In our last two articles, we discussed how dietary supplementation is becoming more prevalent in our society as people look for natural health interventions to replace or complement conventional pharmaceutical therapies, and we specifically looked at safe ways to use vitamin and mineral supplements. Herbal supplementation is a bit more complex, but with a balanced approach you can still supplement safely and effectively. Here are a few tips for a balanced approach to herbal supplementation.
What is herbal supplementation?
The FDA defines a dietary supplement as “a product taken by mouth that contains a ‘dietary ingredient’ intended to supplement the diet1.” Dietary ingredients are further defined as:
- herbs or other botanicals
- amino acids
- substances such as enzymes, organ tissues, glandulars, and metabolites
These products are intended as a means of correcting or preventing deficiencies or imbalances when diet alone does not provide adequate nutrition for good health. Herbal supplementation involves the use of plants or plant extracts to support good health or to correct imbalances. Herbal remedies have been used for centuries by knowledgeable practitioners to treat diseases effectively; however, as with any substance that is used to alter biological functions, there are risks involved. Thankfully, the benefits of most herbal products far outweigh the risks as long as the product is used responsibly.
How do I know if I should supplement my diet with herbs or other botanicals?
Ideally a healthy and varied diet would provide sufficient nutrient intake to provide all the building blocks the human body needs to function at optimal health. However, if dietary or lifestyle modifications are not enough to maintain good health, or if your doctor has suggested pharmaceutical drugs to improve your health and you would prefer a more natural approach, you may want to consider herbal supplementation.
Herbal products in general are less likely to cause adverse effects than conventional medicines2 but there are potential risks to taking some herbal supplements. Concurrent drug/herb use3 is one instance of increased risk of adverse effects due to potential drug-herb interactions. Always consult a knowledgeable practitioner before beginning herbal supplementation if you are already taking other medications or herbal supplements. Polypharmacy is more commonly seen in the elderly and therefore this group is at greater risk for adverse effects resulting from drug-herb interactions. Older adults and persons with liver or kidney damage are also more likely to have impaired metabolism which often increases drug/herb clearance from the body. This creates the potential for more serious adverse effects, as the body is not able to detoxify dangerous compounds resulting from interactions quickly enough to prevent serious damage.
Pregnancy, lactation, and early childhood are also times when extra caution is advised for herbal supplementation. Most medications and herbal products are not considered safe during pregnancy and lactation, and should only be used under the direction of a health professional. Some botanical products that would normally be considered safe have been shown to cause adverse effects such as preterm labor in pregnant mothers4 and thus cannot be recommended during pregnancy. The constituents of some herbal products may be transmitted to breastfeeding children and could potentially cause an adverse effect in the young child. Other botanical products may be considered safe during lactation but not during pregnancy5. Children are more likely to experience an adverse response to an herbal supplement if a dose appropriate for their weight is not given. Anyone in these categories should seek the advice of a professional before supplementing with herbs or other botanical products.
Another risk factor for adverse effects has to do with the supplements themselves. When the process of producing a botanical product is rushed, contamination may occur (e.g., herbs that are not dried properly may be contaminated with mold). Adulteration or mis-labeling also results in inferior, and sometimes dangerous, products. Choosing an inferior botanical product increases the risk of an adverse effect, so it is important to search for high-quality products when selecting herbal products.
Now that we’ve covered some risk factors, let’s talk about the benefits! Most herbs have a phytochemical profile that is much safer than their conventional counterparts. The risk of an adverse effect when taking an herbal supplement is much lower than most pharmaceuticals. While few clinical trials have evaluated herbal efficacy, new research is showing promising proofs that botanicals can be safe and effective treatments for imbalances and diseases6,7 and researchers are currently examining the positive role that traditional herbal remedies play in maintaining good health. If you are not in one of the at-risk groups mentioned above, high-quality herbal supplementation may be the safest way to treat ailments when used under the guidance of a health professional.
A good way to determine whether herbal supplements or other botanicals are appropriate for you is to consult with a qualified health practitioner with a background in botanical safety. A knowledgeable practitioner will be able to help you evaluate your needs and work to avoid adverse effects that may result from inappropriate herbal supplementation. You can use some online databases, such as this drug interaction checker, to do some preliminary research on your own for potential interactions; but before you begin taking any herbal supplement, discuss it with your doctor. Be sure to provide an updated list of all over-the-counter and prescription medications you may be taking so your doctor can accurately evaluate your risk.
Next up, we’ll cover safe herbal supplementation in Part IV of this series.