Tips Of All Sorts

The new yellow pages came out in our area last week, so as usual, I took a spin through to check out the competition. To my surprise, some of the newer practitioners in the area had chosen not to advertise. Our area is pretty thick with chiropractors, and the number of naturopaths and TCM practitioners is on the rise, too, so I was curious why a new practice would overlook this choice. A yellow page ad is relatively inexpensive here.

I've always been a fan of the yellow pages. You can find a list of good reasons here, as well as a list of negative aspects here.

My favorite reason has always been that the yellow pages are how *I* find things. Even for a company I regularly patronize, I don't tend to use the white pages. And if you happen to be a holistic practitioner with a hard-to-spell name, the yellow pages are critical - it may be the only way your patients can find you.

What can be challenging, once you've decided to use the yellow pages, is how much to spend. The most useful piece of information for helping you with this choice (or any advertising choice) is your average annual revenue per patient. To find this, take your total revenue for a year, and divide it by the number of active patients in that same time period. I find this is a handy number to have in mind for many expenses. It seems so much easier to make decisions when you can say, for example, "Okay, all I need to do is get two new TCM patients this year from the yellow pages, and the ad is paid for." It puts things in concrete terms.

If you track your referral sources, you'll also be able to tell how many new patients came through the door in a given year as a result of your yellow pages listing. Using your revenue per patient number, you can then easily tell if your ad was worthwhile, and whether to go bigger or smaller the following year.

Ginseng

Ginseng is a genus of perennial plants with fleshy roots, in the family Araliaceae. In fact, the herbal remedies referred to as “ginseng” are usually derived from the roots of several plants, being panax ginseng -also called Asian or Korean ginseng- one of the most commonly used. This type grows in cooler climates, specifically in the Northern Hemisphere in eastern Asia and North America. Apparently, its active agent is a class of steroid-like compound called ´ginsenoside´. However, as they appear to affect multiple pathways, their effects are complex and difficult to isolate.

A wide variety of ginseng is generally available in many Chinese or Korean herbal medicine shops and ethnic Chinese supermarkets. Although ginseng is mostly related to East Asian medicine, the American type of this herb -Panax quinquefolius- also has been used by Native Americans for centuries. In our days, ginseng is recognized as an adaptogen, since it increases the body’s resistance to stress. Some studies have also shown that ginseng may lower blood glucose, while others indicate beneficial effects on immune function and the hypothalamus-pituitary-adrenal axis. However, the use of combination products and the limitations of some studies (e.g., poor quality in methodology, research focusing on healthy volunteers, small sample size, unstandardized ginseng preparations, varying doses, etc.) the experts in general find it difficult to elaborate conclusions about some of the clinical effects of ginseng.

According to Traditional Chinese Medicine (TCM) Chinese ginseng (panax ginseng) promotes Yang energy, improves circulation, increases blood supply and aids recovery from weakness after illness, and stimulates the body. In the case of American ginseng (panax quinquefolius), it promotes Yin energy, and cleans excess Yang in the body, producing calm.

Fat loss action

Supplements that include ginseng on their component combinations are popular, due to its supposed actions over energy, libido, and blood sugar balance. With the objective of providing conclusive information in terms of ginseng effect over fat loss, the following study was performed at Tang Center for Herbal Medicine Research, Department of Anesthesia & Critical Care, University of Chicago, in Illinois.

Obese and lean mice received daily intraperitoneal injections of panax ginseng berry extract at 150 mg/kg body wt. for 12 consecutive days. On Day 5, the extract-treated mice had significantly lower fasting blood glucose levels as compared to vehicle-treated mice (180.5+/-10.2 mg/dl vs. 226.0+/-15.3 mg/dl, P < 0.01). At the end of the treatment, on day 12, these mice were normoglycemic (134.3+/-7.3 mg/dl) as compared to vehicle-treated mice (254.8+/-24.1 mg/dl; P < 0.01).

On the other hand, while fasting blood glucose levels of lean mice did not decrease significantly after treatment with extract, after 12 days glucose tolerance increased significantly, and overall blood glucose exposure calculated as area under the curve decreased 53.4% (P < 0.01). Furthermore, the extract-treated group (150 mg/kg body wt.) showed weight loss from 51.0+/-1.9 g on Day 0, to 46.6+/-1.7 g on Day 5, and to 45.2+/-1.4 g on Day 12 (P < 0.05 and P < 0.01 compared to Day 0, respectively). The body weight of lean littermates also decreased at the same dose of extract.

According to these data, panax ginseng berry extract may have therapeutic value in treating diabetic and obese patients.

Side effects

In general ginseng appears to be safe and well tolerated, although caution is advised about concomitant use with some pharmaceuticals, such as warfarin, oral hypoglycemic agents, insulin, and phenelzine. It is important to consult a health care provider about any herb or dietary supplement taken, which includes ginseng, in order to ensure safe and coordinated care.

The most common reported side effects are headaches and sleep and gastrointestinal problems, and there has been reported some cases of allergic reactions, as well as breast tenderness, menstrual irregularities, and high blood pressure associated with ginseng products. However, as it was explained, it is very common to mix ginseng with other compounds when it comes to dietary supplements. As these products’ components were not analyzed in those cases, effects may have been due to another herb or drug in the supplement.

Moreaover, since ginseng may lower levels of blood sugar, people suffering from diabetes should be more wary with this herb, especially if they are using medicines to lower blood sugar or taking other herbs that are also thought to have that action, such as bitter melon and fenugreek.

When taking ginseng as a standardized extract, 200 mg per day are advised, while in case of taking the dry root –usually in tea form or chewed- 0.5 to 2 g per day is the common dosage.

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