Side Effects and Risks
– Herbal medicines used in TCM are sometimes marketed in the United States as dietary supplements. The U.S. Food and Drug Administration (FDA) regulations for dietary supplements are not the same as those for prescription or over-the-counter drugs; in general, the regulations for dietary supplements are less stringent. For example, manufacturers don’t have to prove to the FDA that most claims made for dietary supplements are valid; if the product were a drug, they would have to provide proof.
– Some Chinese herbal products may be safe, but others may not be. There have been reports of products being contaminated with drugs, toxins, or heavy metals or not containing the listed ingredients. Some of the herbs used in Chinese medicine can interact with drugs, can have serious side effects, or may be unsafe for people with certain medical conditions. For example, the Chinese herb ephedra (ma huang) has been linked to serious health complications, including heart attack and stroke. In 2004, the FDA banned the sale of ephedra-containing dietary supplements, but the ban does not apply to TCM remedies.
– The FDA regulates acupuncture needles as medical devices and requires that the needles be sterile, nontoxic, and labeled for single use by qualified practitioners only. Relatively few complications from the use of acupuncture have been reported. However, adverse effects—some of them serious—have resulted from the use of nonsterile needles or improper delivery of acupuncture treatments.
– Tai chi and qi gong are considered to be generally safe practices.
– Information on the safety of other TCM methods is limited. Reported complications of moxibustion include allergic reactions, burns, and infections, but how often these events occur is not known. Both moxibustion and cupping (applying a heated cup to the skin to create a slight suction) may mark the skin, usually temporarily. The origin of these marks should be explained to health care providers so that they will not be mistaken for signs of disease or physical abuse.
When thinking about ancient medical systems such as TCM, it is important to separate questions about traditional theories and concepts of health and wellness from questions about whether specific interventions might be helpful in the context of modern science-based medicine and health promotion practices.
The ancient beliefs on which TCM is based include the following:
– The human body is a miniature version of the larger, surrounding universe.
– Harmony between two opposing yet complementary forces, called yin and yang, supports health, and disease results from an imbalance between these forces.
– Five elements—fire, earth, wood, metal, and water—symbolically represent all phenomena, including the stages of human life, and explain the functioning of the body and how it changes during disease.
– Qi, a vital energy that flows through the body, performs multiple functions in maintaining health.
Concepts such as these are of interest in understanding the history of TCM. However, NCCIH-supported research on TCM does not focus on these ideas. Instead, it examines specific TCM practices from a scientific perspective, looking at their effects in the body and whether the practices are helpful in symptom management.
TCM practitioners use a variety of techniques in an effort to promote health and treat disease. In the United States, the most commonly used approaches include Chinese herbal medicine, acupuncture, and tai chi.
– Chinese herbal medicine. The Chinese Materia Medica (a pharmacological reference book used by TCM practitioners) describes thousands of medicinal substances—primarily plants, but also some minerals and animal products. Different parts of plants, such as the leaves, roots, stems, flowers, and seeds, are used. In TCM, herbs are often combined in formulas and given as teas, capsules, liquid extracts, granules, or powders.
– Acupuncture. Acupuncture is a family of procedures involving the stimulation of specific points on the body using a variety of techniques. The acupuncture technique that has been most often studied scientifically involves penetrating the skin with thin, solid, metal needles that are manipulated by the hands or by electrical stimulation.
– Tai chi. Tai chi is a centuries-old mind and body practice. It involves gentle, dance-like body movements with mental focus, breathing, and relaxation.