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 Lesson 1: Herbal Formulatoin
(A sneak peek into our brand new Clinical Skills Herbal Course, exclusively
offered complimentary with Advanced Herbal Course pre-registration.)

What is Herbal Formulation?

Herbal formulas are made by blending together multiple herbs into one comprehensive
blend. This could be for tea, a tincture, pastilles, or many other types of preparations.
After you learn how to formulate your own blends, you will graduate from following
other peoples’ herbal recipes to making your own custom blends for the person or
condition at hand.

Formulating is a necessary skill for anyone who wants to become a clinical herbalist, but
it’s also an empowering tool for the home herbalist and it represents the pinnacle of your
herbal education.

Think of it like spelling. If you have a foundational herbal knowledge, then you’ve learned
the alphabet, you’ve learned how to spell individual words, and now it’s time to write a
story. With a beginning, a middle, and an end, a well-made formula will nourish the body
and gladden the heart - just like a beautifully written story. So grab your pen and
paper, herbies, and let’s start “writing”!

Depending on the goal, formulas may provide the body with needed nutrition, promote
circulation, support the immune system, or restore balance in a myriad of ways.

Herbalists approach formulation from many angles. Some herbalists may take an action
approach. Some herbal formulas are designed to have physiological actions, such as an
antimicrobial effect, and are recommended as a botanical therapeutic.

Other herbalists take an energetic approach. They choose herbs based on their energetic
qualities and the tissue states present, and create formulas to reduce heat in a system or
moisten tissues in a dry constitution.

Traditional systems, such as TCM and Ayurveda, tend to have many formulas that are
already established for use in particular situations. The truth of the matter is that most
herbalists use a combination of the first two approaches when formulating. If it’s an
acute concern, it may be prudent to lead toward the action approach, while those
formulating for chronic conditions may take a more energetic approach.

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Necessary Skills for Formulation
The following skills will be helpful for any herbalists
who are ready to start formulating their own blends.
Think of these items as the herbal alphabet—
everything you need to know before you can start
writing your formulation story.

A strong understanding of materia medica. It’s not

necessary that an herbalist, however, knows all of
the herbs. Just know some herbs very well.
Understand the actions, energetics, and potency of
these herbs.

Thorough intake skills and a firm grasp on the root

cause of the chief concern.

Knowledge of nutrition and lifestyle factors that

impact wellness. The most artfully created formula
may fail if diet and lifestyle changes are not
addressed. Not every herbal formula needs to be
included in a tea or tincture form, though. Herbal
interventions can be incorporated into dietary
recommendations and supplemental measures, like
an herbal bath.

Flexibility is important. Formulating is sometimes a

trial-and-error situation. Even if the dosage is
effective and herbs are sourced from the same
place from year to year, the chemical composition
of the plants may vary. Continue adjusting for
consistency and efficacy.

Organization. Keep good records of formulas and

other suggestions you make.

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One Formulation Method

We cover many formulation methods in our courses, as there are many approaches, but
the following one using three herbs was developed based on the rationale that if a
practitioner is giving 2.5 to 5 milliliters of formula three times per day, a formula
containing more than three herbs won’t reach the dosage recommendations in the British
Herbal Pharmacopeia of 1983, which is considered the standard by many herbalists, even
today.

The first herb in this formulation method is condition specific. Choose an herb that is
known for addressing a particular imbalance or perhaps for balancing the presenting
tissue state.

The second herb is system specific. Pick an herb that is soothing, nourishing, or
otherwise supportive of the effective body system.

The third herb is a corrigent. Corrigent is a substance added to a medicine to mollify or

modify its actions. While you use less of a corrigent, it’s still a really important ingredient.
Corrigents may be herbal stimulants that improve the circulation, and consequently the
uptake, of the formula. They can also be a means of energetically balancing a formula.
Corrigents can also be herbs that improve flavor.

