then over into Siberia. And so, originally, ginseng had a somewhat broader home geographic range. But in the Bencao Gangmu, Li Shizhen reports that the ginseng, due to over-collection and environmental damage, had already gone extinct in the Xiangdong region by the time he was writing, about 500 years ago. The ginseng, in a way, it tells us a lot of history about the need to preserve natural resources and it also illustrates the evolution of Chinese medicine from primarily relying on wild crafted materials in the early stage to often utilizing cultivation of materials for, you know, sustainable supply in the modern era. And the issue you mentioned, hong shen and bai ren shen, and part of that story, really kind of begins in Korea. It’s thought that the cultivation of ginseng originally started to advance in Korea, early on around the Song dynasty. You had periods of time where Korea and China had a relationship where Korea was required to give tribute and one of the tribute items that was required to prevent war was ginseng. And so, there was a lot of pressure on Korea to meet its quotas for ginseng production, and as natural ginseng. As the wild ginseng reserves started to become more depleted, people started to cultivate the roots, transplant the immature roots into cultivation and cultivate it. And the development of hong shen – the red processed form of ginseng, what we call red ginseng instead of white ginseng – the development of hong shen actually came about originally as a preservation method to prevent damage from insects and mold as the ginseng was shipped from Korea to China. And so, hong shen actually started off as a preservation technique. And during my PhD research, one of the things I was looking at was the historical changes in Chinese medicines, and one of the items that we looked at was ginseng. We had a really rich collection that had been preserved in London, of specimens of ginseng over the last 200 years or so. They had over 50 different specimens. And you could see ginseng preparations from Japan, from Korea, from China. White ginseng, red ginseng, and dong yang shen which is a Japanese processing method of ginseng where they’re using part boiling of the root. You can see, basically, the same preparation methods that we use for ginseng today were already in use in the late 1800s. And the root material, the late 1800s, is remarkably similar to the cultivated root material that we have today. The main difference now is that you start to have – in addition to normal field cultivation now – you start to have a little bit more extensive practice of people doing half wild cultivation, where they’re trying to grow ginseng in a wild simulated environment.
Greg: Are they in the Shanxi province or the Shandong province, where it was first grown? Or, because I know they’re trying to grow it in America, too. And actually, can you speak a little bit to that? Obviously, we know that the regions where the medicinal substances are grown play a big part in their therapeutic values, right? In their active constituents.
Eric: Well, I think that if you’re going to look at a ginseng and compare, look at the feasibility of growing ginseng in different ecosystems. On the one hand, you have some evidence that it’s difficult to grow good ginseng in different environments. For example, you had some early experiments in the 1970s in China where they tried to grow ginseng in southern China and the root would grow and it would get very large and fat but it was almost like a turnip – had very little flavor or potency and, you know, virtually no medicinal value – so people discontinued it.
Greg: No body? No head?
Eric: Yeah, it’s basically just turned into like a big radish. It looked big and fat but it was just full of, you know, water or something, not much. That said, they have some researchers reported that they’ve been able to get good ginsenosides ideals off growing ginseng hydroponically. So, there may be totally different ways that ginseng can be grown than people have done it in the past that haven’t yet been systematically researched.
Greg: That would make sense.
Eric: But you could definitely look at American ginseng as a good example of one where the plant was successfully transplanted out of its original ecosystem. But also, American ginseng shows a little bit of the imperfections in that – so if you look at the original homeland of American ginseng, mostly in the cold parts of the eastern US and Canada, mostly in the east. But ginseng has now been – American ginseng – has been successfully cultivated on the west side in Washington and in British Columbia. The material grown in British Columbia, compared to the material grown in Ontario, are still a little bit different macroscopically. And American ginseng’s also been successfully cultivated in China, both in northeastern China as well as in northern China and the area around Beijing. And the area around Beijing actually produces slightly higher quality, typically, than the area around the northeast. So with even within China, you can find certain regions that seem to be more suited to it. But there’s definitely good quality American ginseng that has been successfully grown in China. So in the past, you would be able to, sort of, clearly identify the American ginseng grown in Canada or Wisconsin from that grown in China. But the gap in quality is getting closer and closer as the cultivation technique advances. So I think it’s largely a question of, you know, people used to think you would never be able to grow good wine outside of the old European production regions, right? You know, places like Napa have demonstrated that if you have the right varieties, the right techniques, the right environment. You know, you can’t say geography doesn’t matter because Napa is better than San Diego when it comes to wine. You couldn’t say that the skill and the art can still be successfully adapted.
Greg: Yeah, even down in Baja, California. And there’s this Valle de Guadalupe which is this little temperate valley that grows incredible wines. But anyway, so we’ve learned a bit about ginseng and I think that, you know, for our listeners, that was a really great historical context. And I’m curious now about, and I’m sure our listeners will be curious, about the other herbs and varieties in this category. You know, what would you call this category, emperor herbs? Or, we have a traditional name for the strata of herbs, right? So what are some other emperor-type herbs?
