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Sep 26, 20207 min read

Herbs and Dietary Supplements with Allopathic Medicines

A description of some herbs and dietary supplements and their side effects when taken in conjunction with allopathic drugs.


Written By: Kavya, Akshaya, Haritha


Advil, Benadryl, and Nyquil have all become common household medications. However, it wasn’t too long ago since medications were widespread as they are now, easing people’s discomfort rather swiftly. People have relied on ‘natural’ medications for centuries. From treating chronic illnesses to performing surgeries, herbal medications were used as remedies. Although there are herbs that have been scientifically proven to have medicinal properties, many of the commonly used herbs are still being researched to isolate their health benefits. In this article, we will explore the use of dietary supplements, including herbs, in healthcare and their interactions with allopathic medications and possible side effects.


The information below is not a substitute for professional medical advice. Content meant for education purposes only.


What are herbs?

For thousands of years, herbal remedies have been used by humans to treat illnesses of all kinds. Even along with the use of pharmaceutical drugs, herbs are still widely used in conjunction. In fact, many of the medications we use today have been derived from a more ‘natural’ counterpart. Herbs, in the simplest of definitions, are plants that are aromatic and contain remedial properties (10). Herbs are also considered dietary supplements. Herbs, along with spices, are used in many culinary cuisines around the world for their pungent flavor and smell. Some of the commonly used herbs and spices include but are not limited to: chamomile, ginger, garlic, rosemary, oregano, and basil. Specific herbs intended to treat specific illness must be thoroughly researched and consulted with a professional before self-administration as their interactions might create adverse effects (12).


What are dietary supplements?

Dietary supplements are substances that are taken in order to increase the amount of nutrition we obtain. Although the best way to ensure that we get the necessary nutrients for a healthy body is through a balanced diet, it is becoming more common to use dietary supplements (11). Some of the common dietary supplements include folate, vitamin D, omega-3-fatty acids (11). These supplements, through research, show that they may help regulate a healthier body. It is important to understand the different effects dietary supplements may have on your body before trying them. For example, a person taking blood thinner medication, such a warfarin, can experience negative effects if they are taking vitamin K supplements as it can interfere with the medication (12).


How are they used in healthcare?

Although herbal products can be used in healthcare, they are not regulated by the FDA (Food and Drug Administration). According to the FDA, these types of supplements are regarded as food and not drugs, and they cannot definitively provide treatment for a certain disease or illness (they might help in some way, but these herbal medicines are not considered to be able to “treat, diagnose, cure, or alleviate the effects of diseases,”) (4). Additionally, even though herbal supplements do not necessarily have to be prescribed and are available for use to the general public, they are not recommended for those who are already taking any prescription or over-the-counter medications. This is because some herbal medicines can lead to various side effects when other medications are being consumed simultaneously. Although the number of clinical trials and thorough research done for drugs before usage have not been done for herbal medicines, several of these supplements have proven to be efficient. Alternative medicine is used today by some mainstream doctors, but it has caught on in America as well, with more conventionally trained doctors exploring the benefits of these herbal supplements (5). Before taking any dietary or herbal supplements, you should consult your healthcare provider.


Some Herbs and their Side Effects in Conjunction with Allopathic Drugs

Gynecology

Several herbs such as St. John’s wort, Kava kava, and Black cohosh (Cimicifuga racemosa) are used in gynecology to treat various conditions. For example, Black cohosh is used to relieve menopausal symptoms such as hot flashes, sweating and mood changes (1). St. John’s wort is often used to alleviate symptoms of menopause such as mild depression (1). Kava kava is used to relieve mild to moderate anxiety in menopausal women (1). However these herbs do have side effects. For example, kava kava can damage the liver if taken in excess (1). St John’s wort is notoriously known for inducing the metabolism of many prescription drugs (1). Interestingly, St. John’s wort taken for relieving depression symptoms can decrease the efficacy of oral contraceptives and can cause pregnancy (2). It also reacts with many different types of medications such as those taken for seizures and cholesterol (2). St. John’s wort can accelerate the breakdown of many different medications and render them inactive (12). Black cohosh is not known to cause many side effects other than a stomach upset. However, some studies show that they might inhibit Cytochrome 34A and 26D, which are enzymes essential for the metabolism of several drugs (1).

Kava kava is an herb found in the Pacific Islands and Hawaii. It is commonly used in indegenous cultures (1).


