Combining Supplements

Short answer. More ingredients mean more chances for an interaction, a duplicate ingredient or an unlisted substance, and the sources we read do not show that adding more products makes anyone safer. If you use several products, ask a pharmacist to look at the whole list.

"Adaptogen" is a contested term from Soviet-era research and not a regulatory category, and blends often mix adaptogens with other herbs, vitamins and caffeine. This page is about safety only; for what is known about combining adaptogens specifically, see combining adaptogens. Information only.

What the liver reports show

In an Iceland and US case series of ashwagandha-associated liver injury, four of five patients were also consuming other supplements, and in one case rhodiola was a possible cause along with ashwagandha. [6] Memorial Sloan Kettering lists a case of acute steatohepatitis in a woman who had taken multiple supplements including ashwagandha, plus alcohol and ibuprofen. [7] These are case reports. They show how hard it is to tell which product, or which combination, was responsible; they do not measure how common the problem is.

What a reader can do

1. Keep one written list of everything you take: medicines, vitamins, powders, teas and extracts, with the ingredient list from each label.
2. Bring the actual bottles, or photos of the labels, to a pharmacist or clinician. The kidney foundation recommends this at appointments. [5]
3. Check for the same ingredient appearing in two products. See amounts and duplicate ingredients.
4. Tell every clinician, including surgical teams. NCCIH advises telling providers about all dietary supplements you take. [1]
5. If a side effect appears, NCCIH says to contact your health care provider. [1] See how interactions work.