Since traditional Chinese medicine covers so many different therapies and modalities, the below information includes only examples of safety concerns with selected herbs, supplements, and modalities. For more detailed information, please see Natural Standard monographs on individual therapies.
Chinese herbs can be powerful. Using Chinese herbs may further complicate an existing health condition. There have been reports of adverse effects; a qualified healthcare practitioner, including a pharmacist, should be consulted on dosage.
Studies of the Chinese herb ma huang, which is the main active ingredient in the weight-loss drug ephedra, indicate that use of the substance is associated with serious health complications, including acute hepatitis and deaths. Pregnant or lactating women should not use ma huang or other herbs such as ginseng where safety has not been clearly established.
Chinese herbs, when taken by mouth or applied on the skin, may cause an allergic reaction. For example, shi-un-ko, a Chinese medicine that is applied to the skin, may cause an allergic skin rash.
There have been reports of manufactured or processed Chinese herbal products being tainted with toxins or heavy metals or not containing the listed ingredients. A qualified healthcare professional, including a pharmacist, should be consulted for recommendations of safe herbal products.
Based on one study, Sang Ju Yin or Yu Ping Feng San formulas may cause headache or dizziness. Aristolochic acid, found in some Chinese herbal remedies, may cause kidney damage.
Chinese herbs can interact with drugs, interfering with or exaggerating their effects. In particular, ma huang should not be taken with caffeine. Consumers should consult with a medical professional, including a pharmacist, before mixing herbs with any prescription drugs.
Traditional Chinese medicine should be used with extreme caution in infants and children as harmful effects including blood disorders have been reported.
Acupuncture is generally reported as a safe procedure when performed by an experienced practitioner using standard sterile techniques. Needles must be sterile in order to avoid disease transmission (most practitioners now use disposable needles).
Rare serious and potentially lethal complications have been noted, including infection and organ, nerve, or vascular injury, such as cardiac tamponade. There are several reports of fatalities in the available medical literature. Acupuncture may be unsafe in particular when performed on patients with emphysema or other pulmonary disease (due to multiple case reports of pneumothorax), elderly or medically compromised patients, diabetics (due to poor circulation), or patients with history of seizures.
Electrostimulation acupuncture should be avoided in pregnant women (theoretical) and in patients with a cardiac history, including those persons with an arrhythmia or a pacemaker, due to risk of arrhythmia or interference with pacemaker functioning.
Acupuncture should be avoided in the following conditions: valvular heart disease, known bleeding disorders, use of anticoagulant drugs, unstable medical condition or infection, pregnancy (may induce unwanted labor and possible miscarriage), systemic or local infection, pain of unknown medical origin, medical condition of unknown origin such as dermatologic lesions, neurologic disorders. Acupuncture should also be avoided on areas that have received radiation therapy.
Cupping and moxibustion
Adverse events reported in the scientific literature from cupping and moxibustion are extremely rare. Cupping commonly leaves a temporary bruising of the skin, which disappears on its own. For both cupping and moxibustion, the following precautions and contraindications are based on tradition, clinical experience, and theory rather than controlled research.
Cupping: Avoid the abdomen/sacral area during pregnancy, contraindicated acupuncture points, during high fever, during convulsions or cramps, over allergic skin conditions or ulcerated sores, over an inflamed organ, over inflamed areas in general, in patients with cardiac disease and/or aneurysms, in patients with extreme fatigue and/or anemia, in patients who have just finished exercising or taking a hot bath or shower. Avoid sliding cups over the spine, moles, or other skin abnormalities.
Moxibustion: Use caution with patients with neuropathy. Avoid face, head, nipples, and genitals, skin adhesions, points where needling is contraindicated for the individual patient, in patients with any kind of “heat syndrome” according to acupuncture theory, in patients with strong heat signs (high fever, etc.), on or near inflamed and/or red areas of the body, in patients with diabetic neuropathy, or in any situation where the patient may not respond to the sensations of heat. Patients are advised not to bathe or shower for up to 24 hours after a moxibustion treatment.
Pregnancy and lactation: The abdominal area and the lower back during pregnancy are traditionally avoided in both cupping and moxibustion practice out of concern for adversely impacting the uterus or fetus, although there are no published reports of related adverse effects.
More safety information can be found in the specific monographs on this site for related modalities that are sometimes used with TCM.