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.

Question

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!

Asked by Heralding Angel On Jul 09, 2023

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Jul 12, 2023
Last updated May 01, 2024

Key points

  • How best to take an herbal supplement depends on the specific herbals in question, as absorption rates, interactions, and potential side effects can vary. It's best to follow the instructions provided by the manufacturer or consult a healthcare professional for personalized advice.

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

  • 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

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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