The percentage of herbs varies depending on the client’s needs. An acute formula goes a
bit heavier on the condition-specific herb. When addressing chronic imbalances, formulas
may focus more on system-specific herbs.

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 Lesson 2: Herbal Synergy
(A sneak peek into our brand new Clinical Skills Herbal Course, exclusively
offered complimentary with Advanced Herbal Course pre-registration.)

What is Herbal Synergy?

In herbalism, synergy refers to the ways that the phytochemicals within plants and
within herbal formulations interact with one another to enhance certain herbal
properties or actions or to buffer or stabilize each other.

As a general example, an herb may have multiple constituents that are anodyne (help
soothe pain) in nature. If only one constituent was extracted from the plant and taken as
an isolated compound, it would help to ease pain, but it may not be as effective as when
a whole-herb preparation is used that contains the other anodyne constituents in that
plant.

Along the same line, a single constituent isolated from that plant may not only be
anodyne, but also sedative. However, when the plant is taken as a whole-herb
preparation, other constituents in the plant help to buffer the sedative effect by having a
more stimulating property, and that preparation would not cause sedation.

But synergy doesn’t just apply to the slew of constituents in a single plant. Synergy is
also one of the things that makes combining plants together in formulations so
powerful!

Constituents from various plants can also work together and augment each other’s
actions or help to buffer negative effects. In fact, synergy is one of the reasons that
formulas are so often favored over simples (herbal preparations that use only one plant).
The same example provided above works here as well: two anodyne plants combined
together may have a more powerful effect on pain than if either of them are used alone.

The effect of the whole is greater than the

sum of the individual parts.
In other words, the overall effect of using a particular formula is greater than one would
expect from combining the effects of the individual herbs.

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Here’s a more specific example. Let’s say that
someone is experiencing situational anxiety about a
new job. They decide to try a skullcap (Scutellaria
lateriflora) aerial parts tincture and it doesn’t seem to
have an acute effect on their anxiety. Next, they try
lemon balm (Melissa officinalis) aerial parts tincture. It
perhaps helps ease the anxiety slightly, but doesn’t
have a strong impact.

However, if they then take a tincture formula that

combines skullcap and lemon balm, that formula may
be more effective at helping them manage their anxiety
than taking either herb separately.

Herbal Synergy: Examples in Action

St John’s wort: The antidepressant activity of St.
John’s wort (Hypericum perforatum) is typically
attributed to the constituents hypericin and
hyperforin. However, the flavonoid content of the
herb has been shown to increase the effects of
these constituents, which may explain why using
the whole plant is more effective than using
isolated extracts of hyperforin or hypericin(1).

Sweet Annie (Artemisia annua), turmeric

(Curcuma longa), and black pepper (Piper
nigrum) appear to have synergistic effects against
malaria when taken together(2).

Valerian (Valeriana officinalis) and kava kava

(Piper methysticum) indicate synergistic effects
when used to address stress-induced insomnia(3).

These are just a few of the countless examples in the

literature revealing the synergistic effects of herbal
formulas.

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Bringing Synergy Into Practice

What does this mean for you as you’re formulating an herbal recipe?

For one, it means that you can typically use less of an herb that you’re adding to a formula
than the amount you would use if you were giving the same herb as a simple. For example,
if you suggested that someone take passionflower (Passiflora incarnata) aerial parts
before bed as a simple, you might suggest a dose of ½ tsp (2.5 mL) or more. But if you are
combining passionflower with another herb, such as skullcap, you might only use 1 or 2
mLs of passionflower per dose within the formula.

When considering synergy as a clinical herbalist, you can think of some herbs as
“synergists”—herbs that you can use in small amounts in a formula to enhance the overall
effect of or help balance a formula. Here are a few examples:

If you’ve come up with a stellar formula for digestive health but realize that all of the
herbs in the formula are drying in nature, you might add a moistening herb as a
synergist to help balance the formula.

