In your materia media sheet for Bitter Melon, you write: "Short-term use is appropriate, unless a patient is regularly observed by a clinician." Is this a guideline for folks with MetS, or only for those with diabetes and when taking Metformin? If for MetS, how long is short term use, and when would someone need to get their blood sugar levels re-checked? I also want to get a sense of how powerful this herb is in its ability to lower blood sugar levels. I want to understand when it is appropriate include it in a triune formula with other blood sugar regulating herbs. For example: someone with a Hemoglobin A1c of 5.6 and other signs that point to potential Metabolic Syndrome, how long could a person like this safely take Bitter Melon at 1/18 part in a Triune formula that included American Ginseng (1/9), turmeric (1/9) and cinnamon (1/18 ) in their triune? As well as a daily tea of Holy Basil and Hibiscus and dietary/lifestyle modifications. Could Bitter Melon in tincture form at 1/18 part take things too far? Does it work like that? I've looked back over all the case histories of folks with MetS that we've done in the past 3 years, as well as reviewed all my bitter melon notes and am still seeking the answer to these questions. Thank you. Your huge fan, Lea

If for MetS, how long is short term use, and when would someone need to get their blood sugar levels re-checked? For people with Diabetes and talking pharmaceutical hypoglycemic medication. Does it work like that? It should be fine, at 1/18 part it will not excessively reduce blood sugar levels.