Stress Less, Part II: Implementing Herbal Medicine in Your Practice
Integrative Veterinary Practice: Herbal Medicine View Series »
In today’s high-demand society, stress and anxiety have become more common than ever. Unfortunately, it’s much easier to get it than it is to relieve it—for both pets and people. Tackling anxiety and depression is often a trial-and-error situation. For some, finding the right treatment is easy. For others, it’s a long, drawn-out process that involves trying many different medications and tinkering endlessly with dosages.
But there’s another option. For Dr. Alexia Tsakiris, the answer is to look at the entire patient and all their symptoms—not just their stress: Environment, diet, gut health, age, and all the other big and little variables that could be contributing to their symptoms. Using this information, she then customizes an approach using a combination of herbs best suited to that whole patient. This holistic approach has guided her practice over the course of her career, leading to improved outcomes for both animals and their people.
In the second part of our herbal medicine series, Dr. Tsakiris is back to offer some tips to practitioners who are interested in offering herbal medicine in their conventional practice. Where can you and your staff find reputable training courses? What are the legalities you need to be aware of? Tune in for the answers to these questions and more!
BVetMed, CVA, GDVWHM, RH (AHG)
A graduate of the Royal Veterinary College, Dr. Tsakiris found her passion for integrative medicine early in her career and has been using it ever since. She owns Naturopawthic Veterinary Wellness Center in New Jersey. Learn More »
Krysten Bennett: Thanks for tuning in to episode 77 of Fully Vetted. Today we’re finishing up our two-part series on herbal medicine with Dr. Alexia Tsakiris. In addition to running naturopathic Veterinary Wellness Center in Redbank, New Jersey, Dr. Tsakiris is an assistant professor for the College of Integrative Veterinary Therapies and vice president of the American College of Veterinary Botanical Medicine. She’s joining us on the show again to offer some tips to practitioners who are interested in offering herbal medicine in their conventional practice. Welcome back once again, Dr. Tsakiris.
Alexia Tsakiris: Thank you for having me.
KB: Okay. So last time we talked about some of the herbs you use and don’t use when treating patients with anxiety. Today we are shifting gears and digging into the practicalities of offering alternative modalities like herbal medicine.
Mia Cunningham: What advice do you have for practitioners who are interested in implementing herbal remedies in a traditional practice?
AT: It’s so tough to know where to go. So I would recommend starting with the American College of Veterinary Botanical Medicine. The college is a place where people can go for guidance on where to take classes. If you go there and then from there we’ll have listed places like the College of Integrative Veterinary Therapies, Chi University, IVIS. I think there will be some human classes listed there as well.
But then also if you’re looking for human herbalist classes that you can also do, you can go to the American Herbalist Guild and also you can find qualified certified schools that you can take classes. And so there’s a few different avenues that you can do. And I do feel really blessed as an animal doctor that I can do both and take classes in both because you can see, oh, this person uses it this way, this person uses it that way. More avenues are opening up all the time.
MC: Well, it sounds like there’s an opportunity to advance and get certifications. So is there significant financial investment for these certifications and classes?
AT: I’m not going to pretend like there isn’t. Yes, we have to pay for it no matter what. Did I spend as much as I spent going to vet school? No. But yes, you’ve got to pay to play. So there’s a decent investment, but it’s easy to get started with one class. CIVT offers an introduction course where I think it’s like six weeks. And so maybe like, that’s a nice way just to expose yourself. And there’s little webinars put on by the Veterinary Botanical Medical Association. Whet your palate a little bit, right? See what interests you before you make the full investment jump. There’s ways to do it.
Here’s the other caveat. I guess I should throw this out there. You’re not making the same money as someone who’s doing surgery, but it’s still really fulfilling to be able to be helping your patients. And maybe you are doing surgery as well, and then you’re adding herbs in on top of it and you’re getting even better outcomes. So I think it’s worth it in that way too.
MC: Now I’m going to assume, but does these certifications require renewal?
AT: Yes. I mean, my graduate diploma is my master’s degree, so that is what it is. But for the AHG, yes.
MC: So are there any legal considerations that doctors need to be mindful of when practicing herbal medicine?
AT: So, of course, because we live in a litigious society, so why wouldn’t there be anything? I’m the doctor prescribing them. So of course, there’s always legal considerations matter what I’m doing, right? I have people sign consent forms because herbs are not regulated, right? Like, it’s up to me to know what I’m doing and where I’m getting them from. So there are consent forms.
KB: You touched on this in the last episode, but since we’re on the subject, can you refresh my memory on this? Because it seems to be a gray area in terms of like, are herbs prescribed in the way pharmaceuticals are, or is it more like a non-DVM making a diet recommendation? In other words, do you need to be a veterinarian to give a patient and herbal treatment? How is that regulated, or is it even regulated at all?
