We all know that herbs have many healing properties (and plants are the basis for many medicines), but do these over-the-counter “herbal supplements” really work and are they safe? Here’s what you should know before you take herbal supplements.
I’m a lover of plants and a big believer in their healing properties. In the words of one research biologist, “plants are the master chemists.” Every plant manufactures thousands of phytochemicals, many of them for self-protection against disease organisms, ultraviolet radiation, and other forms of environmental adversity.
People (and many animals) have been using plant-based medicines for thousands of years to take advantage of these protective chemicals. Perhaps 40% of modern pharmaceutical drugs originally derived from plants, and ongoing research throughout the world continues exploring the still largely untapped potential of plants for human health.
What Are Herbal Supplements?
Herbal supplements are products (usually capsules) made from plants to treat illness or improve health; they are used for internal use. It’s important to know that in the U.S. herbal supplements aren’t regulated in the same way as drugs. In fact, the FDA considers herbal supplements foods, not drugs. Often, they are considered dietary supplements (or, more accurately, botanical dietary supplements). This means that herbal supplements are not subject to clinical trials or the same safety standards.
Also, an herbal supplement can’t actually say that it treats a true medical condition. A great example is St. John’s wort; people take it for depression but the label can not say it works for depression as it’s not proven by a regulated government entity; instead, the label might speak to your “mood.”
Are Herbal Supplements Safe?
A recent Canadian study reported that many OTC supplements don’t contain much, or any, of the labeled herb, and may contain unlisted filler ingredients that could cause allergies or toxic reactions. Yet the report was followed by a strong critique from the American Botanical Council, asserting that that the Canadian analysis was flawed and confusing, and suggesting that it should be retracted, then corrected, revised, and re-reviewed before republishing.
Reading the two together highlights the complexity of trying to help consumers and healthcare professionals assess and compare the quality of herbal products. There’s no doubt that some “herbal” products—in particular some of those promoted for weight loss or sexual enhancement—contain active pharmaceutical ingredients—“drugs.”
Just deriving from natural plant materials doesn’t make even a “pure” herbal product safe or effective. But the fact that an herb has been used by traditional healers or people treating themselves for hundreds or even thousands of years suggests it might well be capable of delivering some real effect. Always treat an herbal remedy from any source with respect.
What to Know Before Buying
As one layperson to another, I suggest learning as much as possible about an herbal product and asking a lot of questions before you buy and try it. For example:
- Can you find any high-quality research supporting the safety and efficacy of the herbal product for the use you intend?
- Can you find evidence of potential side-effects or adverse effects from taking this product?
- Might the product interact in some way with the drugs and/or herbal supplements you already take?
- Is it safe for pregnant women or women who might become pregnant while taking it?
- Is it safe for infants or young children?
- Where and how was the herb grown, harvested, processed, and stored?
- Will you take it as a whole herb, a plant part (leaf, flower, root), a “standardized” preparation? As a single herb or a combination of two or more herbs? As a capsule, a powder, an extract, a tea, a tincture, or a cream? Why did you make that choice?
- What dose will you take? How often, and for how long? What factors went into your decision on dosing?
Over the years, I’ve tried many herbal OTC products. Early on, armed with a few reference works (and usually without consulting or informing my doctor), I tried products recommended by friends or advertised in magazines.
Some didn’t do anything for me. One worked really well, but long-term use gave me severe heart palpitations. Another made me violently sick to my stomach. Some products, including a couple recommended by my health professionals, have worked well and I still keep a supply on hand.
These days I’m much more likely to research, collect with care, and use the plants that grow wild around here and that native people used as medicine long before the advent of modern pharmaceuticals.
If you do decide to try an herbal supplement (or make your own), why not talk it over in advance with your healthcare professional? Many pharmacists, in particular, have special training or take a special interest in traditional herbal remedies, and may have access to up-to-date, research-based information you haven’t discovered.
And always be sure to take all the herbs in their containers with you each time you visit your primary care provider, your dentist, or you to the pharmacy with a new prescription to be filled. Ask for a consultation with the pharmacist to learn about any interactions or contraindications between and among the drugs and herbs.
Here’s a subsite of PubMed (public database of references and abstracts on life sciences and biomedical topics) that allows users to look up published scientific research related to specific herbs. Just type the name of an herb into the Search box at the top of the page.
Australian Therapeutic Goods Administration (TGA) launches database of adverse events. Read this article, then click into the database and begin your search. Even though it’s specific to Australia, the database provides volumes of information Americans will find useful.
American Botanical Council (ABC) A wealth of information about medicinal use of herbs.
National Center for Complementary and Alternative Medicine (NCCAM) A good place to start learning about the many therapies that complement but lie outside traditional biomedical practice.
Herbs at a Glance From NCCAM, a series of brief fact sheets that provide basic information about specific herbs or botanicals
Frequently asked questions about herbs and other dietary supplements
How to spot health fraud A Useful checklist, with examples.
Why Plants Are (Usually) Better Than Drugs Dr. Andrew Weil presents his case for plant medicine as a first-line therapy.
What to know before you buy Checklist from the Mayo Clinic