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Frequently Asked Questions 

  • Choose between capsules, granule extract, and draft formulas
    On your intake form, you can indicate whether you'd like to receive your custom formula as a capsule, a granule extract, or a draft. If you are open to all the options, select the "whatever is recommended" option in the intake form. Granules. The most common method of administering herbal medicine that we use is called a granule extract. This is a modern extraction method, where herbs are prepared with a long hot water extraction (called a decoction) and then concentrated and dried into a powder. Granule extracts are added to water and taken like a tea. Granules combine the potency of a decoction with convenience of a tea. The average granule yields a 5:1 extraction, meaning that every 100 gram bottle of granules is equivalent to 500 grams of raw herb equivalent. Our granule extracts are supplied by Evergreen Herbs and Legendary Herbs. Draft. The second most common method we use is called a draft. This is a formula made from raw herbs that have been ground to a fine powder. To take a draft formula, you'll add the powder to an insulated thermos with 16-20 oz of boiling water, steep it from 30 minutes to overnight, strain and drink. Drafts steeped in this way yield a better extraction than a standard tea infusion. Drafts yield a higher volatile oil content than granule extracts, and have a flavor profile more similar to traditional decoctions. Some herbal medicines are better suited for draft extraction, and some are better suited to granule extraction. If you don't know which to pick, just select "whatever is recommended" on the intake form. The herbs for our draft formulas are supplied by Spring Wind Herbs and Nuherb. Capsules. The capsules which we use are granule extracts that have been encapsulated. Capsules are the least customizable option, because the formula composition is already set and there are only so many capsule formulas available. With granules and drafts, we make custom formulas from a library of over 400 different herbs. That said, some conditions are very well suited to capsule formulas and very hard to beat the convenience of capsules, and for those who struggle with the taste of herbs, taking an appropriate capsule formula is much more effective than taking no herbal medicine at all. For best results, we recommend being open to a capsule formula and a granule or draft if there is not a capsule available. If you are only able / willing to take a capsule - Sean will recommend the most appropriate capsule formula for you. Some people who dislike the taste of herbs use a home capsule maker to put their custom granule formula into capsules - which is another good option. Our capsule formulas are supplied by Classical Pearls.
  • Where can I learn more about Chinese Medicine, Herb Quality and Safety?
    Check out our page on Chinese Medicine here for more information!
  • How does Merlin work? ​
    1. Complete our Merlin virtual intake. Fill out the general intake form or choose an intake dedicated to specific concerns, located on the Merlin site. 2. After completing your intake, choose a subscription plan. 3. Your intake will be reviewed by Sean Dugan L.Ac. within 48 hours, you'll receive your first month's supply of your new custom formula in 3 - 5 days from the time you purchase your subscription plan.
  • What can Merlin help me with?
    Merlin custom formulas may help you with a wide variety of complaints, including but not limited to: Headaches and migraines Allergies Sinusitis Menstrual pain or PMS symptoms Irregular periods, fibroids, PCOS Fatigue, adrenal fatigue Poor sleep Stress, chronic "fight or flight" stress response Mood support Nerve pain Gut issues such as diarrhea, constipation, bloating, acid reflux, etc Hot flashes Chronic pain Peripheral Neuropathy Chronic yeast infections Low libido Erectile dysfunction Premature ejaculation
  • How much does Merlin cost?
    Merlin is offered as a monthly subscription. Each month, you'll receive a custom formula created by licensed practitioner Sean Dugan L.Ac. Choose from a monthly delivery of capsules (2 bottles), granule extract (200 grams), or draft (450 grams). All for just $120 per month. Once you've started taking your custom formula, you may choose to continue with the same formula as long as you want, and each month you'll receive another order. As things with your health change or improve, your custom formula may need to be updated or you may want a different custom formula if a new concern arises. To receive a new custom formula, simply fill out the intake formula again before your subscription renews, and Sean Dugan L.Ac. will review it and create a new formula for you.
  • What if I'm looking for more interactive support or help with a severe or complex condition?
    Easy Herbx was created to offer Sean Dugan L.Ac.'s clinical expertise at an affordable rate and in a convenient way. Based on his years of clinical experience and intensive focus on herbal medicine practice, Sean can help many people through the information provided through the Easy Herbx virtual intake. However, if you are looking for a high level of interactive support, with the most detailed analysis of your health, and a treatment plan with regular follow-up care - you may be best served by scheduling in-person or telemedicine visits with me.
