The Saying That Herbal Medicine Only Works If You Take It for a Long Time

"Herbal medicine only works if you take it for a long time, right?"

Half true, half false. And this misunderstanding creates two kinds of loss.

The loss of waiting, saying "it's not time yet," for a remedy that should show its effect quickly. And the loss of quitting, saying "this one doesn't work," on a recovery that needs time.

I explain herbal medicine by dividing it into fast remedies and slow remedies.

The remedy that responds that very evening

Let me start with this. Some herbal remedies respond astonishingly fast.

In theory, this is strange. A large share of herbal medicinal compounds aren't absorbed as they are. The microbes living in the gut work on them first to convert them into their active forms, and they change once more as they pass through the liver. It ought to take time.

So why is it fast?

Because before they travel through the bloodstream around the whole body, they do their work first at the spot they touch.

The path leading from the mouth to the stomach and the intestines is itself an enormous surface. This surface is densely packed with nerve endings, has immune cells standing by, and is crowded with devices that sense stimuli.

The moment the remedy touches this surface, without waiting for absorption, the signal begins right there. It stops, right on the spot, cells that had been hypersensitively excited from pouring out their substances. Nerve endings receive the stimulus right there and send a signal to the brain.

Because it doesn't have to go through the whole body, it's fast.

And so these symptoms respond quickly

• Cramping pain that suddenly clenches
• The pulling sensation of a bubbling, churning belly
• The foreign-body sensation as if the throat is blocked
• Nausea that rises up urgently

These are states in which the body is overreacting. Calming an excessive reaction can be quick. If nothing changes within a few days, I re-examine the prescription.

What inevitably takes time

Conversely, there are cases where no matter how good the remedy is, it cannot skip over time.

Cases where the property of the tissue has changed.

Tissue that has been compressed and swollen for a long time stiffens while holding water. Its density rises and it grows heavy. For this tissue to return to its original property, materials have to come in, the old has to go out, and cells have to be made anew.

This is construction work. It doesn't happen with a single signal.

The same is true when absorption has broken down.

If the gut has long stopped receiving, then immunity calms down → absorption returns → energy is produced → and only then does blood reach the hands and feet. You cannot skip this order.

It's the same when the nerves have become oversensitive.

When pain has lasted a long time, the very circuit that transmits the signal turns into an amplified state. Time is needed for the circuit to return to normal. It's similar to how, for a while after an accident, your heart races every time you pass that road.

And so this is how I put it

What is the goal	Roughly when
Calming an excessive reaction	It often changes within a few days
Reviving absorption and metabolism	It takes a few weeks
Changing the property of stiffened tissue	It takes a few months
Returning an oversensitized nerve circuit to normal	A few months, sometimes longer

These four can be present together in the same person. When that happens, some symptoms ease early, and some symptoms ease later.

This is also why you feel that "it was getting better and then stayed the same." The fast part improves first, and the slow part is still in progress.

And so, what I say at the first visit

When I prepare a remedy for you, I intend to say this.

"This symptom will change within a week. If it doesn't, I've read it wrong, so please let me know."
"This symptom takes about two months. Don't be alarmed if there's little change at the one-month mark."

If I don't tell you the timetable in advance, two things happen. When a remedy that should respond quickly doesn't work, you wait endlessly, and when it's a recovery that needs time, you give up after just a month.

"Let's wait and see" is not medical care. I should be able to tell you what you're waiting for, why, and until when.

Conversely, the signs where you must not wait

While taking herbal medicine, if the following appear, do not wait — contact me.

• Hives, itching, swelling of the face or lips
• Shortness of breath or a feeling of the throat tightening
• Severe abdominal pain, vomiting, black stools
• Eyes or skin turning yellow
• Palpitations, an irregular pulse
• A marked decrease in urine output

None of these are part of "the process of getting better." Stop the medicine.

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That the compounds in herbal medicine are activated through the metabolism of gut microbes is a well-known fact. That nerves and immune tissue are densely concentrated on the surface of the digestive tract is likewise established.

However, whether herbal medicine therefore acts quickly right at that spot is a separate question. It can be seen in the laboratory, but how strongly this pathway operates in people is something no one has confirmed yet. That fast responses and slow responses divide is something I see in the consulting room every time; the explanation for why only goes this far so far.

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I don't like the saying that herbal medicine is a slow remedy.

What is slow is not the medicine, but the recovery. The medicine only hands over a signal; the work that takes time is being done by the body.

So to the question "how long do I have to take it," it would be right to answer this way: "It depends on what you're trying to reverse."

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References

• The gut is the body's largest surface, and most of its immune cells and over 100 million neurons sit in that wall — Immunity, 2017
• Many herbal compounds are not absorbed as they are — gut bacteria have to transform them first — American Journal of Chinese Medicine, 2011
• When pain persists the nerves that carry it grow more sensitive, so the same stimulus feels stronger — Anesthesiology, 2018

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