Herbs, extracts, and vitamins – there is a 70 billion dollar market for natural health supplements, designed to act as alternatives to pharmaceutical research. The idea is that, instead of taking a drug that has been extensively researched for its ability to treat a specific medical issue, there are potentially natural plant based alternatives that can provide the same benefits without the side effects or risks.
Let’s be clear from the beginning: 95% of these herbal supplements do not work. Their claims and beliefs are frequently disproven, and – even when some do have a pharmacological effect – the effect is often less than one would receive from available medications.
Still, the most common response to research that disproves herbal supplements is “what’s the harm?” There is this belief that, just because something doesn’t work as described, if someone believes that it does and feels a benefit from it anyway (called the placebo effect), why does it matter if they try it?
How Can a Natural Herb Be Harmful?
If I hand you a harmless sugar pill that does nothing and tell you that it is a pill to reduce anxiety, you take it, and then you feel your anxiety decrease, that is called the placebo effect. It is the idea of “mind over matter,” where physical changes to your body genuinely occur as a result of expectations and beliefs. You believed the pill to reduce anxiety, and so your mind convinced you that it worked, and your anxiety decreased as a result even though the pill itself had no effect.
Most herbal supplements today take advantage of this placebo effect. There are a few exceptions – which we will talk about later in this blog post – but, in general, most of the time the herbs and supplements do not do what they claim to do. Most of the time they do nothing at all.
The claims they make are based rumor, tradition, or completely made up, and all studies show that the herbs do not work, and yet they are still allowed to make the claims because they are not regulated by the FDA.
Yet, if you ask people that use herbal supplements, many will swear by them and say that they work. This is especially true of supplements for stress, depression, and anxiety. Mental health issues are particularly susceptible to the placebo effect specifically because they are related to a person’s thoughts and feelings. If you feel like an herb is going to work, then of course it is more likely to work.
Depression and anxiety are heavy, life altering experiences. In general, if someone feels like they are able to reduce their depression and improve their mental health through supplements, there’s an argument to be made that any relief is worth it, even if the cause of that relief is questionable science.
But it is also important to understand that these herbal supplement placebos are not necessarily harmless. There can be great harm in relying on an unproven supplement. For example:
- Supplement Ingredients Are Also Unregulated – We know that supplement claims are unregulated. That means that someone can claim that an herb has an effect even though it doesn’t, and they won’t be punished. But the bigger risk is that supplement doesn’t even need to contain the herb. For example, let’s say that there was a claim that spinach extract cured anxiety. Spinach itself is harmless, so taking a spinach supplement is unlikely to make you ill. But the company that creates spinach supplements is under no obligation to put spinach inside of the supplement. You could be swallowing something harmful, like the Datura Inoxia leaf, which is harmful to humans. No one is regulating the industry to know what is put in each capsule. Much of the time, the herb is not even present.
- Anything Can Be Harmful in Excess – Let’s say that the spinach supplement in the example above does contain spinach. Spinach is harmless, yes? Well, no, not necessarily. Even something has healthy as spinach can cause health consequences if taken in excess, and most herbs do not receive nearly as much research as spinach has for long term use.
- Eventually it Won’t Work or Be Enough – The placebo effect is unlikely to last forever. Very few people ever report feeling “Cured’ taking a supplement. Most of the time, the patient returns to baseline in anywhere form 3 to 30 days. For someone with more severe anxiety or depression, this can mean that the person is left without a coping mechanism if they have been relying on herbal supplements as their only form of treatment.
These risks all assume that the herb itself is harmless. But sometimes, it isn’t. There are many stories of herbs that ended up causing severe liver damage or increased cancer risk. Even vitamin supplements can be harmful when taken inappropriately.
Now, there are some herbal supplements that do have a pharmacological effect. Some medications were actually based on real plants. Aspirin, for example, came from willow bark. In the mental health world, kava is an herb that does appear to have a pharmacological effect on anxiety levels. Cannabis is a plant that clearly has real effects on the body.
But even in these cases, where a plant does lead to actual physical changes, caution is still highly warranted. First, because the industry is unregulated, there is no guarantee that the herb you are taking is correctly extracted. But, in addition:
- They Are Improperly Dosed – Taking the wrong dose of a medication can be harmful in the short and long term or cause the herb to have no effect. Different plants will have different doses naturally within the herb, and the exact amount of consume has rarely been studied.
- They Can React to Other Medications – Many herbal supplements, both those that do and do not have a pharmacological effect, react to other medications that you may be taking in ways that can be dangerous.
- They Have the Same Side Effects – Many people do not realize that the side effects of some medications are the result of the medication *working*. For example, a medication that alters serotonin levels for depression may cause stomach and gut related discomfort specifically because there are serotonin receptors in the gut. Any herb that improves serotonin levels would potentially also lead to same gut-related issues.
And, of course, the herbs can be harmful. Kava, for example, caused severe liver damage in some patients that used it. Most people that use kava report no symptoms, but the link between kava and liver damage has been widely recognized, and anyone choosing to take it needs to be aware of the risk.
Should You Throw Out All Your Herbs?
While this blog post may take a negative view of herbal supplements in general, supplementation is never as simple as “yes” or “no.” The science is changing and complicated. Magnesium, for example, is believed to potentially be useful for people with anxiety though – as this study points out – the quality of these studies is low.
We also know that healthy eating can improve anxiety symptoms and that some people are low in nutrients and specific vitamins in ways that may cause anxiety, and can be supported through supplementation.
But what is important is recognizing that science is science – and that what matters most is making smart decisions with your mental health and knowing when you should seek out professional psychiatric services to take greater control over your anxiety, depression, insomnia, and related conditions. If you need a psychiatrist in Dallas, contact Dr. Sehdev of Aware Behavioral Health, today.