Or, you may include a circulatory stimulant herb, such as cinnamon (Cinnamomum
spp.) bark, to a formula to improve the delivery of constituents throughout the body.

Similarly, you might add a digestive stimulant, such as angelica (Angelica

archangelica) root, to improve digestion and assimilation of phytochemicals in a
formula.

These are just a few examples of how you can consider an herb’s synergistic effects when
making thoughtful, well-balanced herbal formulas.

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 Lesson 3: Herb-Drug Interactions

What is an Herb-Drug Interaction?

An herb-drug interaction is a situation in which a particular herb may interfere with

a medication, herb, or supplement. Understanding herb-drug interactions is an
important part of being an herbalist.

First, it’s important to understand there are different types of herb-drug interactions:

A pharmacokinetic interaction occurs when substance A (an herb) alters the

absorption, distribution, metabolism, or excretion of substance B (a pharmaceutical
drug), which then causes a change in the amount of substance B that reaches its
receptor sites or target tissues and/or how long it persists there. A pharmacokinetic
herb-drug interaction causes a change in the strength or duration of a drug’s effect,
but not the type of effect.

A pharmacodynamic interaction, on the other hand, occurs when substance A (an

herb) alters the effect of substance B (a drug). This type of interaction results in
additive effects (increased potency of substance B), antagonistic effects (decreased
potency of substance B), or synergistic effects (greater potency than when either
substance is used alone)(1).

Regardless of whether an herb-drug interaction is classified as pharmacokinetic or

pharmacodynamic, there are three possible theoretical outcomes to the interaction:

1. Increased therapeutic effects

2. Decreased therapeutic effects
3. A unique response that does not occur when either agent is used alone.

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Pharmaceutical drugs are prescribed at levels
intended to maintain a steady, safe, and effective
concentration in the body over a set period of time. An
herb-drug interaction can affect this steady state,
shifting levels of the drug outside of the desired
therapeutic range. Thus if an herb affects the targeted
response of a drug, an individual might no longer
receive a high enough dose of their prescribed
pharmaceutical or they might receive a higher-than-
intended dose. Either scenario can lead to deleterious
effects.

However, there can also be beneficial herb-drug

interactions. For example, using anxiolytic herbs may
allow someone to reduce their dose of an anxiolytic or
sedative medication, leading to fewer side effects.

Common Herb-Drug Interactions

Research has implicated a number of types of drugs
that are likely to have pharmacokinetic and/or
pharmacodynamic interactions with herbs including:

Anticoagulants (e.g., warfarin, aspirin, and

phenprocoumon)

Sedatives and antidepressants (e.g., alprazolam,

amitriptyline, midazolam, and trazodone)

Anti-HIV agents (e.g., indinavir and saquinavir)

Anticancer drugs (e.g., irinotecan and imatinib)

Cardiovascular drugs (e.g., digoxin, nifedipine, and

propranolol)

Immunosuppressants (e.g., cyclosporine and

tacrolimus)(2)

This list is certainly not exhaustive and there are other

pharmaceuticals that can interact with herbs, but
these are the most common drug culprits in herb-
drug interactions. It’s important to note that this
doesn’t mean that anyone taking an anticoagulant or
antidepressant drug should not take any herbs! It just
means that careful research is warranted before
suggesting herbs in combination with these
medications.
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Most of the drugs reported to interact with herbal medicines are administered orally, are
used in chronic treatment regimens, have a narrow therapeutic window, and require
regular monitoring of blood drug levels(3). The therapeutic indices of drugs such as
warfarin, digoxin, cyclosporine, and theophylline are extremely narrow and even a very
minor change in their concentration can result in a substantial alteration in their
therapeutic effect. Even some foods, such as grapefruit juice, broccoli, and garlic, can
alter the therapeutic effects of drugs with narrow therapeutic indices(4,5).

