September 5, 2023 KATHRYN CANNON
Most herbal products indicate a word of caution on the label. Terra Uma herbal products carry that recommendation as well.
Terra Uma products advise, 'Consult your healthcare provider on the use of herbs with medical conditions, prescription drugs, during pregnancy, breastfeeding, and prior to surgery.'
When adding herbs or supplements to your routine, please speak with your physician. Having a medical condition or symptoms of disease can put folks at a higher risk of adverse events with over-the-counter medications, herbs, and dietary supplements. It is important to educate yourself about these risks and to understand why physician partnership is required when developing a wellness routine.
By engaging your entire medical team in your care plan, it ensures you are getting the best care possible and not covering up any indicator symptoms that might require further examination by a medical professional. If your physician or specialist has questions about Terra Uma products, please have them reach out. We are happy to have physician partnership.
This article is meant to be a starting point to understanding pharmaceutical-herb interactions. This article is not intended as medical advice and should not be taken as such. Instead, this is an article indicating why it is important to disclose herbal supplements with your medical team.
Pharmaceuticals and herbs can work well together, but not all herbs and drugs are a good pairing. When you find an herb that you feel may support your body, please run it by your doctor and medical team. This includes tea, as even teas can be powerful in their effects.
Here are risks to consider:
- Risks of interactions with herbs
- Risks of interactions with medications
- Risks of interactions with liver processing (elimination/toxicity)
- Risks of interactions with surgery
- Risks of interactions with high-risk conditions such as certain pre-existing conditions, pregnancy, lactation, or breastfeeding
- Risks of interactions with sensitive or damaged organs, or organ systems (kidneys, liver, thyroid, prostate)
Why is there a lengthy disclaimer on herbal products saying speak with your physician before use?
When a disclaimer indicates that you should consult your physician before use, it is asking, insisting even that you reach out to your prescribing physician and ask them if it is safe to take that specific herbal supplement with your current pharmaceutical load, dietary routine, existing medical conditions, and current state of wellness.
Certain factors make it more likely for someone to have an adverse reaction to herbs.
Those factors are:
- Pre-existing conditions and co-morbidities that complicate the impact of substances in the body
- Two or more herbs taken in combination may have an unintended or adverse effect
- An herb and a pharmaceutical medication are processed through the same enzyme in the liver, causing one of two things to happen:
- The pharmaceutical is eliminated faster than expected (example: Saint John’s wort)
- Can cause an issue when a medication has a narrow therapeutic window of effectiveness (example: thyroid medication)
- The pharmaceutical is available in the system for longer (example: black pepper)
- When a pharmaceutical isn’t eliminated as expected, and another dose is taken, this can cause toxicity due to high serum concentrations
Current use of high-risk medications should be considered when adding herbs to a routine.
High-risk medications may:
- have a narrow therapeutic window
- potential for toxicity
- effect neurochemistry
- potential for interaction
- potential for side effects
There are many medications that independently do not carry a risk, but when combined carry a risk. For this reason, your entire medical team needs to be aware of all prescription medications, current medical trials, herbal, vitamin, and mineral supplementation you are taking, as well as know of any higher risk behaviors like having more than (1) drink per day and smoking tobacco.
Higher risk behavior may not feel harmful, but they may cause an unwanted effect with certain medications and supplements.
Certain medications are considered high-risk independently of their use with herbs. Stopping or decreasing any medication on this list without physician guidance could result in injury. Never stop or start any medication without physician guidance and approval.
Doctors and pharmacists have been educated on the safety and interactions of drugs. If a doctor prescribes a high-risk medication, they monitor the patient closely. Consider your safety important and always keep an open and ongoing relationship with your entire medical team. An herbalist can be a partner in health and will provide guidance on the use of herbs, but will never give you advice on pharmaceuticals.
Folks that may have to be more cautious about what they consume will include those with co-morbidities, complex conditions, complex treatment protocols, and those currently taking over the counter and prescription medications.
In some cases, if taken with certain foods, herbs, or medications these pharmaceuticals may have a different effect.
Types of medications that are typically considered high-risk include, but are not limited to:
- Antibiotics
- Anti-diabetic medications
- Insulin
- Anti-depressant medications
- Anti-anxiety medications
- Anti-psychotic medications (Lithium and other drugs)
- Benzodiazepines/Opiates
- Blood thinners (anti-coagulants)
- Anti-platelets medications
- Chemotherapy
- Cancer treatments and other drug trials
- Immunosuppressants (Including Methotrexate and Cyclosporine)
- Hormone therapies
- HIV medications
- NSAIDS
- Diuretics
- Seizure medications
- Some acne medications
- Heart medications
- Hypertensives
- ACE inhibitors
- Beta-blockers
- Vasodilators
- Digitalis
- Cholesterol lowering drugs (statins and others)
- Calcium channel blockers
- Other heart medications not listed
Complex conditions that respond sensitively to medications may include, but are not limited to:
- Pregnant and lactating women
- Cancer
- Diabetes
- Heart disease
- High/low blood pressure
- Liver cirrhosis
- Low bone density
- Kidney disease
- Thyroid disorders
- Sleep disorders
- Insomnia
- Narcolepsy
- Accidents and injuries resulting in a complex condition
- TBI
- CPTSD/PTSD
- Psychosis
- Neurodivergent conditions
- Autism
- Ehlers Danlos Syndrome
- ADHD
- Mood disorders (bipolar, schizophrenia, BDP, psychosis, anxiety, major depressive disorder)
This is not a complete list, but it offers insight into which types of conditions or symptoms have a higher risk for interactions. For specific and personalized information on pharmaceutical-herb interactions, you need to speak with your prescribing doctor(s) and pharmacist.
Kathryn Cannon is an experienced organic gardener, clinical herbalist, and advocate for patient rights. She founded Terra Uma LLC in 2017 to empower clients to optimize performance and mental health by incorporating plants and fungi into their everyday routines. Kathryn was co-founder of an urban farm and community center in Portland, OR. She currently runs a wellness coaching practice in the Washington, DC area where she assists clients in finding relief with herbs and wellness tools.