Eric: You know, let me think about, sort of, tonics in general. I think, maybe, when you think of like superior, middle, and inferior herbs, it kind of brings to mind this three-tiered classification system in the Shennong – which, in some cases, holds true in the modern day. In some cases, you have some herbs that are extensively used that would be in a lower position, Shennong Bencao. And then others that are in a high position in China but not that extensively as today. But if we think about what are the most important tonics in Chinese medicine, then certainly, of course, ginseng is one of the first ones that comes to mind. Another one would be astragalus. Astragalus is also an item that has a, kind of, an interesting side story. Since a lot of your listeners are Chinese medicine practitioners, a lot of them may already be familiar with the basic Chinese medicine actions of astragalus. Many people that are probably listening from the general public are familiar with astragalus for its effects on the immune system and other modern research that’s been done on it. But it’s an interesting side note that, historically, you actually have plants from two different generations that have been grouped together, as in history. I know, Greg, you studied Chinese medicine quite a while ago, probably the edition of Bensky that we used at the time, that you were studying. The time that I was originally studying, we learned the names astragalus and hedysarum – we very rarely encounter hedysarum – but the thing that’s really interesting is that, after I graduated PCOM, I moved to Taiwan. Over the last 15 years or so, I’ve spent about 10 years in Taiwan. And I started, originally, studying in a hospital there and I’ve always been really interested in herbal pharmacies so I went to a lot of different noble pharmacies and I realized that, actually, all the neighborhood pharmacies in Taiwan, none of them huang qi like we’re used to in America. So in America, we tend to mostly either import the herbs directly from China or we have a lot of herbal medicines imported from Hong Kong. And in Hong Kong, they tend to only primarily use astragalus and in the US, we tend to pretty much only use astragalus. But in Taiwan, they very rarely use astragalus as huang qi. You can get astragalus made by large granule companies or you could get it if you go specifically to the herbal medicine district, pick out astragalus versus hedysarum, then it is possible to buy astragalus in Taiwan. But if you just go to your local neighborhood herb shop, all of them pretty much universally, have hedysarum and not astragalus. And hedysarum has a very similar look to astragalus. The Chinese pharmacopoeia grouped them together, both under the name huang qi, until the year 2000 and they separated them into huang qi and hong qi, which would be red astragalus.
Greg: So, being a little bit warm?
Eric: It has a reddish cortex, whereas huang qi has a more yellowish cortex. But the two of them look very similar and they have a similar taste, except hong qi has a slightly sweeter taste. And so, hong qi in Taiwan, a lot of people think hong qi is the better one. If you’re making chicken soup, if you’re making medicinal food, then hong qi actually has a better taste. If you’re using it for medicine, then a lot of people say, well, astragalus has the most extensive amount of clinical use and the most evidence behind it. But actually, when my teacher did some pharmacognosy research, where they looked at a huang qi and hong qi, and they looked at a variety of different effects on the immune system and both of them had very strong activity but with slightly different effects. So for anybody who’s interested in that paper, we could submit the link or I could put up the link at my website at legendary.com. But we’ve got all of the very nice details about breaking down these two medicinals that were traditionally used interchangeably. So astragalus is one that also has a bit of an interesting story. And then, of course, you’ve got others that are very famous and popular right now like reishi mushroom or goji berry, things that are really hitting a lot of attention. And then we also mentioned some of the things with ginseng. You have some of the other things that are, sort of, sometimes called ginsengs that aren’t actually true ginsengs, a typical case being Siberian ginseng elusive.
Greg: Yeah, I actually wanted to ask you about that because that was what came to some critical acclaim. I think back in the 70s, if I remember, with the Soviet Union and the Olympic team using that as an adaptogen, helping their athletes train for longer hours, recover quicker with less effects to the strenuous workouts. I don’t know if you recall that or if you came across that in any of your research, but that sort of piqued my interest in the use of Siberian ginseng. Actually, early in my practice, I was using it quite a bit just as a supplement for people. Just, kind of, to see how it worked clinically. Do you have any experience with the Siberian ginseng?
Eric: Yeah. You know, I think the story of eleuthero Siberian ginseng is actually kind of a fundamental piece of this whole adaptogen story. Yeah, around the time that people started using the term adaptogen – sort of, a substance that kind of has broad adaptogenic effects, right? It really started around that time when people were doing a lot of that early research on Siberian ginseng in the Soviet Union. You know, a lot of research on panacis ginseng, also in that era. So you have people giving, you know, something like panacis ginseng, giving it to mice and seeing it improves their ability to adapt to a hot environment, cold environment, improves their ability to prolong their swimming time, prolongs their running time. It improves their cognitive performance, basically their maze retention, their maze time, all of these things where they’re giving the substance to the animal and the animal is generally outperforming their peers on a variety of different parameters, right? So that concept of, like, adaptogen really started off, really got a lot of traction starting in the 70s. And the Chinese medicine take on Siberian ginseng, on eleutherococcus senticosi, is actually kind of an interesting story. So, originally, Chinese medicine only used Chinese names to name the plants. It wasn’t really until the early 20th century that they started systematically using Latin names to identify plants and figuring out which Latin botanical names correspond to the traditional Chinese drug names, right? And so, that trend really started around 1905 when a doctor named Huang was one of the first people from a Chinese scholar who went to Japan, studied pharmacognosy in the late 1800s. Pharmacognosy as a western science became popular, it was brought over from the Dutch and then the discovery of ephedrine, led by the Japanese in the late 1800s, led to a huge push towards pharmacognosy and identifying new drugs from natural compounds and new drugs from traditional medicines. And the person who brought that scientific discipline and pharmacognosy over to China, John Huang, was sort of – he started off a medical journal that first was the main place to systematically use Latin names to try to clarify which botanicals were used. And one of the ones that’s an interesting case is the one with eleutherococcus and yan hu suo. So this material, we nowadays in Chinese medicine call it, is an item that doesn’t have a very extensive history in the Bencao literature. Actually, the item that has the more extensive history in the pencil literature is wu jia pi. And wu jia pi, we now know it as acanthopanax gracilistyli and its name in the Chinese pharmacopoeia today specifically just refers to that one species. However, wu jia pi historically, likely included multiple species within the acanthopanax genus. And the traditional history of use in Chinese medicine was probably largely done under the heading of wu jia pi. It wasn’t really used as its own herb, as a distinct medicine much until the latter part of the 20th century. The Chinese paid attention to the early Russian research that was coming out about eleutherococcus senticosi and then they realized that they had a lot of natural resources of the same plants in China. It was a new municipal material that could be developed and they started looking towards it as a source for, like, new drug development and then for a new medicinal material resource exploitation. So, Chinese medicine really didn’t start using Siberian ginseng until the modern era, inspired by that same Soviet research that you were inspired by.
