The Wall Street Journal
By SUMATHI REDDY
April 21, 2014 6:58 p.m. ET
Lyndhurst, Ohio
Christina Lunka appeared nervous and excited as she sat in the Chinese herbal therapy center recently opened by the Cleveland Clinic.
The 49-year-old had been to many doctors seeking help for ongoing issues that included joint pain and digestive problems. Now the Kirtland, Ohio, resident was hoping to find relief through herbal remedies.
“Do you have something for inflammation?” Ms. Lunka asked herbalist Galina Roofener during a one-hour consultation.
At the Cleveland Clinic, herbalist Galina Roofener meets with patient John McGeehan, who complains of chronic nausea. Michael F. McElroy for the Wall Street Journal
“Absolutely,” responded Ms. Roofener. “This is for pain, for digestion, for inflammation, all of the above,” she said, handing Ms. Lunka a bottle with capsules of an herbal combination called Xiao Yao San, which translates as free and easy wanderer. The capsules include about eight different herbs, including licorice, mint leaf and white peony root.
“Please do not expect immediate results,” said Ms. Roofener. “The first effects, three weeks. The best therapeutic potential, three months. It will be slow, tedious work.”
“Western medicine does acute care phenomenally.… But we’re still struggling a bit with our chronic-care patients and this fills in that gap and can be used concurrently,” says Melissa Young, an integrative medicine physician at Cleveland Clinic.
While acupuncture programs have sprouted across the U.S., there are only a handful of herbal clinics. Osher Center for Integrative Medicine at Northwestern University and NorthShore University HealthSystem, affiliated with the University of Chicago, both include herbal medicine among their offerings.
“I’m getting more and more physician referrals [for herbal treatments], which to me is a sign of greater acceptance,” says Leslie Mendoza Temple, medical director at NorthShore’s Integrative Medicine Program. “When I first started here we were pounding on doors to prove we’re not crazy and we’re legitimate and safe.” Referrals come from neurology, oncology, gastroenterology and rheumatology, among other departments, she says.
Jamie Starkey, lead acupuncturist at the Cleveland Clinic who got the herbal clinic started, says there is little scientific research outside Asia on using herbs as medicine. Ms. Starkey says she had to translate studies to convince the Integrative Medicine’s former medical director that an herbal clinic could be effective.
There are thousands of herbs—primarily plant parts but also some animal and mineral products—that are used in traditional Chinese medicine. Herbs are usually used in combinations and can be taken as capsules, tinctures, powders or tea. Herbs can be toxic if taken in the wrong dose.
Quality and potential contamination are issues. At Cleveland Clinic, premade herbal formulas are bought and ordered through KPC Products, a subsidiary of Taiwan’s Kaiser Pharmaceutical Co. Custom-blends are made by Crane Herb Co., based in Massachusetts and California.
At the Cleveland Clinic’s herbal center, new patients are given a one-hour consultation that may include a battery of questions (How’s your sleep? Body temperature? Ringing in your ears? Headaches?), a physical examination of the tongue, and the traditional Chinese method for pulse-taking (three fingers on each wrist to check different pulses corresponding to various organ systems). They are asked to sign a waiver acknowledging that “herbal supplements are not a substitute for a medical diagnosis.”
Consultations are $100 and are not covered by insurance. Follow-ups are $60 and a one-month supply of herbal formulas costs on average about $100. On one day at the clinic last month patients had needs ranging from chronic pain to anxiety, digestive issues and multiple sclerosis.
Lynnette Fleshman, 36, of Euclid, Ohio, was a returning patient coming to the clinic for infertility issues. Her doctor, she says, was pushing her to go the in-vitro fertilization route. Ms. Fleshman, a program coordinator at Cleveland Clinic, was hoping to avoid IVF with the help of herbs.
Infertility, menstrual disorders, PMS and menopausal symptoms are commonly treated by Chinese herbs and can be very effective, Ms. Roofener says.
Ms. Roofener reassures patients with a warm but blunt demeanor. She began practicing acupuncture and Chinese herbal medicine in her native country of Lithuania, where she was a rehabilitation nurse, before moving to the U.S. in 2002 to attend the East West College of Natural Medicine in Sarasota, Fla. After four years of schooling she received licenses to practice Oriental medicine, first in Florida and then Ohio.
Ms. Roofener’s license doesn’t allow her to claim she treats diseases, a Cleveland Clinic spokeswoman says. She can’t say that Chinese herbs will treat colitis, for instance, but she can say that she can stop diarrhea and pain. She cannot treat arthritis but can alleviate joint pain, the spokeswoman says.
Benjamin Katholi, a pediatric rehab physician at Cleveland Clinic, referred two teenage girls with chronic fatigue to the herbal clinic recently. “They had been looked at thoroughly from multiple physicians to evaluate medical issues that might be driving it,” says Dr. Katholi. “I think at our facility there’s a growing openness to integrative treatments and combining Eastern and Western-based treatments,” he says. The patients haven’t yet been seen at the herbal clinic.
John McGeehan, a tennis instructor in Lakewood, Ohio, who suffers from chronic nausea, says he has tried different medications and had “pretty much every test known to man.” After his doctor referred him to the herbal clinic, the 57-year-old was prescribed two herbal formulas. A few weeks later he switched to a different formula. He hasn’t noticed a change in his condition but says, “I’m hopeful.”
Ms. Roofener says Mr. McGeehan’s condition is chronic and will require a few months before any improvements can be seen.
Maged Rizk, a gastroenterologist at Cleveland Clinic who referred Mr. McGeehan, says Chinese herbal medicine is still being critically evaluated. “In the past it wasn’t even considered seriously,” Dr. Rizk says. “At this point there is a thinking, ‘Some of the things we’re doing now aren’t very effective. Should we really be looking at alternatives a little more seriously?’ I think the verdict is still out,” he says.
Write to Sumathi Reddy at sumathi.reddy@wsj.com