  • How to take a tongue photo
    Take a picture of your tongue sticking out of your mouth. Extend your tongue out of your mouth, but without excessive force. Don’t “point” your tongue out. Let it fall out like a dog that is panting. Take the photo natural sunlight i.e. by the window or outdoors (Do it in the shade, not with bright sunlight). This helps get the most accurate colors. For best results, take 2 photos in different lighting.
  • Can I use my insurance?
    If you have Blue Cross of Idaho, Regence Blue Shield of Idaho, Fed Blue or other Blue Card insurance and you have acupuncture benefits on your plan, we can bill your insurance for Orthopedic Acupuncture visits. No insurance in the United States covers Chinese herbal medicine or office visits for Chinese herbal medicine treatment. Chinese Medicine visits at our clinic cannot be billed to any insurance. We are in-network with Blue Cross of Idaho, Regence Blue Shield of Idaho, and associated Blue Card Plans. Acupuncture visits can be billed to these insurances if you have acupuncture benefits on your plan. Please verify acupuncture benefits with your insurance plan before booking, and fill out our online forms as soon as possible so we can verify your benefits. We do not bill insurance for United Healthcare, Medicare, Aetna, Cigna, Pacific Source, Select Health, or any other plan. If you have acupuncture benefits through iiia you can submit receipts to iiia for reimbursement using this form. Contact iiia for more information. I am a community care acupuncture provider for the Boise VA. If you have health coverage through the VA, you can ask your doctor for a referral to acupuncture and select me as the provider you'd like to see.
  • I can only afford one visit. Should I make an appointment?
    Paying for Chinese Herbal Medicine and Acupuncture treatment out-of-pocket can be expensive, there's no way around it. Our healthcare system in the US is flawed, and has not done a good job of integrating safe and effective modalities like Chinese Medicine. The global demand for Chinese herbs continues to rise, and the cost of high-quality herbal medicine at an effective dose is significant. On the other hand, relative to the real cost of Western medical care, it's actually much less expensive. We pay into our health insurance system that subsidizes non-Chinese Medicine care. If we paid cash for the services side-by-side, it would look very different: acupuncture to resolve chronic back pain: ~$2,000. surgery for chronic back pain: ~$20,000 to $100,000. *Not all cases of chronic low back pain can be resolved without surgery, but many of them can be. For orthopedic and musculoskeletal complaints - it can be worth it to come in for just one or two visits if you're dealing with a relatively new and moderate complaint. For 10 year old chronic pain, you're not likely to see the result you want in 1 or even 2 visits, so I don't recommend coming in if you're not planning to follow a treatment plan. For internal medicine complaints - it's unlikely I can do much for you in just one visit. Most internal medicine complaints will take an average of 3 months of herbs and 5-6 office visits. In most cases, I don't recommend that you come in to see me if you can only afford one visit. You can check out our general formulas that are available at the Chinese Medicine of Idaho herb shop to see if they might fit your needs. You might also consider using our Easy Herbx service.
  • Do you take Medicare?
    We cannot bill Medicare. In 2020, Medicare added acupuncture coverage for chronic low back pain to Medicare benefits. However, Licensed Acupuncturist is not yet a designated provider type for Medicare, so we are unable to bill Medicare for this benefit. The Medicare benefit states that the acupuncture services must be billed to Medicare by a Medical Doctor, PA, or NP/CNS. Since the vast majority of Licensed Acupuncturists operate independently, and not under the supervision of an MD, PA, or NP/CNS, this benefit exists but generally cannot actually be used until Licensed Acupuncturists are added to the list of Medicare provider types. A bill to add Licensed Acupuncturists as a Medicare provider type, and thereby make the existing acupuncture Medicare benefits usable, is currently in Congress as H.R.3133 Acupuncture for our Seniors Act 2023. Earlier versions of this bill have been introduced since 2021, and were not passed due to lack of Republican support. The current bill is not likely to pass unless it gains significant Republican support. Do you want to be able to use your Medicare acupuncture benefit? The best thing you can do to make that happen is to contact your Republican representatives and let them know that they need to pass H.R.3133 in the upcoming legislative session.
  • Are Chinese herbs safe?
