Q and A: When and Why to Combine Herbal Supplements

Health professionals answer readers questions about combining herbal supplements.

| November/December 1997

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

1/27/2013 1:51:21 PM

I started to take Liver Tonic, but I have chronic kidney disease. What will be the side effect? This medicine affect my kidney> I am worry, my doctor said that I don't have to take any kind natural medicine because doesn't know the side effect can be damaged the kidney more. I would like to answer this question.

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