Herbal Medicine

Overview

Herbal medicine means using parts of plants — leaves, roots, seeds, flowers or bark — as products to treat or prevent health problems. You will find them as teas, powders, capsules, tablets, tinctures, creams and oils. They are often sold in shops, supermarkets, pharmacies and online, and many people think of them as 'natural' and therefore safe. Herbal products can have real effects on the body, so they deserve the same care you would give to any other medicine.

Yes. Herbal medicines are used by a very large number of people around the world, and many people use them alongside standard medical care rather than instead of it. Because they are easy to buy without a prescription, they are often not mentioned to doctors — which is one of the biggest reasons problems are missed.

Anyone can use herbal medicines, and anyone can have a bad reaction to one. Some people need to be especially careful: people who take several medicines, people with liver or kidney disease, people having surgery, people with serious long-term conditions, pregnant or breastfeeding women, children and older adults.

Symptoms

Common symptoms

• Most people feel no different at all when they take a herbal product, and many notice nothing unusual.
• Mild stomach upset, heartburn, nausea or loose stools
• Headache or dizziness
• Skin rash, redness or itching
• Feeling sleepy, or finding it hard to sleep
• A change in bowel habits that lasts more than a few days
• Feeling unusually tired or weak
• Unusual bruising, nosebleeds, or bleeding that takes longer to stop
• A noticeable change in blood pressure or heart rate

Symptoms in children

• Children's bodies handle plant substances differently from adults, so a product that seems fine for an adult may not be safe for a child.
• Herbal teas, powders and supplements are not suitable for babies and young children unless a doctor or pharmacist has specifically said so.
• Watch for drowsiness, agitation, vomiting, rash, or any change in behaviour after a child has taken or accidentally swallowed a herbal product.
• Keep all herbal products, including teas and oils, out of reach of children — treat them like any other medicine.
• Some herbal creams and oils can irritate a young child's skin.

Symptoms in older adults

• Older adults often take several medicines, which raises the chance of a harmful interaction with a herbal product.
• Kidneys and liver may clear substances more slowly with age, so effects can be stronger or last longer.
• Dizziness or drowsiness from a product can increase the risk of a fall.
• Bleeding risk is higher for people who already take blood-thinning medicines.
• Small print on labels can be hard to read, so ask a pharmacist to check a product with you.

Causes

Main causes

• Herbal products contain active plant chemicals that can affect the body, so a high dose or long period of use can cause side effects.
• Mixing a herbal product with prescription or over-the-counter medicines can change how strongly either one works.
• Labels are not always accurate — products may contain a different plant, extra ingredients, or contamination such as heavy metals or pesticides.
• Buying from unverified sellers online increases the chance of getting a poor-quality or unclear product.
• Some people stop a prescribed treatment in order to use a herbal product instead, which can let a condition get worse.
• Taking several different herbal products at the same time makes it hard to know what is causing a problem.

Risk factors

• Taking several medicines, especially ones that thin the blood, control blood pressure, treat diabetes, affect the heart or suppress the immune system
• Liver or kidney disease
• Pregnancy or breastfeeding
• Being a child, or being an older adult
• Surgery or a procedure coming up in the next few weeks
• A serious long-term condition such as cancer, HIV or having had a transplant
• Using many herbal products at once, or taking more than the label suggests
• Buying products from unclear or unverified online sellers

When to see a doctor

See a doctor urgently if:

• You have a reaction you think is linked to a herbal product — stop taking it and get advice the same day
• You have new bruising or bleeding, or your usual medicine seems to be working differently
• You are due to have surgery or a procedure within the next two weeks and are taking a herbal product
• You are pregnant or breastfeeding and want to take a herbal product
• A child has taken a herbal product and you are unsure whether it was safe

Book a routine appointment if:

• You would like to check whether a herbal product is safe alongside your current medicines
• You are thinking of using a herbal product for a long-term problem
• You feel a product is helping but want to make sure you are using it sensibly
• You want help understanding what is actually in a product you have bought

Diagnosis

There is no single test for 'herbal medicine'. If you feel unwell while taking a herbal product, a doctor or pharmacist will build a picture from your history and some simple checks. They will ask exactly what you are taking, how much, how often, when you started, and what else you take, including prescribed medicines, over-the-counter remedies and supplements. The timing of your symptoms compared with when you started the product is often the biggest clue. Blood tests can show whether your liver, kidneys or blood clotting have been affected, and allergy testing may be suggested if a reaction is suspected.

Tests that may be done

• A careful medicine history, including teas, powders, oils, creams and supplements
• Blood tests to check liver and kidney function
• A full blood count and tests of how well your blood clots
• Blood pressure and heart rate checks, and sometimes a heart tracing
• Allergy testing if a reaction is thought to be allergic
• Urine tests, if kidney effects are suspected
• Sometimes advice to stop the product for a period, with monitoring, to see whether symptoms settle

What to expect at your appointment

You will usually be asked to bring the product and its packaging with you, so keep it rather than throwing it away. Your doctor may ask you to stop the product while tests are done. Never stop a prescribed medicine without speaking to the person who prescribes it. Most people need only a conversation and a blood test, and feel reassured once the picture is clear.

