A remedy can be traditional and natural and still cause harm. It depends on how much you take, which part of the plant it uses, how it was made, and what else you take with it. The U.S. National Center for Complementary and Integrative Health (NCCIH) says plainly that “natural” does not always mean “safe.” The same herb can also be a very different product depending on how it is prepared.
This guide explains why dose and preparation matter and what the research does and does not tell us. It ends with a checklist and questions you can bring to a health care provider. It does not tell you whether to use any remedy.
If Something Feels Wrong Right Now
If you or someone else has trouble breathing, chest pain, a seizure, fainting, confusion, or signs of a severe allergic reaction after taking any herbal product, call your local emergency services now. Bring the product package or a photo of the label if you can do so safely.
Serious reactions to herbal products have been documented. NCCIH reports that some Chinese herbal products have contained sulfites, “which could cause asthma or severe allergic reactions.” It also links ephedra to high blood pressure, heart attack, seizure, stroke, and psychosis.
Why “Traditional” and “Natural” Don't Settle the Dose Question
A long history of use tells you people have used a plant. It does not tell you the right amount for you, in the product in your hand, alongside the medicines you take. NCCIH's own examples show why.
- Kava: NCCIH notes that kava is in the pepper family, but “taking kava supplements can cause liver disease.”
- Ephedra (ma huang): Ephedra has “a long history of medicinal use in China and India.” NCCIH also says that “even in relatively low doses and short-term use,” it has been linked to serious harms. The U.S. Food and Drug Administration (FDA) banned the sale of dietary supplements containing ephedrine alkaloids in 2004.
- Licorice root: NCCIH calls licorice generally safe as a food ingredient. Licorice also contains glycyrrhizin, which “can cause serious adverse effects, such as irregular heartbeat and cardiac arrest, especially when consumed in large amounts or in the long term.”
The ephedra example matters. For some herbs, lowering the dose does not remove the concern, so no single rule like “a small amount is always fine” can stand in for a real safety review.
Three Ways Preparation Changes What You Actually Take
“Preparation” here means everything that happens between the plant and your body: which part is used, how it is processed, and how the final product is made. The sources point to three places where this changes things.
1. Which Components Are Kept or Removed
Licorice is the clearest example from NCCIH. Regular licorice contains glycyrrhizin. A processed form called deglycyrrhizinated licorice (DGL) has that component removed. NCCIH says oral products without glycyrrhizin “might be safe for up to 4 months.” It also warns that “even small amounts of glycyrrhizin from licorice root products have been linked to severe adverse effects in people who consume a lot of salt, in people with hypertension, and in people with heart or kidney conditions.” Same plant name, different preparation, different safety picture.
2. Whether Your Product Matches the One That Was Studied
NCCIH warns that supplements you buy “may differ in important ways from products tested in studies.” A study result for one extract, amount, or form does not automatically carry over to a tea, powder, capsule, or blend with a different recipe.
3. What Happened During Manufacturing
NCCIH reports that some Chinese herbal products have been contaminated with:
- Undeclared plant or animal material
- Drugs, such as the blood thinner warfarin and diclofenac, a nonsteroidal anti-inflammatory agent (the same drug class as some common pain and swelling medicines)
- Heavy metals, such as arsenic, lead, and cadmium
- Pesticides or sulfites
- Incorrect herbs, some of which have caused organ damage
NCCIH also notes that “manufacturing errors, in which one herb is mistakenly replaced with another, also have resulted in serious complications.” A dose written on a label only means something if the product holds what the label says.
An Evidence Ladder: What Is This Claim Actually Resting On?
When you see a traditional remedy described as natural, safe, or effective, ask which rung of this ladder the claim stands on. Higher rungs carry more weight, but none of them replaces a review of your own situation.
- “It's traditional.” This tells you about history of use. It says nothing about the dose, form, or quality of today's product.
- “It's natural.” This describes where it comes from. NCCIH says natural does not always mean safe.
- Label words like “standardized,” “verified,” or “certified.” NCCIH says these terms do “not necessarily guarantee product quality or consistency.”
