Gut Supplement Safety and Interactions
"Natural" does not mean risk-free. Supplements can interact with some medicines, some can raise bleeding risk or change your response to anesthesia before surgery, and many have not been well tested in pregnancy.[NIH Office of Dietary Supplements] Unlike medicines, supplements do not need FDA approval before they are sold.[NIH Office of Dietary Supplements]
Supplements with notable cautions
- Berberine: can interact with many medicines and can lower blood sugar; not for use in pregnancy, breastfeeding or infants.[NCCIH]
- Magnesium (citrate, oxide): NIH upper limit 350 mg a day from supplements for adults; higher risk with kidney disease; can reduce absorption of some antibiotics and bisphosphonates.[NIH Office of Dietary Supplements]
- Garlic extracts (Allicin (Allimed / Allimax)): may increase bleeding risk and interact with some medicines.[NCCIH]
- Licorice: glycyrrhizin in regular licorice root has been linked to serious effects such as irregular heartbeat, especially with large or long-term use and in people with high blood pressure or heart or kidney conditions; deglycyrrhizinated (DGL) products might be safe for up to 4 months.[NCCIH] See DGL licorice.
- Activated charcoal: binds many substances, so ask a pharmacist how far apart to take it from medicines.
- Peppermint oil capsules: can cause heartburn, nausea and dry mouth.[NCCIH]
- Probiotics: may not be safe for people who are very ill or have a poorly functioning immune system.[NCCIH]
- Psyllium: take with at least 8 ounces of liquid; space some medicines 3 hours apart.[MedlinePlus]
Herbal antimicrobial protocols
Herbal protocols discussed in r/SIBO (for example Allicin (Allimed / Allimax), Oregano oil, Berberine and Candibactin-AR / BR) combine concentrated products. Evidence is limited,[PubMed] and these should be used only with a clinician who knows your full medication list.
You can also compare all rated IBS supplements on one page. New to this? Start with how to choose a gut supplement. Our gut supplement shortlists group top-rated options by what people report.