As mentioned above, this alteration can theoretically lead to serious consequences—

concentration levels can rise above the intended therapeutic dose (leading to overdose or
toxicity) or dip below the intended therapeutic dose (leading to therapeutic failure). Thus it
is critical to understand these potential interactions, collecting data on the proposed
mechanisms of interaction for a particular herb and comparing them to the known
pharmacokinetics of any drug you or your contact is taking, especially for drugs with a
narrow therapeutic window.

Assessing Risk Factors of Herb-Drug Interactions

If you’re feeling overwhelmed by the information presented thus far, keep in mind that
most herbs do not pose a serious drug interaction risk. While herb-drug interactions need
to be reviewed on a case-by-case basis, many herbs can safely be combined with
pharmaceutical drugs.

These potential concerns can also be lessened in most cases with a simple solution—one
can decrease the potential for herb-drug interactions by buffering pharmaceutical
absorption with a 4 to 6 hour window, ensuring herbs are taken outside of this time frame.

This rationale is guided by the clinical experience of countless herbalists as well as the
fact that many individual herbal phytochemicals have low bioavailability, due to extensive
metabolism in the intestines and the liver, and don’t often reach systemic circulation in
concentrations that negatively influence drugs(6).

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However, the risk of herb-drug interactions may
increase with the use of:

Multi-component blends of herbs. The more

phytochemicals a person is exposed to the greater
the likelihood of herb-drug interactions.

Extracts with concentrated or isolated active

constituents.

Herbs or phytochemicals that have not been

evaluated or characterized for pharmacological
activity.

Herbs used outside of their traditional use, dose,

and preparation.

Herbs co-administered with pharmaceuticals (as

opposed to staggering administration).

The use of herbs in combination with numerous

pharmaceuticals.

As you can see, this is a complex topic with many

nuances. However, we hope this lesson gives you a
baseline understanding of what herb-drug interactions
are and why they’re so important to understand—
especially if you plan to work with clients or suggest
herbs to anyone taking medication.

THEHERBALACADEMY.COM 10
Lesson 4: Herbs for Autoimmune Conditions
An Introduction to Autoimmune Conditions
The immune system is a complex network of cells, tissues, organs, and other substances that help the
body fight off infection and disease. When someone has a diagnosed autoimmune condition, their
immune system fails to recognize the difference between healthy tissues and potentially harmful
antigens. When this happens, their body may begin to turn on itself and attack otherwise healthy
tissues.

There are more than 80 known autoimmune conditions, ranging from very common to rare. A few of
them include:

Celiac disease: Autoimmune condition in which the body reacts to dietary proteins, namely gluten
(an umbrella term for prolamins found in wheat, rye, and barley), causing inflammation in the villi in
the small intestines. This inflammatory process increases intestinal permeability.

Hashimoto's disease: Autoimmune condition in which the immune system attacks the body’s own
thyroid tissue. This is by far the most common cause of hypothyroidism.

Rheumatoid arthritis: Autoimmune condition affecting the synovium, a tissue type that lines the
joints. This leads to pain and swelling in the joints, and in severe cases bone erosion, joint
deformities, and internal organ damage.

Multiple sclerosis (MS): Autoimmune condition of the central nervous system in which the
immune system attacks the myelin sheaths (the protective outer layer of the nerves). This can
disrupt the communication between our brain and our body.

Psoriasis: Inflammatory autoimmune condition that leads to the skin cells piling up on the surface
(hyperproliferation) and may result in bumps, plaques, and a scaly-like presentation. This is often
linked with underlying food intolerances.

There are many things that may cause an autoimmune disease, including an unhealthy diet, eating food
that we’re intolerant of, gut permeability (leaky gut), heavy antibiotic use, chronic stress, chronic
dehydration, sleep deprivation, and pathogen exposure, among other things.

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2 Herbal Approaches to
Autoimmune Conditions
Herbalists often approach autoimmunity by trying to
support the immune system's overall vitality and
strengthen the body's resistance to disease by
providing essential nutrition and minerals. The goal is
to help soothe inflammation and move the body toward
greater balance.

