## Case Management

There are four possible outcomes from using herbal medicines:

Each situation is managed a little differently. Side effects are discussed on a separate page.

#### Improvement

If a herbal medicine appears helpful and does not seem to cause problems, it can be continued indefinitely, especially if the condition is chronic.

Use of an unprocessed diet (i.e. not from a bag or a can) increases the chances that health can eventually be sustained without use of herbs.

Ideally, herbs should be discontinued only gradually. Leave a little left in the bottle in case the condition comes back or is seasonal in nature.

Back to top#### Improvement then Relapse

If the relapse happened after a formula was discontinued, it should be resumed.

If there is a partial relapse despite continued use of a formula, it signals there has been a change in the nature of the problem and another formula is now called for. A full re-evaluation is advised.

If you end up trying something new, it's a good idea to transition slowly into the new formula as long as there were some positive benefits of the old one. See below for tips on using multiple formulas.

Back to top#### Partial Improvement

If a formula is beneficial, but only to a point, you may see more benefits with a higher dose. Alternatively, another formula may be a better match.

When adding a new formula, continue use of the previous one as well for at least a week or two. See below for tips on using multiple formulas.

Back to top#### No Change or Worsening

Improvements are generally expected within about two to three weeks of starting a formula. If there is no change or things get worse, either:

- The formula is not appropriate, or
- The dose is too low

Consult the chart on recommended dosages. If the dose is appropriate, a new formula is indicated and a re-evaluation called for.

Back to top#### Using Multiple Formulas

Occasionally, there is no one complete solution, and two or more formulas are needed to fully address problems. Generally multiple formulas can each be used at their full dose, but you might be able to get by with as little as half doses if things are going well.

If you're having to use opposite formulas from a Chinese medical perspective, you might want to ensure they don't get in each other's way by giving the tonic in the morning and the formula that clears excesses or internalizes Yang at night. Natural Path formulas are conveniently color-coded, so you can tell what each one does.

As a general rule when using multiple formulas, if you have the luxury of time, try introducing them a week or so apart, so you know the impact of each one.

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