Traditional Chinese medicine is a medical system that has been used for thousands of years to prevent, diagnose, and treat disease. It is based on the belief that qi (the body's vital energy) flows along meridians (channels) in the body and keeps a person’s spiritual, emotional, mental, and physical health in balance. Traditional Chinese medicine aims to restore the body’s balance and harmony between the natural opposing forces of yin and yang, which can block qi and cause disease. Traditional Chinese medicine includes acupuncture, diet, herbal therapy, meditation, physical exercise, and massage. Also called Oriental medicine and TCM.

What’s the Bottom Line?

How Much Do We Know About Traditional Chinese Medicine?

The approaches that make up traditional Chinese medicine (such as acupuncture, tai chi, and herbal products) have been the subjects of many clinical studies and scientific reviews.

What Do We Know About the Effectiveness of Traditional Chinese Medicine?

Some psychological and/or physical approaches used in traditional Chinese medicine practices, such as acupuncture and tai chi, may help improve quality of life and certain pain conditions. Studies of Chinese herbal products used in traditional Chinese medicine for a range of medical conditions have had mixed results.

What Do We Know About the Safety of Traditional Chinese Medicine?

Some Chinese herbal products have been contaminated with toxic compounds, heavy metals, pesticides, and microorganisms and may have serious side effects. Manufacturing errors, in which one herb is mistakenly replaced with another, also have resulted in serious complications.

What Is Traditional Chinese Medicine?

Traditional Chinese medicine (TCM) has evolved over thousands of years. TCM practitioners use various psychological and/or physical approaches (such as acupuncture and tai chi) as well as herbal products to address health problems.

What the Science Says About the Effectiveness of Traditional Chinese Medicine

Acupuncture

Acupuncture is a technique in which practitioners stimulate specific points on the body, usually by inserting thin needles through the skin. Studies suggest that acupuncture stimulates the release of the body’s natural painkillers and affects areas in the brain involved in processing pain; however, some trials suggest that real acupuncture and sham acupuncture are equally effective, indicating a placebo effect. Results from a number of studies, however, suggest real acupuncture may help ease types of pain that are often chronic, such as low-back pain, neck pain, osteoarthritis/knee pain, and carpal tunnel syndrome. It also may help reduce the frequency of tension headaches and prevent migraine headaches.

Tai Chi

Tai chi combines certain postures, gentle movements, mental focus, breathing, and relaxation. Research findings suggest that practicing tai chi may improve balance and stability in older people and those with Parkinson’s disease, reduce pain from knee osteoarthritis, help people cope with fibromyalgia and back pain, and promote quality of life and improve mood in people with heart failure.

Chinese Herbal Products

Chinese herbal products have been studied for many medical problems, including stroke, heart disease, mental disorders, and respiratory diseases (such as bronchitis and the common cold), and a national survey showed that about one in five Americans use them. Because many studies have been of poor quality, no firm conclusions can be made about their effectiveness.

What the Science Says About the Safety of Traditional Chinese Medicine

Reports and studies of herbal products used in TCM have found a variety of safety issues.

• Some Chinese herbal products have been found to be contaminated with undeclared plant or animal material; drugs (such as the blood-thinner warfarin and the nonsteroidal anti-inflammatory agent diclofenac); heavy metals (such as arsenic, lead, and cadmium); pesticides or compounds called sulfites, which could cause asthma or severe allergic reactions; or incorrect herbs, some of which have caused organ damage.
• Relatively few complications from using acupuncture have been reported. Still, complications have resulted from the use of nonsterile needles and improper delivery of treatments. When not delivered properly, acupuncture can cause serious adverse effects, including infections, punctured organs, collapsed lungs, and injury to the central nervous system.
• Tai chi and a similar technique called qigong appear to be safe practices. While it’s unlikely that tai chi will result in serious injury, it may be associated with minor aches and pains. Women who are pregnant should talk with their health care providers before beginning tai chi, qigong, or any other exercise program.

