Asian herbal medicine is one component of traditional Chinese medicine (TCM). It involves the therapeutic use of specific herbal preparations. These preparations are often complex combinations of different raw herbs and herb extracts.
Treatment can be administered alone, but is often done in combination with acupuncture. Administration methods include pills, powders, tablets, capsules, and tinctures. None of these herbal preparations have been studied enough to establish their range of effectiveness and toxicity. Thus, it is extremely important for patients to exercise caution and be aware of the specific herbs being used in their treatment.
Evaluation in MS and Other Conditions
The information available on the effectiveness of Asian herbal medicine in the treatment of MS is limited. Ping Fu Tang, a mixture of 17 different herbs, was evaluated in one study of 45 people with MS. After three years of follow-up, the group treated with herbal therapy was observed to have a decrease in attack rate. However, due to problems with the study design, these results are difficult to interpret.
As one might imagine, most research done on this subject is conducted in Asia. This has led to a lack of availability of full English translations of the work. Only short summaries of the studies are available, making them hard to interpret. Several, small Chinese studies published in the 1990s showed beneficial effects of different herbal preparations. One study showed, surprisingly, that an immune-stimulating herb, Ganoderma lucidum, appeared to slow the disease course in five people with MS. Due to the limited information in the articles, it is not possible to carefully scrutinize the studies.
Some of the herbs used in TCM have known immune-suppressing and anti-inflammatory effects. In theory, these herbs could be beneficial to those with MS. Some of these herbs include Ginkgo biloba, Re Du Qing, berberis,Tripterygium wilfordii, and Stephania tetrandra.
Tetrandrine, a compound derived from Stephania tetrandra, has shown some promising results. It suppresses the immune system through biochemical process that are different from those used by most conventional medications. Furthermore, when given in combination with conventional medications, it produces additional immune-suppressing effects. In one study, tetrandrine was demonstrated to decrease the severity of an animal model of MS. Further research into the effects of this and the other compounds needs to be done in order to provide more definitive results.
T. wilfordii has been more thoroughly researched. It has been demonstrated to decrease the activity of T cells and other components of the immune system. It has lessened the severity of disease in animal models of MS and lupus. Some clinical studies have shown mild clinical improvement in other immune disorders, such as lupus and rheumatoid arthritis, but the studies involving people with MS have been limited. These studies are far from conclusive, and, due to the possibility of serious side effects (see below), this therapy cannot be recommended for treatment of MS or other immune diseases.
People with MS should be aware that some herbs have the potential to stimulate the immune system. Although these effects have not been specifically investigated in humans, the potential for increased immune system activation represents a theoretical risk for people with MS. Some of the herbs that may stimulate the immune system include:
– Japanese herbal medicine: kakkan-to, kanzo-bushi-to, shosaiko-to
– Chinese herbal medicine: Asian ginseng (panax ginseng), acanthopanax obovatus, angelica sinensis (dong quai), artemisis myriantha, artemisis annua, astragalus (astragalus membranaceus), coix, epimedium sagittatum, ge-gen-tang, ligustrum lucidum, salvia miltiorrhiza, sophora flavescens, xiao-chai-hu-tang, licorice, green tea, certain mushrooms (maitake, reishi, and shiitake)
In addition to immune system effects, some Chinese herbal preparations may produce serious toxic effects on other bodily systems. Licorice, if used regularly, may lower blood levels of potassium and increase blood pressure. T. wilfordii has caused side effects as minor as upset stomach, but has also been linked to much more serious toxicity such as infertility and, in at least one case, death. Ephedra, known in traditional Chinese medicine as ma huang, made headlines in 2003 when the FDA banned products containing the substance. It has been associated with potentially dangerous, neurological and cardiovascular side effects, with fatal results in rare cases. Other potentially toxic herbs include, aristolochia fangchi, guiji, baijiaolia, jin bu yuan, bushi, caowu, chuanwa, naoyanghua, datura preparations, fuzi, yangjinhua, and guangfangji.
People with MS should approach Asian herbal medicine cautiously, especially when considering long-term treatment. The lack of English translations prevents careful review of much of the research literature in this area. Safety and efficacy are not well established, and, as some herbs have toxic or immune-stimulating properties, people with MS should be careful when pursuing Asian herbal medicine as a treatment option.
References and Additional Reading
Bowling AC. Complementary and Alternative Medicine and Multiple Sclerosis. New York: Demos Medical Publishing, 2007, pp. 29-39.
Freeman L. Mosby’s Complementary and Alternative Medicine: A Research-Based
Approach. St. Louis: Mosby, 2001, pp. 333–369.
Lin Y-C. Acupuncture and traditional Chinese medicine. In: Oken BS, ed.
Complementary Therapies in Neurology. London: Parthenon Publishing,
2004, pp. 113–125.
Navarra T. The Encyclopedia of Complementary and Alternative Medicine. New York:
Checkmark Books. 2005, pp. 2–5.
Borchers AT, Hackman RM, Keen CL, et al. Complementary medicine: A review of
immunomodulatory effects of Chinese herbal medicines. Am J Clin Nutrition
Chan TYK, Critchley JAJH. Usage and adverse effects of Chinese herbal medicines.
Human Exp Toxicol 1996;15:5–12.
Ho LJ, Lai JH. Chinese herbs as immunomodulators and potential disease-modifying
antirheumatic drugs in autoimmune disorders. Curr Drug Metab
Lai JH. Immunomodulatory effects and mechanisms of plant alkaloid tetrandrine
in autoimmune diseases. Acta Pharmacol Sin 2002;23:2093–1101.
Xi L, Zhiwen L, Huayan W, et al. Preventing relapse in multiple sclerosis with
Chinese medicine. J Chin Med 2001;66:39–40.
Zhang L-H, Huang Y, Wang L-W, et al. Several compounds from Chinese traditional
and herbal medicine as immunomodulators. Phytother Res