My question is about the use of whole herbs versus active constituents. As an acupuncturist and Chinese herbalist, I’ve been trained to favor whole herb administration over active constituents. The thinking in Chinese medicine is that the whole plant contains a mixture of biologically active compounds, which would presumably be more favorable in terms of efficacy and safety. I know we’ve had a lot of discussion in this program about which curcumin supplements people favor most and why, but I’m wondering if you can comment on why we wouldn’t use the whole turmeric rhizome instead. Is it just that the research doesn’t exist on the whole plant, or does using the whole plant make dosing complicated or both? I read an interesting paper in the International Journal of Pharmacology stating that an ethanol extract of whole turmeric rhizome exhibited greater anti-inflammatory effects than curcumin. This makes me wonder further about other substances such as berberine. Is it more or less advantageous to use berberine in isolation or in whole herbs such as coptis and phellodendron?

Chris Kresser: Yeah, that’s a great point and great topic of discussion. Of course, it’s controversial. As an acupuncturist and Chinese herbalist myself by training, I’m definitely aware of that argument, and I think there are situations where the whole plant has been shown to be superior, and there are situations where the extract has been shown to be superior. I do tend to lean more in the direction of whole herb administration in many cases for the reasons that you mentioned, and I think there is just a lot that we don’t understand about plant medicine, the activity of the various ingredients, and how they interact and support each other. At the same time, in terms of looking at the literature on efficacy and safety, there are a lot more studies that have been done on extracts. That’s not necessarily a good thing. It’s in part just because of our Western reductionist perspective, but it does mean that we have a lot more information about how those extracts work, the effects that they have on disease, and how they interact with other substances, which starts to become a concern if your patient is taking various medications. It’s easier to track what the various interactions might be if you’re using extracts in those cases than when you’re using herbs that have many different ingredients or biologically active compounds.

So, I don’t think there is a right or a wrong answer here. I think it depends a lot on your training. Since you’re an herbalist, Jamie, and you have a much better understanding of botanical and plant medicine than someone who doesn’t have that training, you might be better off favoring more whole plants and botanicals because you have a better grasp over the various interactions and how those things work, whereas a physician, for example, who doesn’t have that training might be better off using extracts because it’s a little bit easier to track. There is more published literature available that he can access, and it fits more within the paradigm of medicine that he was taught. So, that’s my take. Hopefully it’s helpful.