More To Consider

• If you’re considering TCM, be sure to discuss this with your health care providers. Don’t use TCM to replace or delay seeking conventional care.
• If you have a health condition, talk with your health care provider before using TCM herbal products.
• Ask about the training and experience of the TCM practitioner you are considering. Most states and the District of Columbia have laws regulating acupuncture practice, and most states require certification from the National Certification Commission for Acupuncture and Oriental Medicine.
• If you are pregnant or nursing, or are thinking of using TCM to treat a child, be especially sure to consult your (or the child’s) health care provider.
• Tell all your health care providers about any complementary or integrative health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

If you’re looking for a complementary health practitioner to help treat a medical problem, it is important to be as careful and thorough in your search as you are when looking for conventional care.

Here are some tips to help you in your search:

1. If you need names of practitioners in your area, first check with your doctor or other health care provider. A nearby hospital or medical school, professional organizations, state regulatory agencies or licensing boards, or even your health insurance provider may be helpful. Unfortunately, the National Center for Complementary and Integrative Health (NCCIH) cannot refer you to practitioners.

2. Find out as much as you can about any potential practitioner, including education, training, licensing, and certifications. The credentials required for complementary health practitioners vary tremendously from state to state and from discipline to discipline.

   Once you have found a possible practitioner, here are some tips about deciding whether he or she is right for you:

3. Find out whether the practitioner is willing to work together with your conventional health care providers. For safe, coordinated care, it’s important for all of the professionals involved in your health to communicate and cooperate.

4. Explain all of your health conditions to the practitioner, and find out about the practitioner’s training and experience in working with people who have your conditions. Choose a practitioner who understands how to work with people with your specific needs, even if general well-being is your goal. And, remember that health conditions can affect the safety of complementary approaches; for example, if you have glaucoma, some yoga poses may not be safe for you.

5. Don’t assume that your health insurance will cover the practitioner’s services. Contact your health insurance provider and ask. Insurance plans differ greatly in what complementary health approaches they cover, and even if they cover a particular approach, restrictions may apply.

6. Tell all your health care providers about the complementary approaches you use and about all practitioners who are treating you. Keeping your health care providers fully informed helps you to stay in control and effectively manage your health.

What’s the Bottom Line?

How much do we know about acupuncture?

There have been extensive studies conducted on acupuncture, especially for back and neck pain, osteoarthritis/knee pain, and headache. However, researchers are only beginning to understand whether acupuncture can be helpful for various health conditions.

What do we know about the effectiveness of acupuncture?

Research suggests that acupuncture can help manage certain pain conditions, but evidence about its value for other health issues is uncertain.

What do we know about the safety of acupuncture?

Acupuncture is generally considered safe when performed by an experienced, well-trained practitioner using sterile needles. Improperly performed acupuncture can cause serious side effects.

What Is Acupuncture?

Acupuncture is a technique in which practitioners stimulate specific points on the body—most often by inserting thin needles through the skin. It is one of the practices used in traditional Chinese medicine.

What the Science Says About the Effectiveness of Acupuncture

Results from a number of studies suggest that acupuncture may help ease types of pain that are often chronic such as low-back pain, neck pain, and osteoarthritis/knee pain. It also may help reduce the frequency of tension headaches and prevent migraine headaches. Therefore, acupuncture appears to be a reasonable option for people with chronic pain to consider. However, clinical practice guidelines are inconsistent in recommendations about acupuncture.

The effects of acupuncture on the brain and body and how best to measure them are only beginning to be understood. Current evidence suggests that many factors—like expectation and belief—that are unrelated to acupuncture needling may play important roles in the beneficial effects of acupuncture on pain.

Acupuncture for pain conditions and others:

For Low-Back Pain

• A 2012 analysis of data on participants in acupuncture studies looked at back and neck pain together and found that actual acupuncture was more helpful than either no acupuncture or simulated acupuncture.
• A 2010 review by the Agency for Healthcare Research and Quality found that acupuncture relieved low-back pain immediately after treatment but not over longer periods of time.
• A 2008 systematic review of studies on acupuncture for low-back pain found strong evidence that combining acupuncture with usual care helps more than usual care alone. The same review also found strong evidence that there is no difference between the effects of actual and simulated acupuncture in people with low-back pain.
• Clinical practice guidelines issued by the American Pain Society and the American College of Physicians in 2007 recommend acupuncture as one of several nondrug approaches physicians should consider when patients with chronic low-back pain do not respond to self-care (practices that people can do by themselves, such as remaining active, applying heat, and taking pain-relieving medications).

