Ayurvedic Herbs: Medicine Interactions, Pregnancy and Children

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"Natural" does not mean safe with your medicines or in pregnancy. Herbs are active substances, and a product can also be contaminated. The NHS advises checking first with a pharmacist before taking a herbal medicine if you already take other medicine, including medicines bought without a prescription. [1] This page covers Ayurvedic herbs. For general principles, see how interactions work.

Evidence labels used here: established (documented safety advice), promising but limited, insufficient evidence, evidence of harm.

Herb and medicine interactions

What the NHS says. It lists medicine types that may not mix well with herbal medicines, including blood thinners such as warfarin. [2] It also says combining them may cause harmful effects or stop your medicine working. [3]

Examples from commonly used Ayurvedic herbs:

Each herb has its own page: see Ayurvedic ingredients and where to find each guide, adaptogen safety and turmeric. Multi-herb Ayurvedic formulas make interactions harder to predict, because the full list or amounts may be unclear.

What to do

• Tell your prescriber and pharmacist the exact name of each product and bring the label. Do this before surgery as well. See talking with a health professional.
• Do not stop a prescribed medicine to try an Ayurvedic one. Ask your prescriber first.
• Watch for new symptoms after starting a product, and stop and seek care if you feel unwell. See liver safety.

Pregnancy and breastfeeding

• The NHS says you should not take herbal medicines if you are pregnant or breastfeeding. [11]
• NCCIH says some Ayurvedic products may contain ingredients that could be harmful, and advises consulting a health provider if pregnant or nursing. [12]
• NCCIH says ashwagandha should be avoided in pregnancy and not used while breastfeeding. [13]
• NCCIH says turmeric supplements during pregnancy may be unsafe. [14] Turmeric as a food spice is a different matter, and we did not find a source setting a food limit.
• Metal-containing products are a particular concern; see heavy metals and product quality.

For general guidance, see pregnancy and breastfeeding and therapies in pregnancy.

Children

The NHS says herbal medicines are not recommended for children because not enough is known about their safety. [15] Published case reports describe severe lead poisoning in a 4-year-old given an Ayurvedic herbal medicine [16] and mercury toxicity in a 5-month-old. [17] Some herbs have been studied in children: a systematic review of five Bacopa studies reported mild side effects in 2.3% of participants but called for replication before the results can be trusted. [18] [19] [20] Treat that as preliminary evidence, not a recommendation. See children and teens and therapies for children and older adults.

Who should take extra care

People who are pregnant or breastfeeding, have liver or kidney disease, are about to have surgery, have autoimmune or thyroid disorders (NCCIH does not recommend ashwagandha for these groups [21]), or take several medicines.

Related pages

• Herb safety and interactions
• Interactions by drug class