Traditional Chinese Medicine and Bleeding Risk – What You Need to Know

If you’ve ever tried a Chinese herb tea or visited a TCM clinic, you know the appeal: natural‑looking remedies and centuries‑old wisdom. But natural doesn’t always mean safe, especially when you’re on blood thinners or have a bleeding disorder. This guide breaks down the most common TCM herbs, explains how they might affect bleeding, and shows you how to keep your CRUSADE Bleeding Score in check.

Common TCM Herbs That May Affect Bleeding

Herbs like Dong Quai (Angelica sinensis), Hawthorn (Crataegus), and Ginseng are popular for blood health, but they can also thin the blood. Dong Quai is often called “female ginseng” because it helps hormone balance, yet it contains coumarin‑like compounds that can prolong clotting time. Hawthorn berries are celebrated for heart support, but they act like mild anticoagulants. Ginseng, especially American ginseng, may interact with warfarin and newer oral anticoagulants, boosting their effect.

Other herbs such as Turmeric (Curcuma longa), Garlic (Allium sativum), and Ginkgo biloba are used for circulation and inflammation. All three have platelet‑inhibiting properties, meaning they can increase bleeding if taken with prescribed blood thinners. Even “mild” formulas that combine several herbs can stack these effects, so it’s worth looking at the full ingredient list.

How to Evaluate Bleeding Risk When Using TCM

The CRUSADE Bleeding Score helps clinicians estimate bleeding risk based on age, kidney function, blood pressure, and medication use. When you add TCM herbs, treat them like any other drug. Start by noting the herb name, dose, and frequency, then add these details to your medication list before calculating the score. If the score nudges into a higher risk category, talk to your doctor about adjusting the dose or swapping the herb for a safer alternative.

Ask your pharmacist or TCM practitioner for a clear breakdown of active compounds. Some practitioners provide a “bleeding‑risk flag” for herbs that can thin blood. If you can’t get that info, a quick web search for the herb name plus “anticoagulant” will usually reveal any red flags. When in doubt, pause the herb for a few days and see if your lab results (like INR or aPTT) change.

Remember, timing matters. Taking an anticoagulant and a TCM herb at the same time can amplify the effect, while spacing them out by several hours may lessen the impact. Always keep a written record of what you take, and share it with every healthcare provider you see.

In short, traditional Chinese medicine offers many benefits, but it isn’t free from bleeding concerns. By knowing which herbs can thin blood, using the CRUSADE Bleeding Score as a safety net, and keeping open communication with your care team, you can enjoy TCM without compromising safety.