For Neck Pain

• A 2009 analysis found that actual acupuncture was more helpful for neck pain than simulated acupuncture, but the analysis was based on a small amount of evidence (only three studies with small study populations).
• A large German study with more than 14,000 participants evaluated adding acupuncture to usual care for neck pain. The researchers found that participants reported greater pain relief than those who didn’t receive it; the researchers didn’t test actual acupuncture against simulated acupuncture.

For Osteoarthritis/Knee Pain

• A 2014 Australian clinical study involving 282 men and women showed that needle and laser acupuncture were modestly better at relieving knee pain from osteoarthritis than no treatment, but not better than simulated (sham) laser acupuncture. Participants received 8 to 12 actual and simulated acupuncture treatments over 12 weeks. These results are generally consistent with previous studies, which showed that acupuncture is consistently better than no treatment but not necessarily better than simulated acupuncture at relieving osteoarthritis pain.
• A major 2012 analysis of data on participants in acupuncture studies found that actual acupuncture was more helpful for osteoarthritis pain than simulated acupuncture or no acupuncture.
• A 2010 systematic review of studies of acupuncture for knee or hip osteoarthritis concluded that actual acupuncture was more helpful for osteoarthritis pain than either simulated acupuncture or no acupuncture. However, the difference between actual and simulated acupuncture was very small, while the difference between acupuncture and no acupuncture was large.

For Headache

• A 2012 analysis of data on individual participants in acupuncture studies looked at migraine and tension headaches. The analysis showed that actual acupuncture was more effective than either no acupuncture or simulated acupuncture in reducing headache frequency or severity.
• A 2009 systematic review of studies concluded that actual acupuncture, compared with simulated acupuncture or pain-relieving drugs, helped people with tension-type headaches. A 2008 systematic review of studies suggested that actual acupuncture has a very slight advantage over simulated acupuncture in reducing tension-type headache intensity and the number of headache days per month.
• A 2009 systematic review found that adding acupuncture to basic care for migraines helped to reduce migraine frequency. However, in studies that compared actual acupuncture with simulated acupuncture, researchers found that the differences between the two treatments may have been due to chance.

For Other Conditions

• Results of a systematic review that combined data from 11 clinical trials with more than 1,200 participants suggested that acupuncture (and acupuncture point stimulation) may help with certain symptoms associated with cancer treatments.
• There is not enough evidence to determine if acupuncture can help people with depression.
• Acupuncture has been promoted as a smoking cessation treatment since the 1970s, but research has not shown that it helps people quit the habit.

Challenges of studying acupuncture:

Studying acupuncture is challenging because:

• Clinical trials often differ in terms of technique, the number of acupuncture points, the number of sessions, and the duration of those sessions.
• Results of an acupuncture session may be associated with a person’s beliefs and expectations about their treatment or from their relationship with the therapist, rather than from acupuncture treatment itself.

What Is Simulated Acupuncture?

In some clinical trials, researchers test a product or practice against an inactive product or technique (called a placebo) to see if the response is due to the test protocol or to something else. Many acupuncture trials rely on a technique called simulated acupuncture, which may use blunt-tipped retractable needles that touch the skin but do not penetrate (in real acupuncture, needles penetrate the skin). Researchers also may simulate acupuncture in other ways. However, in some instances, researchers have observed that simulated acupuncture resulted in some degree of pain relief.

What the Science Says About Safety and Side Effects of Acupuncture

• Relatively few complications from using acupuncture have been reported. Still, complications have resulted from use of nonsterile needles and improper delivery of treatments.
• When not delivered properly, acupuncture can cause serious adverse effects, including infections, punctured organs, collapsed lungs, and injury to the central nervous system.

