Being natural products, individuals wrongly believe they are always safe. Others fear that health care professionals may have negative attitudes towards their use and do not report using such remedies to avoid confrontations.
Although local drinks, dietary, herbal and multi-vitamin supplements seem harmless, some can be potentially dangerous, especially since they contain potent chemical substances that can interact with food or alcohol.
Here are commonly used herbs that may pose a risk to diabetes medicines:
- Herbal bitters
Eating bitters regularly has been shown to curb sugar cravings; soothe gas and bloating, improve digestion, help maintain healthy blood sugar levels and balance appetite.
However, experts’ assessment of an herbal bitter indicate that it could pose a risk to persons with diabetes taking metformin, the first-line medication for the treatment of type 2 diabetes, particularly in people who are overweight.
Researchers found that although herbal bitters exert blood glucose-lowering activity, when given concomitantly with metformin, it results in the reduction in the blood sugar lowering effect of metformin.
In rat models, experts found the constituents of certain bitters displacing metformin, causing a reduction in its blood sugar lowering (hypoglycaemic) activity and reduction in the duration of action of the metformin.
The researchers suggested in the 2017 edition of Tropical Journal of Pharmaceutical Research that Aloe vera, which is a constituent of certain bitters, may be responsible for the reduction in the effectiveness of metformin.
The researchers included Matthew I Arhewoh, Sylvester O Eraga, Jonah Irabor and Magnus A Iwuagwu, all from the Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, University of Benin.
- Okra
Okra, scientifically known as Abelmoschus esculentus, has long been favoured as a food for the health-conscious. Much more, medical research suggests that okra boost skin health, protect infant health, prevent certain cancers and strengthen bones. It also lowers total cholesterol levels, aids the immune system and lowers blood pressure.
But experts warn against eating okra or taking its water extract at the same time as metformin, saying that this can cause a reduction in absorption of this prescription drug in the intestine of a diabetes patient, thus making it less effective in blood sugar control.
Researchers in 2011 stated in International Scholarly Research Network that although okra may improve blood sugar control, it should not be taken concurrently with metformin hydrochloride in controlling diabetes mellitus.
- Mango leaves
Mango leaves—particularly their extract—have been used to treat asthma and diabetes for centuries. For one, the extract can improve insulin production and distribution of glucose. It also lowers bad cholesterol. Nonetheless, mango leaves have the potential to interact with almost all types of prescription drugs for blood sugar control in diabetes.
- Moringa oleifera
Moringa oleifera, also known as horseradish tree or drumstick tree has been used for generations to treat and prevent diseases such as diabetes, heart disease, anaemia, arthritis, liver disease, and respiratory, skin, and digestive problems.
Moringa might lower blood sugar just as diabetes medications. But taking moringa along with diabetes medications might cause the blood sugar to go too low. So, the dose of diabetes medication might need to be changed.
Researchers in the 2016 Journal of Ethnopharmacology had also indicated that its concurrent use with prescription drugs such as Sitagliptin can compromise blood sugar level control with negative consequence in diabetic retinopathy.
- Garlic
Some supplements and herbs lower the blood sugar and can make it drop too low when taking metformin. Herbs and supplements in this category include chromium, ginseng, magnesium, vanadium, aloe, bitter melon, bilberry, dandelion, fenugreek, garlic, gymnema, lipoic acid and carmitine.
St. John’s wort and Dong quai can increase the sun sensitivity caused by metformin. Guar gum can interfere with the medication’s absorption, and gingko biloba combined with metformin made glucose tolerance worse in patients — their blood sugars remained higher with the combination.
- Ginger
For thousands of years, people have been using ginger as a natural remedy for various conditions, including nausea, motion sickness, menstrual pain and joint pain associated with osteoarthritis. Some studies also indicate that fresh ginger protects against cancer.
Last but not least, ginger lowers blood sugar. If taken with metformin or other medicines for diabetes, it can lead to life-threatening hypoglycemia.
Hypoglycemia is dangerous because the individual may faint and die without urgent medical help. Its symptoms include shakiness, sweating, hunger, difficulty thinking clearly, dizziness, difficulty talking or loss of consciousness.
- Neem
Research suggests that neem extracts reduce plaque or gingivitis, protect against insect bites, treats malaria and other diseases.
Nonetheless, if taking diabetes medications (including both oral diabetes medications and insulin) in combination with neem, drug interactions could occur. These interactions may increase the risk of low blood sugar.
In 2015, researchers in World Journal of Pharmacy and Pharmaceutical Sciences said that co-administration of neem leaf extract with two diabetes medicines (glibenclamide and glimepiride) may adversely affect treatment outcome especially with prolonged administration of the herb and this may impair patient’s safety.
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