Research Brief: Can TCM Herbs and Anticoagulants be Taken Together?
In my clinical practice, I have encountered numerous patients and doctors who are concerned with the use of TCM herbal formulas. Especially for many chronic illnesses, patients might come in with various prescriptions that might pose a threat in herb / drug interaction. While the concerns are valid, I do want to propose the use of TCM herbal formula for many patients. In my practice, it’s not uncommon to use acupuncture along with those herbal formulas as well.
Why There is a Need
While prescription drugs can help the patients’ need in symptom management, herbs, especially TCM herbal formulas, focus on restoring and optimizing the body’s functions. One of the many concerns that has been brought up is the use of anticoagulants and the concurrent use of TCM herbs.
Side Effects of Anticoagulants
Anticoagulants in conditions like stroke, cardiovascular diseases , DVT and chemo-induced thrombosis are life saving. However, that doesn’t mean they don’t come with side effects. One of the major side effects is internal bleeding, such as gastric bleeding or cerebral hemorrhage. Thus anticoagulants are a double-edged sword, both life saving and life threatening.
Another perspective on the use of anticoagulants is that blood clots caused by illness signify underlying inflammation, either chronic or acute. Due to long-term poor lifestyle habits, high stress, and malnutrition, which cause blood clots and vascular damage, anticoagulants are required. For optimized quality of life, however, other modalities are also needed.
The Study
The use of TCM herbal formulas is common practice in Taiwan. When I came across the cohort study on anticoagulants with concurrent use of herbal formula, I felt really encouraged. Especially when the research has formulas that are traditionally used to promote blood, such as San Qi(Panax notoginseng) or Shu Jing Huo Xue Tang (疏經活血湯), which are sometimes frowned upon by doctors as a result of lack of understanding and training on Chinese herbs.
Study Design and Participants
This study used data from Taiwan’s National Health Insurance. It looked at 4,470 patients on blood thinners. Half of the patients took Chinese herbal medicine with their anticoagulants, and the other half did not. The two groups were similar in age, gender, and health conditions to accurately compare the effects of Chinese medicine on bleeding risk.
Chinese Medicine Used
Herbs like licorice, San Qi, ginseng, and balloon flower, as well as herbal formulas such as Shu Jing Huo Xue Tang, were present in the study. These herbs seemed to help lower the risk of bleeding when taken with blood thinners.
Main Goal
The study focused on whether patients had to go to the hospital for serious bleeding events, like stomach or brain bleeding, which can happen when taking blood thinners.
Results
Patients using both Chinese herbs and blood thinners had a lower risk of major bleeding compared to those using only blood thinners. Stomach bleeding was reduced by about 35%, and other types of bleeding were also less common.
Conclusion
Combining Chinese herbs with blood thinners might reduce the risk of bleeding without affecting how the blood thinners work. This could be a useful option for people who need long-term blood thinners.
This study matters because blood thinners, while important for preventing dangerous clots, can cause serious bleeding problems. If Chinese herbs can safely lower the risk of bleeding without affecting how well blood thinners work, it could help patients avoid these complications. This is especially important for people who need to stay on blood thinners for a long time, like those with heart issues. Combining traditional medicine with modern treatments could offer a safer way to manage their health.
Reference
1.Concurrent use of Chinese herbal medicine and anticoagulants may reduce major bleeding eventsHsu SM, Lin HJ, Kao YW, Li TM, Shia BC, et al. (2022) Concurrent use of Chinese herbal medicine and anticoagulants may reduce major bleeding events. PLOS ONE 17(8): e0271965. https://doi.org/10.1371/journal.pone.0271965