More to Consider

• Don’t use acupuncture to postpone seeing a health care provider about a health problem.
• If you decide to visit an acupuncturist, check his or her credentials. Most states require a license, certification, or registration to practice acupuncture; however, education and training standards and requirements for obtaining these vary from state to state. Although a license does not ensure quality of care, it does indicate that the practitioner meets certain standards regarding the knowledge and use of acupuncture. Most states require a diploma from the National Certification Commission for Acupuncture and Oriental Medicine for licensing.
• Some conventional medical practitioners—including physicians and dentists—practice acupuncture. In addition, national acupuncture organizations (which can be found through libraries or by searching the Internet) may provide referrals to acupuncturists. When considering practitioners, ask about their training and experience.
• Ask the practitioner about the estimated number of treatments needed and how much each treatment will cost. Some insurance companies may cover the costs of acupuncture, while others may not.
• Help your health care providers give you better coordinated and safe care by telling them about all the health approaches you use. Give them a full picture of what you do to manage your health.

Cupping is a practice used in traditional medicine in several parts of the world, including China and the Middle East. It involves creating suction on the skin using a glass, ceramic, bamboo, or plastic cup. Negative pressure is created in the cup either by applying a flame to the cup to remove oxygen before placing it on the skin or by attaching a suction device to the cup after it is placed on the skin. In “wet cupping,” the skin is pierced, and blood flows into the cup. “Dry cupping” doesn’t involve piercing the skin.

Bottom Line

• There’s been some research on cupping, but most of it is of low quality.
• Cupping may help reduce pain, but the evidence for this isn’t very strong.
• There’s not enough high-quality research to allow conclusions to be reached about whether cupping is helpful for other conditions.

Safety

• Cupping leaves temporary marks on the skin. The origin of these marks should be explained to health care providers so that they won’t be mistaken for signs of physical abuse.
• Cupping can cause side effects such as persistent skin discoloration, scars, burns, and infections, and may worsen eczema or psoriasis.
• Rare cases of severe side effects have been reported, such as bleeding inside the skull (after cupping on the scalp) and anemia from blood loss (after repeated wet cupping).
• Because cupping equipment can become contaminated with blood (intentionally in wet cupping or inadvertently in dry cupping), using the same equipment on more than one person, without sterilization between patients, can spread bloodborne diseases such as hepatitis B and C.

You may have seen the flowing postures and gentle movements of tai chi and wondered what it’s all about. Tai chi is an ancient mind and body practice. While more research is needed, studies suggest that it may have many health benefits.

Tai chi is sometimes referred to as “moving meditation.” There are many types of tai chi. They typically combine slow movements with breathing patterns and mental focus and relaxation. Movements may be done while walking, standing, or sitting.

“At its root, tai chi is about treating the whole person and enhancing the balance and crosstalk between the body’s systems,” says Dr. Peter Wayne, a longtime tai chi researcher at Harvard Medical School. “It’s a promising intervention for preserving and improving many areas of health, especially in older adults.”

Several studies have found evidence that tai chi can increase balance and stability in older people and reduce the risk and fear of falls. Each year, more than 1 in 4 older adults falls, and 1 out of 5 of these falls causes a serious injury such as broken bones or a head injury.

“Trying to be careful can make you more prone to falls,” Wayne says. “Tai chi may help you move more confidently and safely again.” Some NIH-funded research suggests that tai chi may also improve balance and prevent falls in people with mild-to-moderate Parkinson’s disease.

Research suggests that practicing tai chi might help improve posture and confidence, how you think and manage emotions, and your quality of life. Studies have found that it may help people with fibromyalgia sleep better and cope with pain, fatigue, and depression. Regular practice may also improve quality of life and mood in people with chronic heart failure or cancer. Older adults may find that tai chi can help improve sleep quality and protect learning, memory, and other mental functions.

Further study will be needed to fully evaluate and confirm the potential benefits of tai chi. But since the practice involves moving slowly and mindfully, there’s little chance of harm when done correctly.

“Whether you’re interested in trying tai chi to help with a chronic health issue or the stresses of everyday life, tai chi—if taught properly—can be a great complement to other ways of healthy living and rehabilitation,” Wayne says. “I think we’re all looking for tools to help us live productive, long lives with a little more grace and ease.”

There are different styles and ways to practice tai chi, Wayne says. If you’re interested in trying it, you can start simply. For instance, try standing behind and holding onto a sturdy chair for support, then mindfully rock back and forth to build awareness of all the parts of your body and their connections. Eventually, you might move on to practice more complex movements or sequences.

