Is Chinese herbal medicine safe?

Critics are calling for better regulation of this centuries-old industry.

You want to avoid colds and flu and you read somewhere that Chinese herbs can help. You buy a remedy online or visit a practitioner. After all, it's a registered, regulated industry, right? Well, sort of. What you might not know is that in April, Australian customs officials seized Chinese medicines that contained potential allergens, toxins and ingredients obtained from protected animal species.

Stringent regulation needed

Apart from in Victoria, there is no government regulatory body for the industry. That will change on July 1, the date the government requires all Chinese medicine practitioners to register and meet minimum standards 
of education, training and English. "We welcome national registration," says Judy James, CEO of the Australian Acupuncture and Chinese Medicine Association (AACMA). "It's been in place in Victoria since 2001, but we've lobbied for 30 years."



There are about 4000 practitioners in Australia. About 1200 are in Victoria, leaving almost 3000 who aren't accredited unless they choose to join an association such as the AACMA, which has its own strict standards. But there is nothing to stop anyone from saying they are a Chinese medicine practitioner. Regulation should stop that, but for some the proposed standards are not high enough. 

"There are currently medical boards for 10 health professions," says Dr Steve Hambleton, president of the Australian Medical Association. "They set strict standards for practitioners. For instance, GPs must complete almost 50 hours of continuing professional development (CPD) activities per year." These are approved by the Australian Medical Council. If they don't complete the activities, a practitioner can't re-register, so they can't practise.

The Chinese Medicine Board of Australia is proposing 20 hours of CPD per year. "It should be on a par with the other professions," Dr Hambleton says. He believes regulation of the industry will offer some protection to the public, but could give kudos to a therapy that has yet to fully prove itself. He also questions how something with such varying levels of evidence can be regulated. "Good and poor evidence exists," he says. "We have an open mind. Many modern drugs come from herbs. The most effective antimalaria drug – artemether – comes from a plant. But we need more scientific evidence." James believes more than 2000 years of continuous use is evidence enough. "There is a body of well-established literature that backs up the use of Chinese medicine, and guides diagnosis and treatment," she says. "Over centuries, it has developed into a complex theoretical framework. It's coherent and internally consistent. Evidence has been gathered over many years of practical and clinical testing in the field, as well as clinical trials."

An evolving form of health care

"It's 2000 years of anecdotes, not strong, scientific evidence," Dr Hambleton says. "Experience is important, but it doesn't beat double-blind, randomised, controlled tests." And what about those toxic ingredients? James says the fact that they were discovered proves current regulations are working. "Those products were not approved for sale in Australia," she says. "The Therapeutic Goods Administration strictly regulates what can be sold. The items seized were manufactured overseas. We can't control them, but we can control what enters our market and that's what happened."



For James, Chinese medicine is a living and evolving form of health care that, if carried out by a qualified practitioner, can be finely tuned to address an individual's health problems. She thinks such individualisation 
of treatment is one reason why some research may not do Chinese medicine justice. "It's not one herb fits all," she says. "Double-blind clinical trials work well for single ingredients, but Chinese medicine is about complex combinations of herbs tailored to an individual's needs. If you're in the hands of a qualified practitioner – which regulation will ensure – it is a safe form of treatment."

For Dr Hambleton, Chinese medicine is a grey area: "I'd like to see more evidence and I want people to understand what evidence is available. If you're still happy to spend money on Chinese medicine, fine, but you deserve to know what level of evidence backs up the claims."

Source: Body and Soul

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