Greg: Interesting. Are there any – would that be considered a banned substance? I wonder, in the Olympics, like with the International Olympic Committee?
Eric: I’m not entirely sure about that but the main concern with it is that you have several other plants in the acanthopanax genus. So eleutherococcus acanthopanax – some botanists will call this plant one name or the other – but you have several plants in the acanthopanax genus that are sold as ci wu jia that are not the genuine species. And so the main issue with ci wu jia on the Chinese market is an issue of identity – proper identification and using the correctly identified material – because the name means “spinae” and what you see is that a lot of other very spiny materials are sold from the acanthopanax genus, sold as ci wu jia. The genuine material actually has very few spines and it’s got somewhat limited natural resources. So, historically, the root was used but over time it’s become the root as well as stem. And because the stem is cheaper to grow and sustainably harvest than to dig up the root, most of the material in the market now is stem material rather than root material. And then a lot of the material on the market that’s sold as ci wu jia is not actually the correct species. But these other, more spiny acanthopanax – and some of those do appear to have pharmacologic activity – but some of them may also have glycosides and other compounds of concern for safety. So with sugar, the most important thing is having correctly identified material. I’m not aware of it actually, being banned for sports performance.
Greg: Okay. So we’ve been talking quite a bit about this class of herbs, that the superior class of herbs. And we could go on and on, there are many others, right? I mean, we didn’t mention cordyceps and there’s a host of others. And maybe – you know, feel free to bring up any others that you’re particularly fond of or interested in – but in Traditional Chinese Medicine, maybe enhancing performance isn’t just giving these adaptogenic type of herbs or superior type of herbs. But we have an entire classification, right? Per the Shennong that you alluded to, that stratify different treatment methods that may enhance a person’s health, you know? To do various things before you’re giving them this type of herb that you know is specifically promoting physical performance or mental, cognitive performance. So maybe, can you talk a little bit about that? The strategy – like, maybe you’ve got a clear damp, for example, before you get into tonifying. Or invigorate the blood, like we use san qi or something like that.
Eric: Well, I think that most practitioners of Chinese medicine generally agree that the ideal therapy for improving any one person’s cognitive ability is going to vary depending on their constitution. So overall, the the best possible way to go about it would be for a person to see a Chinese medicine practitioner so that they have a clear understanding of what is their constitution, like in Chinese medicine. Because somebody who has poor cognitive ability – because they suffer from dampness and they don’t have clear thinking – is going to require a different type of therapy than somebody who has poor cognitive ability because they have blood deficiency and they don’t have enough nourishment to the head, right? People need two totally different styles of treatment. And so, ultimately, there’s no substitute for that type of pattern differentiation. That being said, there are some herbal medicines that are significantly powerful and perceptible. And the one that I’ve personally found to be the most perceptible, in terms of something that I would say cognitive function, would be panax ginseng ren shen. And I find that ginseng, when I take it consistently, it makes me think a little bit clearer, it makes my mood a little bit better, it makes my stamina just a little bit stronger – on all these very small ways, you know? It doesn’t, I don’t feel really particularly more energy or like any sort of short-term boost – like, as if I had drank a cup of coffee. But I noticed that over weeks or over time, I start to just be a little bit, you know, the same Eric but just a little bit better. All the different tasks to be just a little bit better. And so, I think that to me, that’s probably one of the things that strikes me as something that where there really is some true perceptible cognitive benefit. But that aside, I would say that I would caution us to sort of remember that our understanding of this stuff and the pharmacology is really constantly evolving. Because for much of the time in the past, people looked at ginsenosides as the key active ingredients of ginseng and ginsenosides are saponins that have significant pharmacologic activity. And the different prominence of these different ginsenosides is one of the key differentiating features between closely related herbs like American ginseng (xi yang shen), panax ginseng (ren shen), notoginseng (san qi) – they all have ginsenosides but they have them in different proportions and different ratios. It’s also similar differences between ren shen, and hong ren shen, and bai ren shen. And the white and the red processed forms, they differ in their ginsenosides that occur and then that occurs due to the steam, due to changes from the steaming tech when the root is steamed. But, so, most of the past research is always focused on ginsenosides. Now, they’re starting to realize that there’s also a lot of polysaccharides in ginseng that may be of interest that weren’t being previously investigated. So the polysaccharides tend to be these long chain molecules that are difficult to, in terms of the chemical analysis, it’s difficult to or it’s expensive and time-consuming to isolate and quantify and characterize these polysaccharides. And because many of the polysaccharides don’t enter the bloodstream, a lot of times in the past, a lot of people had dismissed them in terms of being, like, key markers for the pharmacologic activity of a root like ginseng. But now, they’re discovering that the ginseng root seems to have effects on the gut microflora. And so, it may be that some of these things that previously weren’t investigated and many other tonic herbs, like dendrobia, are also very rich in polysaccharides, same with the huang qi. So some of these items – we may have have been overlooking some potentially therapeutic active compounds, just by overlooking, not having a clear understanding of the gut microbiota and not having complex integrated enough pharmacological discovery tools to see all the network relationships in these complex systems.
Greg: It’s interesting, that you mentioned the gut biome. And that makes sense when you think about ginseng, you think about the entering of meridians – the lung, and spleen, and stomach, right? What else, kidney? I’m forgetting but it makes sense that that would stimulate better thinking, improved health, improved stamina. If you related to the gut biome, I’m sure there are more systems that it influences, as well. I’m surprised – or maybe there is some pharmacological, some pharmaceutical – have there been pharmaceutical advents from ginseng?