Is Tai Chi Right for Me?

• Talk with your health care provider about your physical activity and limits. Ask whether tai chi might be a good option for you.
• Look for classes based on your age and health. Some classes may be geared toward college students and stress management; others may be designed for folks over age 60 with particular medical conditions.
• Observe several teachers and classes to find a fit for you. There are different teaching styles, levels, and ways to practice tai chi.
• Don’t be discouraged if you can’t do all the movements. Think about the potential health benefits, and try to be patient with yourself.

Everyone has to start somewhere!

Common Names: astragale, astragale à feuilles de réglisse, beg kei, milk vetch

Latin Names: Astragalus membranaceus

Background

• Astragalus has been used for centuries in traditional Chinese medicine in combination with other herbs.
• Its root is used for health care purposes.
• Commonly combined with other herbs, astragalus has been promoted as a dietary supplement for many conditions, including upper respiratory infections, allergic rhinitis (hay fever), asthma, chronic fatigue syndrome, and chronic kidney disease, among others. It’s also promoted to strengthen and regulate the immune system. Topical use (application to the skin) of astragalus is promoted for improving blood flow and speeding wound healing.

How Much Do We Know?

• There are no high-quality studies in people of astragalus for any health condition.

What Have We Learned?

• Patients with nephrotic syndrome (health problems related to kidney damage) are susceptible to infections. A 2013 research review found that taking astragalus may be associated with a lower risk of upper respiratory tract infections in children with nephrotic syndrome than prednisone treatment alone. However, the review concluded the studies were of low quality.
• An astragalus-based herbal formula didn’t extend the lives of people with advanced lung cancer, a small 2009 trial reported. The study (with 24 people) was supported in part by the National Center for Complementary and Integrative Health (NCCIH).

What Do We Know About Safety?

• Astragalus may be safe when used orally and appropriately. (Doses up to 60 grams daily for up to 4 months have been used without reported adverse effects.) Some possible side effects with oral use include rash, itching, nasal symptoms, or stomach discomfort, but these are uncommon.
• Astragalus may interact with medications that suppress the immune system.
• Some astragalus species, usually not found in dietary supplements, can be toxic to livestock. Several species that grow in the United States contain the neurotoxin swainsonine and have caused “locoweed” poisoning in animals. Other species contain potentially toxic levels of selenium. Too much selenium can lead to diarrhea, irritability, nausea, skin rashes, and nervous system problems.
• Little is known about whether it’s safe to use astragalus during pregnancy or while breastfeeding. Some research in animals suggests that astragalus can be toxic to the mother and fetus.

Keep in Mind

• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.

Common Names: ginkgo, Ginkgo biloba, fossil tree, maidenhair tree, Japanese silver apricot, baiguo, yinhsing

Latin Names: Ginkgo biloba

Background

• Ginkgo, one of the oldest living tree species in the world, has a long history in traditional Chinese medicine. Members of the royal court were given ginkgo nuts for senility. Other historical uses for ginkgo were for asthma, bronchitis, and kidney and bladder disorders.
• Today, the extract from ginkgo leaves is promoted as a dietary supplement for many conditions, including anxiety, allergies, dementia, eye problems, peripheral artery disease (when buildup of plaque narrows the blood vessels that carry blood to the head, organs, and limbs), tinnitus, and other health problems.

How Much Do We Know?

• There have been a lot of studies on the possible health effects and risks of people using ginkgo.

What Have We Learned?

• There’s no conclusive evidence that ginkgo is helpful for any health condition. Although some studies suggest that ginkgo may help to slightly improve some symptoms of dementia, the findings have been described as unreliable. Also, other studies have had conflicting findings. Ginkgo neither helps prevent dementia or cognitive decline nor prevents Alzheimer’s-related dementia from getting worse—this is according to studies that include the long-term Ginkgo Evaluation of Memory Study, which enrolled more than 3,000 older adults and was funded in part by the National Center for Complementary and Integrative Health (NCCIH).
• For various health conditions, a small amount of evidence suggests a benefit from taking ginkgo, but the overall evidence is not conclusive. These conditions include anxiety, diabetic retinopathy, glaucoma, peripheral artery disease, premenstrual syndrome (PMS), schizophrenia, and vertigo.
• Research seems to suggest that ginkgo doesn’t help with memory enhancement in healthy people, high blood pressure, tinnitus, multiple sclerosis, seasonal affective disorder, or the risk of having a heart attack or stroke.

