Ayurvedic Herbs With Diabetes, Thyroid and Blood Pressure Medicines

Diabetes medicines

What trials found. A Cochrane review looked at Ayurvedic treatments for diabetes. It found six trials of proprietary herbal mixtures and one of whole-system Ayurvedic treatment, enrolling 354 people with type 2 diabetes in total. [1] The authors said that, because of methodological weaknesses and small samples, they could not draw definite conclusions about whether the treatments work. [1] Evidence label: insufficient evidence. See Ayurveda for type 2 diabetes and weight for the full picture.

Why low blood sugar matters. An umbrella review of herbal medicines for type 2 diabetes advises careful monitoring for low blood sugar (hypoglycaemia) when herbs are used with diabetes medicines, because data on herb-drug interactions are lacking. [2] It also says herbal medicines should be used only as an add-on to conventional treatment, with shared decisions between clinicians and patients. [2] In the Cochrane trials, hypoglycaemic episodes were rare: one participant in one study, none severe. [1] Rare in small trials does not mean rare in everyday use.

Hidden ingredients. A review of liver injury from Ayurvedic drugs lists adulteration with prescription medicines and contamination from poor manufacturing among the causes of harm. [3] If a product contains an undeclared glucose-lowering drug, the effect on top of your own medicine could be larger than you expect. See adulterated Ayurvedic products.

Know the signs. The NHS lists symptoms of low blood sugar as feeling hungry, dizzy, anxious or irritable, sweating, shaking, tingling lips and a pounding heart; severe low blood sugar can cause a seizure or loss of consciousness. [4] Follow the plan your diabetes team gave you for treating a low, and seek emergency help (911 in the US) if someone cannot be woken or is having a seizure.

Thyroid medicines and thyroid conditions

NCCIH says ashwagandha is not recommended for people with autoimmune or thyroid disorders, and that it might interact with thyroid hormone medicines. [5] Two published case reports show why:

• A 73-year-old woman who used ashwagandha root extract for two years to treat her own underactive thyroid developed a fast heart rhythm and an overactive thyroid; she recovered after stopping the supplement. [6]
• A previously healthy 47-year-old man developed a painless thyroid inflammation with overactive-thyroid symptoms; his symptoms and thyroid tests improved after he stopped ashwagandha. [7]

Both authors describe these as rare. [6][7] Case reports show something can happen; they cannot say how often. Evidence label for harm: case reports only. Symptoms of an overactive thyroid include nervousness, anxiety, trouble sleeping, tiredness, sensitivity to heat, a fast or irregular heartbeat, trembling and weight loss. [8] Do not treat an underactive thyroid with an herb in place of medicine; thyroid testing and treatment come from a clinician. For the herb itself, see ashwagandha in Ayurveda.

Blood pressure medicines

• Ashwagandha. NCCIH lists blood pressure medicines among those it might interact with. [5]
• Licorice (mulethi). Its component glycyrrhizin can cause serious effects such as irregular heartbeat and cardiac arrest, especially in large amounts or long-term use. [9] Small amounts have been linked to severe effects in people with hypertension and in people with heart or kidney conditions. [9] Interactions with corticosteroids have also been reported. [9] See licorice and arjuna in Ayurveda.
• Metals. Lead in some Ayurvedic products can raise blood pressure in adults. [10] [11]

At a glance

What you can do

1. Bring every product to your prescriber or pharmacist and ask about each by name. See Ayurvedic herbs and prescription medicines and interactions by drug class.
2. Ask which numbers to track (blood sugar, blood pressure, thyroid blood tests) and how often.
3. Do not change doses on your own. Report new symptoms to the prescriber promptly.
4. Tell your Ayurvedic practitioner which medicines you take and ask them to put advice in writing.