Eric: Well, there have been. There’s been a tremendous amount of, there’s been thousands of scientific papers published on ginseng. So there’s, in terms of an item, there’s going to be more research on cognitive effects and performance and enhancing effects on ginseng than almost any other herbal medicine. But it’s also interesting to, when you look at the Chinese scientific literature in the west, a lot of people think of something like ginseng as being okay. This thing gives you energy and they try to research it like it’s a magic bullet, the thing that will improve cognitive performance or athletic performance is something that will give you energy. But actually, if you look at a lot of the things that have been researched in China for clinical trials, for cognitive performance or exam performance, a lot of them are actually calming items. You know, things that are based on like calming spirit. And that actually makes sense because you have a lot of – when a person needs peak mental performance for an exam, oftentimes they have already studied and what they need is to have a calm and focused mental state. Though if they have too much coffee, they could actually perform poorly on the test because they’re a little bit too wide. If they don’t have enough coffee, maybe they’ll show it.
Greg: Yeah. You bring up coffee – we haven’t even talked about coffee in this. What do you think about coffee, anyway? I mean, it’s an herb.
Eric: Well, you know, I think – and coffee is definitely a botanical substance of a long cultural history of use and clear pharmacology – I’m a big fan of a really delicious cappuccino myself.
Greg: Yeah, different effect from ren shen.
Eric: I find very little in the way of, like, a short-term increase of energy invention. What I find when I take ren shen, is that I feel a little bit more – my energy is a little bit more sustained.
Greg: Yeah, actually, the peak and valley.
Eric: I don’t necessarily like when I drink a cup of coffee – I notice the change in energy right away, sure. When I take ginseng, it’s more that if I take it consistently over a couple weeks, I start thinking I feel different now than I did a few weeks ago.
Greg: Yeah, I think it’s really important to reiterate what you were saying about, you know, the person’s nature. Because I think a lot of our listeners, and just people I know in general, they’re equating herbs for performance to stimulants like caffeine that you would get from coffee or tea. So what you said earlier is really important and I think that, you know, that people need to really understand that and to have guidance around it. I mean, I know you and I both see patients that come in with sacks and lists of things that they’re taking to kind of try and find the right therapeutic hum from all these different vitamins or minerals and supplements. And I think that’s more of a, kind of, western herbalist approach to things, too, which we haven’t really talked about the differences in the kind of eastern approach to the western approach. So maybe talk a little bit about that. That’s kind of a beautiful thing, how Chinese medicine works compared to like western prescribing of herbs.
Eric: Well, Chinese medicine is pretty much always dependent on the poly pharmacies. So, Chinese medicine almost always uses multiple substances together in a formula, often customized for each individual patient. With western herbal medicine, you would say western herbal medicine today has largely grown out of modern science and pharmacognosy. And so, if we think about historically how Chinese medicine evolved – the style of diagnosis, and the use of herbal medicines based on classical formulas and taste, traditional Chinese medicine actions and traditional relationships with other herbal medicines – that fundamental paradigm is largely unchanged over the last several thousand years. It’s sort of been consistent, continually refined, continually expanded, and it’s continually evolved. But a lot of the same fundamental principles that guide Chinese medicine today were established almost 2000 years ago. And the situation with western herbal medicine is a little bit different because western herbal medicine, historically, also had things like tastes and properties. They would describe, you know, an herb as being warm to the third degree or they would describe the nature. They would just use the taste of herbs to be correlated with properties. So there was actually a history in western noble medicine of viewing herbs based on temperature, flavor. But over time, like western herbal medicine, the challenge with western herbal medicine was that it lost its continuity. And initially, you had an early period of time when the ideas and some of the fundamental works were created. But then, when we mentioned before, you had the Dark Ages when herbal medicine largely fell out of further development until the Renaissance period. And then in the 1800s, as pharmacognosy developed as a science here, you’re starting to have the integration of botany where you have botany emerging as a science. You have the discipline of chemistry emerging, you know, the integration of these different sciences together with medicine. And one of the first big innovations there around, in the very early 1800s, was the isolation of of morphine from the opium poppy. And so, the opium poppy had a long history of use, worldwide – in Europe, across the Middle East, all the way over to China, India – you had a long history of use of poppy as a painkiller. But it wasn’t until they were able to isolate morphine from it and make, basically, the first pure alkaloid to be isolated from a natural material that sort of started off. You had this time, as they were distilling alcohol and trying to, sort of, you had this quest to find the spiritual essence, right? And that’s why we call alcohol “spirits,” right? That was part of this quest to find, to separate the refined from the crude and the base in nature. And so, the idea you could find a single molecule that would have the effect of the whole, it was a huge advancement in early chemistry. And in the early 1800s, they isolated many of the famous early alkaloids. So you had things like atropine from datura, you had things like nicotine from tobacco, you had all of these famous single compounds started to become isolated and medicine gradually moved from being like – you had something like aconite, where aconite had a long history of use in western herbal medicine. But aconite, for much of its early history, was only regarded as poison. It was only once they started using it in really extremely controlled dosages, that they started using it as a medicine. But rather than in China, aconite had been used as a medicine since early period of time. But in China, they basically applied the same type of principles of cooking to the preparation of medicinal substances and they discovered that using heat would greatly reduce the toxicity of aconite. And so, by preparation methods, or what they call “pao zhi” in Chinese medicine, they were able to control the toxicity of aconite enough that it was able to be used internally and develop it as an internal medicine from an early time period in Chinese medicine. Aconite didn’t start to become used internally in western medicine until like early 1700s and it was used in extremely small doses. And so, when you had this natural variable potency of the natural material which really – if you look at something like datura or you look at something like aconite, they’re very classic representative examples of a highly potent substance in nature – its natural plant source is very variable, very toxic, very dangerous with a very narrow therapeutic range. And so, being able to isolate something that can be measured and administered in a very pure form that has that medicinal effect without that variability and that other noise within the plant, it was regarded as very desirable. But I’d say that maybe western medicine has gone just one step too far. Like, if we looked at the previous edition of the US pharmacopoeia 100 years ago, the US pharmacopoeia was full of plant-based medicines, right? But as synthetic medicines evolved, there became less emphasis on plant-based medicines. And now, I think science is sort of coming full circle, starting to have more sophisticated methodology, and tools, and techniques, and equipment to measure these complex multi-component medicines and complex biological systems. I think that we’re gradually going to start moving back to having much more of a focus on whole plants, natural products, and new drug development in western medicine is going to start to come back – more towards its herbal roots, I’d say.
