Cover Image

Impact of herbal supplements nowadays: an overview

L. I. Ramirez, O. N. Kanwugu, M. N. Ivantsova


At present, people around the world are looking for more natural alternatives for treating all kinds of health conditions as well as improving the general wellbeing. As such, the consumption of herbal supplements has increased globally, generating billions in revenue. The use of these herbal products is firmly rooted in the traditional use of medicinal plants for disease prevention and treatment, practiced in several cultures. Although herbal products are recognized by the WHO as an essential component of the healthcare system, there have been increasing concerns regarding their quality and safety. Generally, herbal products are not strictly regulated as they are largely categorized under dietary supplements, thus escaping the rigorous scrutiny meted out to pharmaceuticals. Notwithstanding that many consumers generally perceive herbal products as benign and inherently safe, several reports have shown that herbal products can induce mild to acute adverse effects of clinical significance. Moreover, some herbal products on the market have been reported to be contaminated with microorganisms, environmental toxins, and adulterants. Furthermore, evidence regarding the efficacy of herbal supplements is extremely discrepant.


herbal supplements; drug; herbal interactions; herbal medicine; traditional medicine; phytomedicine

Full Text:



WHO. WHO global report on traditional and complementary medicine 2019: World Health Organization; 2019. Available from:

Zhang J, Hu K, Di L, Wang P, Liu Z, Zhang J, et al. Traditional herbal medicine and nanomedicine: Converging disciplines to improve therapeutic efficacy and human health. Adv Drug Deliv Rev. 2021;178:113964. doi:10.1016/j.addr.2021.113964

Ahmad Khan MS, Ahmad I. Chapter 1 - Herbal Medicine: Current Trends and Future Prospects. In: Ahmad Khan MS, Ahmad I, Chattopadhyay D, editors. New Look to Phytomedicine: Academic Press; 2019. P. 3–13. doi:10.1016/B978-0-12-814619-4.00001-X

Aronson JK. Herbal medicines. In: Aronson JK, editor. Meyler's side effects of drugs: the international encyclopedia of adverse drug reactions and interactions. Oxford: Else-vier; 2016. P. 707–742. eBook ISBN: 9780444537164

Amer MR, Cipriano GC, Venci JV, Gandhi MA. Safety of Popular Herbal Supplements in Lactating Women. J Hum Lact. 2015;31(3):348–353. doi:10.1177/0890334415580580

Mehmood Z, Khan MS, Qais FA, Samreen, Ahmad I. Chapter 18 - Herb and Modern Drug Interactions: Efficacy, Quality, and Safety Aspects. In: Ahmad Khan MS, Ahmad I, Chattopadhyay D, editors. New Look to Phytomedicine: Academic Press; 2019. P. 503–520. doi:10.1016/B978-0-12-814619-4.00019-7

Lipman TO. Herbal supplements. Curr Gastroenterol Rep. 2005;7(4):302–307. doi:10.1007/s11894-005-0023-z

Chattopadhyay N, Maurya R. Herbal Medicine. Reference Module in Biomedical Sciences: Elsevier; 2015. doi:10.1016/B978-0-12-801238-3.05061-3

Pauzi NAM, Cheema MS, Ismail A, Ghazali AR, Abdullah R. Safety assessment of natural products in Malaysia: current practices, challenges, and new strategies. Rev Environ Health. 2021; 34582637. doi:10.1515/reveh-2021-0072

Woo CSJ, Lau JSH, El-Nezami H. Chapter 10 - Herbal Medicine: Toxicity and Recent Trends in Assessing Their Potential Toxic Effects. In: Shyur L-F, Lau ASY, editors. Advances in Botanical Research. 62: Academic Press; 2012. P. 365–384. doi:10.1016/B978-0-12-394591-4.00009-X

Pereira K. Herbal Supplements: Widely Used, Poorly Under-stood. Plast Surg Nurs. 2016;36(3):126–130. doi:10.1097/PSN.0000000000000154

Karch SB. SUBSTANCE MISUSE | Herbal Medicine. In: Payne-James J, editor. Encyclopedia of Forensic and Legal Medicine. Oxford: Elsevier; 2005. P. 145–152. doi:10.1016/B0-12-369399-3/00344-X

Ritchie MR. Use of herbal supplements and nutritional supplements in the UK: what do we know about their pattern of usage? Proc Nutr Soc. 2007;66(4):479–482. doi:10.1017/S0029665107005794

Jansen C, Baker JD, Kodaira E, Ang L, Bacani AJ, Aldan JT, et al. Medicine in motion: Opportunities, challenges and data analytics-based solutions for traditional medicine integra-tion into western medical practice. J Ethnopharmacol. 2021;267:113477. doi:10.1016/j.jep.2020.113477

Tessier DJ, Bash DS. A surgeon’s guide to herbal supple-ments. J Surg Res. 2003;114(1):30–36. doi:10.1016/s0022-4804(03)00130-6

