Herbal and Supplemental Treatments Contraindicated in Children

Strongly Contraindicated Herbal Supplements

The FDA banned ephedra-containing supplements after the herb was linked to serious cardiovascular side effects, including 15 deaths among young people in the US 1
High-dose ephedrine use causes nervousness, anxiety, tachycardia, hypertension, and seizures 1
Kava should be held for 2 weeks before any surgical procedure and avoided in children due to excessive sedation risk when combined with anesthetics, benzodiazepines, and opiates 2
St. John's wort is contraindicated when used with SSRIs or MAOIs due to serotonin syndrome risk, and it significantly reduces effectiveness of multiple critical medications including oral contraceptives, immunosuppressants, and anticoagulants 3
St. John's wort must be discontinued at least 2 weeks before surgical procedures due to multiple drug interactions 2, 3

The American College of Rheumatology conditionally recommends against using supplemental or herbal interventions specifically to treat juvenile idiopathic arthritis (JIA) due to safety concerns about unregulated supplements and lack of efficacy data in children 4, 5, 6
The American Academy of Otolaryngology found significant serious adverse effects of unconventional therapies for children, most associated with inadequately regulated herbal medicines 7, 8
Herbal products lack governmental oversight for quality or purity and may alter blood levels of conventional medications, including anticoagulants 7, 8
For children with type 2 diabetes, the American Academy of Pediatrics recommends against CAM dietary supplements due to lack of product standardization, FDA regulation, and potential adverse effects 9
Adverse effects from dietary supplements in children include gastrointestinal discomfort, hypoglycemia, favism, insomnia, and increased blood pressure 9

Lack of FDA regulation means no standardization of content or potency between products 3
Herbal products may alter blood levels of conventional medications, creating unpredictable and potentially dangerous interactions 7, 8

Physicians should actively question patients and families about herbal supplement use during every medical history, educate about potential adverse effects, and discourage use of potentially dangerous or ineffective products 9
Parents reporting CAM use are more likely to struggle with adherence to conventional medicine 9
All herbal supplement use must be disclosed to healthcare providers before starting new medications or undergoing procedures 3