The Tests Are Normal, But You Still Feel Unwell — Explaining Herbal Medicine Through Modern Pharmacology

There are people whose test results come back normal, yet whose bodies still feel unwell.

Insomnia, palpitations, indigestion, chronic fatigue. Often they get tested at several hospitals only to be told "nothing is wrong" and sent away. In those moments, I tell my patients this: it is a fortunate thing that the tests show no abnormality, but that does not mean "your body is working normally."

I am a Korean medicine doctor who prescribes herbal medicine. But I try not to explain herbal medicine only in the old language of "your qi is deficient, so we tonify it." What is actually happening in the body — how the blood flows, where pressure accumulates, how the nerves respond — I explain it through those principles, and I compose herbal formulas that fit them. This article is a direct transcription of the explanation I give my patients in the consultation room.

Why Do the Tests Come Back Normal While You Still Feel Unwell

Hospital tests mostly look at the question of "is there inflammation in the tissue, has organic damage occurred." Whether inflammatory markers have risen, whether tissue is eroded or broken down, whether there is a tumor. These things show up well on tests.

Yet many symptoms appear before organic damage sets in, because the body's internal environment and function are the first to go wrong. It is not that the heart is diseased but that the autonomic nervous system regulating the heartbeat has become oversensitive; not that the stomach is eroded but that the nerves directing digestion are not doing their job. These problems of function and environment shift moment to moment and have not yet damaged the tissue, so they are hard to capture in an image taken at a single point in time.

That is why "nothing is wrong" and "you are fine" are two different statements. I begin my care by looking for this disturbance in regulatory function.

How Do I Understand and Prescribe Herbal Medicine

Each herbal ingredient is in fact a bundle of many pharmacological compounds. For a long time I have studied what these compounds actually do in the body. Here are a few examples.

• The perspective of blood flow and pressure. Some herbs relax narrowed blood vessels to aid circulation; others help drain fluid that has pooled in one place. I compose a prescription by asking, "in this person's circulation, what is blocked and what is overflowing."
• The perspective of the route. Each compound reaches the body by a different road. Some are absorbed in the stomach as they are; some are absorbed only after the microbes of the large intestine change their form; and some signals travel up along the nerves of the gut without passing through the blood at all. Different roads also mean different arrival times. This is part of why the same medicine works differently from person to person, and why I always ask about digestion and the state of the gut, whatever symptom brought you in.
• The perspective of the nerves and their responses. Some herbs calm nerves that are overly tense; others stabilize abrupt reactions. This matters especially when approaching autonomic symptoms.

Seen this way, even the same "insomnia" has different causes from person to person, so the prescription differs. Rather than giving everyone one predetermined formula, I compose it to fit that person's condition — that is what herbal medicine care means to me.

Why I Explain This Much

Anyone who has walked out of a clinic hearing only "nothing is wrong" will know the feeling. The words are not untrue, and still the mind is not put at ease. If you do not know what has gone out of order and how, you cannot tell whether you are getting better either. So I begin by explaining why the symptom arose and why this medicine is being used. Only then does it become concrete — what to watch for during treatment, and what to change in daily life.

Another reason is my own personal experience. I too am someone who has directly experienced the symptoms that come when the autonomic nervous system wavers. Because I know the frustration of that time — when the tests said there was no real problem yet the body kept feeling uncomfortable — I do not take my patients' symptoms lightly.

Who Might This Help

• Those who have been to several hospitals but heard only "nothing is wrong" while the symptoms remain
• Those whose autonomic-related symptoms overlap, such as insomnia, palpitations, dizziness, and cold hands and feet
• Those whose blood pressure, blood sugar, and weight are not being managed together, requiring a look at overall metabolism
• Those whose long-standing pain improves only briefly during treatment and then recurs
• Those who want to be treated after hearing a full explanation of why they hurt and why this medicine

There are places herbal medicine does not resolve. When needed, I first recommend imaging or other clinical care, and I tell you in advance how far Korean medicine treatment can help in your current condition.

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