Herbal supplements are products made from plants, fungi, or algae that you take by mouth to support your health. They fall under the legal category of dietary supplements, not drugs, which means they’re regulated more like food than medicine. Americans spent a record $13.2 billion on herbal supplements in 2024, a 5.4% jump from the year before, reflecting how widely these products are used for everything from immune support to managing menopause symptoms.
How Herbal Supplements Differ From Drugs
The distinction matters more than most people realize. Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), herbal supplements are classified as a special category of food. This means manufacturers don’t need to prove their products are effective before selling them. They can describe how an herb affects the body’s structure or function (for example, “supports immune health”), but they cannot claim to diagnose, cure, or treat any disease.
Prescription and over-the-counter drugs, by contrast, must go through rigorous clinical trials and receive FDA approval before reaching shelves. The FDA can only pull an herbal supplement from the market after proving it poses a significant or unreasonable risk of illness or injury. The burden of proof falls on the government, not the manufacturer. For new dietary ingredients that weren’t sold before 1994, companies must notify the FDA at least 75 days before launch and provide evidence the ingredient is reasonably safe, but this is a far lower bar than drug approval.
Common Herbal Supplements and Their Uses
Thousands of herbal products line store shelves, but a handful dominate the market:
- Echinacea is one of the most popular herbs for colds, flu, and respiratory infections. It stimulates both the general and targeted branches of the immune system and has antiviral, anti-inflammatory, and antimicrobial properties. Native Americans used it for these purposes long before it appeared in capsule form.
- Garlic supplements are primarily taken to lower cholesterol and blood pressure. Research has also identified liver-protective, brain-protective, and antioxidant effects.
- Ginkgo biloba is widely used to improve memory and mental sharpness, particularly in older adults with poor blood flow to the brain. Its active compounds protect cellular energy production and neutralize damaging molecules in the body.
- Saw palmetto is taken mainly by men to manage symptoms of an enlarged prostate. It works by blocking an enzyme that converts testosterone into a more potent form linked to prostate growth.
- Black cohosh is commonly used for menopause symptoms, especially hot flashes. It appears to interact with estrogen receptors in the body, though researchers haven’t pinpointed exactly which compounds are responsible.
Forms You’ll Find on Shelves
Herbal supplements come in several forms, and the one you choose can affect how quickly and completely you absorb the active compounds. Capsules and tablets filled with dried, powdered plant material are the most common. Tinctures are liquid extracts made by soaking plant material in alcohol or another solvent for an extended period, which pulls out a broad range of compounds. Teas and decoctions use hot water as the solvent. Decoctions involve simmering tougher plant parts like roots and bark, while teas (infusions) steep softer material like leaves and flowers.
Standardized extracts deserve special attention. Standardization means the manufacturer has measured and adjusted the levels of one or more key compounds so that every batch delivers a consistent amount. This helps ensure you get the same dose each time, which matters because the chemical makeup of plants varies with growing conditions, harvest timing, and processing. When a label says “standardized to 24% flavone glycosides” on a ginkgo product, it means the manufacturer tested and confirmed that concentration of the active compound.
What the Label Tells You
Every herbal supplement sold in the U.S. must carry a “Supplement Facts” panel enclosed in a bordered box. This panel lists the serving size, servings per container, and the name and quantity of each dietary ingredient. Ingredients with no established Daily Value are marked with a symbol referencing the footnote “Daily Value Not Established,” which is the case for most herbs.
If a product contains a proprietary blend (a mixture of ingredients where the company doesn’t disclose individual amounts), the label must use the term “Proprietary Blend” or a similar descriptor, list the total weight of the blend, and then list individual ingredients in descending order by weight. This means the first ingredient listed is present in the largest amount, but you won’t know exactly how much of each herb you’re getting. Many informed consumers prefer products that list individual ingredient amounts instead.
Safety Risks and Drug Interactions
“Natural” does not mean harmless. Several popular herbs interact with prescription medications in ways that can be dangerous. St. John’s wort, widely used for mild depression, is one of the most problematic. It interferes with immunosuppressant drugs, HIV medications, oral contraceptives, blood thinners, heart medications, and anti-anxiety drugs. The interactions aren’t minor: in transplant patients, St. John’s wort has caused organ rejection by reducing the effectiveness of anti-rejection drugs.
Ginkgo biloba taken alongside the blood thinner warfarin increases the risk of major bleeding events. Chamomile can also interact with warfarin and with sedative medications. Cat’s claw, an herb used for inflammation, may interact with blood pressure drugs, blood thinners, immunosuppressants, and medications processed by certain liver enzymes.
The core issue is that many herbs contain compounds that either amplify or reduce the effects of prescription drugs, often by speeding up or slowing down the liver enzymes that metabolize those drugs. If you’re taking any prescription medication, knowing which herbs could interfere is essential before adding a supplement.
Manufacturing Standards and Quality Control
Herbal supplement manufacturers must follow Current Good Manufacturing Practices (cGMP) laid out in federal regulations. These rules cover personnel training, facility sanitation, equipment maintenance, quality control testing, batch records, packaging, labeling, and handling of complaints and returns. The goal is to ensure that what’s on the label matches what’s in the bottle, that products aren’t contaminated, and that each batch is consistent.
In practice, compliance varies. The FDA inspects facilities but can’t reach every manufacturer every year. Independent studies have repeatedly found supplements that contain less of the active ingredient than claimed, include unlisted ingredients, or are contaminated with heavy metals or other substances.
How to Choose a Reliable Product
Third-party certification is the most practical tool you have. Four well-established programs test supplements independently: USP Verified, NSF Certified Sport, Informed Sport, and BSCG Certified Drug Free. A seal from one of these organizations on a product means an outside lab has verified that the supplement contains what the label says, doesn’t contain harmful levels of contaminants, and was manufactured properly. No certification system guarantees an herb will work for your intended purpose, but it does confirm the product is what it claims to be.
Beyond certification seals, look for products that list individual ingredient amounts rather than hiding behind proprietary blends. Choose standardized extracts when available, since they offer more predictable dosing. And check whether the company provides a certificate of analysis, a document showing the results of third-party testing for that specific batch. Reputable companies often make these available on their websites.