10 Common Mistakes When Using Herbs


Verywell / Alexandra Shytsman

Herbal medicine has grown in popularity as many people look for more natural solutions. Herbs are even finding their way into more and more foods and beverages. While many can have beneficial effects, there are safety considerations that need to be kept in mind.

Perhaps because herbs are natural, or because they are not regulated in the same way as medicines, many people find that they unwittingly make potentially harmful mistakes when using herbs and herbal products. Here are 10 mistakes that are commonly made when using herbs and how to sidestep them.

You Take Herbal Product Claims at Face Value

You should know about any potential side effects and safety concerns from an independent resource that is current and is based on scientific research. Some manufacturers will describe their products as natural and therefore safe, but many have the potential to cause serious adverse effects if taken incorrectly.

For example, a 2003 study published in Obstetrics and Gynecology warns that the "use of bust-enhancing products should be discouraged because of lack of evidence for efficacy and long-term safety concerns." And a 2016 commentary in the Journal of Breast Health not only confirmed that the effectiveness of these products has not been established but also questioned whether or not they might have an impact on the accuracy of breast imaging in medical settings.

And yet these pills have a history of being incredibly popular. Herbs used in many breast enhancement pills, such as hops, have been found to have potent estrogenic effects which have prompted studies to investigate their safety. Another popular ingredient, fenugreek, is not recommended during pregnancy in high doses and there have been concerns over safety when consumed in amounts larger than those found in food.

Tip: Do your own research by using reliable sources such as the National Center for Complementary and Integrative Health (NCCIH), which is part of the National Institutes of Health, and Natural Standard.

You Are Not Sharing Herb Use With Your Primary Doctor

More than a third of American adults use some form of alternative medicine, according to the NCCIH. However, most of these people are not reporting this information to their doctors.

In fact, a 2019 research letter in JAMA Oncology finds a third of cancer patients are using alternative medicines and most are not sharing that information with their doctors. 

There is increasing evidence that not sharing this information could pose serious risks to your health. Many herbs interact with common medications and medical procedures, and that may increase side effects or reduce the effectiveness of your treatment.

Tip: Bring a list of herbs you are considering taking (or already using) to your doctor. Ask that it be reviewed in the context of your overall health and medication use and that the list be added to your chart for future reference.

You Are Taking Herbs That Increase Bleeding Risk

Anticoagulant drugs such as aspirin or warfarin (commonly referred to as blood-thinners) prevent the formation of blood clots inside arteries, reducing the risk of stroke and heart disease. When they are combined with herbs and supplements that also have an anticoagulant effect, they can increase the risk of bleeding.

Foods that contain vitamin K, such as leafy green vegetables, can also interfere with warfarin. Herbs and supplements that should not be combined with anticoagulants include:

  • Aloe vera
  • Chamomile
  • Coenzyme Q10
  • Danshen
  • Devil's claw
  • Dong quai
  • Feverfew
  • Fish oil
  • Garlic
  • Ginger
  • Gingko
  • Ginseng
  • Goji
  • Saw palmetto
  • Willow bark

Tip: If you are taking more than one of these herbs or are taking them with warfarin, aspirin, or other anticoagulants, consult a licensed holistic practitioner, such as a naturopathic doctor, for guidance. Be sure to inform your physician of all herbs and supplements you are taking as well. Blood tests called the prothrombin time and international normalized ratios (PT/INR) can be used to assess blood clotting.

Your Chamomile Tea Is Interacting With Your Medication

Although most people think of chamomile tea as being harmless, it can have some serious side effects, especially when combined with certain medications.

In addition to increasing the risk for internal bleeding, it may also interact with other medications by altering how they are broken down in the body.

Tip: Make sure you review the drugs that can interact with chamomile before taking a sip.

You Are Taking Herbs With Immunosuppressants

Immunosuppressants are drugs that lower the body's ability to reject a transplanted organ. They are also used to control the symptoms of autoimmune diseases.

Herbs that stimulate the immune system may counteract with these medications, resulting in transplant rejection, exacerbation of autoimmune disease symptoms, or even the triggering of an autoimmune disorder in people who are genetically predisposed. Common immunosuppressant drugs include:

  • Cyclosporine
  • Azathioprine
  • Corticosteroids, including prednisone
  • Methotrexate

If you are taking an immunosuppressant drug, do not take the herbs alfalfa, astragalus, echinacea, ginseng, licorice root, or the mineral zinc.

