TCM for Older Adults: Common Uses and Medicine Interaction Concerns

Who this page is for

Older adults, and the family members who help them, often ask whether Chinese medicine can sit alongside the medicines they already take. The honest answer is that some practices are low risk, while herbs deserve a careful review, because older adults often take several prescriptions, which makes interactions more likely. This page covers common uses, what research shows, and the interaction concerns. It gives no doses and does not suggest changing any prescribed medicine.

Why older adults use Chinese medicine

A survey of 3,418 adults aged 50 and over in Shanghai found that cardiovascular disease, lung disease, cancer, prostatitis, arthritis and nervous system diseases were associated with using traditional medicine, and that belief in and use of it were prevalent. [1] Use is shaped by culture, family and health conditions, not only by evidence. See TCM outside China and integrative Chinese medicine.

Practices with a role for older adults

• Tai chi and qigong. NCCIH says research suggests tai chi may improve balance and stability in older people and those with Parkinson's disease, and that tai chi and qigong appear to be safe, though minor aches and pains are possible. [2] See Tai Chi, Qigong and adapted yoga and movement if balance or mobility is limited.
• Acupuncture. The NHS says acupuncture may not be safe if you take blood thinning medicine or are at increased risk of bleeding, or have a skin condition or skin infection. [3] Tell the practitioner about every medicine. See acupuncture side effects and precautions.
• Herbs and patent medicines. These carry the largest interaction concerns, covered next.

The medicine interaction concern

Interactions happen when something you take changes how another medicine works or adds to its effect. Reviews describing herbal and conventional drug interactions note that they do occur and may put people at risk, but knowledge is incomplete. A systematic review of case reports found 108 suspected interactions, with warfarin the most common conventional drug involved. [4] Chinese medicine specifically has been reviewed for warfarin, a blood thinner with a narrow safe range. A 2021 review of 64 articles concluded that herbs may either strengthen or weaken warfarin's effect through several mechanisms, and that clinical use needs caution. [5] A 2015 paper aimed to raise physicians' awareness of potential interactions between Chinese herbs and warfarin. [6]

The NHS lists statins, antidepressants, diabetes medicines such as metformin, blood pressure medicines such as ramipril, blood thinners such as warfarin and hormonal contraception as medicines that do not mix well with herbal medicines, and says to check with a pharmacist first, including for over-the-counter medicines. [3]

Why many herbs in one prescription adds complexity

In an analysis of Taiwan's national insurance data, 41.6% of patients receiving Chinese herbal prescriptions got a polyherbal prescription (more than five items), and the authors said potential herb interactions and iatrogenic (treatment-caused) risks should be monitored. [7] That study covered all ages, not older adults only. For older adults who already take several medicines, a long ingredient list makes interaction checking harder. See Chinese herbs and prescription medicines and Chinese herbs with diabetes, blood pressure medicines.

Liver, kidney and product quality

The NHS says people with kidney or liver problems should not take herbal medicines. [3] NCCIH reports some Chinese herbal products have been contaminated with undeclared drugs such as warfarin and diclofenac, heavy metals and pesticides, or contained incorrect herbs that caused organ damage. [2] See liver injury from Chinese herbs and kidney injury and aristolochic acid.

Before and after surgery

Tell the surgical team about any herb you use. See Chinese herbs before and after surgery and supplements before surgery.

A practical approach

1. Make a written list of every prescription, over-the-counter medicine, vitamin, herb and tea, and bring it to every appointment.
2. Ask a pharmacist to check herbs against your medicines before you start them.
3. Tell your TCM practitioner and your doctor about each other.
4. Do not stop prescribed medicines. [3]
5. Report new symptoms such as unusual bruising, bleeding, yellow skin or eyes, dizziness, or confusion to a clinician promptly.

More general guidance is on older adults and natural remedies and older adults, polypharmacy and supplements.