Question About How To Take Multiple Herbal Supplements At Once
In our latest question and answer, our pharmacist talks about some general recommendations in regard to herbal supplement administration.
Hi, and thank you for offering this valuable service! My situation is this: I've taken myself off Wellbutrin (02/23), Escitalopram (6/23), and Lisinopril/HCTZ (11/23). While I felt a bit weepy a few days after discontinuing Escitalopram, I haven't experienced any other effects from stopping the medications. However, I have started taking other herbals to help with any withdrawals. My question is, is it best to take multiple herbal pills at once, or should they be spaced out somehow? Thank you, and keep up the great work!
Jul 09, 2023- Different herbal supplements have different absorption requirements, with some like St. John's Wort and milk thistle typically taken on an empty stomach, while others like ginger and turmeric are better taken with food to reduce stomach upset.
- You should work with your doctor before making any changes to your medication regimen, especially if you're treating conditions like high blood pressure or mental health issues.
- It's best to follow the specific instructions on each herbal supplement's label or ask a healthcare professional for personalized guidance based on your particular supplements and health situation.
Answer
Hello! I'd be more than glad to be of help to you, but it's important to note that I would need to know exactly what herbal medications you are talking about to give you a specific answer.
I do want to mention from the get-go that I strongly encourage you to work with your doctor regarding stopping the medications you mentioned in your question. It's important to be appropriately monitored when making changes to your medication regimen, especially when you are treating conditions like high blood pressure/mental health.
Getting on to your question, different herbals have different absorption rates, interactions with food, potential side effects, and administration recommendations.
The above being said, I can provide you with some general examples of herbals that are typically recommended to be taken on an empty stomach (or by themselves) and some that are better taken with food.
Some examples of herbals that are often recommended to be taken on an empty stomach include:
- St. John's Wort: It is commonly suggested to take St. John's Wort on an empty stomach as taking it with food may decrease absorption.
- Milk thistle: Some formulations of milk thistle are recommended to be taken on an empty stomach, as this may enhance its absorption.
Herbals that are typically recommended to be taken with food include:
- Ginger: Ginger is often suggested to be taken with food to help minimize the potential for gastrointestinal irritation.
- Turmeric: Taking turmeric with food is generally thought to enhance its absorption and to reduce the risk of digestive discomfort.
Remember, these are just examples, and I encourage you to write back with the specific herbals you have in mind so I can provide some more personalized direction.
I will point out that in general, most herbals are best absorbed on an empty stomach, but again, there certainly are exceptions to this rule.
Final Words
It's always best to follow the recommendations provided by the manufacturer or consult a healthcare professional (like us!) who can offer personalized advice based on your specific needs and circumstances.
I hope this information helps! If you have any more questions, feel free to ask.
References & sources
- Effect of milk thistle on the pharmacokinetics of indinavir in healthy volunteers — PubMed
- Milk thistle (Silybum marianum): A concise overview on its chemistry, pharmacological, and nutraceutical uses in liver diseases — PubMed
- Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. — PubMed
Glossary — Terms in This Answer
- Absorption
- The process by which a medication or herbal substance enters the bloodstream and becomes available to work in the body.
- Medication regimen
- The specific plan for when and how a person takes their medicines.
- St. John's Wort
- An herbal supplement commonly used to help with mood and mental health that may be less effective if taken with food.
- Milk thistle
- An herbal supplement often used to support liver health.
- Gastrointestinal irritation
- Stomach or digestive discomfort such as nausea, cramping, or upset stomach.
- Turmeric
- A golden-colored spice with anti-inflammatory properties that is better absorbed when taken with food.
- Formulations
- Different preparations or versions of a medication or herbal product, such as tablets, capsules, or liquids.
- Empty stomach
- Taking a medication or herbal supplement without eating food before or at the same time.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
More answers from Brian →