What Do We Know About Safety?

• For most people, ginkgo leaf extract appears to be safe when taken by mouth in moderate amounts.
• Side effects of ginkgo may include headache, stomach upset, dizziness, palpitations, constipation, and allergic skin reactions. If you have a known bleeding risk, you should be cautious about ginkgo possibly increasing your risk of bleeding.
• In a 2013 research study, rodents given ginkgo leaf extract had an increased risk of developing liver and thyroid cancer at the end of the 2-year tests. Whether these results apply to humans is unclear.
• Ginkgo may interact with some conventional medications, including anticoagulants (blood thinners), research reviews show.
• Ginkgo taken orally may be unsafe during pregnancy. It might cause early labor or extra bleeding during delivery if used near that time. Little is known about whether it’s safe to use ginkgo while breastfeeding.
• Fresh (raw) or roasted ginkgo seeds and the unprocessed ginkgo leaves can contain dangerous amounts of a toxic substance.

Keep in Mind

• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.

Common Names: ginger

Latin Names: Zingiber officinale

Background

• Native to parts of Asia, such as China, Japan, and India, ginger has a leafy stem and yellowish-green flowers. The spice comes from the rhizome (underground stem) of the plant.
• Ginger has been used for medicinal purposes in China for more than 2,500 years, and it has had a prominent role in Chinese, Indian, and Japanese medicine since the 1500s.

How Much Do We Know?

• There have been many studies of the use of ginger for health purposes in people.

What Have We Learned?

• Ginger has been studied for several types of nausea and vomiting. Almost all of these studies tested dietary supplements rather than foods.
  • Research shows that ginger may be helpful for mild nausea and vomiting associated with pregnancy.
  • Most studies of ginger for motion sickness haven’t shown it to be helpful.
  • In general, ginger hasn’t been shown to relieve nausea and vomiting associated with cancer chemotherapy, although it might be helpful if taken in combination with certain types of chemotherapy or certain drugs used to prevent nausea and vomiting.
  • It’s uncertain whether ginger is helpful for postoperative nausea and vomiting.
• A small amount of research suggests that ginger dietary supplements might be helpful for menstrual cramps.
• There’s not enough evidence to show whether ginger supplements are helpful for symptoms of knee osteoarthritis.

What Do We Know About Safety?

• Ginger has been used safely in many research studies where it was taken orally (by mouth) as a dietary supplement. Ginger products may also be safe for topical use (on the skin).
• Ginger can have side effects such as abdominal discomfort, heartburn, diarrhea, and mouth and throat irritation, especially if taken in large doses.
• Some studies of the use of ginger during pregnancy suggest it is safe, but the evidence is not conclusive. If you’re considering using ginger while pregnant, consult your health care provider. Little is known about whether it’s safe to use ginger while breastfeeding.

Keep in Mind

• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.

Common Names: Asian ginseng, Chinese ginseng, Korean ginseng, red ginseng, white ginseng

Latin Names: Panax ginseng

Background

• Asian ginseng is native to the Far East, including China, Korea, and far-eastern Siberia. It has been used for health-related purposes in traditional Chinese medicine for thousands of years.
• Asian ginseng is one of several types of ginseng. The terms red ginseng and white ginseng refer to Asian ginseng roots prepared in two different ways.
• The part of the plant most frequently used for health purposes is the root.
• Asian ginseng taken orally is promoted for increasing resistance to environmental stress and as a general tonic to improve well-being. Asian ginseng is also promoted as a dietary supplement for a variety of other reasons—to improve physical stamina, concentration, and memory; stimulate immune function; slow the aging process; and relieve various other health problems, such as respiratory and cardiovascular disorders, depression, anxiety, and menopausal hot flashes. Topical use (applied to the skin) of Asian ginseng as part of a multi-ingredient preparation is promoted for premature ejaculation.
• Asian ginseng contains many substances; those thought to be most important are called ginsenosides (or panaxosides).