Greg: Well, would that be incredible, yeah. I think as you’re talking, I’m thinking about the standardization of medicinals that are coming out of Japan these days and how they’ve really, you know, taken that standardization to the next level. What they, I guess they look for, they don’t look for every component of the plant though they’re looking for just particular components and standardizing based on that – is that your understanding of what they’re doing over there?
Eric: Well, I would say worldwide – both in China as well as Japan – one of the things that they’re really starting to focus on is what they would consider to be, like, the complex fingerprint. So in the past, you have hundreds of different compounds within, even sometimes, a single given herb and then when you have multiple herbs cooked together in a formula, the chemistry becomes extremely complex. They have a very difficult challenge for, like, quality control, for example. For Kampo medicine, where you have multi-herb prescriptions that are being – you can have a, sort of, a minimum. You can look at multiple different marker compounds and say, “Okay, we want to control for a minimum amount of these marker compounds to verify that the correct herbs were used and that they were used in a sufficient quantity.” The overall therapeutic efficacy of that formula, the degree to which it’s actually correlated to those marker compounds, is often understudied, right? And unknown because when we look at which things, if you’re trying to do quality control testing, one of the first things you need to do is verify that this is the correct medicinal used. And so, you’re looking at which compounds in a plant are unique, are distinct, are abundant. But some of the things like, for example, Chinese pharmacopoeia, control for a choice. It tests for a compound that’s not unique to ren shen but it’s abundant in Toronto, has a far more unique and highly potent therapeutic marker compound, but it’s not economical to test for it as it occurs in such a small quantity that you don’t have enough of it available as like a pure analytical reference standard. To compare it to the part of the limitation of what companies can test for is dependent on what library of reference materials they have available. And so, if you wanted to try to understand – like, let’s say you grew a Chinese herb, some chai hu in your backyard, and you wanted to understand like its entire chemical profile – you may find it commercially available, there’s only a few individual cyclosapenins that are commercially available as reference materials that you could use with HPLC and quantify the levels of those particular compounds. So you have in any given chromatograph, the fingerprint of a plant, you’re going to have a huge number of different peaks and compounds. You only know the identity of a certain number of those peaks and so now you’re starting to have more profound testing ability, you’re starting to have much more stronger ability to do comprehensive quality control. So using some of these things, they’re able to build a complex fingerprint of a given herb. And so, they’ll take many different batches of huang lian and feed the computer data of huang lian samples grown from different parts of China, in different regions. And over time, the computer can start to recognize patterns that can even help to clarify which production region this huang lian came from. So not only is it coptis Chinensis, this is a particular species, but even what part of China was it grown. That’s starting to be, like, the new frontier of complex fingerprinting.
Greg: Yeah, that’s amazing. And then they can pair that with therapeutic effects, I guess. Presumably with different hospitals or clinics in the in the region and determine, you know, which products are best suited for which things, I would imagine.
Eric: Right. Anyway, it’s also going to be very useful for, in the future, for formula standards. Because with formulas, you’re trying to figure out – you have so many different, you have such a complex matrix of chemicals you want to figure out – when you’re doing the identity testing or quality control testing for a single herb extract, it’s a little bit more straightforward to have a validated methodology. But when you’re dealing with really complex formulas, then having that really complex fingerprinting becomes a really profound tool.
Greg: That’s expensive, the tools you mentioned, the HPLC and TLC, those are expensive processes to do that with every single herb. I mean, isn’t that pretty pricey?
Eric: Well, you’re definitely going to be spending a few hundred dollars per test. If you had to do it, you know, at an outside lab or just if you had to fund your own lab but it’s pretty routine within Chinese medicine quality control testing to do HPLC and thin layer chromatography. So a lot of, in the 2015 Chinese pharmacopoeia you have well over 100 items that have HPLC constituent minimum requirements and then you have many items that have thin layer chromatography requirements. So basically, you find that like for a large granule company, every single product is getting thin layer chromatography and HPLC is routine part of their testing. But the part that’s the more routine and actually comparatively cheap part of that – it’s the more advanced and the more expensive – is this next generation complex multi-fingerprint testing which is, so far, mostly used for research rather than routine quality control.
Greg: I guess I had that as a question for you – under identification – like, how do we know what we’re getting anymore? But I think this is answering the question. I mean, you have obviously the age-old “go to the field, look at it, pull it out of the ground” and if it looks like what you think it looks like, or you can match that with pictures or things like that, but that’s one way. But then, really looking at the different scientific, like the HPLC and TLC multi-layer, that’s really how we know, right?
