Reframing Inflammaging: A Clinical Perspective on Acupuncture, Chinese Herbal Medicine, and Ageing

Rethinking Qi in Modern Clinical Terms

Inflammaging—a term now well established in the biomedical literature—describes low-grade, persistent inflammation that accumulates with age. It underpins many of the chronic, non-specific symptoms we see in older patients: fatigue, musculoskeletal pain, poor sleep, digestive slowing, and decreased resilience.

These symptoms often present before frank pathology is measurable, making early intervention both difficult and crucial. This is where Traditional Chinese Medicine (TCM)—particularly acupuncture and Chinese herbal medicine—offers a valuable, evidence-aligned framework.

🩺 Rethinking Qi in Modern Clinical Terms

Much of the scepticism surrounding TCM arises from historical mistranslations. Notably, the French diplomat Georges Soulié de Morant inaccurately translated the Chinese term qi (氣) as “energy” or “life force,” leading to an entrenched but misleading Western interpretation.

A more accurate understanding recognises qi as functional physiology—the body’s capacity to metabolise, transport, regulate, and maintain internal coherence. In clinical terms, this includes:

• Oxygen delivery and blood circulation

• Tissue repair and immune responsiveness

• Hormonal regulation and autonomic rhythm

• Mitochondrial output and metabolic resilience

Where qi is impaired, we often see fatigue, inflammatory tone, poor recovery, and impaired circulation—exactly the clinical phenotype of inflammaging.

🌿 TCM Definition of Health

In Traditional Chinese Medicine, optimal health is defined by:

• A constant supply of well-nourished, oxygen-rich blood reaching all tissues

• A system in which metabolic, immune, and circulatory functions are coordinated and regulated

• The capacity for repair, adaptation, and resilience in response to stressors

Inflammaging, through this lens, is understood as a progressive breakdown in these coordinated functions—often involving what TCM describes as “qi and blood deficiency,” “internal dampness,” or “Liver constraint.”

🔬 Acupuncture: Regulating Inflammation and Resilience

Mechanisms of Action:

• Modulates inflammatory mediators including TNF‑α, IL‑6, and CRP

• Enhances vagal tone and HPA axis regulation, improving autonomic balance and HRV

• Increases microcirculation and perfusion, supporting mitochondrial and immune function

• Activates descending pain modulation pathways, reducing nociceptor hypersensitivity

Evidence:

• A large meta-analysis (Vickers et al., 2018, JAMA Internal Medicine) showed acupuncture has statistically and clinically significant effects for chronic pain, particularly in musculoskeletal conditions.

• A randomised controlled trial by Kim et al. (2015) demonstrated that acupuncture significantly reduced fatigue severity in patients with idiopathic chronic fatigue.

Clinical Relevance:
Patients experiencing early inflammaging symptoms—particularly pain, fatigue, poor sleep, and stress sensitivity—often respond favourably to regular acupuncture. This provides a non-pharmacological, well-tolerated adjunct to conventional care.

🌿 Chinese Herbal Medicine: Internal Regulation and System Support

Mechanisms of Action:

• Many formulas exhibit anti-inflammatory, antioxidant, and immunomodulatory properties

• Targets systemic drivers of dysfunction: poor digestion, impaired detoxification, fluid stagnation, and tissue undernourishment

• Supports gut–immune integrity, endocrine balance, and constitutional recovery

Evidence:

• A 2022 meta-analysis of 84 RCTs (Zhang et al., Frontiers in Pharmacology) concluded that Chinese herbal medicine significantly reduced fatigue, improved quality of life, and lowered inflammatory markers in patients with chronic fatigue syndrome.

• Experimental pharmacology studies have shown that many Chinese herbs modulate pathways involving NF-κB, COX-2, and IL-1β.

Clinical Relevance:
For patients who present with vague, multisystem complaints but no clear pathology, Chinese herbal medicine offers whole-system regulation that is difficult to achieve with targeted drugs alone.

🔄 Integration into Conventional Practice

Acupuncture and Chinese herbal medicine do not need to replace biomedicine—they can enhance and complement it.

• Help patients tolerate physiotherapy, exercise, or dietary changes

• Improve quality of life and reduce symptom burden in chronic disease

• Provide proactive support before pharmaceutical intervention becomes necessary

• Bridge the gap between lifestyle advice and actual physiological regulation

🧠 For the Sceptical Practitioner

It’s understandable to approach TCM with caution. The language is unfamiliar, the framework is different, and mistranslations have muddied its reception in the West.

But that tide is turning.

There is a growing body of RCTs, pharmacological research, and neuroimmunological studies validating many of TCM’s foundational concepts—especially in areas where conventional medicine lacks whole-system tools.

By referring patients early—for acupuncture and/or herbal consultation—you’re not endorsing mysticism. You’re expanding care options and offering a pathway that has already helped millions worldwide.

✅ Clinical Takeaways

• Inflammaging is real, modifiable, and best addressed early.

• “Qi” reflects the body’s physiological competence—circulation, regulation, recovery.

• Acupuncture and Chinese herbal medicine improve resilience, reduce inflammation, and support function.

• RCTs increasingly support these modalities as safe and effective adjuncts.

• Early referral improves outcomes—and may prevent decline.

📍 On the Pulse Clinic, South County Dublin
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