Herbs and supplements are aggressively marketed and used by many people interested in more "natural" treatments. They are widely available for the treatment of various conditions, and to promote general health. Often sold in health food stores and available without a prescription, they are frequently viewed as harmless and safer than prescribed drugs. However, most herbs and supplements are not tested by the FDA for safety or effectiveness. They are also not regulated for content, so different products with similar names may be quite different. In addition to the side effects listed below, any medication, including herbs, can cause allergic reactions. Also, all supplements that contain alcohol could interact with metronidazole (Flagyl) or disulfiram (Antabuse). You should tell your doctor about any herb or supplement you are taking, as it could interact with other medications or cause other health changes.

Echinacea
Uses: Stimulating the immune system and preventing colds.
Drug interactions: Interacts with blood thinners.
Precautions: Do not take if you are pregnant, diabetic, alcohol dependent, have liver disease, rheumatoid arthritis, HIV, leukemia, lupus, multiple sclerosis, active tuberculosis, asthma, or nasal allergies.
Side effects: Nausea, vomiting, diarrhea, nervous stimulation.

Ephedra (ephedrine)
Uses: Treatment of asthma, bronchitis, depression, emphysema, narcolepsy, nasal congestion, pulmonary disease; dieting, bodybuilding, energy supplementation.
Drug interactions: MAO Inhibitors, guanethidine, tricyclics, and methyldopa.
Precautions: Do not take if you have heart disease, diabetes, high blood pressure, hyperthyroidism, hallucinations.
Side effects: Insomnia, nervousness, appetite loss, dizziness, dry mouth, difficulty urinating, headache, high blood pressure, increased sweating, lightheadedness, nausea, racing heart, irregular heartbeat, vomiting, weakness, bronchospasm, stroke, heart attack.

Ginko
Uses: Increase blood flow, improve memory, and relieve dizziness.
Drug interactions: Blood thinners, aspirin, NSAIDS ( ibuprofen, naproxen, ketoprofen), and trazodone.
Precautions: Do not take if you have history of stroke, platelet dysfunction, bleeding disorders.
Side effects: Upset stomach, diarrhea, headache, fainting, trouble speaking, weakness, unusual bleeding or bruising.

Ginseng
Uses: Increase endurance and stamina, strengthen mental performance, and boost immune system.
Drug interactions: Blood thinners, MAO Inhibitors, antipsychotics, stimulants (including caffeine), prednisone, antidiabetic medications.
Precautions: Do not take if you have high or low blood pressure, cancer, fever, diabetes, heart problems, psychosis, insomnia, coagulation defects, or if you are pregnant.
Side effects: Headache, nervousness, agitation, insomnia, diarrhea, fast or irregular heartbeat, skin rash, unusual vaginal bleeding.

Goldenseal
Uses: Treatment of infections of the mouth, lungs, traveler's diarrhea, urinary infections, inflammation, indigestion, cold and flu symptoms.
Drug interactions: None listed.
Precautions: Do not use if you are pregnant or if you have hallucinations or high blood pressure.
Side effects: Nausea, vomiting, diarrhea, nervous stimulation.

Kava Kava
Uses: Reducing anxiety, stress, restlessness.
Drug interactions: None listed, but possibly alcohol or other sedatives.
Precautions: Do not take if you are pregnant, depressed, or have psoriasis.
Side effects: Muscle weakness, loss of coordination, vision changes, weight loss, bloody urine, yellowing of skin.

Melatonin
Uses: Improve sleep.
Drug interactions: None listed, but may not be safe with immunosuppressants or other things that cause drowsiness.
Precautions: Do not take if you have lupus, autoimmune disease, schizophrenia, depression, liver disease, or diabetes.
Side effects: Concentration difficulties, dizziness, fatigue, headache, irritability.

St John's Wort
Uses: Treatment of depression.
Drug interactions: Protease inhibitors and digoxin.
Precautions: None listed.
Side effects: Constipation, dizziness, dry mouth, GI irritation, sun sensitivity, restlessness, skin rash, sleep disturbance, tiredness, and severe fever with stiffness (serotonin syndrome).

Valerian Root
Uses: Reducing anxiety, restlessness and insomnia.
Drug interactions: None listed.
Precautions: May not be safe if you have liver disease.
Side effects: Headache, blurred vision, nausea, change in heartbeats, morning grogginess, dark urine, stomach pain, hallucinations, insomnia, nausea, excitability, sedation, sensation disturbance.

Yohimbine
Uses: Increase blood flow, treatment of impotence, dilate pupils, enhance energy.
Drug interactions: None listed.
Precautions: Do not take if you are pregnant or have kidney disease, heart disease, high blood pressure, depression, liver disease.
Side effects: Rapid heartbeat, sweating, nervousness, tremor, irritability, headache, dizziness, flushing.

These are just some of the herbs and supplements that are currently being used. There are other supplements (or supplement combinations) that are marketed and sold to more specialized groups of consumers (e.g. seriously ill patients, bodybuilders). And undoubtedly new products will continue to be developed and promoted as beneficial for a particular illness or effect. New products, in particular, should be carefully evaluated for their safety and appropriateness to your particular need. But all herbs and supplements that are available without a prescription should be taken only in the context of an overall plan for symptom reduction or health maintenance, and with full knowledge of their effects and side effects. When in doubt, postpone taking these products until you can consult with a knowledgeable unbiased resource, including the physicians at the Arthur Ashe Student Health and Wellness Center and The Counseling Center.