Supplements are super popular with over 57% of Americans using at least one dietary supplement in 2018 and over 10 billion dollars in sales in 2020.1-2 This shows that people are interested in holistic health products and seeking natural ways to care for their bodies. We think this is great!
However, there is some concern among the medical community that all this interest in supplements could lead to health problems for individuals who choose to take strong herbal supplements that may or may not be appropriate for their medical conditions and/or current medication regimens. With this in mind, we’ve decided to share a few supplements that are powerful and potentially quite helpful, but which require extra caution. You see, if you believe in the power of herbs and natural remedies, then you must acknowledge that they can also cause adverse events when used inappropriately, they’re not benign, inactive substances!
So, without further ado, here are six supplements that we advise extra caution with.
DHEA is a powerful hormonal supplement that is typically used to help with low-ovarian-reserve infertility/subfertility. Its powerful hormonal action makes it very effective for some women and rather problematic for others. Because DHEA acts on our hormonal systems, those taking it need to be aware that it can cause side effects including acne, oily skin, and male-pattern hair growth. Do not take DHEA if you are pregnant, breastfeeding, or have a hormonal condition such as PCOS, as it can cause problems under these conditions.3
Also be aware that DHEA doesn’t just affect the hormones associated with our sex organs but can also affect those active in mood and emotions. Avoid using DHEA if you have been diagnosed with any kind of mood disorder, as DHEA can exacerbate symptoms and increase risk of experiencing mania (a psychiatric condition in which the person sleeps very little and engages in reckless behaviors not typical of their personality or lifestyle).3
DHEA can interact with certain medications, especially those that act on the nervous system, including certain anti-seizure medications, sedatives, and mood stabilizers. It’s also recommended that people taking hormonal medications not take DHEA as it can interact with those as well; this includes birth control, hormone replacement therapy, and many other medications.3 It’s our opinion that DHEA should only be used under the supervision of licensed medical provider.
Dong Quai, or Female Ginseng is a commonly used herbal supplement in women’s health. People claim that it helps with mood swings, menstrual cramps, and menopausal symptoms. Most people tolerate this herb well, but it does come with some odd, and potentially dangerous, side effects. The most common side effect is that Dong Quai increases the skin’s sensitivity to sunlight, thereby increasing chances of getting sun burned. It also increases chances of miscarriage if you’re pregnant, so don’t take Dong Quai if you are pregnant or trying to become pregnant.4
This herb also has some drug-herb interactions, primarily with ACE inhibitors and anticoagulants, but with other medications too.4 Before using it, check with your doctor to see if Dong Quai could interact with any medications you’re currently taking.
Yohimbe, also spelled Yohimbe and Johimbi, is an herbal supplement made from the bark of a tree native to Africa. People use it to treat ailments ranging from erectile dysfunction to angina (chest pain related to poor blood circulation in the chest), to diabetic neuropathy. It’s also commonly taken as a weight loss supplement.5 We don’t recommend the use of Yohimbe unless under the direct supervision and recommendation of physician, as it’s been strongly associated with seizures, heart attacks, and other serious events requiring medical care.5 If you do choose to use this herb, be certain you consult with your healthcare provider. Yohimbe can interact with certain medications, especially monoamine oxidase inhibitors (MAOIs), so definitely don’t take Yohimbe if you are using an MAOI such as phenelzine, tranylcypromine, etc.5
St. John’s Wort
St. John’s Wort is a traditional, herbal remedy from ancient Europe that has been purported to help with a variety of ailments including depression, insomnia, menopausal symptoms, and ADHD among others. Studies support the use of this herb for treating mild to moderate depression and anxiety.6
When taken on its own, with no other herbs or medications, St. John’s Wort has shown to be generally safe for most adults for up to 12 weeks. However, St. John’s Wort does interact, quite dangerously, with a lot of different medications so extreme caution is still warranted. Don’t take St. John’s Wort if you are using any of the following medications, as the likelihood for dangerous interactions is quite high: antidepressants, birth control pills, organ transplant medications, certain heart medications such as digoxin and ivabradine, certain HIV medications such as irinotecan and imatinib, Warfarin, and certain statins including simvastatin.6 Even if you aren’t using any of the medications listed here, please consult your healthcare provider before taking St. John’s Wort.
