Johns Hopkins Medicine – Updated for October 2021

Author: Johns Hopkins Medicine Affiliate

What are herbal supplements?

Products made from botanicals, or plants, that are used to treat diseases or to maintain health are called herbal products, botanical products, or phytomedicines. A product made from plants and used solely for internal use is called an herbal supplement.

Many prescription drugs and over-the-counter medicines are also made from plant products, but these products contain only purified ingredients and are regulated by the FDA. Herbal supplements may contain entire plants or plant parts.

Herbal supplements come in all forms: dried, chopped, powdered, capsule, or liquid, and can be used in various ways, including:

• Swallowed as pills, powders, or tinctures
• Brewed as tea
• Applied to the skin as gels, lotions, or creams
• Added to bath water

The practice of using herbal supplements dates back thousands of years. Today, the use of herbal supplements is common among American consumers. However, they are not for everyone. Because they are not subject to close scrutiny by the FDA, or other governing agencies, the use of herbal supplements remains controversial. It is best to consult your doctor about any symptoms or conditions you have and to discuss the use of herbal supplements.

The FDA and herbal supplements

The FDA considers herbal supplements foods, not drugs. Therefore, they are not subject to the same testing, manufacturing, and labeling standards and regulations as drugs.

You can now see labels that explain how herbs can influence different actions in the body. However, herbal supplement labels can’t refer to treating specific medical conditions. This is because herbal supplements are not subject to clinical trials or to the same manufacturing standards as prescription or traditional over-the-counter drugs.

For example, St. John’s wort is a popular herbal supplement thought to be useful for treating depression in some cases. A product label on St. John’s wort might say, “enhances mood,” but it cannot claim to treat a specific condition, such as depression.

Herbal supplements, unlike medicines, are not required to be standardized to ensure batch-to-batch consistency. Some manufacturers may use the word standardized on a supplement label, but it does not necessarily mean the same thing from one manufacturer to the next.

Precautions when choosing herbal supplements

Herbal supplements can interact with conventional medicines or have strong effects. Do not self-diagnose. Talk to your doctor before taking herbal supplements.

• Educate yourself. Learn as much as you can about the herbs you are taking by consulting your doctor and contacting herbal supplement manufacturers for information.
• If you use herbal supplements, follow label instructions carefully and use the prescribed dosage only. Never exceed the recommended dosage, and seek out information about who should not take the supplement.
• Work with a professional. Seek out the services of a trained and licensed herbalist or naturopathic doctor who has extensive training in this area.
• Watch for side effects. If symptoms, such as nausea, dizziness, headache, or upset stomach, occur, reduce the dosage or stop taking the herbal supplement.
• Be alert for allergic reactions. A severe allergic reaction can cause trouble breathing. If such a problem occurs, call 911 or the emergency number in your area for help.
• Research the company whose herbs you are taking. All herbal supplements are not created equal, and it is best to choose a reputable manufacturer’s brand. Ask yourself:
  • Is the manufacturer involved in researching its own herbal products or simply relying on the research efforts of others?
  • Does the product make outlandish or hard-to-prove claims?
  • Does the product label give information about the standardized formula, side effects, ingredients, directions, and precautions?
  • Is label information clear and easy to read?
  • Is there a toll-free telephone number, an address, or a website address listed so consumers can find out more information about the product?

What are some of the most common herbal supplements?

The following list of common herbal supplements is for informational purposes only. Talk to your doctor to discuss specific your medical conditions or symptoms. Do not self-diagnose, and talk to your doctor before taking any herbal supplements.

It is important to remember that herbal supplements are not subject to regulation by the FDA and, therefore, have not been tested in an FDA-approved clinical trial to prove their effectiveness in the treatment or management of medical conditions. Talk to your doctor about your symptoms and discuss herbal supplements before use.