Treatment

The first step is usually to stop the herbal product and see whether symptoms settle, with advice from a doctor or pharmacist. Treatment then depends on what has happened: many reactions are mild and need only rest, fluids and time, while more serious effects such as liver or kidney problems, bleeding or a severe allergic reaction need hospital assessment and monitoring. Your care team will also review your other medicines to make sure nothing else is interacting.

Self-care at home

• Stop taking the product and keep the packaging, label and receipt
• Write down what you took, how much, and when your symptoms started
• Tell your pharmacist — they can check for interactions quickly
• Drink plenty of fluids and rest if you feel mildly unwell
• Do not start another herbal product to try to 'fix' the first one
• Keep a simple list of everything you take, and update it whenever something changes
• Follow the label instructions exactly and do not take more than suggested
• Be cautious with 'detox' or 'miracle cure' claims, and with products that promise rapid results

Medical treatments

Doctors treat the effects a herbal product has caused rather than the product itself. Depending on the problem, this may involve medicines to calm an allergic reaction, fluids and monitoring if you are dehydrated, close observation in hospital if the liver, kidneys or heart are affected, or treatment to help bleeding settle. Your care team will also review your regular medicines and adjust them if needed. If you are worried about a health problem you were hoping the herbal product would treat, your doctor can discuss proven options with you.

When is surgery considered?

Herbal products can affect bleeding and how the body responds to anaesthesia, so tell your surgical and anaesthetic team about everything you take. You may be asked to stop certain products a couple of weeks before an operation. Never stop a prescribed medicine before surgery unless you have been told to.

Living with this condition

If you choose to use herbal products, treat them as seriously as any medicine. Keep an up-to-date list on your phone or in your bag, and show it at every appointment, including dentist and pharmacy visits. Buy from sellers you trust, choose products with a clear list of ingredients and a batch number, and try one new product at a time so you can tell what suits you. Remember that a herbal product should support your care, not replace treatment your doctor has recommended.

Lifestyle tips

• Tell every healthcare professional what you take, every time
• Ask your pharmacist to check a new product against your current medicines
• Buy from reputable sellers and avoid products with unclear or missing ingredient lists
• Take one new product at a time, and follow the label
• Avoid alcohol heavily if you are taking herbal products that affect the liver
• Eat a balanced diet, stay active and protect your sleep — these do more for most people than any single supplement
• Be wary of very confident claims, celebrity endorsements or products sold as a 'cure'

Diet and exercise

Herbs used in normal cooking amounts as flavourings are generally fine and are part of a healthy diet. Concentrated capsules, powders and extracts are a different matter and should be treated as medicines. No herbal product can replace the basics: a varied diet with plenty of vegetables and fibre, regular movement you enjoy, enough sleep, and limits on alcohol and smoking. If you are thinking about a product for weight, energy or fitness, talk to a pharmacist or doctor first.

Mental health and emotional wellbeing

Some people turn to herbal products for low mood, anxiety or poor sleep. That is understandable, but it is worth speaking to a professional too, because talking therapies and other support can help a great deal, and some herbal products interact with medicines used for mental health. If you are feeling low, anxious or overwhelmed, please reach out to your doctor or a local support service. If you ever have thoughts of harming yourself, contact your local emergency number or a crisis line in your country straight away — help is available, and you deserve it.

Prevention

You cannot remove all risk, but you can lower it a lot. Tell your doctor and pharmacist about every herbal product you use. Ask them to check for interactions before you start something new. Buy from trusted sellers with clear labels, follow the instructions, avoid taking several products at once, and be extra careful if you are pregnant, breastfeeding, caring for a child, living with liver or kidney disease, or preparing for surgery. If a product seems too good to be true, it usually is.

Complications

If left untreated

• Liver damage, which can be serious and is sometimes permanent
• Kidney damage
• Dangerous bleeding, especially alongside blood-thinning medicines
• A herbal product interfering with heart, diabetes or immune-suppressing treatment
• A serious allergic reaction
• Effects on anaesthesia and recovery during surgery
• Delayed diagnosis or treatment of a condition that could have been helped sooner
• Harm during pregnancy, or to a breastfeeding baby

Long-term outlook

Most people who have a reaction to a herbal product recover fully once they stop taking it, especially when they get advice early. The great majority of herbal users never have a problem. The key is openness: telling your care team what you take turns a hidden risk into something they can check and manage. If you have been using a product and feel unsure, a simple conversation with your pharmacist or doctor is a good next step.

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