Are Herbs Safer Than Medicines?

As many of our New York patients know, we are pharmacists and own integrative pharmacies along with our new vitamin store, Woodstock Vitamins. 

We get lots of slack from “competitors” at health food and vitamin stores: “You sell harsh chemicals that are unnatural, how can you sell vitamins?”

More commonly, and the subject of today’s rant, we often hear “Our natural products are safer than medicine.

This week we had a talking head from an herbal company come and visit.  While she was extolling the virtues of her line, she made a comment that horrified us. She said none of her products had any drug interactions. While we knew that was simply insane, how many marketing stops did she make that day where the staff believed what she said?

Besides probably violating a few FDA regulations, she violates laws of common sense. Natural products, no matter the source or type, work in the same manner as drugs:  they activate or inhibit the finite number of pathways in our body, causing some change in us. Saying that natural products are safer than drugs is only done by people who don’t understand how it all works.

Unfortunately, this isn’t a pharmacology lesson.  Sorry, I know you were excitedly putting your geek gear on.  Instead, let’s focus on the ways an herbal product could be unsafe for you.  There are four main ways:

  1. The active ingredient itself could be unsafe for you – interacts with medicines, causes short or long-term side complications or is addicting.
  2. The product is contaminated.  There is yucky stuff that shouldn’t be there like heavy metals or naturally occurring toxic substances that should not be there.
  3. The product is adulterated.  This is a bit different than contamination.  This is often intentional; the product may be spiked with another agent that isn’t supposed to be there or isn’t on the label.
  4. The product isn’t labeled appropriately.

Dangerous Herbs

There are MANY dangerous naturally occurring products, especially herbs.  Comfrey root is banned from oral use because it has toxic substances called pyrrolizidine alkaloids that damage the liver and can lead to death.  Graviola has been used recently for “cancer” but can easily cause Parkinson’s-like symptoms and nerve damage.  We can’t list them all but always check with an expert before using a new herb. 

It’s super critical to tell your doctor or pharmacist what herbs you take because drug interactions are actually more common with herbs than with traditional medicines. Some of the interactions can be life-threatening. 

To over-simplify it, herbal compounds are often “unrefined” and interact with numerous body systems – the same ones a traditional therapy may also interact with.  Modern medications are usually more “refined” when it comes to this; they have a lower incidence of drug interactions (note: I’m not talking about side effects or complications, just drug interactions).

Here are a few examples of common herb and drug interactions:

  • Licorice interacts with blood pressure medication
  • St. John’s Wort interacts with many medications
  • Milk thistle interacts with warfarin and tamoxifen


The next risk of herbal products comes via contamination. Herbs are plants and take nutrition from their surroundings, right?  It rains everywhere, right?  Many herbal products could (and some have been shown to) contain high levels of lead, cadmium, arsenic, fluoride, acetone, hexane, or even banned pesticides.  


A majority of ginkgo supplements sold in this country are actually spiked with another herb called saphora japonica. This makes the product look like it has high levels of the active ingredient. Vendors do it to save money, knowing many manufacturers aren’t checking. They are simply testing for one of the active ingredients and not the full profile of an herb.

Another example is bilberry. The price of bilberry has gone up dramatically. Rather than pay more for the raw materials, companies are selling products that are a mix of red food coloring, charcoal, and black soybean hulls.  To be fair to these companies, charcoal is natural [/sarcasm].

One more?  Why not!  Pomegranate – the antioxidant we all know and love – is often spiked with wood pulp to increase the ellagic acid (the active element) counts, often to numbers that are higher than could occur in nature.

Proper Labeling

Another problem with herbal products is that the labeled strength really is misleading.

Eating an entire herbal plant itself doesn’t give us the desired benefit.  It’s a specific part of the plant that then synthesizes a single (or even group) of compounds that does the trick.  It’s much like fish oil; the fish oil itself doesn’t matter but the amount of EPA and DHA in it does.

That doesn’t stop Brand X from taking dead, dried-up Ashwagandha root, grinding it all up, and putting 500mg of this into a capsule.  Here you’re getting fiber from the plant with maybe a speck of the active.  You actually need concentrated withanolides from ashwagandha, not the whole root itself.

This makes an herbal product unsafe because it’s mislabeled.  More importantly, if you are using herbal therapy and are unintentionally underdosing, that can be a big problem too.  Conversely, if you switch to a similar dose of a correctly made herb, you could then in fact overdose.

PROTIP:  Grinding the whole plant is called “crude herb”.  Buying crude herb products is really a waste of money – you’re really paying for fiber. Herbal concentrates are much more effective therapeutically and if made properly will give you a consistent dose from batch to batch.

Making Natural Products Safer

We know that anyone reading this will know that the blanket statement “natural products are safer” is not very accurate.  Many natural products can be dangerous and not respecting what these products actually are can lead to short and long-term health complications.

Herbs, in particular, can be dangerous for many easily identifiable reasons.  They also are an important part of a wellness regimen and many of them have a proven benefit.   We can make it so these products are in fact the safer option.  That’s where we come in…

Each staff member is trained on how to quickly screen products, especially herbs, for drug interactions using one of the country’s most respected resources, the Natural Medicine Comprehensive Database.  A pharmacist is either on-site or readily available to assist further.  All of our staff are trained on when a doctor should be involved as well.  We know where to find the answer, how to interpret it, and when it’s not up to us to help you decide.

And to keep the bragging train going, we know the supplement industry so we know where to look for quality herbal products.  

We source our herbs are sourced from suppliers that are just as dedicated to the cause of quality in the supplement industry as we are.  

They only buy whole herbs from sustainable sources.- never any powders or premade concentrates. This is one step that ensures that the products are not adulterated.

They also have the most advanced herbal laboratories and production facilities in the world.  All incoming herbs are quarantined and checked for contaminants.  

Don’t forget – we’re here to discuss.  Just because a store is smart enough to stock pure high-quality herbs doesn’t mean that they have the proper training to help you use them safely.  Have an herb or natural product and want to be sure it’s safe for you?  Ask our experts today!

Just trying to keep it real…

Dr. Neal Smoller, Holistic Pharmacist

About Neal Smoller

Dr. Neal Smoller, PharmD, is a licensed pharmacist: and owner of Village Apothecary, an independent pharmacy in the most famous small town in America—Woodstock, NY. He’s also the host of the popular wellness podcast, The Big Mouth Pharmacist.”


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