Eric: Yeah. And I think – I believe you might have had some experience visiting herbal factories – you’ve got a little bit of an exposure to how much more advanced the situation is over in Asia, when it comes to the plant extracts, than it is in the States. So, yeah, you basically have like a multi-step when it comes to basic identity testing. If we think about herbal authentication, you basically have a flow chart where it really begins in the Bencao literature, in the historical text, which plant was the authentic material. And then you have the botanical identification where, you know, in terms of taxonomy, from a person seeing the live flowering plant right with speciesism. And then, you could have the same species of plant that produces, you know, like having the right species alone is not sufficient, right? You also need to have the correct plant part, right? You want to have the correct quality. And so, like thinly or chromatography testing is extensive. So you have macroscopic, using the naked senses looking at it – looking at the fractured surface, smelling it, tasting it – this is like the traditional method of identifying and Chinese medicine involved a very sophisticated approach to naked sense organoleptic discrimination. So with enough experience and the good intact specimens of herbs, a well-trained person can identify a tremendous amount about the quality, origin, and botanical identity of Chinese medicine. But to be more definitive, or especially for like a herbal company where you need to meet GMP requirements, you’re going to have to demonstrate that every identification test in the Chinese pharmacopoeia was completed. And so, the macroscopic and botanical identification is only one part of that. The next step is the microscopy, and then thin layer chromatography, and HPLC. So you’re usually going to be using that basic range of tests on most of the incoming herbal medicines that need to be identified. Then, you’re also going to be doing other quality control testing for things like heavy metals, constituents, pesticides, all that other stuff.
Greg: Molds, bugs. Well, bugs are gonna die in the cooking process. People are so freaked out about bugs, it’s like, it’s a little bit of protein. I mean, you know, considering that the average person who consumes herbs, or patients or even practitioners. You know, we’re not really trained to go out in the field. I wasn’t trained to go out in the field and recognize chuan xiong or anything else for that. Man, I can recognize dang shen because it grows around here, kind of. But, you know, most of the times, people just buy it like I buy my herbs from you. They come in a bottle, they’re granules. So what should people be looking for when they’re looking for a reputable company? Like, what does Legendary provide for people? And what, you know, what should I be looking for when I’m purchasing herbs?
Eric: Well, I think when it comes to purchasing herbs, I think the first thing to be aware of is that we’re lucky to have a really good supply chain in the state. So we have a very good range of companies to choose from. We have several people that are doing herbs with very good quality control, very good identification and testing. And so, we have like a relatively small number of suppliers that are, I would say, really top-tier suppliers. But of the ones that really are top tier suppliers, we have some really great choices. So I think that there’s – with granules, one of the things to be aware of is that granules there’s only a relatively finite number of top-tier factories in the world that make these types of products, right? And of the main companies that are in the US, most of them are distributing products from this same relatively short list of top-tier factories in Taiwan and mainland China. And so, you tend to have relatively – among these good factories – the basics of identity testing, safety, quality control, all of that stuff is actually extremely well controlled. When you’re getting into more of the, you know, going into some of the really traditional Chinatown-style shops, then you start to have to be aware of more issues of regional customary substitutes and easily confused Chinese medicines. So if you were to go to the average Chinatown pharmacy – pretty much anywhere in the US – of the 400 herbs or so that you commonly use, there’s about two dozen or so that you want to be aware of certain issues of identification or quality discernment. So there are a few things to be aware of, I got a couple of articles on the issue of herbal identification.
Greg: Yeah, that’ll be great. We’re definitely going to link to your website, too, for more in-depth information about a lot of the topics that we’ve been discussing today. I do want to point out that I think it’s really important to mention what you just said about, like, going into Chinese herb stores and, you know, oftentimes they have little boxes of the patent medicines that sometimes can be mixed with pharmaceutical substances. Is that still true?
Eric: I think that, well, it’s definitely true that that’s historically been a significant problem. It’s the degree to which it’s prevalent, I would say it definitely exists. For me, personally, I would tend not to use a lot of those small inexpensive patent medicines. I would tend to go more for the core main suppliers just because you’re, in addition to the question of like quality and safety, you also need to have a good bang for your buck. You know, make sure that the medicine, that the money that you’re putting towards the medicine, is going to give you a good significant therapeutic effect. And so, I think that raw and granules are the best delivery forms, in terms of giving you the value for potency.
Greg: Yeah. So we talked a little bit about the sources and where they’re grown and the sustainability of herbal medicine. I mean, when I was in China, I was awestruck by the amount of herbs that were going out. Meaning, you know, I looked at the warehouse in Tianjin and it was – you’ve seen it, it’s 400 yards long and four stories high, and that’s like three months supply of granules – and that was moving out too. You know, how sustainable is that? How sustainable is it? And with, you know, the demand just in China alone, of the Chinese herbs and now there’s a big movement with the Chinese government – we both know they’ve got these 10-year plans of moving medicine westward, if you will. These cultural plans to really, you know, disseminate Chinese medicine and get it out there into the world, beyond the borders of Asia and South East Asia. How sustainable is that, you know? With the wild craft, it is only so much. And then, you know, the farms. Do you know? I mean, is this something that we should be concerned about, as an industry?
Eric: So that, yeah, I think the issue of natural resources is one of the fundamentally, in ecology, is a fundamental issue for Chinese medicine. Of the herbs that we commonly use in Chinese medicine, about 150 to 200 of them are primarily cultivated in origin. And so, you have most of the items – where there’s really a large amount of clinical use in most cases – those are primarily coming from cultivated sources. And so, just simply to meet the market requirement and in some situations, actually, more consumption creates more production. And so, you have some items where, you know, ecologically it’s a very good situation. Like, for example, I’ve been to like gou teng farms in Guangxi province where they’re just growing the gou teng all over the mountainside, just growing it in a half wild environment, it naturally occurs in the wild environment there but it’s not really economical. In the past, throughout most of the history of Chinese medicine, there was enough gou teng that people could just collect it from the wild because they’re just collecting the aerial part of it, then the plant would stay alive and continue to grow back. But as you know, as time goes on, the amount the gou teng is not worth enough. For somebody to go into the forest, to go into the field to collect it, it’s much more efficient for them to cultivate it. But because it’s cultivated, because it grows naturally well in that environment, they can grow it in the wild environment and just cover entire mountainsides with it. And there is a very sustainable approach to cultivation that doesn’t really have any particular negative impact. In other cases, you have some herbs where you have very high intensity of cultivation requirement so something like san qi notoginseng, basically extinct from the wild, there’s not a known live plant of notoginseng in the wild. As far as we know, the plant is already virtually extinct outside of cultivation.
