Tradition herbs

Ashwagandha

Ashwagandha (Withania somnifera) is a leading rasayana, or rejuvenating tonic, in Ayurveda, traditionally used to build strength and resilience to stress. Meta-analyses of small randomised trials suggest standardised extracts may modestly improve sleep and lower self-reported stress and anxiety over several weeks, but no claim reaches moderate certainty because the trials are few, small, use different extracts and disagree in effect size. Rare cases of liver injury have been reported, several European authorities and the Australian TGA have reviewed its safety, and it is advised against in pregnancy and breastfeeding.

• Mind
• Sleep

Brahmi / Bacopa

Brahmi (Bacopa monnieri) is classed in Ayurveda as a Medhya Rasayana, a rejuvenative specific to the brain, and is used for memory. Randomised trials of standardised extracts taken for about 12 weeks found improvements on some memory and attention-speed tests in healthy adults and older adults, but results vary across cognitive domains and trials are small, so no claim here rises above low certainty. Gastrointestinal side effects such as nausea, cramps and more frequent stools were reported in trials.

• Mind
• Vegan

Contamination/adulteration of TCM imports

Laboratory surveys of traditional Chinese medicine (TCM) herbal products have found heavy metals (lead, cadmium, mercury, arsenic), undeclared pharmaceutical drugs, and plant or animal species not named on the label, including endangered species. Rates vary widely between studies, countries and product types. Herbs containing aristolochic acid, sometimes present because one herb was mistaken for another, have caused kidney failure and urinary-tract cancers, and the U.S. FDA detains imports of products that contain them. The evidence is laboratory surveys, case reports and epidemiology rather than trials, which is expected for questions of product quality and harm.

Culinary spices

Culinary spices such as cinnamon, ginger and garlic have long histories in folk and traditional medicine, and several have been tested in randomised trials, mostly as concentrated supplements rather than as food. Trials suggest small improvements in blood glucose markers with cinnamon in adults with type 2 diabetes, less nausea with ginger in pregnancy and lower blood pressure with garlic in adults with high blood pressure, and a large Chinese cohort linked regular spicy food with lower mortality. None of these findings reaches moderate certainty, because the trials are small, varied in product and dose, and highly heterogeneous, and the mortality evidence is observational. Spices in food amounts are generally regarded as safe; heavy use of cassia cinnamon can bring coumarin intake up to the tolerable daily intake.

• Vegan

Herb–drug interactions (TCM)

Herbs used in traditional Chinese medicine, such as danshen, dong quai, ginkgo, ginseng and liquorice, have been reported to interact with conventional medicines, most often the anticoagulant warfarin, which has a narrow therapeutic range. Most of this evidence is case reports, laboratory and animal studies; the few randomised trials are small, of low quality and often find no significant effect, so for most individual herbs the size and frequency of any interaction is unknown. Two effects are better established: regular glycyrrhizin-containing liquorice raises blood pressure and lowers plasma potassium, and St John's wort (not a TCM herb, but the reference example) lowers blood levels of many medicines by inducing drug-metabolising enzymes.

Other non-vegan TCM ingredients

Traditional Chinese medicine (TCM) uses animal-derived materials alongside herbs, among them donkey-hide gelatin (e jiao), deer antler and deer-horn gelatin, tortoise-shell gelatin, scorpion (quanxie) and animal bile, and a 2015 count found animal-derived medicines and the proprietary medicines made from them made up about a fifth of the medicines in the Chinese Pharmacopoeia. Some Chinese herbal products have also been found to contain undeclared animal material. Several animal ingredients carry conservation and legal facts: China banned trade in rhino horn and tiger bone in 1993, removed pangolins from the Chinese Pharmacopoeia in 2020, and bear bile has been taken from farmed bears, while demand for e jiao drives a global donkey-skin trade. These are documentary and regulatory facts rather than trial outcomes, so none is graded high.

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Traditional products to avoid

Regulators and researchers have documented three recurring safety problems with some traditional remedies: toxic metal content in a share of Ayurvedic medicines, especially rasa shastra preparations that deliberately include metals; herbs containing aristolochic acids, which are linked to kidney damage and urinary tract cancers; and undeclared pharmaceutical drugs found in some Chinese herbal and supplement products. Some traditional products also contain animal-derived ingredients such as bear bile.

• Vegan

Triphala

Triphala is an Ayurvedic blend of three dried fruits (amalaki, bibhitaki and haritaki) that the tradition uses as a digestive and rejuvenative rasayana. Small randomised trials suggest a triphala mouthrinse lowers plaque and gum inflammation scores about as much as chlorhexidine, and give very uncertain signals for blood lipids and body weight. No claim reaches moderate certainty because the trials are few, small, heterogeneous and use varied formulations; product quality is the main safety concern.

• Longevity

Tulsi / holy basil

Tulsi (holy basil, Ocimum tenuiflorum) is a revered herb in Ayurveda, where it is called an elixir of life and is held to support longevity and general wellbeing. Small randomised trials in stressed adults report lower perceived stress and better self-rated sleep with tulsi extracts, and older small trials in adults with type 2 diabetes report lower blood glucose, but most studies are small, short and of limited quality. No claim here reaches moderate certainty because the human trials are few, small, mostly conducted with a single proprietary extract or in local journals, and at high or unclear risk of bias. Short-term use was well tolerated in trials; safety beyond about 8 to 13 weeks, in pregnancy and alongside blood-thinning medicines is not established.

• Mind
• Sleep

Turmeric and curcumin

Turmeric root has a long history in Ayurvedic, Chinese and other traditional medicine systems, and European herbal regulators register it as a traditional remedy for mild digestive discomfort on the basis of long-standing use. In trials of adults with knee osteoarthritis, turmeric extracts and curcumin reduced pain and stiffness scores compared with placebo and were tolerated about as well as placebo over weeks to months. No claim reaches moderate certainty because a 2026 critical review rated the systematic reviews behind the joint findings as of extremely low methodological quality, with most outcomes graded low or very low. Rare but potentially severe liver injury has been reported with concentrated turmeric and curcumin supplements, especially high-bioavailability or black-pepper-enhanced products.

• Recovery
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