The Toxicity of Chinese Herbal Medicine

The Toxicity of Chinese Herbal Medicine

Chinese herbal medicine categorizes herbs into three grades: superior (上品), medium (中品), and inferior (下品) in the ancient time. Superior and medium herbs generally possess mild medicinal properties and rarely cause toxicity. However, some inferior herbs have stronger medicinal properties that, if used improperly, can lead to toxicity. Understanding the toxicity of Chinese herbal medicine is complex due to historical misconceptions and differences in how toxicity is viewed in traditional Chinese medicine (TCM) versus Western medicine.

Traditional Classification and Toxicity

1. Normal Use: When used correctly, the toxicity of herbs often reflects their medicinal bias rather than adverse side effects in the Western sense. This bias is part of what gives the herb its healing properties. For example, herbs like “Aconite” (附子, Fuzi), though considered toxic in Western contexts, are used safely and effectively in TCM when prescribed correctly for the right conditions.
2. Overuse: Overuse of any substance, whether herbs, supplements, or even food, can be harmful. This principle applies to Chinese herbal medicine as well. Dosage and duration of use are critical factors in ensuring safety.
3. Improper or Incorrect Use: Incorrect use of herbs, such as prescribing the wrong herb for a condition, can lead to harm. Even herbs considered non-toxic can cause adverse effects if used inappropriately. This underscores the importance of accurate diagnosis and proper prescription in TCM.

Herbs Requiring Caution

1. Newly Discovered Toxic Herbs: New herbs like “Tripterygium wilfordii” (雷公藤, Lei Gong Teng) have been found to have toxic properties, which can help with Rheumatoid arthritis.
2. Highly Toxic Non-Traditional Herbs: Some herbs not traditionally used in TCM but found to have high toxicity should be approached cautiously.
3. Western Herbs with Unknown TCM Properties: Herbs introduced from the West, whose effects are not well understood in TCM, should be used carefully.

I never use these types of medicine in clinical practice, but patients often ask me about them. My answer is that it is not necessary, because we can completely replace this type of medicine with very safe traditional Chinese medicine.

Monitoring and Regulations

For patients with severe liver or kidney deficiencies, regular monitoring of liver and kidney function may be necessary when using herbs long-term(more than 3-4 months). It’s also worth noting that many herbs considered toxic in Western studies are banned in countries like Australia. Only herbs deemed highly safe by Western standards are permitted for use. This regulatory approach has a dual impact: it minimizes the risk of misuse of highly toxic herbs, but it also limits the availability of effective treatments for certain conditions that require these herbs.

Conclusion

The toxicity of Chinese herbal medicine is a nuanced topic that depends on correct use, dosage, and understanding of the herbs’ properties. Misuse and overuse can lead to harmful effects, but when used correctly, many herbs are safe and highly effective. Recognizing the importance of accurate diagnosis and proper prescription, along with understanding historical and regulatory contexts, ensures the safe and beneficial use of Chinese herbal medicine.