What this acupuncturist wants you to know before going all in with medicinal herbs and mushrooms

There’s this place in LA where you can literally drink the extract of a mountain ant, which has adaptogenic properties and can give you an energy boost. I know this, because I did a shot of mountain ant in the name of wellness. (And so I could post about it on Instagram. I am a monster. Let’s move on.) It didn’t actually taste bad, there was just kind of an ick factor. It made me feel a little tingly, like I’d just taken a scoop of pre-workout.

TBH, I wasn’t really expecting it to do much. That’s one of the weird things about medicinal herbs and mushrooms (and, well, ant extracts): Because they’re not prescribed by a traditional doctor, it can feel like they’re safe and totally fine to take however we want. We treat them as a way to cure or help with ailments, but aren’t concerned about the side effects because they are “natural.” It’s a strange dichotomy.

The natural wellness market has boomed in the last 20 years. My local coffee shop has even started selling medicinal mushroom elixirs. But before you go playing doctor and dabbling with these natural herbs and potions, there are a few things you should know. I enlisted the help of  Elizabeth Trattner, A.P., L.Ac., Dipl. Ac., NCCAOM, a doctor of Chinese and integrative medicine. Consider this your primer on what to know before adding medicinal herbs and mushrooms into your wellness routine.

“Natural” is still potent, and can interact with your other medications

Good news: Medicinal herbs and mushrooms can be really beneficial natural remedies. Bad news: “Just because it is natural doesn’t mean it is open season taking it without a risk,” Dr. Trattner says. It’s like we see them as less dangerous than prescriptions, yet we expect them to do the job of mainstream medication. (Cough, CBD, cough.)

While Dr. Trattner says that herbal medicine might not be as strong as Western prescription medication, it’s still effective—and thus should be taken seriously. “In fact, some medication we use today [once] was in the form of plants.”

Plus, your body processes both herbs and drugs through your liver, Dr. Trattner says. The CYP450 enzymes in this metabolic pathway help your body break down substances like medications (herbal and big pharma alike)—and the rate at which they are metabolized determines how long those medications will be active in your body.

“Supplements, plant medicine, and herbs are a multibillion dollar industry, but just because it is natural doesn’t mean it is safe.” —Elizabeth Trattner, A.P., L.Ac., ACCAOM

This matters because if you’re taking herbs on top of prescription meds, you can run into some gnarly side effects. “Herbs and drugs can potentiate each other,” Dr. Trattner says, meaning that they can combine to be even more powerful. She says this can do things like make blood pressure too low, thin blood, and change blood sugar.

She says if you are taking any medication—either prescription or over-the-counter—you should speak to your primary care physician and/or your pharmacist about medicinal herb and mushroom interactions. “St. John’s Wort can affect the metabolism of certain medication, and so can caffeine,” Dr. Trattner says. For a list of herbs that interact with medications, she points here and here.

In the case of mushrooms, you want to watch out for allergic reactions and a changing of the immune system, “especially if you’re on any type of immunomodulatory medication,” she says. “Mycelium [mushrooms] have a potent effect on the immune system,” she says, so people who are allergic or under cancer or rheumatologic treatment should be very cautious when using them.

“Supplements, plant medicine, and herbs are a multibillion dollar industry, but just because it is natural doesn’t mean it is safe,” Dr. Trattner says—at least, not for everyone at all times in their lives.

Yeah, you should probably consult an expert

Even if you’re not taking any medications, Dr. Trattner says you want to proceed with caution when trying herbs and mushrooms. “I cannot tell you how many times I have patients coming in with half a health food store of supplements that are making their symptoms worse,” she says.

Dr. Trattner says that if you’re going to DIY with herbs, only take one at a time, and only for short-term use. If you want to take multiple herbs or mushrooms, or go on something long-term, she says to consult an herbalist. Find a doctor of Chinese medicine, a naturopath, or a licensed herbalist. “Our job is to know herbal medicine and how to use it safely,” she says, so they can help with a diagnosis and a treatment plan. (And again, can’t say this enough: If you are on any prescription meds, talk to your doctor or pharmacist first.)

There are a lot of supplements out there, and some of them are better than others

You know how when you walk into the supplements aisle at Whole Foods, you’re greeted with a bajillion options to choose from? There’s a reason for that. The supplement industry has grown exponentially since the Dietary Supplement Health Education Act (DSHEA) passed in 1994, Dr. Trattner says. “The marketplace has grown from roughly 4,000 products to more than 40,000,” she explains. So, naturally, it can be tough to navigate. (I can’t even decide what shoes to buy from the Net-a-Porter sale and I’m not even ingesting those.)

Working with an herbalist also allows the expert to recommend brands (and herbs and mushroom varieties themselves) that truly deliver on their promises. “Most people do not realize what goes into making a quality supplement and how to correctly label, source, and produce it,” Dr. Trattner says.

While there are many companies that have merit, Dr. Trattner cautions that sometimes claims are made that may not be justified. “Right now there are thousands of studies on botanicals, and although there are many amazing benefits from using gifts from nature, readers need to proceed with caution and be educated consumers.”

Concerns about quality are also an issue, she explains, due to reports about contaminated products and variations between what is printed on the bottle and what is actually present in the bottle. “Whenever possible, cultivation under standardized and controlled conditions is desirable. Good agricultural and collection practices for medicinal plants (including food) are therefore the first step in quality assurance, directly impacting both the safety and efficacy of the final product,” she explains. So basically, you want a supplement that started out as a quality raw product.

“It seems like the world has taken eating well into pop culture and eating healthy is glamorous and hip. Mind you, I think it is a great way to raise awareness, but consumers need to be educated on the proper way to take supplements, read labels correctly, and moreover how to buy ones that are safe,” Dr. Trattner says.

Using herbs and mushrooms as an alternative, natural remedy is totally legitimate—and can be majorly beneficial for many people. However, just like you can’t just prescribe yourself antibiotics or pain meds, you shouldn’t just start taking herbs without some kind of expert help. “Herbalism is a very intense practice of medicine that takes years of study to understand how ingredients interact with each other,” Dr. Trattner says. It’s like when you try to diagnose yourself on WebMD without consulting an actual doctor—and we all know how well that usually turns out.

Now, get primed on all things Ayurvedic herbs (and, yes, you should still consult an expert before you use these as well). Also, your adaptogen habit could be harming the environment.