Q and A: When and Why to Combine Herbal Supplements

In every issue of Herbs for Health, professionals from a variety of health-care fields ­answer your questions about using medicinal herbs. Medical doctor Robert Rountree and herbalist Daniel Gagnon responded for this issue.


Please comment on the considerations one should have in taking numerous herbal supplements and appropriate ways to separate them throughout the course of a day. To be more specific, I routinely take gingko, gotu kola, ginseng, milk thistle, St.-John’s-wort, echinacea, dandelion, cranberry, garlic, uña de gato, kava-kava, spirulina (and a variety of other green stuff), with other vitamins and minerals. It turns out to be a lot of “pills.” What should I be aware of in this multivitamin and herbal regime? Is there any harm in taking so many?
M. E.
Cincinnati, Ohio

I agree that you are taking a lot of pills! In order to accurately answer your question, it is important to ­distinguish what effect you are trying to achieve–are you taking them to improve your overall health or do you have a specific condition that you are trying to treat? Also, what is the strength of the preparations you are using?

Several of the herbs you list are typically used as tonics, or adaptogens, meaning that they are commonly given for extended periods of time to enhance cognitive, metabolic, or immune function. I would place gingko (Gingko biloba), gotu kola (Centella asiatica), various types of ginseng, garlic, uña de gato (Uncaria tomentosa, or cat’s claw) spirulina (Arthrospira platensis), and multivitamins in this category.

In contrast, herbs like St.-John’s-wort (Hypericum perforatum), kava-kava (Piper methysticum), and echinacea (Echinacea angustifolia, E. pallida, and E. purpurea) are mainly prescribed as treatment for specific illnesses (e.g., depression, anxiety, or acute infections).

Although combination formulas have the potential to provide synergistic effects, the more herbs you include in your daily regimen, the harder it becomes to tell whether or not you are benefiting from each one. You also have an increased risk for developing side effects such as allergic reactions, indigestion, or overstimulation. My recommendation would be to review your program in detail with a trained herbalist who could tailor it to meet your specific needs.
–Robert Rountree

If you are like most people, you hear about herbs for different ailments and because they potentially address your symptoms, you incorporate them in your daily health regimen. Suddenly you find yourself taking multiple herbs two or three times a day. The questions that arise at this point are: Does this method of treating yourself replicate the pill-for-everything paradigm typical of allopathic health care? Are you successfully treating your core issues and truly building your health in a holistic way? In short, are you missing the forest for the trees by taking a handful of supplements each day in lieu of attending to the “basics” of sound holistic living? Here are the basics I feel help all of us stay on track holistically:

• Focus your herbal intake. Write down what your primary health challenges are. See if there is a common thread or one disease that seems to underlie many of your symptoms. Consult with a physician who can help you pinpoint the origin of these symptoms.

• Get back to the basics with diet, rest, and exercise. Nothing replaces the nutrients from eating fruits, whole grains, green leafy, orange, or other vegetables. Cut out or reduce sugar, fats, meats, and other highly refined prepared foods. Also, no amount of supplementation replaces good old-fashioned rest and daily exercise.

• Taking herbs to cleanse, support, and tonify your vital organs goes to the core of how your body responds to everyday situations. Five elimination organs need to be supported: liver, kidney, intestines, lungs, and skin. Cleanse and rebuild one of these organ systems for about a month, then move on to the next one. Herbs like dandelion (Taraxacum officinale), burdock (Arctium lappa), nettles (Urtica dioica), osha (Ligusticum porteri), and yellow dock (Rumex erispus) are helpful. Work with your health-care provider to get better results. I suggest a naturopathic physician, who will be familiar with herbs and their uses.
–Daniel Gagnon

Robert Rountree, M.D., is a physician at the Helios Health Center in Boulder, Colorado, co-author of Smart Medicine for a Healthier Child (Avery, 1994), and an advisory board member for the Herb Research Foundation.

Daniel Gagnon is a medical herbalist living in Santa Fe, New Mexico. He is a professional member of the American Herbalist Guild, vice chairman of the American Herbal Products Association, and owner of an herbal retail store in Santa Fe.

The information offered in “Q & A” is not intended to be a substitute for advice from your health-care provider.

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