Talking to Your Doctor About Traditional Healing and Remedies

Why this conversation matters

Many people use traditional remedies, teas, tonics, or visits to a healer, and most never mention it to their doctor. A 2019 systematic review of 86 papers found disclosure rates varied from 7% to 80%, and a meta-analysis of 14 studies found about a third (33%) of people disclosed use of biologically based complementary medicine (herbs, supplements and similar). [1]

Telling your care team is not about asking permission or being talked out of your culture. It is about safety. The NCCIH says that when patients tell their providers about complementary health practices, they can better stay in control and manage their health more effectively. [2]

Why people stay quiet

The review listed reasons for not telling: the provider never asked, fear of disapproval, thinking it was unimportant, believing the provider lacked knowledge, lack of time, and believing the remedy was safe. [1] The reasons people did tell included being asked, believing the provider would support them, and believing disclosure matters for safety. [1] If any of those sound familiar, you are in good company, and a respectful clinician should want to know.

What can go wrong when it stays hidden

Some herbal products change how medicines work. NCCIH says supplements can decrease the effects of medicines, while others increase their effects, including unwanted side effects. It notes that for many there is little information on interactions. [3] Examples it names include St. John's wort, which interacts with many drug types; uncertainty about Asian ginseng with blood pressure, statin and some antidepressant medicines; concentrated green tea supplements reducing blood levels of some drugs; and goldenseal changing how the body handles metformin. [3] People who take medicines with a narrow therapeutic index, such as digoxin, cyclosporine or warfarin, should take special care to tell their providers. [3]

The NHS says herbal medicines are not recommended for children because not enough is known about their safety, and that people should not take them if they are pregnant or breastfeeding, have kidney or liver problems, or take certain medicines. It lists statins, antidepressants, diabetes medicines such as metformin, blood pressure medicines, warfarin and the combined contraceptive pill as medicines that do not mix well with herbal medicines. [4]

What to bring and say

NCCIH gives four tips. [2]

1. List every complementary health practice you use on your patient history form, "from acupuncture to zinc."
2. At each visit, tell your providers what you use, including over-the-counter and prescription medicines and dietary and herbal supplements. Make a list in advance and take it with you.
3. If you are thinking about a new practice, ask about its safety, effectiveness and possible interactions with prescription and nonprescription medicines.
4. Do not wait to be asked. Start the conversation.

NCCIH also advises bringing a written list of everything you take, how often, and the doses. [3] Bringing the actual bottles or packets is a helpful extra, because names on labels can differ from what people call a remedy at home.

Questions you can ask

NCCIH suggests questions for people with cancer that work for anyone: What is known about the benefits and risks of this product or practice? Do the benefits outweigh the risks? What are the potential side effects? Will it interfere with my treatment? [5] Add: "Is this safe with my other medicines, with surgery coming up, or in pregnancy?"

If you worry about being judged

• You can say plainly: "I use this for a reason that matters to me, and I want my care to fit together." You do not have to defend your tradition.
• If one clinician dismisses you, a pharmacist is another good person to ask about interactions.
• You can ask for an interpreter or for someone who understands your community's care. See cultural safety and cultural humility in health care.
• If you also see a healer or traditional practitioner, consider telling them what your doctor has prescribed. Nothing here suggests stopping a prescribed medicine on your own; check with the prescriber first.

Before surgery or procedures

Mention herbs and remedies well before an operation or procedure. See supplements before surgery.

Related reading

Coordinating complementary and medical care, traditional herbs and prescription medicines, informed consent in complementary care, and the general guide to talking with a health professional.