Surgery

Taking herbal supplements before surgery is known to cause complications during recovery (3). Ginger and garlic, commonly used in cooking, are also used as natural medicines. Ginger is used to relieve respiratory ailments, motion sickness, nausea and vomiting (3). However, when ginger is consumed preoperatively, it can cause prolonged bleeding due to the inhibition of thromboxane synthase, a protein required for blood clotting (3). Garlic is used as an antibiotic, diuretic and antihypertensive, can cause nausea, halitosis and hypotension if used in excess (3). When used in preoperative patients, it can cause increased bleeding during recovery. Garlic also reacts with cardiovascular medications, and hypoglycemics (3). Ginkgo biloba is another herb that is commonly taken to improve memory and dementia and is most used by the elderly. This herb is also taken to relieve conditions like asthma and eye problems (3). Taking ginkgo can cause problems such as prolonged sedation after surgery and also lowers a patient’s seizure threshold (3).

The leaf of the Gingko biloba tree is used to improve memory and intellectual decline (2).


Ophthalmology

Several herbal supplements have been found to cause ocular side effects, or problems related to the eye and vision (9). The roots of the plant Echinacea purpurea are commonly used to treat fevers, cold, influenza and urinary tract infections (9). However, there have been reported cases of eye irritation as well as conjunctivitis from topical Echinacea use (9). There is also a possibility of Echinacea activating autoimmune responses, therefore, Echinacea should be avoided in patients with autoimmune diseases (9). Licorice (Glycyrrhiza glabra) is used to treat upper respiratory tract infections as well as gastric ulcers and constipation due to its anti-inflammatory properties (9). Ingesting too much licorice has shown to cause temporary vision loss (9). Those who have migraine headaches should be careful with licorice since its effects could become addictive (9). Niacin, found in red meat and yeast, has been used to treat arthritis, diabetes and schizophrenia among other conditions (9). Side effects include dry eyes, discoloration of eyelids, and an adverse reaction called cystoid macular edema (9). This results in edema of the retinal space and could cause vision loss. Most side effects resolve within two weeks of stopping niacin therapy (9).

Echinacea purpurea is used to treat conditions such as influenza and respiratory tract issues (3).


Some Examples of Dietary Supplements

Dietary supplements such as Vitamin B6, Vitamin C, Vitamin E and thiamine (Vitamin B1) are used to relieve conditions such as PMS (premenstrual syndrome) and infertility (1). Although the mechanism of action of Vitamin E is still unclear, it is thought to reduce prostaglandin formation by releasing arachidonic acid, thereby relieving dysmenorrhea, a condition that causes extremely painful menstrual cramps due to uterine contractions (1). Thiamine is also used to relieve dysmenorrhea. Vitamin B6 has been shown to relieve emotional symptoms of PMS. Vitamin C has been used to treat infertility by affecting progesterone levels (1). A reason it could be effective in treating infertility is due to its antioxidant properties (1).


Other kinds of dietary supplements are taken for overall health and wellness, and to take care of certain health conditions. This includes Vitamin D and taking Calcium in order to strengthen bones, Folic acid to reduce the risk of birth defects, and Omega-3 fatty acids which can help with heart disease (6). Although these kinds of supplements cannot be used as a replacement for the foods important for a healthy diet, they can help you gain nutrients when your daily intake doesn’t involve consuming a variety of foods.


Can you take more than one supplement at a time?

You may not be aware that certain supplements cannot be taken together. Although many don’t have detrimental effects, it is important to do your research before taking multiple supplements at a time, whether this includes herbal or other medicines. Let’s first discuss some general combinations of supplements that can be harmful. Both Calcium and Magnesium are one of these examples, and although they can be taken together, a minimum of 2 hours is recommended between each. This is in order to gain the maximum benefits from consuming both supplements (7). Another example of supplement-combos to avoid is Copper and Zinc, which help our immune systems. But, because zinc can get involved with the absorption of copper, it can lead to copper deficiency (7).

Herbal supplements and drug interactions (4).


Additionally, you should be careful when thinking of taking herbal medicines while consuming other prescription drugs. We will look into an example of the effects of an herbal supplement taken with a drug. Echinacea (American Cone Flower) has been known to help stimulate the immune system and treat the common cold. Compared to other herbal supplements, the drug interactions with Echinacea are not as serious, but they can influence blood levels of drugs such as Tizanidine (Zanaflex) (8).

Many parts of the Echinacea flower are used for medicinal purposes (5).


So, it is important to note that herbal supplements can alter the effects of a drug on the body, and supplements taken together can also lead to other issues. As we have seen, there are many herbal medicines that often interact with other drugs, and it may be possible that other herbal supplements taken together may cause certain effects.


There are many alternative ways to obtain a cure for illnesses. Although herbs and dietary supplements may provide transient relief, it is important to consider lifestyle changes with any type of medication being taken. Our health should be approached through a holistic perspective. Similar to that of allopathic medications, one should be cautious while adding new dietary supplements to their diet.


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