How Much Do We Know?

• Many of the published randomized controlled trials on Asian ginseng may not be high-quality studies. Therefore, our understanding of Asian ginseng’s health effects is limited.

What Have We Learned?

• Results from a 2013 review of 65 randomized controlled trials suggest that Asian ginseng may help improve glucose metabolism and lower blood sugar. However, the scientists who published the review noted some issues with the studies they examined: that many were not high quality and that ginseng preparations were diverse.

What Do We Know About Safety?

• Short-term oral use (up to 6 months) of Asian ginseng in recommended amounts appears to be safe for most people. However, questions have been raised about its long-term safety, and some experts recommend against its use by infants, children, and women who are pregnant or breastfeeding.
• When used short-term as part of a specific multi-ingredient topical skin application, Asian ginseng is likely safe. Safety after prolonged repetitive topical use has not been determined.
• Insomnia (trouble sleeping) is the herb’s most common side effect. Others include menstrual problems, breast pain, increased heart rate, high or low blood pressure, headache, loss of appetite, and digestive problems.
• Some evidence suggests that Asian ginseng might affect blood sugar. If you have diabetes, consult your health care provider before using Asian ginseng.
• There are uncertainties about whether ginseng might interact with certain medications, such as calcium channel blockers and other high blood pressure medications, as well as statin medications and some antidepressants. Studies on the effect of Asian ginseng on the anticoagulant (blood thinner) warfarin (Coumadin) have had mixed results. If you’re taking medication, consult your health care provider before using Asian ginseng.
• Asian ginseng may be unsafe when taken orally during pregnancy. One of the chemicals in it has been found to cause birth defects in animals. Little is known about whether it’s safe to use Asian ginseng while breastfeeding.

Keep in Mind

• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.

Common Names: turmeric, turmeric root, Indian saffron

Latin Names: Curcuma longa, synonym Curcuma domestica; Curcuma aromatica

Background

• Turmeric, a plant in the ginger family, is native to Southeast Asia and is grown commercially in that region, primarily in India. Its rhizome (underground stem) is used as a culinary spice and traditional medicine.
• Historically, turmeric was used in Ayurveda and other traditional Indian medical systems, as well as Eastern Asian medical systems such as traditional Chinese medicine. In India, it was traditionally used for disorders of the skin, upper respiratory tract, joints, and digestive system.
• Today, turmeric is promoted as a dietary supplement for a variety of conditions, including arthritis, digestive disorders, respiratory infections, allergies, liver disease, depression, and many others.
• Turmeric is a common spice and a major ingredient in curry powder. Curcumin is a major component of turmeric, and the activities of turmeric are commonly attributed to curcuminoids (curcumin and closely related substances). Curcumin gives turmeric its yellow color.
• Turmeric dietary supplements are made from the dried rhizome and typically contain a mixture of curcuminoids. Turmeric is also made into a paste for skin conditions.

How Much Do We Know?

• Much research has been done on substances from turmeric, but their health effects remain uncertain.

What Have We Learned?

• Turmeric and curcumin have a variety of interesting biological activities, but they’re challenging to study because curcumin is unstable (it easily changes into other substances) and has low bioavailability (not much of it reaches the bloodstream) when it’s taken orally. In addition, curcumin products may differ in composition or contain more substances than expected, which makes the results of research on these products difficult to understand and compare. Because the actions of turmeric and its components in people are complex and not well understood, no clear conclusions have been reached about whether these substances have benefits for health conditions.
• NCCIH is funding research to determine whether and how curcuminoids may be converted in bone tissue into substances that may have effects on bone diseases.

What Do We Know About Safety?

• Turmeric and conventionally formulated curcumin products are probably safe when taken orally or applied to the skin in the recommended amounts.
• Efforts have been made to develop curcumin products with increased bioavailability, and many modified products are already on the market. Improving bioavailability might lead to increases in harmful effects as well as desirable ones.
• Turmeric may be unsafe for use during pregnancy in amounts greater than those commonly found in food. Little is known about whether it’s safe to use turmeric in amounts greater than those commonly found in food while breastfeeding.

Keep in Mind

• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.