What Does a Clinical Herbalist Do?
The Benefits and Limitations of seeing a Clinically Trained Western Medical Herbalist
Why See a Clinical Herbalist?
Most people who are considering seeing a clinical herbalist have health problems that are unclear, recurring, chronic, complex, multi-system, or difficult to assess alone.
Increasingly fragmented healthcare provision in the UK can make it slow and frustrating to find the right combination of solutions for an actual strategy.
Often, folks end up playing symptom whack-a-mole using interventions suggested by a range of people. But no one has a full overview of the case or coordinates a cohesive treatment plan.
I wrote this post because many of my patients report feeling overwhelmed by fragmented care and trying to work out which practitioners could help. If you're wondering whether a clinical herbalist could support you, then hopefully this post answers your questions.
Clinical herbalists are those who focus on assessing and treating active health concerns in individual patients. The process is thorough, person-centred, holistic (assessing the entire case rather than individual parts), and strategic.
In this context, herbs are plants and fungi that affect the body beyond nutrition. They contain bioactive compounds, meaning natural chemicals that influence how the body functions, rather than simply providing nutrients. Coffee is a familiar example: caffeine has pronounced and easy-to-observe effects beyond nutrition.
Most clinical herbalists are specialists in herbs but generalists in human health. We aim to coordinate the variety of care that most chronic and complex health problems require.
There are many herbal traditions, and most are a few thousand years old. Some, such as Western Herbal Medicine (WHM), incorporate biomedical science into an older, experience-based tradition.
When people discuss ‘types of herbalism,’ they’re usually referring to either:
the tradition of the practitioner, such as Western herbalism, TCM, Ayurveda, or bioregional herbalism
or the way the practitioner practices, such as a clinical, community, or family practitioner.
Each type of practitioner serves a different and equally essential role in our healthcare ecosystem.
The focus of this post is on how a Western Herbal Medicine clinical practitioner pratices.
There are a wide variety of herbalists even within just Western Herbal Medicine. I can only explain how I trained and how practitioners I learned from usually practice. So this article should give you a general idea of what to expect from a herbalist from my lineage.
Contact me here if you’d like guidance on which type of support is best suited to your current situation.
If you want to know about my practice specifically, see this FAQ or my About page.
What Happens in a Consultation?
Thorough Case-taking
First consultations are about 1 hour long so we have time to discuss your entire case, work out symptom timelines, and review supplements and medication. We aim to make sure you have space to process your experience and explain your health goals.
We like to discuss things like sleep, digestion, stress, menstrual cycles, energy, mood, pain patterns, daily life, and support networks; as much of the patient’s experience as is comfortable for them to discuss.
Of course, people are complicated, so a lot of this unfolds over successive, shorter follow-up consultations.
Collaborative Assessment
Clinical herbalists have training in interpreting common test results. We can support your understanding of tests performed by your doctor. We can explain the limitations of testing, which can help if you’ve been told your results are “normal” but you’re still experiencing symptoms.
We can also provide advice and support about accessing testing when necessary. However, biomedical testing often isn’t a necessity before herbal treatment, and we can advise if testing is needed.
Sometimes we’ll refer you to another kind of specialist for assessment, for example if your issue is musculoskeletal and we’re seeing you online, we may refer you to a local specialist for physical examination.
Patients are the experts on themselves, and this is especially true for management of chronic health problems or other disabilities. As a result, herbalists like to work together with a patient to create an accessible treatment strategy.
Diagnostic Processes
It’s notoriously difficult to diagnose yourself, even with broad knowledge of what conditions and symptom pictures are possible.
Clinical herbalists are trained to map out a selection of possible conditions and home in on which are most likely. Different herbal traditions do this differently.
As someone who is primarily a western herbalist, I use the same process as biomedical practitioners combined with a traditional style of assessment (including energetics) to fine-tune my understanding of the person & their ailment.
The steps are:
Gather information on symptoms, medical history, current medications, way of life, and physical examination findings.
List all the possible causes.
Rank the possible causes in order of likelihood. This involves considering several factors, such as:
which diagnoses are most common,
which demographics are likely to be diagnosed,
which symptom picture fits most neatly,
and which diagnoses are most dangerous if missed out or most treatable if they’re caught early.
Even if unlikely, potentially dangerous or urgent conditions are kept on the final list to ensure they remain in mind.
Use further tests or questions to narrow down the list.
Decide on a working diagnosis: the explanation that matches the patient’s experience best and is therefore most likely. This is the last step in the biomedical approach to understanding the disease.
Then, I’ll consider how the working diagnosis is expressing itself in this specific person’s body. Out of all the symptoms this disease can cause, which ones are they currently experiencing? Which factors undermined this person’s robustness in the first place so they could get sick? Or have they been exposed to an aggressive disease that took hold in spite of the fact that they’re still robust and vital?
I like to go through this process even if a patient arrives with a diagnosis. Herbalists have the luxury of more time to spend with patients. So, for the sake of thoroughness, it’s worthwhile thinking about the problem afresh.
Safe Practice and Medication Coordination
Western clinical herbalists very often provide treatment alongside biomedical treatment, so we’re experienced assessing herb-drug interactions.
We use texts like the ones listed below to cross-check all medication and treatments with any herbs we plan to use. We’re also trained to use herbs safely in transitional states such as pregnancy, infancy, childhood, etc.
In many cases herbs can improve efficacy or reduce side effects of biomedical treatments.
