After living and studying in India for a decade, I enrolled in the Master’s course in Medical Anthropology at Oxford in 2002 as one of twelve students from five countries. Studying at Oxford was such an inspiring experience that I continued with a D.Phil. in Social Anthropology, researching longevity practices and concepts of the life-span in Tibetan societies in India (Gerke 2012a). I then taught at three universities in the USA and Germany, and pursued a post-doc at the Humboldt University, Berlin, on detoxification methods in Tibetan pharmacology and on how ideas of toxicity are translated cross-culturally (2011-2015). Critical course discussions that we had at Oxford on efficacy made me look at issues of safety and helped me think anthropologically about toxicity. How can we study toxic ingredients of medicines with research methods specific to anthropology in the absence of laboratories and biomedical testing tools? Looking at changing anthropological approaches to efficacy and safety are my entry points for this article, which provides some of the groundwork necessary to address questions of how Tibetan doctors translate their ideas of toxicity and detoxification to a Western audience.