Greg: So, where are they growing that?
Eric: They primarily grow it in Yunnan, in Wenshan county. This is the traditional name of san qi – one of its names is tianxi because it came from a region called Tianjin in Guangxi, near the border of Yunnan. And so, basically, along that border between Yunnan and Guangxi province has been the traditional region where it’s grown. But most of the san qi has grown in a county called Wenshan county and Yunnan. And the challenge of san qi is that it requires a relatively long time for the field to recover after a crop has been grown. So after growing san qi, they can’t grow san qi in the same location for about 35 years. And so, they have to constantly rotate the land that’s being cultivated and so they’re starting to gradually run out of prime, of premium land to cultivate it. But as they grow it in other parts of Yunnan, closer to Kunming, they find that it’s difficult to achieve the same quality that they get in Wenshan. And so, for an herb like san qi, we’re heavily dependent on its cultivation but its cultivation environment may be, in the future, running into some finite limits unless people can learn how to grow it and adapt it well to other places. But this has already been successfully achieved with other herbs that were once thought impossible. So something like tian ma was critically endangered in the 70s and the entire Chinese medicine market was full of counterfeits of all different things like dried potatoes and everything. But nowadays, no account acquiring genuine handmade is not a problem at all because it was extensively grown. They just needed to learn how to pair it with a symbiotic, it needs a symbiotic fungus in order to absorb nutrients. So once they learned how to pair it with this fungal partner, then they were able to successfully grow it. The same is true with something like dendrobium orchids – traditionally, they were very difficult to cultivate but now that they’ve got a cell culture and they were able to grow them in a lab from cell culture, then they’re able to grow juvenile plants in a lab and then move them to a natural, you know, like a wood type of media and then sell them to farmers to grow them out and then buy them back. So they’re able to make these very well vertically integrated supply chains for some of these medicines that, in some ways, is actually, you could say, having a positive ecological benefit – causing, you know, more economic benefits in some of these rural areas and actually causing more of the plant to be cultivated.
Greg: So, you know, I often get questions and I’m sure you get this question all the time, too – about the use of pesticides in China and the the quest for organic. What do you say to your customers or to people that are concerned about the use of insecticides or pesticides, these types of things in China? And is that as big of an issue as the concern that we hear?
Eric: Well, it’s definitely an issue. I think you have certain – sometimes it can be a little bit, maybe, exaggerated in the public imagination as to the compared to the real situation. But it’s definitely a major concern for certain Chinese medicines. So for some items like ginseng, notoginseng, chrysanthemum, goji berry – for certain items, you do have problems with excessive pesticide use. Most of the items where you have problems with pesticides, you also have solutions. So you have good agricultural practice farms for notoginseng, you have good farms for ren shen, and you have organic farms for ren shen. You have organic farms for wu wei zi, you have a GFP. You have, you know, low pesticide material. You have a lot of a wide range of products that are available on the market. And so, I think that the biggest problem tends to be from – let’s say you have a lot of the best material on the market is being consumed by large well-managed companies. So most of the large well-managed companies – they have the equipment to do pesticide testing, they have the capability to buy direct from farms, capability to test the soil. Some of the companies even have, sort of, a vertical management from the seed and seedling and soil conditions, controlling the sops for the entire cultivation of the plant from start to finish. And so, that type of ideal model is the way that the field is gradually evolving. The problem is that you have all these small family farms that, as you know, we have a huge demand for more clear supply chains, more standardized links, more thorough order to basically have the most control over pesticides. You really need to have control from the farm level, right? And you need to have the company that’s buying the material accepting some of the risk from the farmer and investing in the production of the earth and so many of the small family farms. Like, you take an herb like bai shao – it’s grown really extensively in the area around Bozhou, China – we have hundreds and hundreds of small family farms each growing one very small plot of it and then it gets harvested, collected, mixed together, and graded based on its morphological features into different quality grains. But because it’s coming from multiple farms and it’s being mixed together, it’s much easier for that material – like, if you had one farmer that was growing without pesticides, another that was growing with them, that material can be mixed together. So for the companies that are trying to really avoid pesticides, it’s best for them to control it from the farm level. Challenges that’s gradually going to cause all of those small family farmers, many of whom have done things organically for generations, gradually it’s going to become progressively more difficult for them to compete in a world that favors large producers, standardized links, and strictly controlled supply chains. So there’s, kind of, a good and a bad side – both to the the way the herbal medicine world is evolving. My teacher did a relatively extensive project with Harvard in the past and they collected samples of commonly used Chinese medicines using GPS tracking, collecting both wild and cultivated materials and did a really extensive paper looking at pesticide residues and heavy metals. And they found that about two-thirds of the Chinese medicines that they tested overall had no detectable pesticides and then – I’d have to look at the exact statistics – but I think it was something like of the 35 percent that had some detectable ones, you had a very small percentage that was above the limit, right? And then some that you have detection but below, but within what would be considered like a safe limit in the EU. And so, I would say it’s generally not difficult to find. There is adequate supply of Chinese herbs that meet the requirements for like the EU, for pesticides and stuff. But you do have to seek out quality sources.
Greg: Yeah and I think you mentioned that. You know, most of the main suppliers – for example, where you and I both get our herbs – they have a level of certification from the Chinese government, that’s the top layer of certification for an industry is the military. The second tier, I think, down is for hospitals and medicinal companies like herbal suppliers and things like that. So the company – for example, the place where we get our herbs at the highest level of certification – so I feel confident that what we get is really high quality and are really on that. And I know that our FDA goes over there and visits and actually, you know, walks through the same plant that you and I walk through to look at our quality control. But I just wanted to ask you that from your experience because I get that question quite often.