    The herbs that we use go through rigorous scientific testing to ensure correct botanical identity and active ingredients. They are screened for heavy metals, microbial contamination, and pesticide contamination. Granule extracts produced in China and Taiwan are held to the same high standards as pharmaceutical drug manufacturing, standards that are more highly regulated than anything seen in the US supplement market, which is largely unregulated. The suppliers that provide our granule extracts also provide herbs for modern hospitals in China and Taiwan. Our Chinese Herbs must pass the following tests to make it to us: ​ Organoleptic Visual Check TLC Active Ingredient Check Total Heavy Metal Test Total Yeast and Mold Test Salmonella Test Loss on Drying Test Acid-Insoluble Ash Test Individual Heavy Metal Tests (Lead, Cadmium, Mercury, Arsenic) Aflatoxin Test Microscopic Cellular Identity Check HPLC Potency Level Test Total Aerobic Microbial Count Test E.coli Test Enterobacteria & Other Gram Negative Bacteria Test Total Ash Content Test Dilute EtOH Extract Test Pesticide Test (over 100 pesticides tested) ​ Not only are the specific herbs we use safe, Chinese herbs are safe in general. Historically, problems with herb safety fall into two main categories: abuse or improper use, and adulteration. These issues are not unique to Chinese herbs, but Chinese herbs have more PR problems due to political perception and stigmas. Improper use includes cases where athletes and diet pill companies have abused certain herbs that have stimulant qualities. Overuse of stimulants of any kind can easily lead to a variety of problems, and this is not unique to Chinese Medicine or a common problem that we see. Safety issues resulting from improper use of Chinese herbal medicines are easily avoided by seeing a qualified practitioner who will recommend the appropriate herbs and appropriate dosages for you. Adulteration has been a historical problem because the Chinese herb trade is a business., and there have been bad actors, just like in any sector. A classic example would be people selling Cordceyps sinensis fruiting bodies - one of the most expensive herbs on the planet - and slipping small lead bars inside the fungus to get paid more (herbs are typically sold by weight). Things like this are very easily avoided by using reputable suppliers who do rigorous quality testing. So probably best not to use Amazon sellers or random herb websites. Concerns about heavy metal and pesticide contamination are real, and that's why we use companies that test for these. A lot of people have the misconception that anything from China must be contaminated, because they just think about China as massive cities. China is a big place, and if you compare rural China to the midwestern US, the latter is not necessarily more pristine. Heck, your neighborhood probably sprays a lot more insecticide and herbicide on lawns and gardens than the regions we source herbs from. After addressing the issues around contamination and abuse/misuse, there is another reason why Chinese herbal medicine is fundamentally safer than modern medicines. Each individual herb that we use contains hundreds of unique phytochemicals. Some of these compounds have similar actions, some of them have opposite physiologic actions that balance each other. Pharmaceutical drugs are made by identifying an active ingredient in a plant, isolating it and concentrating it thousands of times over. This makes modern drugs very strong, and that's why they are valuable. But it also makes them more forceful, and fundamentally less safe. They don't work with your body to make something happen, they make it happen whether your body likes it or not. That's basically how we get side effects - the forceful and unilateral nature of drugs. Herbs are fundamentally milder in action. Each herb has small amounts of many compounds, and our body is more able to take up what is helpful and excrete what is not needed. To make it even more safe, in Chinese Medicine we don't just use single herbs. Instead of using 100 grams of one herb that has a particular physiologic effect, we will use 10 grams of 10 different herbs that all support the same goal but with different phytochemicals that do it in slightly different ways. This multiplies the safety profile even more. At its core, Chinese herbal medicine uses less force than modern drug medicine, but through a deep understanding of human physiology, is able to elegantly apply a small amount of force in a way that causes a profound effect. One way to think about the difference between Chinese herbal medicine and modern pharmaceutical medicine is like this: imagine that a large boulder blocks your path and needs to be moved. Using Chinese herbal medicine is like wedging a 2x4 between a smaller rock and the boulder and using a small amount of force, with leverage in the right place, to roll the boulder out of the way. Using a modern drug medication is like blowing the boulder up with a stick of dynamite - it's fast and effective, but the large amount of force applied via explosion can cause collateral damage. Some boulders require dynamite, many of them do not.
  • How much does it cost?
