Chinese Herbal Medicine: What It Is and What Research Shows
What Chinese herbal medicine is, how formulas are used, what Cochrane-level reviews say about the evidence, and the contamination, kidney, liver and drug-interaction risks.
Content last updated . This page has not been medically reviewed.
What it is
Chinese herbal medicine is the use of plant and sometimes other materials, usually in combinations called formulas, within traditional Chinese medicine (TCM). NCCIH lists herbal products alongside acupuncture and tai chi as approaches TCM practitioners use. [1] Formulas are traditionally chosen to fit a person's pattern, not only a named disease: see Traditional Pattern Differentiation. Herbs may be sold as raw herbs prepared as decoctions (boiled teas), powders, capsules or ready-made "patent" products. Plants have been in use in Chinese medicine for a very long time; for example, kushen (Sophora flavescens) is described as important since the Qin and Han dynasties. [2]Single-herb profiles are on other pages, for example Herbs by Wellness Goal and Herb Safety and Interactions.
What research shows
Chinese herbal products have been studied for stroke, heart disease, mental disorders and respiratory diseases, but NCCIH says that because many studies were of poor quality, no firm conclusions can be made about effectiveness. [1]| Question | What the source found | Strength |
|---|---|---|
| TCM Cochrane reviews overall | Of 104 reviews, 70 were on herbal medicine; only 5 overall positive, 42 insufficient evidence, 54 no firm conclusion [3] | Largely inconclusive |
| Herbal medicine for stroke | An overview of 8 Cochrane reviews (71 trials, 5,770 people) showed potential improvement in neurological deficit, but high risk of bias meant no affirmative recommendation could be drawn [4] | Promising but limited |
Each formula is a different product, so a result for one formula does not apply to another. Trials may use different doses, forms and comparators, and herbal studies that cannot be blinded or use poorly matched placebos are open to expectation effects.
Safety
- Contamination and substitution. Some Chinese herbal products have been found to contain undeclared plant or animal material, drugs such as warfarin and diclofenac, heavy metals such as arsenic, lead and cadmium, pesticides, or sulfites; wrong herbs have caused organ damage, and mistaken herb replacement has led to serious complications. [1]
- Kidneys. Herbs containing aristolochic acid are a known cause of kidney damage, and herbal nephrotoxicity can come from the herbs themselves, incorrect processing or storage, adulteration, heavy metals, dosing or interactions. [5] In Taiwan, exposure to aristolochic acid herbs was linked with higher risk of renal failure and upper urinary tract cancer. [6]
- Liver. A systematic review of published reports describes herb-induced liver injury after herbal medicine use. [7]
- Medicines. A systematic review found 149 articles describing 78 herbs, foods or supplements reported to interact with warfarin, including Chinese wolfberry, ginkgo, ginger and green tea. [8] Never stop or change a prescribed medicine on your own because of an herb.
Details on quality and interactions: Chinese Herbal Products: Quality, Contamination and Medicine Interactions.
Who should check first
Talk to your health care provider before using TCM herbal products if you have a health condition, and tell all your providers what you use. If you are pregnant, nursing or giving herbs to a child, be especially sure to consult first. [1] If you feel unwell after starting a herbal product, stop it and seek medical care, and bring the product with you. In the US, Poison Help is 1-800-222-1222 (see poison help by country). See also Talking With a Health Professional.Practitioners
Rules for herbal practitioners differ by country and state; see TCM Qualifications, Licensing and Medical Care.Frequently asked questions
Does Chinese herbal medicine work?
It depends on the formula and condition. NCCIH says no firm conclusions can be made because many studies were of poor quality. [1]
Are Chinese herbs safe because they are natural?
No. Contamination, wrong herbs, aristolochic acid and interactions have all been reported. [1][5]
Can Chinese herbs interact with my medicines?
Yes. Many herbs and supplements have been reported to interact with warfarin. [8] Ask your pharmacist or doctor.
Are patent medicines safer than raw herbs?
Proper evidence not found in the sources we checked comparing the two. Contamination has been reported in Chinese herbal products generally. [1]
Which herbs contain aristolochic acid?
Aristolochia-based herbal medicines are the source named in the reviews we read. [6] Ask a pharmacist before using any herb of unknown identity.
References
- National Center for Complementary and Integrative Health (NCCIH, US). Traditional Chinese Medicine: What You Need To Know. Last updated April 2019. Read 2026-10-22.
- Sophora flavescens Ait.: traditional usage, phytochemistry and pharmacology. Journal of Ethnopharmacology 2015. PubMed 26087234. Read 2026-10-22.
- Cochrane systematic reviews on traditional Chinese medicine: what matters, the quantity or quality of evidence? Phytomedicine 2022. PubMed 35104758. Read 2026-10-22.
- Overview of Cochrane reviews on Chinese herbal medicine for stroke. Integrative Medicine Research 2020. PubMed 31908922. Read 2026-10-22.
- Nephrotoxicity and Chinese herbal medicine. Clinical Journal of the American Society of Nephrology 2018. PubMed 29615394. Read 2026-10-22.
- Aristolochic acid-containing Chinese herbal medicine and upper urinary tract urothelial carcinoma in Taiwan: a narrative review. World Journal of Urology 2023. PubMed 35867141. Read 2026-10-22.
- Herb induced liver injury after using herbal medicine: a systemic review and case-control study. Medicine 2019. PubMed 30921214. Read 2026-10-22.
- Warfarin and food, herbal or dietary supplement interactions: a systematic review. British Journal of Clinical Pharmacology 2021. PubMed 32478963. Read 2026-10-22.