Is a supplement containing garlic root extract, propolis extract, Echinacea (Echinacea) purpurea extract, elderberry fruit extract, and aromatic Solomon's seal rhizome safe to use during pregnancy?

Safety of Herbal Supplement During Pregnancy

This supplement containing garlic root extract, propolis extract, Echinacea purpurea extract, elderberry fruit extract, and aromatic Solomon's seal rhizome should NOT be used during pregnancy due to insufficient safety data and lack of evidence supporting efficacy for any pregnancy-related condition. 1, 2

Evidence-Based Rationale

Lack of Safety Data

• No rigorous scientific studies exist demonstrating the safety of these specific herbal supplements during pregnancy, and the Teratology Society has explicitly stated that it should not be assumed they are safe for the embryo or fetus 1
• Healthcare providers should advise women not to expose their fetuses to the risks of herbal medicines given the absence of controlled safety data 1
• None of the individual components in this supplement have been adequately studied in pregnancy, with no clinical trials identified for most ingredients 2

Individual Component Analysis

Echinacea purpurea:

• One small prospective human study found no increase in major malformations, but this single study is insufficient to conclude safety in pregnancy 2
• Only two small animal studies exist, providing inadequate evidence for safety recommendations 2
• Efficacy for upper respiratory tract infections is dubious, with equal numbers of high-quality studies showing positive and negative results despite over 2000 persons studied 2
• Insufficient evidence exists regarding both efficacy and safety in pregnancy 3, 4

Elderberry fruit extract:

• No animal or human studies of safety in pregnancy have been identified 2
• While three clinical trials showed efficacy against influenza, only 77 persons total received treatment, and none were pregnant women 2
• One case report documented mild gastrointestinal discomfort in a pregnant patient using elderberry 5
• Due to complete lack of safety evidence, healthcare personnel should not advise pregnant women to use elderberry 2

Garlic root extract:

• Insufficient evidence exists regarding both efficacy and safety in pregnancy 3, 4
• No specific pregnancy safety studies have been conducted 4

Propolis extract:

• No pregnancy-specific safety or efficacy data identified in the medical literature
• Lacks any evidence base for use during pregnancy

Aromatic Solomon's seal rhizome:

• No pregnancy-specific safety or efficacy data identified in the medical literature
• Complete absence of evidence for use during pregnancy

Critical Safety Concerns

Quality Control Issues

• Herbal medicines have poor quality control, and the active ingredients are chemicals similar to those in purified medications with the same potential to cause serious adverse effects 1
• These products are not subject to the same rigorous testing as pharmaceutical medications 1

Misconception of Safety

• The public and some healthcare providers regard herbal medicines as "gentle and safe," but there is no scientific basis for that belief 1
• Pregnant women frequently do not consult physicians about herbal medicine use, despite easy access to these products 4

Recommended Alternatives

Evidence-Based Pregnancy Supplementation

Instead of unproven herbal supplements, pregnant women should use:

• Prenatal multivitamin containing: folic acid (0.4-5 mg depending on BMI), iron (30-60 mg), vitamin D (≥1000 IU), calcium (1200-1500 mg), vitamin B12, zinc (15 mg), copper (2 mg), selenium (50 μg) 6, 7, 8
• Ginger (below 1000 mg/day) is the only herbal remedy with consistent evidence for safety and efficacy in pregnancy, specifically for nausea and vomiting 3, 4
• Vitamin A should only be in beta-carotene form (5000 IU), never retinol form due to teratogenicity risk 6, 9

For Upper Respiratory Infections

• No herbal supplements have proven efficacy and safety for URTIs in pregnancy 2
• Supportive care and consultation with obstetric provider for appropriate pharmaceutical options when needed

Clinical Pitfalls to Avoid

• Do not assume "natural" equals "safe" - herbal products contain active chemicals with potential for harm 1
• Do not recommend herbal supplements based on traditional use without scientific evidence of safety in pregnancy 2
• Do not use multiple herbal ingredients in combination, as this further complicates safety assessment and increases risk of adverse interactions 1
• Avoid all herbal products in the first trimester when organogenesis occurs and teratogenic risk is highest 9, 1