As hypertension, or high blood pressure, remains a major risk factor for strokes, heart attacks, and other life-altering conditions, medical experts are urging those living with hypertension to pay closer attention not just to diet and lifestyle, but also to the supplements they might be taking. A new analysis published by nutrition and cardiology professionals highlights five common supplements—bitter orange, licorice root, caffeine-containing products, yohimbine, and ephedra—that could spell danger for individuals struggling to keep their blood pressure under control, a finding especially important to Thailand where herbal remedies are deeply ingrained in the culture (EatingWell).
Supplements are often seen as a way to support heart health, but the line between healing and harm can be thin. The warnings from this expert-backed report cut through common misconceptions, revealing that several popular, naturally derived ingredients possess stimulant properties or interfere with the body’s fluid balance, thus elevating blood pressure to dangerous levels.
Bitter orange tops the list. Marketed largely for weight loss and enhancing athletic performance, its extract contains synephrine, which “can raise blood pressure and trigger dangerous heart rhythms,” according to one cited cardiologist. The risk is measurable—a systematic review found that prolonged use of bitter orange may increase systolic blood pressure by 6 mmHg and diastolic by 4 mmHg. Such increases, even if incremental, have been tied to heightened likelihood of heart attacks and strokes.
Licorice root is familiar to many Thais both as a medicinal herb and a flavouring agent in sweets and traditional remedies. Yet licorice contains glycyrrhizic acid, a compound that promotes sodium retention and can significantly raise blood pressure if consumed regularly. One study referenced in the report found that even low doses containing 100 milligrams of glycyrrhizic acid significantly increased blood pressure. Moreover, licorice can lead to potassium depletion, risking muscle weakness and heart rhythm disturbances. Notably, supplement labels are not always accurate, with some tested products containing up to 50% more active compound than stated.
Caffeine, ubiquitously consumed in tea, coffee and increasingly trendy energy drinks, is also widely present in supplements designed for increased alertness or athletic prowess. Experts warn that even low doses of caffeine can result in systolic and diastolic increases of around 2 mmHg—a seemingly slight but significant boost for those whose cardiovascular health is fragile. Guarana, a caffeine-rich Amazonian seed, is an ingredient to watch for, as its stimulant effects mirror or exceed those of caffeine.
Yohimbine, derived from the bark of the yohimbe tree, is commonly found in products marketed to improve sexual function, physical performance, or even paradoxically, blood pressure. However, experts confirm that yohimbine is a potent stimulant, raising levels of norepinephrine, which in turn constricts blood vessels and heightens both heart rate and pressure—a dangerous combination for hypertensive individuals.
Ephedra, known in some Asian traditions for its role in treating colds and headaches, is perhaps the most notorious among these supplements. Although the US Food and Drug Administration has banned its use in dietary supplements due to its association with heart attacks, stroke, and sudden death, ephedra’s active chemicals, particularly ephedrine, remain in use in some pharmaceutical products such as asthma medications. As such, experts strongly urge individuals to consult healthcare professionals before taking any supplement or medication containing ephedra derivatives, particularly given the risk of dangerous interactions with prescribed blood pressure-lowering drugs.
This evidence-based warning carries powerful implications for Thailand, where both traditional herbal preparations and over-the-counter supplements play a significant role in health management, especially among elderly and rural populations, according to surveys by the Thai Ministry of Public Health (source). In urban centers like Bangkok and Chiang Mai, increased access to imported supplements adds complexity—consumers may be drawn to Western dietary supplements without realizing that certain “natural” components can aggravate chronic health conditions such as hypertension.
It’s crucial to note that the underlying condition—hypertension—rarely presents early symptoms, hence its moniker “the silent killer.” Studies indicate that roughly one-third of the adult Thai population is affected, yet less than half are aware of their condition (Wikipedia). Traditional Thai diets high in salt, along with increasing rates of obesity and physical inactivity, compound the problem. Thus, for Thai consumers who might complement Western medicine with traditional remedies or supplements, expert oversight is essential.
Analysis across various reputable sources, such as the Mayo Clinic and Verywell Health (Mayo Clinic, Verywell Health), echoes similar warnings. Arnica, Panax ginseng, and guarana—all present in herbal or energy tonics—are repeatedly associated with increased blood pressure. Even though these products are not outlawed in Thailand, a lack of stringent regulation means that supplement contents can deviate significantly from their labels, further complicating safe usage.
For those diagnosed with hypertension, lifestyle modifications remain the safest, most proven method of managing blood pressure. Medical consensus, as outlined by the American Heart Association and mirrored in Thailand’s health guidelines, recommends adhering to the DASH diet (rich in fruits, vegetables, whole grains, and low in added salt and fats), engaging in regular aerobic and strength exercise, maintaining a healthy weight, prioritizing restful sleep, and practicing stress management techniques.
Specific action for Thai readers includes discussing all supplement use—herbal or synthetic—with their healthcare provider, especially for anyone prescribed anti-hypertensive medications. The intersection of folk remedies, modern medicine, and over-the-counter supplements is a space where interactions may occur, sometimes with life-threatening consequences.
With hypertension rates rising in Thailand, driven by urbanization and dietary shifts, awareness campaigns on the risks associated with these five supplements are urgently needed. Policy measures to better regulate supplement content and labeling, coupled with increased education for consumers, could help mitigate risks. As dietary supplements are classified differently from pharmaceutical drugs in Thailand, many products bypass rigorous safety checks.
Looking ahead, mounting research signals that personalization of both pharmaceutical and supplement regimens—guided by genetic, dietary, and lifestyle factors—could yield the best health outcomes for Thai patients. As the country modernizes amid an aging population, striking a balance between tradition, convenience, and science will be key.
For now, experts offer clear, actionable guidance: “Read labels carefully, prioritize whole food-based nutrition, and consult your physician whenever considering a new supplement, especially if you have hypertension.”
References:
- 5 Supplements to Avoid If You Have High Blood Pressure, According to Experts – EatingWell
- Supplements and high blood pressure – Wikipedia
- Medications and supplements that can raise your blood pressure – Mayo Clinic
- 8 Vitamins and Herbs to Avoid if You Have High Blood Pressure – Verywell Health
- Dietary supplement prevalence in Thailand – PMC