    Acupuncture new patient visits are $150, and follow up visits are $100. Herbal Medicine Evaluation & Treatment new patient visits are $150, and follow up visits are $100. Acupuncture + Herbal Evaluation & Treatment new patient visits are $200, and follow up visits are $150. Herbal medicine costs varies between $30 and 60 per week, depending on the dosage of herbs needed.
  • What type of Acupuncture you practice?
    There are many styles of traditional acupuncture practice. This includes TCM, Dr. Tan, Master Tung, Five Element, orthopedic, scalp, and auricular acupuncture are some of the many traditional acupuncture techniques. Since acupuncture is unfamiliar to many people here in the US, it can be confusing. People tend to think there must be one type that is better than the rest. This is really not the case. There are many approaches in any medical discipline, and this is no different with acupuncture. What works well for you and what you're looking for may be very different than the next person. One person might be looking to talk to an acupuncturist about their emotions, and receive a very gentle distal acupuncture treatment. Another person doesn't want to talk about anything, they want the muscle spasm in their neck released with local needling. I am trained in TCM, Master Tung, Orthopedic Acupuncture, Xing Nao Kai Qiao, scalp, auricular, and Battlefield acupuncture techniques. I also incorporate some Tuina massage techniques, guasha, and cupping myofascial release into acupuncture treatments as needed.
  • Do I take Chinese herbal medicine as a tea, capsule, etc?
    There are a variety methods of taking herbal medicine - including teas, tinctures, and capsules. In Chinese Medicine we primarily use hot water extracted herbs in the form of decoctions. A decoction is cooked, simmered for 20-60 minutes, whereas a tea is infused in boiling water. Both decoctions and teas are drunk, typically warm or hot. Granules. The most common method of administering herbal medicine that I use is called a granule extract. This is a modern method where a decoction is prepared into a concentrated powder. You add water, and drink it "like a tea." Both decoctions and granule extracts taste bad, but granule extracts save you from cooking an hour every day. Your family will also thank you for not filling the kitchen with intense herbal aromas. Granules are often referred to as "powder" but are very different than grinding raw herbs into a powder. ​ Draft / San preparation. The second most common method I use is draft, or San preparation. The raw herbs are ground to a fine powder, then added to an insulated thermos with boiling water and steeped overnight. This is effectively a tea or infusion, but the steeping method yields a better extraction than a standard infusion. This method is chosen when we need to use herbs with higher volatile oil content than granule extraction can provide. Capsules. The capsules which I use are granule extracts that have been encapsulated. Capsules are the least customizable option, because the formula composition is already set and there are only so many capsule formulas available. With granules and draft / San preparations, we make custom formulas from a library of ~ 400 different herbs. The capsule method can also be more challenging to achieve a high therapeutic dose. Capsule dosage can range from taking 6 capsules/day to 18 capsules/day or more to equal a typical granule dosage. That said, some conditions are very well suited to the available capsule formulas. It's very hard to beat the convenience of capsules, and for those who struggle with the taste of herbs, taking an appropriate capsule formula is much more effective than taking no herbal medicine at all. For best results, I recommend being open to a capsule formula and a granule or draft / San if there is not a capsule available. If you are only able / willing to take a capsule - I will recommend the most appropriate capsule formula for you. If there is not a capsule formula that is available that I think will work for you - I will let you know. Some people who dislike the taste of herbs use a home capsule maker to put their custom granule formula into capsules - which is another good option. ​ Where do you get your herbs? Your herbs will either be prepared in my Chinese herbal pharmacy, or ordered from the closest large Chinese herbal pharmacy, which is located in Oregon. Herbs ordered typically arrive in 2-3 days.
  • How much treatment will I need? How long will it take?