IMMUNE MODULATORS

Immune modulators are a safe choice for most

individuals suffering from an autoimmune condition
and may help to regulate an immune response. For
many herbalists, they are a top choice for
strengthening and tonifying an inflamed immune
system.

Immune-modulating herbs include:

Reishi (Ganoderma lucidum) mushroom

Codonopsis (Codonopsis pilosula) root
Tulsi (Ocimum tenuiflorum) aerial parts

VULNERARIES FOR GUT HEALING

As we discussed earlier in this lesson, some

autoimmune conditions can be traced back to
dysregulation in the gut. To address this issue, many
herbalists turn to gut-supportive herbs when
supporting clients with autoimmune conditions.
Vulneraries are herbs that support healing of tissues,
whether through coating and soothing or speeding
their replication on a cellular level.

A few vulnerary herbs for gut support include:

Calendula (Calendula officinalis) flower

Plantain (Plantago spp.) leaf and seed
Marshmallow (Althaea officinalis) root

Herbalists may also consider bitters for digestive

support, and nervines for stress reduction.

THEHERBALACADEMY.COM 12
Herbs to Avoid with Autoimmune
When we begin to look at selecting certain herbs for certain individuals with autoimmunity,
we want to be very sure that we are not contributing to an overactive immune response.
This can result in a cytokine storm characterized by an excessive production of cytokines,
which can result in an intense inflammatory response or something called a flare.

This is why, when working with an autoimmune condition, it’s important to understand
which herbs should be used with caution so as to not cause an overactive immune
response.

A few herbs to approach with caution are:

Echinacea (Echinacea spp.) roots, flower heads, leaves

Elderberry (Sambucus nigra, S. canadensis) flower, berry
Cat’s claw (Uncaria spp.) inner bark

THEHERBALACADEMY.COM 13
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THEHERBALACADEMY.COM 15
 References
Lesson 2
1. Braun, L., & Cohen, L. (2005). Herbs & natural supplements: An evidence-based guide. Elsevier.
2. Rasoanaivo, P., Wright, C.W., Willcox, M.L., & Gilbert, B. (2011). Whole plant extracts versus single
compounds for the treatment of malaria: Synergy and positive interactions. Malaria Journal, 10(S4), 1475-
1481. http://doi.org/10.1186/1475-2875-10-S1-S4
3. Wheatley, D. (2001). Stress-induced insomnia treated with kava and valerian: Singly and in combination.
Human Psychopharmacology, 16(4), 353-356. http://doi.org/10.1002/hup.299

Lesson 3
1. Phelps, K., & Hassed, C. (2011). General practice: The integrative approach. Elsevier.
2. Di, Y.M., Li, C.G., Xue, C.C., & Zhou, S.F. (2008). Clinical drugs that interact with St. John’s wort and
implication in drug development. Current Pharmaceutical Design, 14(17), 1723-1742.
http://doi.org/10.2174/138161208784746798
3. Chen, X-W, Sneed, K.B., Pan, S-Y., Cao, C., Kanwar, J.R., Chew, H., & Zhou, S-F. (2012). Herb-drug
interactions and mechanistic and clinical considerations. Current Drug Metabolism, 13, 640-651.
http://doi.org/10.2174/1389200211209050640
4. Gurley, B.J. (2014). Clinically relevant herb-drug interactions: Past, present, and future.
https://nccih.nih.gov/training/videolectures/clinically-relevant-herb-drug-interactions
5. Low Dog, T. (2011). Food, supplement, and drug Interactions [Presentation]. 8th Annual Nutrition and
Health Conference, 2011. Arizona Center for Integrative Medicine. San Francisco, CA.
https://www.youtube.com/watch?v=2XpGuMW7jKQ
6. Batz, F. (2013). Supplement-drug interactions webinar. American College of Healthcare Sciences.
https://www.youtube.com/watch?v=KrZfQ-oXHWI

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