Know Your Medicines
Safe Use of Traditional Chinese Medicine (TCM)

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Safe Use of Traditional Chinese Medicine (TCM)

Many people believe in Traditional Chinese medicine (TCM) for its holistic approach towards disease management or prevention. However, a common misconception is that since TCM is natural, it is safe and free from side effects.

This is unfortunately not the case in many occasions. Some TCM herbs e.g. bitter almond, apricot kernels contain poisonous compounds which may cause harm if not used properly.

Here are a few tips for the safe use of TCM.

  • Always inform your healthcare professionals (Doctors, nurses, pharmacists) of any supplements, vitamins or tonic that you are taking as they may contain TCM
  • Do not purchase  supplements from unreliable or bogus sources
  • Be cautious if the supplements have exaggerated claims on disease management
  • Watch out for side effects such as bruises on body, bleeding, yellowish skin, diarrhoea etc.
  • It is recommended to start TCM at smaller doses or amounts initially. This may be increased gradually if there are no problems or side effects experienced
  • If your condition does not improve after a trial of TCM, please seek a second opinion from a western doctor


TCM may not be suitable for you if you have the following conditions:

  • Patients with hypertension or hyperthyroidism: Some tonics or supplements that contain ginseng, ephedra, deer’s antlers etc contain compounds that may aggravate these conditions
  • Patients on blood thinners (e.g. warfarin, clopidogrel): Be cautious when taking supplements containing “blood invigorating” herbs such as ginkgo biloba, lingzhi, cordyceps, dong quai, ginseng, as the likelihood of bleeding maybe increased
  • Patients on anti-seizure medications: Be cautious when taking supplements containing gingko as these herbs may interact with medications for fits and result in poor seizure control
  • Patients with breast or prostate cancer: Avoid herbs like horny goat weeds that may contain hormone-like ingredients which may aggravate their condition
  • Patients with gastric problems: Always take TCM after food as they may contain acidic herbs e.g. hawthorn
  • Patients with lower limb swelling: Refrain from acupuncture or massage as swelling could be due to deep vein thrombosis or other serious underlying causes and medical attention should be sought
  • Patients with liver or kidney diseases: Be cautious when taking TCM as some herbs may affect the liver or kidney
  • Elderly or frail patients: Taking excessive cooling herbs or laxative herbs like cassia seeds may cause diarrhoea in some elderly or frail patients and excessive diarrhoea may result in dehydration


TCM may also affect the effectiveness and/or toxicities of some western medications:

  • Some Chinese medicines contain calcium e.g. gypsum and hence may interact with some medicines like antibiotics (ciprofloxacin, tetracycline) and levothyroxine
  • Some herbs such as lingzhi, cordyceps, aurantium may affect metabolism of western medicines and may result in unexpected side effects


Written by: Ricky Ang 
Vetted by: PSS Public Education Chapter