AT: Yeah, because herbs are not FDA regulated. People can say whatever they want to say these days, quite honestly. So, yeah, there are people out there calling themselves herbalists and they’re not.
Listen, I think yes, either you should be a veterinarian who has studied herbal medicine, or you should be a super qualified herbalist who has taken courses in veterinary medicine. You need to know your patients, not just be willy nilly about things.
KB: When you were practicing as a conventional vet, did you get any resistance from pet owners or your colleagues when you began suggesting unconventional treatments like herbal medicine?
AT: Ten years ago, when I was in a general practice and I was practicing integrative medicine, where I was doing conventional and herbs and acupuncture, you know, as I was kind of starting to influence people into what other possibilities we could do, it would be a conversation of, “Hey, this is what I’ve learned about, this is what it does, this is how it can potentially help. Do you want to add it in? And let’s see how it goes.” And for the most part, most people were pretty open to it. Some people were not. And I’m not here to tell you what to do, right? Everybody can look at it, decide.
But even my boss at the time was like, “What is this? What is this stuff you’re doing?Because these patients are coming back and they’re so much better.”
Now that I specialize just in using herbs, they’re coming to me and I’ll say maybe 1% of them will be hesitant. And that’s fine. Everybody has to take it at their own pace. But if they’re hesitant, then they need to also understand what are their expectations? Because just seeing me is not going to make a difference. Acupuncture will absolutely help, but the body needs a bit more support. So, right now I’m pretty blessed in that way.
KB: Client compliance is something that’s that’s a bit tenuous even under the best circumstances. So in you add in herbal medicines and all these different remedies, I imagine that can be a little overwhelming. Do you find that it’s difficult to convince pet owners to continue with the treatment plan at home?
AT: Totally. So whether you’re in conventional GP or holistic, it really doesn’t matter. Compliance is always an issue. Always, always, always. Let’s just go back to Prozac. You say, “Here’s the bottle of Prozac.” Then they finish the Prozac and they’re like, “My dog is not cured.” I’m like, really? Wow. Huh. Okay, let’s keep going. So it’s it is a compliance thing of like, just keep going. This is maintenance, right? It’s telling people this is maintenance. This is not the magic pill that’s going to fix you forever. It’s like any other chronic disease where you have to continue to support the system, because otherwise, not going to do anything.
MC: How about training staff in this practice?
AT: CIVT and Chi, and I’m sure there’s others out there, but they’re the two off the top of my head—those schools offer courses for technicians, so that’s one great way you can start to give them a little bit more. I mean, my techs, honestly, they just jumped in both feet and started learning and they’re mixing herbs and some are taking a little course here and there. And obviously, I’m a talker, and so I’ll just talk through cases with them and why I’m using herbs. And so just in that way, they’ve learned a ton. My staff is amazing. So they’ve just come on board and been like, “We’re going to learn whatever you teach us.” I’m really proud of them.
MC: That’s awesome that you’ve had that buy in from them. I would imagine that it really contributes to the to the work culture around there.
AT: Absolutely. We have cultivated our work culture to be how we need it to be. There’s four of us, and we have all burnt out on vet mad. And so, when we opened, we’re like, “How do we want to be every day? What should veterinary medicine be every day?” We should not be working through lunch. That’s dumb. Why do we even bother having a lunch, right? So we take off, we sit down at lunch. It is mandatory. We all get firm with each other. If someone’s trying to do work, it’s like, “No, take a break. Lie down flat. Like whatever you have to do, take a break.” We’re trying to really change the culture of how we practice, so that we’re not burning out and really enjoying what we’re doing and enjoying our patients instead of being aggravated by everybody all the time.
KB: That sounds great. Can I come work for you?
AT: Come on over. It’s a really good time.
KB: It sounds like it is. You’re probably all really relaxed, having a good time.
AT: That’s the ultimate goal. That’s the goal. We’re doing our best every day. That’s all you can do. Some days we get there; some days we just don’t. But come back the next day. Try it again.
KB: So speaking of being relaxed and cultivating a culture of wellbeing, we know there’s a lot of stressed-out pets and there’s also—newsflash!—a lot of stressed-out humans. Can you use some of these herbal remedies on both humans and pets, or is it—again, you’re probably going to go back to the there’s-no-one-size-fits-all approach—but like, can we talk about that a little bit?
