Herbs used as medicine can often confuse patients. Patients are familiar with pharmaceutical drugs which often have very specific requirements in regards to dosing and use, as well as specific instructions for what to do when a dose is missed. Because of these types of standard dosing rules with pharmaceuticals, marketing companies that promote herbal supplements for health often use similar dosing as a marketing tactic to give a certain amount of familiarity to the herbs as a way of making the consumer comfortable with the product.
For traditional herbal medicines where the herbs are prescribed based on a specific medical condition as described by herbal medical diagnostics, the dosing can vary greatly. The proper dosing of herbs as medicine is often a lot less stringent than the dosing of pharmaceuticals. Part of the reason for this is that many pharmaceuticals have specific metabolic requirements and concentrations that need to be maintained in the body in order for them to work properly. Herbs are essentially extreme foods. The function is more based on altering the general function of the body from the change in food/fuel that the body uses. Because of this, the rules about dosage are more flexible.
If you are taking a herbal medicine prescribed by an herbalist, you should ask about the reason behind the dosing recommendations. Often a herbalist will give very specific dosing instructions, just the keep things as simple as possible for the patient. Sometimes if the patient understands the reasoning behind the dosing strategy, then the patient can better adjust and manage the dosing of the herbal medicines.
In Traditional Chinese herbal medicine there are some rules of thumb that herbalists use when prescribing. If the condition is acute and assumed to be a short term issue, the usual is to use high frequency dosing and stop herb use quickly when no longer needed. Herbs are not time released like medications so for long term chronic conditions the herbs are often prescribed on a regular schedule so that there is a regular influence of the herbs on the body. For children the same principles apply. Often however the dose will be adjusted based on the size of the child and often where the child is in development rather than just the age. A teenager has a very different way of functioning compared to a preteen- even if they are the same size. Often the herbal formulations chosen reflect this dynamic as well.
Often pharmaceuticals have specific guidelines for how to handle the situation of missing a dose. Herbs generally are more flexible in this type of situation. As the herbal medicines are essentially extreme foods, it is helpful to think of the herbs in the same way you think of a meal. If you skip a meal you may have a snack and maybe delay the timing of the next meal. You would not sit down and eat two meals at one time. This is generally a good rule of thumb when dealing with missed doses of herbal medicines. If there are questions make sure to ask the herbalist who prescribed the herbal medicine as to what is the best way to take a particular herbal medicine and why.
