Traditional Chinese medicines (TCMs) have become increasingly popular in Western societies. TCMs are seen by many as natural and safe, and incorporating the rich historical knowledge of nature by an ancient culture.
As The Medical Journal of Australia noted, ‘[t]he increasing use of complementary and alternative medicine (CAM) within industrialised, “advanced” Western nations presents itself as something of an enigma. As a social phenomenon, it is not well understood or indeed much researched … It is curious that this growth is occurring in countries where Western science and scientific method generally are accepted as the major foundations for healthcare, and “evidence-based” practice is the dominant paradigm. As medicine experiences an explosion in its knowledge base and genomic medicine opens a whole new approach to medical care, we are witnessing the rapid expansion of a branch of healthcare whose claim to be “scientific”, so far at least, has been widely debated.’ (The rise and rise of complementary and alternative medicine: a sociological perspective, by D Coulter and Evan M Willis, Med J Aust 2004; 180 (11): 587-589)
Admittedly, TCMs do have a long history of usage, dating back millenniums, but scientifically speaking they largely remain what can only be categorised as ‘alternative medicine’.
“Do you know what they call ‘alternative medicine’ that’s been proved to work? Medicine.”
Storm, Tim Minchin
‘Storm’ is an irreverent take on alternative medicines, by much-loved agent provocateur, Tim Minchin
It would also appear that TCMs are the fortune cookies of the ‘medicine’ world because you never quite know what you will find inside.
Is it arsenic, often ten times over the acceptable limit, lead, paracetamol, or … tasty snow leopard?!
If you thinking to yourself ‘well that’s an exaggeration’, you would be wrong.
A recent study by a team from Curtin University found those exact undeclared ingredients, and more, in TCMs. Their paper titled ‘Combined DNA, toxicological and heavy metal analyses provides an auditing toolkit to improve pharmacovigilance of traditional Chinese medicine (TCM)‘ was recently published in Scientific Reports.
“Genetic analysis revealed that 50% of samples contained DNA of undeclared plant or animal taxa, including an endangered species of Panthera (snow leopard). In 50% of the TCMs, an undeclared pharmaceutical agent was detected including warfarin, dexamethasone, diclofenac, cyproheptadine and paracetamol. Mass spectrometry revealed heavy metals including arsenic, lead and cadmium, one with a level of arsenic >10 times the acceptable limit. The study showed 92% of the TCMs examined were found to have some form of contamination and/or substitution.”
So, how does that snow leopard taste in your TCM?
The snow leopard is an endangered species which was entered on the IUCN Red List of Threatened Species because as of 2003, the size of the global population was estimated at 4,080–6,590 adults, of which fewer than 2,500 individuals may reproduce in the wild. Consequently, TCMs and their increasing use in Western societies represent another global environmental and biodiversity crisis in the making.
Even when your TCMs are uncontaminated, the chance of which is only one in ten according the the study, some of the herbs used can interact with pharmaceutical drugs resulting in serious side effects, or be unsafe for people with particular medical conditions.
TCMs are regulated as ‘medicine’, and overseen by the Therapeutic Goods Association (TGA). However, the TGA’s regulatory scheme has two lists of approved medicines: ‘registered’ and ‘listed’ – with listed items requiring less evidence for their approval than registered ones. Listed ‘medicines’ include vitamin and mineral supplements, TCMs and herbal medicines.
Under Australian regulations, TCMs are assessed for the safety and quality of their ingredients, but not always for how well they work. Consequently, there are a plethora of safety and legal issues surround their use.
There are people who turn to ‘alternative medicines’ in truly tragic personal circumstances, and one can only empathise with people in such situations as they try everything that may offer the slightest of hopes.
However, the National Health and Medical Research Council, Australia’s peak funding body for medical research, has expressed a concern about reports of non-evidence based treatments, including complementary and alternative medicines, being used to treat conditions that are chronic, serious, or could become serious, in place of evidence-based treatments.