Medicine or Food Supplement? Where Do Chinese Herbs Belong?
The hot topic of the month here in the Philippines is the polarization of the medical profession when it comes to the use of Stem Cell Therapy. While I do not wish to further contribute to this polarization, I find that my personal discussions with other physicians with regards to this matter always end up on the topic of definitions of drugs vs supplements as well as what is experimental vs what is “proven”.
To get straight to the point, allow me to state my position on how Chinese Herbal Medicine fits into the scheme of things. Currently, Chinese herbal products would mostly be classified as food supplements. The distributors and retailers love this because being classified as “merely” supplements, their products do not need to undergo the same rigorous evidence and proof examination required of drugs.
Psychologically, the unfortunate implications of this is twofold: Firstly, most medical professionals end up scoffing at Chinese herbs because of the implication that they are “merely” supplements. On the other hand, it is easier to abuse such products because there are no standards as to their proper use and safety profiles.
The fact of the matter is that I consider Chinese herbal products – whether to be decocted at home or in pill or ointment form, should be considered drugs and should be regulated. I often say that when I studied TCM in China, half of what I studied were side effects and how to combat them.
In truth, it is entirely possible for Chinese herbal products to be registered as drugs in the Philippines. There is at least one product (an ointment for burns) that is approved by the FDA as a drug. It is such a useful drug that in our institution, the Philippine General Hospital, our burn unit uses it as a cheaper alternative to silver sulfadiazine. I have had at least one burn surgeon tell me that “it works miracles”.
What does this prove so far? It proves that as long as the evidence is there, the FDA will have no problem approving these therapeutics as drugs.
So what’s the problem?
The problem is how to design good studies for Chinese herbs. Such studies must take into account the fact that Chinese medicine has a different paradigm with regards to the pathophysiology and treatment of disease. Chinese medicine takes into account the whole picture and not just the symptom.
It is erroneous, for example, to study the effect of a particular formula for joint pain when Chinese medicine recognizes at least four different types of joint pain. If the joint pain is due to cold, then one cannot use formulas that cool down. If the joint pain is due to heat then one can.
What therefore is needed? The FDA needs to recognize that Chinese medicine has its own way of doing things and that it requires its own experts to do the evaluating. For that to happen, Chinese medical practitioners must be recognized and regulated as a true profession as it is in the United States and Australia.