AT: Totally. So, yes, not a one size fits all, but maybe it’s not as tricky as I’ve made it out to be in my head. But like, if a client comes in to see me with their pet, I am Dr. Alexia treating their pet, right? And so then often we will talk about them (the client), but I can’t be Dr. Alexia talking to them about their stuff. I could be Alexia, the registered herbalist, talking to them. I just have this thing where, like, I can’t really treat them per se—one, because I am not their doctor, but also I feel like I should see them in another building or with another hat on, and they’re calling me “Alexia,” not “Doctor.” So I will treat the patient, obviously. But oftentimes, while a patient has, like, acupuncture needles in, doing what I do, you get to really know your clients and everybody just starts sharing. And especially when they’re like, “I wish you were my doctor,” I’m like, “Well, I can make some recommendations for other people. In the meantime, why don’t you have a look at ashwagandha and see what you think?”
Or maybe I’ll give a tea to the pet and obviously everybody can share tea. It’s tea, right? So I’ll mix up tea. I made an anxiety tea a few weeks ago for myself. And then I had a client who was telling me how she was super stressed about helping her dad move into a nursing home. And I’m like, “Here, take some tea home, let me know how it is.” Like, if anything, at least is just like nice tea to drink and hopefully it helps you to just relax and take a moment.
So I don’t treat humans per se, but I just love sharing everything that I know and that then gives them kind of a stepping stone as to where to go next, whether it be with their doctor or their acupuncturist, chiropractor or naturopath. I’m constantly handing out names of human practitioners.
I had a client last Friday who has Crohn’s disease. She brings her dog in every week for treatment and I’m like, “Why aren’t you going for acupuncture?” She said, “I used to go, but I can’t afford it now.” I said, “Well, you bring your dog here every week. So, why don’t you not bring her next week and you go for acupuncture instead. Start treating yourself.” Because if you’re not healthy, you’re doing your dog no favors. If you’re stressed out, you’re going to stress her dog out, which some people don’t want to hear, but it’s the truth. I mean, when we’re stressed out, we stress our kids out. So why wouldn’t we stress our pets out? So I am a big proponent of people also taking care of themselves.
KB: Do you sell this anxiety tea on your web? Because I’m I’m really interested in this.
AT: I know. I should. Just stop by the office! I’ll give you a batch.
KB: Oh, sure. Okay. Next time I’m in New Jersey.
AT: Yep, that’s right. Come on over. (Laughs) I mean, one day, yes. In the future, I will absolutely be doing that.
MC: Well, before we let you go, can you share with us a memorable case where you had a patient achieve a particularly remarkable outcome with the use of herbal medicine?
AT: Yes. So it was about, I think five years ago, maybe six. I had this poor little dog, Raven, come in to see me. Raven was this, little mixed-breed thing from Alabama. And the mom who brought Raven in, it was actually her son’s dog. He was in school in Alabama, so he had gotten Raven in Alabama. But poor Raven was this like emaciated, skin-and-bones dog, who for the last year had been vomiting and unable to gain weight. And this kid really did everything—like, he took her to all the specialists and they did a fecal transplant. Like, they were doing things for her.
And so then finally Raven came up here (to New Jersey) to hang out with Mom, because I think the college student just couldn’t handle it anymore. Understandably so. And so she saw internal medicine specialist here. They did endoscopies, biopsy. It turned out she had H. Pylori and was just a total inflamed mess and not able to absorb protein. So they put her on all the conventional meds that you are to put her on, and she was on them for months and months. But Raven wasn’t gaining weight.
I do tend to be kind of the fourth opinion where people are like, “I don’t know what else to do, so I’m coming to see you.” And so Raven came in to see me and I made herbs that, Okay, these are the herbs she takes in the morning because we’re addressing X, Y, Z. And then we put her on herbs in the evening because I wanted to make sure that we were helping with gut inflammation and all of the above.
And so, Raven stopped vomiting. She went back and saw the specialist after a month and they were like, “What did you do to this dog?” And you know, when you’re telling people, they’re like writing it down, I’m like, “Yes! Let me tell you all the things I did, because I would love for you to do the same thing.” It was so remarkable because everybody really they tried their hardest to do everything they could for her and she just wasn’t responding.
Listen, we can sit here and argue that, like, it was because finally the antibiotics kicked in three months later, or finally the prednisone helped. But I think the herbs were the final thing that she really needed for her body to finally heal, regulate her immune system, and get things under control.
And now when Raven comes in, she’s fat. It’s really funny, but I can’t tell the client to make her lose weight, because after all that time of her being skin and bones, I’m like, “Just enjoy your weight, honey. It’s cool.”
KB: Yeah, she earned it.
AT: She totally did. Totally did. Absolutely.
KB: What a great story and a great way to end this episode. Thank you again for doing this. It’s been so much fun talking to you.
AT: Thank you for having me. Have a beautiful day!