How best to start herbs? Seemed clear at first, but I'm unsure.

My ND is starting me on herbs for Bartonella and I'm considering Bicillin shots for Lyme. I may end-up going totally herbal for Lyme. But, in the interim, here are my questions:

1. Take herbs with or without food? Buhner said it doesn't matter. I would rather take them with food as I have gastritis from all of the oral antibiotics I've taken.

2. Lowest dose to start with and how best to ramp-up? My ND is aggressive and started me at 10 drops 2 x per day for Sida Acuta. I told her I thought that was way too high for me. So, she said to start at 5 drops 2 x per day. That still seems insane! I was going to start at 1 drop per day, but how quickly do you ramp-up?

3. How much liquid do you put the herbs in? Just a little? Does it have to be water? Do you need to hold it under your tongue for a minute?

I've read Buhner, Horowitz, Rawls, etc. I've read so much I can't keep it all straight.

For those that are using herbs if you could offer your two cents, I would really appreciate it. My ND doesn't always provide enough detail, and I don't realize it until I'm ready to implement. Thanks very much.

Thanks, Girlie. That's really helpful.

Bless your heart! I know exactly what you mean about doctors not providing enough detail.

I started Buhner's herbs the first of June. I started one way and 7 weeks later backed up and restarted with the Bartonella protocol. I learned some lessons along the way. I realized I was adding herbs and increasing doses too quickly.

I agree with everything Girlie said plus the following.

I knew I was sensitive and needed to start very low. With tinctures, I start with 1-3 drops depending on what it is. With powdered herbs, I started with around 1/16th of a tsp. Even that was too much of cat's claw for me. I had to put cat's claw on hold.

Since I restarted with the bartonella protocol, I made sure to do the following:

1. I start ONE herb per week at a low dose. I wait at least a week before adding another.

I realized it often took me 3 or 4 days before I would feel the effects of an herb. Waiting a whole week made it much easier for me to see how that herb affected me, whether it was going to give me a herx or not, and gave me an idea of how quickly I could increase the dosage on that herb. (EGCG and quercetin I started together at the same time.)

2. I started at very low doses: 1-3 drops of a tincture, 1 capsule, or 1/16th tsp of a powdered herb like knotweed. If 1 capsule is too much, you can open it and dump a little out for each dose.

At first, I obsessed over trying to do everything exactly like Buhner said, but I realized I didn't seem to take well to tinctures. I suspect the alcohol bothers me. Most of his protocols only give tincture dosages. However, I decided to take Rhodiola, Ashwaganda, and Hawthorne in capsule form. For many herbs, I assume Buhner feels only tinctures are potent enough to be effective, but I chose these three in capsule. I feel like they are helping me, so I haven't started to question the effectiveness of the capsules for these.

3. This time around, I decided to try to get all the supportive herbs in first before adding any antimicrobials like Sida Acuta or IHA.

4. If I have trouble with an herb, either a bad response or worse symptoms, then I either try it at a reduced dosage or skip it and move on to another herb.

5. If after a week, I am still feeling worse or having a herx, I wait longer before adding another herb.

It seems slow and feels like I'll never get there, but since I restarted this way, I have been able to get more herbs in, and I've noticed some progress. I've found that some herbs I've had an easy time with and others I can't even tolerate tiny doses.

NOTE: I've also noticed that I can have delayed herxes or worsening of symptoms. I also tend to have long herxes. Others may tend to have them for a few hours to a few days. Mine tend to last a couple of weeks.

Thanks, Psilo and Walking. I appreciate the caution about moving slowly and steadily. That was my instinct when the ND prescribed 10 drops twice a day to start and said it was okay to start all the herbs at once.

I'm always surprised, whether it be with ABX or herbs, when LLMDs start you out at a high dose. I know they are trying to help you heal as quickly as possible, and I'm sure some people respond fine to that approach, but some of the herxes I have had due to assuming the optimal dose of, or too many ABXs, right from the start could have been avoided.

I'll be careful with the herbs and add increased dosages and new herbs at a slow pace. Thanks so much!