With almost 12% of the U.S. population having diabetes, so many of us are looking for ways to manage our blood sugar. Natural alternatives like herbal supplements may be among the strategies people consider.

But while certain foods and spices can be helpful for diabetes, it’s important to approach herbal supplements with caution. One common assumption is that because something is “natural” it’s good for you, but supplements can come with safety risks, especially when used to treat diabetes.  

How so? “Herbal supplements can interact with diabetes medications and lead to hypoglycemia, which can cause dizziness, fatigue and even a loss of consciousness,” says Whitney Stuart, M.S., RDN, a certified diabetes care and education specialist and founder of Whitness Nutrition. For your health and safety, it’s important to know about the herbal supplements experts say you shouldn’t take if you have diabetes. Learn about the four that made this list.

Herbal Supplements Not Recommended for Diabetes

1. St. John’s Wort

Having diabetes increases the risk of having depression by 2- to 3-fold. That’s where someone might turn to St. John’s wort, an herb that’s often used to treat depression and other mood disorders. However, it can interfere with certain diabetes medications, reducing their efficacy and potentially leading to poor blood sugar control. Additionally, St. John’s wort may cause fluctuations in blood glucose levels, making it harder to manage diabetes effectively. One small study showed that taking this herbal supplement impaired glucose tolerance (a measure of how well your body can process glucose). Given the higher risk of depression that those with type 2 diabetes face, it’s important to talk to your doctor about any mood concerns you have, so they can help guide you toward the right treatment for you.

2. Ginseng

Ginseng is one of the most popular herbs taken in the U.S. But it doesn’t play nice with diabetes. “One herbal supplement that could be dangerous to take if you have diabetes is ginseng, as it may contribute to lower blood sugar levels and therefore interact with diabetes medications,” says Mascha Davis, M.P.H., RDN, author of Eat Your Vitamins. Some research suggests that ginseng may lower blood glucose, which could raise your risk for hypoglycemia, especially if you manage your blood sugar with medication.

3. Aloe Vera

While often praised for its topical skin-soothing properties, aloe vera can have significant side effects when ingested, particularly for those with diabetes. Some research indicates that oral consumption of aloe vera can lower blood sugar levels, which may result in hypoglycemia if combined with diabetes medications. Furthermore, the lack of standardization in aloe vera supplements can mean that contents and dosages of these supplements can vary widely, resulting in unpredictable impacts on blood glucose control. If you have diabetes, talk to your health care provider first before taking aloe vera.

4. Berberine

Berberine is a natural compound that has been used in traditional medicine for centuries, particularly in Chinese and Ayurvedic practices. While popular, “berberine should be avoided by individuals with diabetes on medication such as insulin or metformin because of its ability to lower blood sugar and cause hypoglycemia,” Stuart says.

The supplement can also interact with a variety of drugs, posing additional risks if you take multiple medications for diabetes or other health conditions. As with other supplements, the quality and concentration of berberine products on the market can be highly inconsistent. For these reasons, if you have diabetes, talk to your doctor before trying berberine.

Alternative Approaches to Manage Diabetes

For those focused on managing diabetes, here are some ways to do so safely and effectively:

• Make dietary changes: Incorporating a balanced diet rich in whole grains, lean proteins, healthy fats and plenty of fruits and vegetables may help manage blood glucose levels. These Meal Plans for Diabetes are a great place to start.
• Stay active: Regular exercise, such as walking, swimming or yoga, can improve insulin sensitivity and aid in healthy weight management.
• Relieve stress: Techniques such as meditation, deep-breathing exercises and mindfulness may reduce stress, which is known to affect blood sugar levels.
• Monitor blood glucose: Regularly checking blood sugar levels can help individuals make informed decisions about their diet, exercise and medication.
• Seek out education and support groups: Participating in diabetes education programs and support groups can provide valuable information and support from others who are managing the condition right along with you.
• Stick to your medication: Taking medications as prescribed and discussing any side effects or concerns with health care providers can ensure effective management of diabetes.

The Bottom Line

While herbal supplements are often dubbed “natural,” that doesn’t mean they’re always safe. If you have diabetes, approach herbal supplements with caution. Certain herbs can interfere with blood sugar levels and diabetes medications, leading to potentially serious health complications. Because supplement companies are responsible for putting out safe and accurately labeled products, it’s up to you to take a few precautions to stay safe. “If you choose to supplement, be sure to speak with your provider who can educate you on drug interactions and recommend a third-party tested product,” says Davis.