- “Studies show…” Check whether the studies used the same form and amount. For Chinese herbal products, NCCIH says many studies “have been of poor quality,” so “no firm conclusions can be made about their effectiveness.”
- An independent summary of the evidence. NCCIH's Herbs at a Glance fact sheets cover common names, what the science says, possible side effects, and cautions for specific herbs.
- A review by someone who knows your health history and medicines. This is the only rung that fits the evidence to you.
Known Versus Unknown
What the Sources Establish
- The FDA “is not authorized to review dietary supplements for safety and effectiveness before they are marketed.”
- Some herbal products have been contaminated or mislabeled, including with prescription drugs.
- Some herbs interact with medicines. NCCIH notes that St. John's wort “makes many medications less effective.”
- Certain supplements “may increase the risk of bleeding or affect your response to anesthesia.”
- “Many dietary supplements have not been tested in pregnant women, nursing mothers, or children.”
What Often Remains Uncertain
- Whether a specific product contains exactly what its label lists, in the amounts listed
- Whether a traditional preparation and a modern capsule of the “same” herb act the same way
- Whether research on one extract applies to a different form or blend
- For many Chinese herbal products, whether they work for the conditions studied, because much of that research has been low quality
Practical Checklist: Know What You're Looking At
Use this list to gather facts before a conversation with a health care provider. It is a way to organize information, not a green light to use any product.
- Full name: Write down the common name and, if listed, the scientific (Latin) name. Since wrong herbs have ended up in some products, an exact name helps you and your provider look up the right plant.
- Plant part: Root, leaf, stem, seed, or whole plant?
- Form: Tea, powder, capsule, tincture, cream, or multi-herb blend?
- Processing: Does the label say anything was removed or concentrated, like “deglycyrrhizinated” or “extract”?
- Amount: How much per serving, how many servings, and for how long?
- Maker: Who made it, and is there a lot or batch number?
- Label claims: Note words like “standardized” or “certified,” and remember what they do and don't guarantee.
- Your medicines: List every prescription, over-the-counter medicine, and supplement you take.
- Special situations: Pregnancy, nursing, a child's use, an upcoming surgery, or a long-term health condition
- Keep a record: Store all of this in one place. Our guide on why each ingredient and dose in an herbal formula should be documented includes a worksheet you can use.
Questions to Bring to Your Health Care Provider
- Does this herb or blend have known interactions with any medicine I take?
- Is the form I have (tea, extract, capsule) similar to what was studied, if it was studied at all?
- Is there a component in this herb, like glycyrrhizin in licorice, that matters for my health history?
- Should I tell my surgeon or anesthesia team about this before a procedure?
- Does anything change if I am pregnant or nursing, or if this is for a child?
- What signs should make me stop and get help?
NCCIH advises telling all your health care providers about any complementary approaches you use. It also says not to use traditional Chinese medicine “to replace or delay seeking conventional care.” If you are meeting a traditional medicine practitioner, our guide on how to ask what a traditional practice actually involves covers questions about scope, training, and safety.
For a broader look at how traditional remedies and modern research fit together, see our guide to evaluating herbal remedies through modern science.
What This Page Does Not Do
This page does not diagnose any condition, recommend any remedy or amount, or tell you to start, stop, or change any medicine. It does not rank or endorse any product or seller.
Medical disclaimer: This article is general educational information, not medical advice. Talk with a qualified health care provider about your own situation. Read our full medical disclaimer.
Independence: NewEasternHealth.com is an independent consumer wellness publication. It is not a medical practice, clinic, or health care provider. It is not connected to any healthcare practice formerly associated with this domain. See our non-affiliation notice and our standards.
Where This Information Comes From
- Traditional Chinese Medicine: What You Need To Know, National Center for Complementary and Integrative Health (NCCIH)
- Herbs at a Glance, NCCIH
- Using Dietary Supplements Wisely, NCCIH
- Licorice Root, NCCIH
- Ephedra, NCCIH