Tibetan Medicine: What Research Shows by Specific Use

The size of the research field

A systematic review of clinical studies on Tibetan medicine available in the West found 40 studies from 39 publications, very heterogeneous in study type, size, conditions, treatments, outcomes and quality. [1] It concluded that the number of clinical trials is small and that methods and results are heterogeneous. [1] It did not include Russian, Tibetan or Chinese publications. [1] In other words, there is a lot we do not know, and trials published elsewhere may exist.

Evidence by specific use

Padma 28 in more detail

• Cochrane review (2016 update). All five trials compared Padma 28 with placebo for at least 16 weeks. [2] Pain-free and maximum walking distances rose in the Padma 28 groups, but in general the studies compared before and after treatment and made no direct comparisons between Padma 28 and placebo. [2] Pooling two studies (193 people), the Padma 28 group walked about 96 meters farther on maximum walking distance, rated very low quality. [2]
• Limits the reviewers stated. The clinical importance of the changes is unclear because no quality-of-life data were reported. [2] Ankle brachial index showed no change. [2] The reviewers said the longer-term effects are unknown and the clinical significance is questionable. [2]
• Side effects. Mild effects such as gastrointestinal discomfort, tiredness and skin eruption were reported but did not differ from placebo. [2]
• A wider overview. A separate overview of Padma 28 found 29 trials, with the highest level of evidence in intermittent claudication, and noted that Padma 28 has been registered in Switzerland as a drug for symptoms of circulatory disorders. [8] The authors said further randomized trials are needed. [8] This is an overview rather than a Cochrane review, and it also covered uses such as respiratory infections and multiple sclerosis, where the trials were not confirmed. [8]

Intermittent claudication is pain in a limb during exercise that is relieved by rest, caused by chronic occlusive arterial disease. [2] Anyone with leg pain on walking should see a clinician, because standard treatment and checks for heart and circulation problems matter. Padma 28 should not replace them.

Mercury-containing preparations

Whether processed mercury preparations are safe is a separate question and is covered on precious pills and heavy metal safety. One cross-sectional human study found no significant differences from healthy comparison people on 23 non-specific symptoms, but it could not show cause and effect. [9]

Preclinical findings

Many papers test Tibetan formulas in cells or animals. These can suggest ideas for trials but do not show a benefit in people. For example, a review of one formula describes neuroprotective, anti-inflammatory and analgesic effects in preclinical studies. [7]

What we looked for and did not find

We ran PubMed searches for systematic reviews and randomized trials of Tibetan medicine, including searches for depression, anxiety, digestive problems and diabetes. Beyond the formulas above, we found no other Cochrane review of a Tibetan formula and no usable trial for mental health (including the traditional rlung or "wind" disorders), digestion or diabetes, so for those uses: Proper evidence not found in what we searched. Many trials are published in Chinese-language journals and may exist outside what we could read.

Practical points

• Ask which exact product was tested, because results for one formula do not transfer to another.
• Check who funded a study and whether it was blinded; we did not check the funding of the trials above.
• Do not stop prescribed medicines or delay care. See understanding evidence in complementary health and talking with a health professional.