However, because they can interact, combining herbs and drugs requires extra care and knowledge. I highly recommend seeing a herbalist if you plan to use herbs during any of the potentially vulnerable states mentioned above.
Most harm in healthcare comes from a lack of knowledge or having just enough knowledge to be over-confident but not enough knowledge of potential pitfalls.
Herbalists can also identify any redundant, low-quality, or conflicting supplements. Often, a supplement list can be whittled down to one or two options.
Most people don’t need to be taking supplements all the time, but they can help if targeted for specific issues.
Some supplements carry risks if they’re taken unnecessarily for long periods of time. This is particularly true of certain vitamins and nutrients that can accumulate in the body.
Core Safety References:
Herbal Contraindications and Drug Interactions Plus Herbal Adjuncts with Medicines - Francis Brinker, N.D.
The Essential Guide to Herbal Safety - Simon Mills and Kerry Bone
Clinical Guide to Blending Liquid Herbs - Kerry Bone
British Herbal Compendium Volume 2 - Peter R. Bradley (Ed.)
Natural Medicines Database (NatMed Pro) - TRC Healthcare
Botanical Safety Handbook - American Herbal Products Association (AHPA)
ABC Clinical Guide to Herbs - American Botanical Council
Bespoke Herbal Formulations & management plans
Each prescription is unique to each patient and reflects their specific health condition(s), vitality, robustness, temperament, needs, and priorities.
I usually provide prescriptions for my patients, but I also provide enough detail about their herbal formula so that patients can source their prescriptions elsewhere if they wish. It’s also good to have a record of what you’ve taken for future reference.
My management plans are also tailored entirely to what is accessible and likely to help the most. There are often many things we could technically do to improve our health. However, we only have so much time and energy, especially whilst unwell. An experienced practitioner can home in on which changes are likely to yield the best results with the least effort.
Herbalists aim to address all the contributing factors that caused the issue, remove unnecessary stressors, manage symptoms, and re-grow vitality so that patients can live as fully and joyfully as possible.
This sometimes means suggesting enriching activities, helping find a movement practice you enjoy, and/or giving advice about nutrition.
My patients are invited to opt out of this advice via my intake form.
I can make recommendations about education and self-management for patients who are in a position to do these things. Usually, we discuss these more after the main issues have been dealt with. You really don’t need more work on your plate while actively unwell.
Follow-up and Adjustment
Follow-up appointments are usually every 2 weeks for the first 4-8 weeks, to adjust your formula as you respond to the herbs.
These sessions are up to 40 minutes long, so there’s plenty of time to discuss issues more broadly if you need to.
Referral and Integrated Care
I make an effort to learn about a variety of other types of health and wellbeing practitioners so I can recommend other support where necessary.
If you provide support to the kinds of people I treat, then please get in touch so I can learn more about your modality and approach.
What is Herbal Medicine Most and Least Helpful For?
Clinical herbalism isn’t suitable for emergency care, for example: an acute infection requiring intravenous antibiotics, broken bones that need setting, or anything else requiring a paramedic or A&E.
In these situations, biomedicine (also sometimes misnamed allopathic, conventional, or modern medicine) is ideal. It’s consistently been highly focused on emergency care for over 200 years.
There are herbalists who train in emergency herbal care, but this is quite rare. The living lineage of practitioners trained in a combination of biomedical first aid and herbal first aid is very small and young.
Outside of emergencies, herbalism can be incredibly versatile. Practitioners may be trained in:
chronic & complex conditions
acute infections that don’t require intravenous antibiotics
supporting biomedical treatment
supporting fertility
functional health problems such as mild-anxiety and sleep disturbances
early-stage problems that aren’t yet diagnosable
preventative care
supporting emotional and psychological health
improving overall vitality and well-being
I’ve made this article as broadly useful as possible by describing what you can expect from a western clinical herbalist more generally. But one beauty of herbalism is the variety among herbalists, even within one tradition. If you’d like to learn more about how I specifically practice then this blog post may interest you.
The Value of Clinical Herbalism
coordination and consistency throughout treatment.
a person-centred approach where the specific person experiencing illness is the central focus of healthcare.
whole-body coherence; viewing the body primarily as an interconnected system, rather than isolating specific parts or symptoms.
Time to thoroughly investigate your own experience and find patterns that a rushed appointment might miss.
Resolution of the contributing factors.
Growing vitality, robustness, and genuine self-care knowledge to prevent future illness.
Support going through transitions to prevent them causing illness.
A precise approach; herbal formulations and management plans are tailored to your specific needs, including accessibility needs.
Empowerment; Knowledge is power, and when you’re well enough to engage more deeply with self-knowledge, I’m very keen to help you develop a clear understanding of your health and the tools you need to manage it for the rest of your life.
How to Begin
If you’ve been struggling with unclear, chronic or recurring health issues and feel frustrated by the fragmented nature of care currently available, then I highly recommend speaking to a clinical herbalist.
Whether or not you’re interested in learning about herbs specifically, a clinical herbalist can provide a cohesive, strategic approach that centres your priorities as an individual whole person.
If you have questions or want to check if my practice is suitable for you, please get in touch here.
You can book your initial consultation here.
If I’m fully booked, then feel free to contact me anyway.
I can refer you to other herbalists and/or add you to my waitlist.
Disclaimer: This content is for educational purposes only and does not constitute medical advice or establish a practitioner-client relationship. I am a qualified clinical herbalist, but this information should not replace consultation with your own healthcare provider.