Kava goes by several names including Kava kava, Awa, Ava, and Yagona. This herb hails from the Pacific Islands where native peoples have been using it for thousands of years, both medicinally and ceremonially. There is a lot of evidence to show that Kava may be beneficial in helping with anxiety and depression, but there are serious concerns about its safety.7
Kava has been linked to liver damage and drug interactions with a variety of medications. As yet, it’s unknown whether the reported cases of liver damage resulted from the Kava alone, were preexisting conditions, or came about because of drug/herb interactions with Kava.7
Don’t take Kava unless you’re under the direct supervision of a doctor and don’t take it if you are pregnant, breastfeeding, or a minor. Possible side-effects of long-term Kava use include jaundice, fatigue, abdominal pain, joint pain, and nausea and vomiting.7
Shatavari is an Ayurvedic herb from the Indian subcontinent that has been used in women’s health for thousands of years. In Western culture, the herb is often included in galactagogue (milk-inducing) teas, tinctures, and supplements to help increase milk supply in breastfeeding mothers. Western medicine doesn’t know much about this herb, but there is some concern that if taken during the first trimester of pregnancy, it could have teratogenic effects, meaning it could cause birth defects.8 Because of this we recommend that you avoid Shatavari if you are pregnant or trying to become pregnant.
In Closing, Remember…
This is certainly not a comprehensive list of herbs and supplements that require caution. As a company that believes in the efficacy and power of natural therapies, remedies, and health-promoting products, we also acknowledge that many products have the potential for harm when used inappropriately. Because of this, we strongly encourage our readers to always discuss any supplements they are taking with their healthcare team and to use discretion when researching new products.
It’s worth mentioning that some of the adverse reactions reported for some supplements could possibly be due to contamination of said products, or even to the illegal practice of spiking supplements with prescription drugs. Because of this, we encourage everyone to choose products that have been third-party tested to ensure quality and purity. Wholesome Story has been third-party testing since the beginning for both your peace of mind and ours. Safety first!
In parting, remember that eating healthy, whole foods, and lots of plants foods, is one of the simplest, safest, and most effective things we can do to promote good health in our bodies. As with every preventative/restorative measure though, sometimes these changes alone are not enough to help our bodies function the way we want or need them to. If you are struggling with health problems, please contact your doctor or other healthcare provider such a Naturopathic Doctor, Dietitian, or Mental Health Professional to see if they can offer appropriate guidance and care. We at Wholesome Story believe that healthy communities require community effort, so we advise you to keep your healthcare community aware and involved in your journey as you pursue better health.
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- Products - data briefs - number 399 - February 2021. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db399.htm. Published February 19, 2021. Accessed April 21, 2022.
- Smith T, Eckl V, Morton Reynolds C. Herbal Supplement Sales in US Increase by Record-Breaking 17.3% in 2020. American Botanical Council. https://www.herbalgram.org/resources/herbalgram/issues/131/table-of-contents/hg131-mkrpt/. Published 2021. Accessed April 21, 2022.
- Mayo Clinic Staff. DHEA. Mayo Clinic. https://www.mayoclinic.org/drugs-supplements-dhea/art-20364199#:~:text=Safety%20and%20side%20effects,%2C%20don't%20use%20DHEA. Published February 12, 2021. Accessed April 21, 2022.
- DW Z. Dong Quai. Memorial Sloan Kettering Cancer Center. https://www.mskcc.org/cancer-care/integrative-medicine/herbs/dong-quai. Published April 2021. Accessed April 21, 2022.
- Yohimbe. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/yohimbe. Published November 2020. Accessed April 21, 2022.
- St. John's wort. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/st-johns-wort. Published October 2020. Accessed April 21, 2022.
- Sinai. Kava Kava. Mount Sinai Health System. https://www.mountsinai.org/health-library/herb/kava-kava. Published 2022. Accessed April 21, 2022.
- Gallagher J. Adverse effects of herbs as galactogogues. Australian prescriber. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6003012/. Published June 2018. Accessed April 21, 2022.