The good, the bad and the ugly of traditional Chinese Medicine

By Andrew Porterfield

The 2015 Nobel Prize in Physiology or Medicine, shared by Chinese scientist Youyou Tu for her development of an effective antimalarial treatment derived from the wormwood plant Artemisia annual, put the ancient practice of Chinese medicine under a spotlight. It showed the positive side of combining more recent scientific methods with traditional medicine.

But a light was also shone on long-held concerns about traditional medicines.

Ancient healing meets modern medicine

Chinese traditional medicine, which includes the use of acupuncture and complex mixes of herbs, is ancient, with practices that reach back thousands of years. Over the past few decades, these practices have become popular in the West, particularly in the US and Europe. Mainstream medical institutions, such as a complementary and alternative health program at the University of New Hampshire, today study how herbal preparations are made and what benefits they might provide patients. Alternative medicine information is also available from a range of reputable sources, including the National Institutes of Health, which has its own National Institute of Complementary and Integrative Health.

Other organizations are not so reliable. “Disappointed with your current healthcare?” asks one website that sells what it calls Chinese herbs. “Traditional Chinese medicine has helped millions of people with their health concerns.”

Traditional Chinese practices, if used correctly, may be the original “precision medicine,” if you ask their practitioners. Typically, a “patient” will visit with a traditional specialist, who will concoct a cocktail of sorts, a suspension of a wide variety of herbs, spices and other (usually) organics that is supposed to be tailored to that patient’s ills.

Impacting genes

Can Chinese medicine impact the human genome, and deliver on its promises? A variety of individual responses to these therapies might be explained by epigenetic influences on gene expression.

  • A Korean research team found in mice that stimulating a specific acupuncture point associated with neurostimulation and Parkinson’s disease changed the expression levels of 799 genes. These genes could become biomarkers that indicate changes in neuronal activity and possibly point to treatments for the disease.
  • A Chinese group found changes in mRNA and protein expression in mouse lung tissue after stimulation of three acupoints with acupuncture needles. These expression changes appear to affect regulation of macromolecular biosynthesis, transportation and metabolism, the team reported.
  • A Taiwanese team analyzing 3,294 medicinal herbs and other compounds found that 36 percent of them worked with histone-modifying enzymes, and one-third of those promoted chromatin condensation, which compacts chromosomes and affects DNA repair and gene expression.

Natural isn’t harmless

Not all traditional medicines are beneficial, however. In fact, any responsible practitioner or specialist will warn that herbal treatments can be hazardous.

Aristolochic acid, which is part of many traditional Chinese preparations for menstrual cramps, rheumatism and (sometimes) weight loss, was also associated with kidney failure and urinary tract cancer, two studies reported.

In addition, traditional Chinese preparations have been found to contain heavy metals and plant toxins. Cases of adverse reactions have been reported, including some deaths. These concoctions are not regulated in either the US or Europe as drugs, but they can have powerful actions by themselves and equally powerful interactions with prescription drugs.

Another issue with Chinese traditional medicines has been identifying the ingredients of any individual herbal preparation. This issue has stemmed from either contaminants or the use of a substitute compound from similar, but not identical, species of plant. Since more than 5,000 species are used for therapies, and most of them are animal- or plant-derived organics, such identification has been difficult. But high-throughput screening and new whole-exome or whole-genome sequencing analysis has permitted scientists to more precisely determine what’s in the mix.

These techniques also have uncovered compounds derived from endangered animal and plant species, including bear bile powder from the endangered Asiatic black bear, and horn powder from the endangered Saiga antelope. The presence of these compounds is a violation of the Convention on International Trade in Endangered Species (CITES). Other compounds that were not declared by the makers were not endangered, but still a matter of concern: water buffalo, cow, deer and sheep DNA was discovered in 78 percent of preparations tested by an Australian team. “Even in the 15 (traditional Chinese medicines) tested here, the occurrence of CITES-listed species, potentially toxic/allergenic plants and non-declared constituents was all too common,” the researchers said.

There’s no question that traditional medicines, including Chinese herbal therapies, have a physiological effect, including an effect on disease. And many treatments, including the anti-malarial that won Professor Tu a Nobel Prize, can best any western-invented treatments. It’s important to note, however, that traditional Chinese medicine, Ayurvedic and other Asian medical traditions are not just interesting chemicals that can be part of western medicine—all these traditions come with their own, equally ancient philosophy and unique views on existence and health. Such treatments as artemisinin and acupuncture were developed under these philosophies, not western ones. For Asian traditional therapies and therapists as well as for western medicine, it’s about a meeting of minds as much as matter.

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Andrew Porterfield is a writer, editor and communications consultant for academic institutions, companies and non-profits in the life sciences. He is based in Camarillo, California. Follow @AMPorterfield on Twitter.

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