You Decide Herbs Are the Way to Manage Fatigue

Constant weariness, tiredness, or lack of energy may warrant a trip to your primary care provider. While diet and supplements (including herbs) may help, the first step is to make sure that the cause of the fatigue isn't an underlying illness, such as:

  • Anemia
  • Asthma
  • Autoimmune disease, such as lupus or rheumatoid arthritis
  • Sleep disorders such as obstructive sleep apnea
  • Hypothyroidism
  • Chronic fatigue syndrome
  • Depression

Fatigue can also be a symptom of other conditions such as infectious diseases (e.g. mononucleosis), heart failure, diabetes, liver or kidney disease, Addison's disease, autoimmune diseases (e.g. lupus), cancer, and malnutrition, or due to medication side effects.

Tip: See your primary health provider first. They will ask you questions and make sure you have the proper laboratory and/or imaging tests to rule out these conditions. Then you can think about natural approaches.

You Consider Herbs a Replacement for Coffee

Yerba mate is a popular coffeehouse drink—a herbal tea that energizes without causing jitters. Widely consumed in Central and South America, it's often touted as a healthier alternative to coffee. However, yerba mate has been associated with esophageal, oral, lung, and bladder cancers in several research studies.

Although research shows the cancer link is more common in people drinking huge amounts of yerba mate (greater than 1 liter a day) or extremely hot tea, you might want to avoid it until there's more evidence to show that it's safe for consumption.

Energy drinks, such as Red Bull, Monster Energy Drink, Full Throttle, contain caffeine and a slew of vitamins and herbs. One of the biggest concerns is that not enough is known about the combined effects of these ingredients. Many ingredients are believed to work in conjunction with caffeine to boost its stimulant power. Most energy drinks also contain high amounts of sugar and are as unhealthy as soda drinks.

Tip: If you're looking for healthier drink options, consider water with a splash of pomegranate or cranberry juice.

You Are Using Herbs Long-Term to Manage Constipation

Some herbs, such as aloe, cascara, frangula, senna, and rheum herbs, are anthranoid laxatives. While they may be effective, prolonged use may cause the bowels to lose the ability to move on their own. Such herbs have been linked to chronic diarrhea, muscle weakness, potentially dangerous irregular heart rhythms, and kidney or liver impairment.

These stimulant herbs should not be used for longer than a week. It is a good idea to consult your doctor if constipation and gastrointestinal symptoms continue.

Tip: Ask your doctor about weaning off laxatives gradually and recovering normal bowel function. The key is to do it slowly, usually in combination with a fiber supplement such as psyllium and adequate fluids.

You Are Not Stopping Herbs Before Surgery

Your surgeon needs to know about everything you are taking in advance of a procedure in order to prevent complications. Herbs and supplements can interact with anesthesia or cause excessive bleeding.

Using herbs before surgery can also affect blood pressure, electrolyte levels, and dieresis. Since herbs should be discontinued at least two weeks prior to surgery, make sure your surgeon knows about them so your surgery date can be set far enough out. Herbs and supplements that are the riskiest to use before surgery include:

  • Chamomile
  • Coenzyme Q10
  • Ginkgo
  • Ginger
  • Ginseng
  • Glucosamine and chondroitin
  • Kava kava
  • Licorice
  • Omega-3 fatty acids, flaxseed oil, fish oil
  • Saw palmetto
  • St. John's wort
  • Valerian
  • Vitamin E

Researchers recommend that all herbs and supplements be discontinued two to three weeks prior to surgery. Be sure you have a discussion with your doctor about what is recommended in your case.

You Are Not Taking Herbs Consistently

It's important to take herbs and supplements regularly and as recommended in order to assess whether or not they are working. A common mistake is to start taking a supplement, skip a day or two, and then start taking another down the line because you haven't noticed an improvement. If you're not consistent, you'll probably never know whether an herb is effective.

Tip: Get a day-of-the-week pill organizer online or at your local drugstore.

A Word From Verywell

Remember that herbal and dietary supplements are not held to the same rigorous testing standards as pharmaceutical drugs. Be sure to do your research and choose supplements that have been tested by a verified third party.

Overall, always discuss any herbs you are taking or are considering taking with a medical professional. This is crucial for your health and safety.

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Article Sources
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