Eric: And often times what you’ll find is, that you’ll have pesticide testing that’s done at the raw material acquisition stage because it’s much cheaper for them to test the herbs that they’re considering buying before they’ve already bought. You have the key element of pesticide testing happens, that original raw material screening stage, and you also have pesticide testing that’s done by the factories on finished products. But you also have pesticide testing done by like, for example, European distributors so often. Because in Europe, a lot of the items that are included in the European pharmacopoeia, they’re required to be retested within Europe to demonstrate identity and then pesticide residues. And so, oftentimes, we feel lucky that we’re able to buy a lot of the same batches that are then being independently tested in Europe for a broad spectrum of pesticides. You not only have the factory testing but you also have a tier of independent testing going on too.
Greg: Oh, do we do that in the States?
Eric: Basically, yeah, there’s labs that have independent testing in the States.
Greg: We don’t do that before import though, right? You’re saying they do that in Europe before?
Eric: Europe is a requirement, yeah. The US law around pesticides is actually a little bit challenging because the US law sets pesticide requirements – they’re all crop specific – and so, for example, like the amount of pesticide that’s present in the cherries, a given pesticide could be different than the amount that’s permissible. And say, apples, you can have one pesticide that’s allowed to be used in cherries, it’s allowed to be used in apples but because there’s no official standard for weights, you can’t have any detectable pesticides.
Greg: Crazy. So, let’s shift gears a little bit. We’ve been talking a lot about the historical context and the quality. What about modern research? You alluded to the research that’s been done on ginseng. And what is modern research telling us about herbs in general and specifically related to peak performance – and we kind of got off track with that – but what are you aware of in the modern research about any particular herbs or in general about peak performance and the use of herbal medicine?
Eric: Well you know my area of expertise, mostly towards the traditional materia medica and quality discernment. So, exactly in the area of peak performance has never been my core specialty.
Greg: How cautious should people be when they’re taking herbs? When they’re taking medicine? You know, we in clinical practice, we are concerned about herb-drug interactions. So, are there good resources for people? What should people do before they take herbs, I guess is my question for you?
Eric: Well, I think the issue with herb-drug interactions is one of those things where it really requires, like, a critical assessment of the evidence because right now, what’s happening is you have a lot of interest in the topic of herb-drug interactions but you have only a relatively small number of cases where there’s a really well-documented interaction in the literature. And so, you have a lot of things where people have these hypothetical interactions or hypothetical scenarios or they haven’t filtered the evidence based on how strong the evidence is for the suspected interaction. So a lot of people are afraid that the doctor will give a patient a laundry list of different dangers of using herbal medicine but oftentimes there’s very little selection of, like, really what is the true risk of these adverse events coming up, coming about. A typical example that I remember when I was in Taiwan, we had some researchers from the NIH come over looking to build a drug interaction database with Chinese medicines. And we started to mine the available Chinese data and you have in China many reports that were previously done on paper records within individual hospitals that are now all starting to be digitized and shared. So as China’s gradually moving more towards electronic medical record keeping, this type of big data that you’re going to start seeing from electronic medical record keeping may clarify a lot of things that we weren’t previously aware of. In some cases, that may well also say a lot about the safety of Chinese medicine as well as the dangers, right? You know a typical example of that, like, if you look at the electronic medical records of Taiwan, you have about 30 million patient visits per year using Chinese medicine. And so, you have a tremendous amount all being done within an integrated electronic medical record system. So you can store the data and figure out, “Okay, how many patients with allergic rhinitis were taking this formula, where we’re taking a single modification – a, b, and c?” And now, you can look at the total prescribing data by licensed practitioners and you could say something like “ephedra” which was banned in the US for foods and dietary supplements, right? Due to concerns over its safety. But if you look at how ephedra is actually prescribed in Chinese medicine, they’re not utilizing it for weight loss, they’re not utilizing it for athletic performance. They’re often, you know, using it based on its traditional indications. You have about 4000 doctors prescribing in the Taiwan medical system, and you have correlation of adverse events reported. So you can tell that, like, three of the top ten formulas by volume in Taiwan contain ephedra but the number of adverse events reported in Taiwan – through nurses, through hospitals, through media reports, through Chinese medicine doctors, through western medicine doctors – the number of total adverse event reports that make it into the – they have a centralized database where they investigate each report that’s been filed or appears in the media. And you can correlate the number of actual adverse incidents to the amount of doses prescribed and actually the data suggests that it’s quite safe when used correctly by well-trained practitioners. So I think that that’s going to be the big future for clarifying some of these issues. That safety or drug interaction is going to be as Chinese medicine moves into it much more of this big data and we’ll be able to start to really systematically move from beyond, like, isolated individual case reports where there’s a lot of variables and a lot of hypotheticals about herb-drug interactions to be having much more solid data.
Greg: That would be great. It would be awesome to get ma huang and xi xin back in the clinic, wouldn’t it? Well, Eric, I know we’ve gone for quite some time talking and you’re just an encyclopedic knowledge base of something that’s very fascinating and I know I want to learn more and continue to learn more and many of our listeners will want to learn more. So your website is legendaryherbs.com, right?
Eric: Yes, it is.
Greg: www.legendaryherbs.com, and you have articles?
Eric: A lot of articles and blogs.
Greg: Blogs, it was a wonderful resource. And I just want to thank you so much, you know, for spending some time with us today and enlightening us. And I really look forward to seeing you back here in San Diego at some point soon.
Eric: Well, thank you Greg, I look forward to doing more with you guys tomorrow, with Pika.
Greg: Yeah, thank you so much, it’s been a pleasure.
Eric: Thank you so much.