    This is highly variable depending on the person and the severity of their condition. There is no way for me to give an accurate prognosis without evaluating your condition at your first appointment. Some general guidelines: Orthopedic and musculoskeletal complaints (like neck or back pain) tend to respond faster than internal medicine complaints (like chronic insomnia). The longer you've had the problem, the more treatment it takes to resolve. Some examples: Orthopedic and musculoskeletal complaints. You've been having neck or back pain that's new within the past month. 1 to 2 orthopedic acupuncture treatments may be enough to correct this, but it may take up to 6 treatments depending on the severity. You've had neck or back pain off and on for 10 years. The pain is moderate-severe and you have bony changes like bone spurs, scoliosis, disk degeneration, stenosis, arthritis, or excessive spinal curvature. I will recommend orthopedic acupuncture 1-2 times per week for 12 visits. You may see improvement quickly, or it may take the full 12 visits until you see significant improvement. 80% of my patients with musculoskeletal pain see significant improvements within 12 visits. Depending on your individual condition, you may or may not need maintenance care. Most of the time patients can use therapeutic exercise to maintain the improvement, others will opt for maintenance care. With maintenance care, we do less acupuncture over time, gradually spreading out the visit frequency while maintaining the improved state. Internal medicine complaints. (insomnia, painful menses, digestive issues, etc) *For most internal medicine complaints, expect to be taking herbs for 1-3 months for new conditions, and 3-6 months (or more) for chronic conditions. During herbal medicine treatment, expect to come in for follow up visits every 2 to 4 weeks. That being said, since I treat a wide variety of internal medicine complaints, it is very hard to make generalizations about timeline. Examples: These are not a prognosis, but are intended to give a general idea of treatment timeline for some of the conditions I treat. Painful menses, irregular cycles, PMS. 90% of my patients coming in for gynecological complaints see significant improvement within 3 months of herbal medicine treatment. This involves coming in for a new patient visit, and follow up visits every 2 to 4 weeks, and taking herbs throughout the treatment. Some patients see significant change within the first cycle, but 3 months is the most realistic timeframe. After that, maintenance with a lower (less expensive) dose of herbs and infrequent visits can be used to prevent recurrence. Sometimes mild lifestyle modification is all that's needed for maintenance, other times nothing is required for maintenance. Allergies. With allergies, I expect to see improvement within a week or two. Stabilization may take a month or more, and longer with chronic longstanding allergies. Chronic sinus infections / sinusitis. While you may feel improvement within a week, for long term resolution and breaking the cycle of recurrence, this usually involves taking herbs for 3 months, sometimes 6 months. Cardiovascular and metabolic complaints. For fatty liver disease, high cholesterol, high blood pressure, irregular heart rhythms - the minimum treatment time is 6 months. Insomnia. Response to insomnia treatment can varies widely. You may see improvement in a few weeks, or it could take several months. Severe and longstanding insomnia often requires lifestyle modification, and some insomnia does not respond to treatment at all.
  • Can you help me with ___________?
    Please visit the Acupuncture and Chinese Medicine pages to see lists of common complaints that I help people with. Are you looking for help with something that's not on those lists? Those lists are not exhaustive, so it's still possible that I can help you. Chinese Medicine treatment is holistic in nature, which means that it is able to help people with a very wide range of conditions. All health conditions arise from imbalance and dysfunction of one or more body systems. By using holistic assessment and treatment methods, the symptoms and the root cause of many conditions can be improved or resolved. Still wondering if I can help you with something that's not listed on the website? You can fill out the form at the bottom of the page to send me your question.
  • Can I use my FSA / HSA benefits?
    Many HSA / FSA plans can be used for Acupuncture visits, Herbal Medicine office visits and herbal medicine at our clinic, but it's important to check with your individual plan. As providers, we do not have any contract with your unique HSA / FSA plan. It is your responsibility to understand your HSA / FSA benefits. If your plan requires a letter of medical necessity to be signed, it must be signed by a Medical Doctor - we cannot sign it. We can provide receipts to you for goods and services, that is the extent of our interaction with your HSA / FSA plan.
  • Your bio says you treat internal medicine conditions with Chinese herbal medicine. What do you mean by "internal medicine conditions"?
    By internal medicine conditions, I mean any condition that is not strictly a musculoskeletal or orthopedic condition. So for example - neck or back pain is generally going to be categorized as musculoskeletal/orthopedic. Gynecological complaints, digestive issues, sleep issues, allergies, and anxiety would be examples of internal medicine conditions - problems that involve your body’s complex internal chemistry and functions. I prefer to treat internal medicine conditions with Chinese herbs, because Chinese Herbal Medicine is the strongest and most effective holistic treatment method for addressing internal medicine conditions that's available today. Acupuncture can be useful in addressing internal medicine conditions when used with the appropriate timing and dosage. However, my expertise lies in treating internal conditions with herbal medicine, and I always steer my patients towards the method of treatment that will yield the best results for them, be that acupuncture, herbal medicine, or a combination of the two. For more information on acupuncture and Chinese herbal medicine, see my Acupuncture and Chinese Herbal Medicine pages.

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