Herbal and Dietary Self-Care Products: Safety, Interactions, and the Evidence Gap

Herbal medicines, dietary supplements, and other over the counter (OTC) products are widely used by the public to manage health conditions ranging from minor ailments (e.g. common cold and allergies) to chronic conditions (e.g. pain, diabetes, and cardiovascular disease), often alongside, or instead of, conventional treatments. Studies consistently show that patients rarely disclose this use to their healthcare professionals; thus, the resulting knowledge gap leaves both clinicians and patients exposed to preventable risk. Recent scoping reviews mapping the evidence base for these products have found that although a small number of products carry promising efficacy evidence, safety reporting across trials remains inconsistent and underprioritised. Herb-drug interactions with prescribed medications are particularly poorly characterized, despite their potential clinical significance for patients combining self-care products with conventional treatment.At the same time, the mechanistic basis for many of these interactions (i.e. pharmacokinetic, pharmacodynamic, and phytochemical) is often only partially understood, limiting clinicians’ ability to counsel patients confidently. Bridging clinical and epidemiological evidence with mechanistic and phytochemical research is needed to move this field from descriptive mapping toward practical guidance grounded in evidence. The aim of this Research Topic is to consolidate clinical, epidemiological, and mechanistic evidence on the safety of herbal and dietary self-care products into a single, citable evidence base, closing the safety-reporting gap identified across existing scoping reviews and pairing clinical evidence with the mechanistic and phytochemical research needed to explain it.We welcome original research, systematic and scoping reviews, mechanistic and pharmacokinetic studies, and practitioner- or patient-facing perspectives addressing:• Herb-drug and supplement-drug interactions between OTC products (e.g., St John’s Wort, kava, saffron, valerian, omega-3s, probiotics) and prescribed medications, including pharmacokinetic and pharmacodynamic mechanisms • Original research and reviews addressing safety-reporting gaps identified in existing scoping reviews of OTC herbal and dietary products • Phytochemical and bioactive-compound mechanisms underlying efficacy and/or adverse interaction risk of herbal and dietary self-care products • Quality control, authentication, and chemical characterization of herbal products as a basis for safety and reproducibility • Patient and practitioner perspectives on self-managing health conditions with herbal and dietary products alongside conventional care, including disclosure behavior and risk communication • Pharmacy and primary-care practice approaches to identifying, counseling on, and monitoring concurrent use of self-care products and prescribed medication • Regulatory and public-health perspectives on OTC herbal product safety standardsPlease note: All submissions should self-assess using the ConPhyMP tool and comply with the standards set out in the ConPhyMP statement (Front. Pharmacol. 13:953205): https://ga-online.org/best-practice/. Submissions must fully comply with the Four Pillars of Best Practice in Ethnopharmacology (full text): https://www.frontiersin.org/files/pdf/4_pillars_FULL_TEXT.pdf. Clinical trial submissions will be considered for review only if randomized, double-blinded, and placebo-controlled. Statistical power analysis or justification of sample size is mandatory, as is detailed chemical characterization of the study product (per the ConPhyMP statement).Ultimately, this collection aims to clarify product by product, where the safety evidence is strong, where it is promising but incomplete, and where meaningful risk remains uncharacterized. In practice, this should give pharmacists, GPs, and other healthcare practitioners citable guidance grounded in evidence for counseling patients who combine OTC self-care products with prescribed medication, shifting the field from fragmented, descriptive mapping toward guidance that reduces undisclosed concurrent use and improves patient safety outcomes. Topic editors: Sukvinder Kaur Bhamra, Dr Prithviraj Karak Source: https://www.frontiersin.org/research-topics/83642/herbal-and-dietary-self-care-products-safety-interactions-and-the-evidence-gap