The Same Remedy Works Differently When the Gut Is Different

I gave the same prescription, and one person responds well while another finds it flat. Similar body weight, similar symptoms, yet the responses differ. In such cases, before I suspect the dose of the remedy, I first think of the gut (腸) that completes that remedy inside the body.

A remedy is not completed the moment you take it

Many herbal compounds don't act in the exact form in which they entered the mouth. A large share enter with a sugar (糖) attached, and only when gut bacteria strip off that sugar do they turn into their active substances. In other words, the final assembly of the remedy is done not by the person, but by that person's gut bacteria.

Because the composition of gut bacteria differs from person to person, the same remedy is activated differently in each person. People who have recently taken antibiotics, whose gut is always poor, or whose eating habits are skewed to one side have a weak version of this assembly process. That's why the same remedy works well for one person and feels flat for another.

Many medicinal compounds take their active form through the metabolism of gut bacteria. One compound in licorice, and various other glycoside compounds, pass through this pathway.

But this article looks at one path among several. Some compounds do not go through this path and simply cross the membrane, and some signals travel straight up along the nerves of the gut. Today I look at the share the gut takes on. (What herbal medicine actually does)

This is why, before changing the remedy, I first look at the condition of the body receiving the remedy, especially the state of the gut. When the same remedy doesn't work, it's often not that the remedy is weak, but that the gut meant to complete it is exhausted. When you tend to the gut first, a remedy that had been flat sometimes shows its full strength.

The gut gets sorted out before the herb

When I decide on a prescription, I don't look only at the symptoms — I also look at the state of digestion and the gut, and recent antibiotics or eating habits. If the gut has broken down, I steady the gut before the remedy. Even in the hours after you've left the clinic, soothing the gut's environment so the body properly receives the remedy — this is where herbal medicine has its place. It's not a way of forcibly cranking up the remedy's effect, but of first preparing the place where the remedy will be completed.

When you should go to the hospital first

That said, when the gut has been poor for a long time, there is something that must be checked. If you're losing weight, if there's blood in your stool, if abdominal pain wakes you at night, or if anemia is present as well, the disease of the gut itself must be examined first. If these signs are present, I recommend internal medicine and a colon examination first.

This is not something to blame yourself for

There's no need to blame yourself, asking "why doesn't that remedy work for me?" It's not a matter of willpower, nor a bad constitution. It's only that the body's conditions for completing the remedy aren't yet in place. Let's put those conditions in place together, starting there.

References

• Because the make-up of gut bacteria differs from person to person, a medicine that bacteria have to switch on can work to different degrees — Yale Journal of Biology and Medicine, 2016
• The licorice compound too becomes active only after gut bacteria strip its sugar away — Frontiers in Nutrition, 2021
• After antibiotics, gut bacteria fall and the conversion of ginseng compounds into their active form measurably weakens (animal study) — Foods, 2023

Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)