Herbal supplement fans love how simple, natural, and trustworthy herbs are: “The most commonly used herbs have an excellent safety profile,” says Dr. Bill Rawls, Medical Director of Vital Plan. “After being used for thousands of years by humans, they have a proven track record.”
Still, you may wonder about the best way to take herbs in order to reap the maximum benefit with the lowest risk of even minimal side effects. To help you do just that, Tim Yarborough, Wellness Director of Vital Plan, answers your top questions.
Can I start with the maximum serving?
“With any new herbal or natural supplement, it’s a good idea to begin with a lower serving, and gradually increase it every couple of days until you’ve reached the recommended amount,” says Yarborough. “This lessens the chance even more that you’ll experience side effects.”
If possible, take your first serving at the beginning of a weekend. That way, if you do develop any unexpected side effects, it won’t throw off your weekday 9-to-5 routine.
Finally, stick with the limitations indicated on the label unless your healthcare practitioner advises otherwise: Don’t exceed the recommended serving, and don’t take the herb for a longer (or shorter) period than recommended. Either way, you may miss out on the plant’s optimal benefits.
Should I worry about taking herbs with my medication?
Nearly 25% of American adults take both a prescription drug and a dietary supplement, according to the American Academy of Family Physicians. Most likely there’s nothing to worry about, but there are times when you shouldn’t combine certain herbs, or mix herbs with medicine.
The best approach is to discuss any supplements you’re considering taking with your doctor, but you can start by doing some research on herb-drug interactions at the University of Maryland website. Some of the most common herbs that interact with prescription medications include:
- Black cohosh: It may reduce the effectiveness of statins, cholesterol-lowering medications.
- Cranberry and gingko: There’s a potential for increased risk of bleeding when it’s taken with the blood thinner Warfarin (Coumadin).
- American ginseng: It may slightly lower blood sugar levels, so use it carefully if you’re taking diabetes medications such as Metformin.
- Milk thistle: This herb may reduce the effectiveness of drugs that are metabolized by the CYP2C9 enzyme such as Warfarin and diazepam (Valium).
- Goldenseal: It’s been shown to inhibit two enzymes that are responsible for metabolizing more than half of all over-the-counter and prescription drugs. Don’t take goldenseal with any other medications.
- St. John’s wort: This plant has been shown in clinical studies to reduce the effectiveness of a wide variety of drugs, including Warfarin, the heart failure drug digoxin, and oral contraceptives.
What if I have trouble swallowing capsules?
You’re in good company: research shows that almost 40% of us have trouble getting pills down. Fortunately, there are some simple ways around it.
“Try taking your serving with a thick, viscous liquid such as coconut or almond milk to wash it down quickly,” suggests Yarborough. The fat in these beverages can also help your body better absorb the supplements, especially those containing fat-soluble vitamins.
Another tack: hide your capsules in soft food such as applesauce, yogurt, or even bread. And if you’re still finding it hard to swallow, you can always open up the capsule and ingest the powder directly.
“Just keep in mind that many of these herbs have a sharp, bitter taste,” says Yarborough. “You may want to mix them with something sweet, like applesauce or a fruit smoothie.”
When is the best time to take herbs?
Yes—and that’s whenever you can remember to take them, says Yarborough. “But all things being equal, we usually recommend taking herbs twice a day with some food, as some of these substances can cause nausea or heartburn if they’re taken on an empty stomach,” he advises. And if you discover that your supplement is stimulating, make sure you take your last serving by 5 pm so it doesn’t interrupt your sleep.
What if I do experience side effects?
If symptoms include intensified fatigue, muscle pain, and flu‐like symptoms such as headache, nausea, and an upset stomach, it may be a Herxheimer reaction, a.k.a. herxing, a phenomenon where sufferers feel worse before they feel better. “This may be due to dying bacteria, which release endotoxins that circulate throughout your body and can cause an intense whole-body reaction,” explains Yarborough.
Fortunately, herxing symptoms usually improve within a few days to a few weeks. But if you still feel lousy, you can try reducing your serving to see if that helps relieve symptoms, and then gradually increase the serving again until you’re back up to the full recommended serving. Some people find relief from lifestyle measures such as sipping ginger tea, applying heat to sore areas or taking a hot bath or sauna, and getting outside into the fresh air.
If your symptoms continue to worsen, or if you experience an allergic-like reaction (hives, itching, skin rash, runny nose, watery eyes, wheezing), stop taking the herb immediately and consult your healthcare practitioner for advice.
Ultimately, the best way to benefit from herbs is to get them into your body, says Dr. Rawls. “Figure out what works best for you to take them regularly, and that’s your ideal plan for optimal benefits.”