Fraunfelder FW. PART 6 - Herbal medicines and dietary supplements – an overview. In: Fraunfelder FT, Fraunfelder FW, Chambers WA, editors. Clinical Ocular Toxicology. Ed-inburgh: W.B. Saunders; 2008. P. 41–43. doi:10.1016/B978-1-4160-4673-8.X0015-0

Ernst E, White A. The BBC survey of complementary medicine use in the UK. Complement Ther Med. 2000;8(1):32–36. doi:10.1016/S0965-2299(00)90833-1

Smith T, May G, Eckl V, Reynolds CM. US sales of herbal supplements increase by 8.6% in 2019. Herb Gram. 2020;127:54–69. Available at:

Liu C-X. Overview on development of ASEAN traditional and herbal medicines. Chin Herb Med. 2021;13(4):441–450. doi:10.1016/j.chmed.2021.09.002

Cleveland Clinic. Herbal Supplements: Cleveland Clinic; 2019. Available from:

Furhad S, Bokhari AA. Herbal Supplements. In: StatPearls [Internet]: StatPearls Publishing; 2022. Jan. Available from:

Johns Hopkins Medicine. Herbal Medicine: Johns Hopkins University; 2020. Available from:

Williams CT. Herbal Supplements: Precautions and Safe Use. Nurs Clin North Am. 2021;56(1):1–21. doi:10.1016/j.cnur.2020.10.001

Shams R, Oldfield EC, Copare J, Johnson DA. Peppermint oil: clinical uses in the treatment of gastrointestinal diseases. JSM Gastroenterol Hepatol. 2015;3(1):1035. Available from:

Vincent A, Fitzpatrick LA. Soy isoflavones: are they useful in menopause. Mayo Clin Proc. 2000;75(11):1174–1184. doi:10.4065/75.11.1174

Olenina L, Patel IP, Portal AP. Health Information Tea Tree. Available from:

Banerjee SK, Maulik SK. Effect of garlic on cardiovascular disorders: a review. Nutr J. 2002;1(1):1–14. doi:10.1186/1475-2891-1-4

Gruenwald J. Chapter 20 - The regulation of botanicals as drugs and dietary supplements in Europe. In: Iwu MM, Wootton JC, editors. Advances in Phytomedicine. 1: Elsevier; 2002. P. 241–248. doi:10.1016/S1572-557X(02)80029-0

Low TY, Wong KO, Yap ALL, De Haan LHJ, Rietjens IMCM. The Regulatory Framework Across International Jurisdic-tions for Risks Associated with Consumption of Botanical Food Supplements. Compr Rev Food Sci F. 2017;16(5):821–834. doi:10.1111/1541-4337.12289

Bone K, Simon Mills M, Fnimh M. Principles and practice of phytotherapy: modern herbal medicine: Elsevier Health Sciences; 2012. doi:10.1016/C2009-0-48725-7

Farah MH, Edwards R, Lindquist M, Leon C, Shaw D. International monitoring of adverse health effects associated with herbal medicines. Pharmacoepidemiol Drug Saf. 2000;9(2):105–112. doi:10.1002/(SICI)1099-1557(200003/04)9:2<105::AID-PDS486>3.0.CO;2-2

Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements. Drug Saf. 1997;17(5):342–356. doi:10.2165/00002018-199717050-00006

Cuzzolin L, Zaffani S, Benoni G. Safety implications regarding use of phytomedicines. Eur J Clin Pharmacol. 2006;62(1):37–42. doi:10.1007/s00228-005-0050-6

Mainardi T, Kapoor S, Bielory L. Complementary and alternative medicine: Herbs, phytochemicals and vitamins and their immunologic effects. J Allergy Clin Immunol. 2009;123(2):283–294. doi:10.1016/j.jaci.2008.12.023

Zuin VG, Vilegas JHY. Pesticide residues in medicinal plants and phytomedicines. Phytother Res. 2000;14(2):73–88. doi:10.1002/(sici)1099-1573(200003)14:2<73::aid-ptr577>;2-#

Ichim MC, Booker A. Chemical authentication of botanical ingredients: a review of commercial herbal products. Front Pharmacol. 2021;12(632). doi:10.3389/fphar.2021.666850

Valencia Orgaz O, Orts Castro A, Armenter C, Pérez-Cerdá Silvestre F. Valoración del consumo preoperatorio de plantas medicinales en la consulta preanestésica. Rev Esp Anestesiol Reanim. 2005:453–458.

Makino T, Wakushima H, Okamoto T, Okukubo Y, Deguchi Y, Kano Y. Pharmacokinetic interactions between warfarin and kangenkaryu, a Chinese traditional herbal medicine, and their synergistic action. J Ethnopharmacol. 2002;82(1):35–40. doi:10.1016/s0378-8741(02)00175-7

Tres JC. Interacción entre fármacos y plantas medicinales. An Sist Sanit Navar. 2006: 29(2):233-252. Available from:


Copyright (c) 2021 L.I. Ramirez, O.N. Kanwugu, M.N. Ivantsova

Scopus logo WorldCat logo DOAJ logo CAS logo BASE logo eLibrary logo

Chimica Techno Acta, 2014-2022
ISSN 2411-1414 (Online)