Botanical & Herbal Medicine: An Evidence-Informed Approach to Medicinal Plants and Mushrooms

Plants have been used medicinally for thousands of years. Today, botanical medicine combines this long history of plant-based medicine with modern research and clinical assessment to determine when a botanical may be appropriate—and when it may not be.

You may have heard botanical medicine referred to as herbal medicine, herbal therapy, or plant-based medicine. While these terms are sometimes used interchangeably, botanical medicine encompasses much more than simply drinking an herbal tea or taking an over-the-counter supplement.

In naturopathic medicine, botanical therapies can be used as one component of an individualized treatment plan. Depending on the botanical and the reason it is being used, they may be considered to support areas such as digestion, sleep, stress, metabolic health, immune function, or treatment-related symptoms.

Importantly, natural does not automatically mean safe or appropriate for everyone. Botanicals can have meaningful physiological effects and can interact with medications and other supplements. The goal is therefore not to use as many herbs as possible, but to select the right botanical, in the right form and dose, for the right person.

What is botanical medicine?

Botanical medicine is the therapeutic use of plants and plant-derived substances to support health and address specific health concerns.

Botanicals can be prepared in many different ways, including:

• Teas and infusions

• Tinctures

• Capsules and tablets

• Powders

• Liquid extracts

• Topical preparations

The preparation matters. Different extraction methods can change which compounds are present and how concentrated they are.

This is one reason why two products that both contain the same plant may not necessarily have the same effects.

Botanical medicine is also not simply about choosing an herb based on a symptom. A botanical may have different effects depending on the dose, preparation, duration of use, the person's health history, and other medications or supplements they are taking.

How does botanical medicine fit into naturopathic care?

Botanical medicine is one of several tools that may be used within naturopathic medicine.

Rather than starting with a particular herb and trying to find a reason to use it, an individualized approach starts with the person.

This may involve considering:

• Your symptoms and health concerns

• Your medical history

• Current medications and supplements

• Relevant laboratory testing

• Your diet and lifestyle

• Your treatment goals

• Potential contraindications or interactions

• The evidence supporting a particular botanical

The result may be a botanical recommendation, but it may also be that a botanical isn't the most appropriate intervention.

Sometimes the best botanical recommendation is no botanical at all.

What can botanical medicine be used for?

Botanicals have been studied for a wide range of health concerns.

Depending on the specific botanical and the individual, botanical medicine may be incorporated into care for areas such as:

Digestive health

Some botanicals have traditionally and clinically been used to support digestive symptoms such as nausea, indigestion, cramping, or changes in bowel function.

For example, ginger has been studied for nausea and may be useful in certain situations, including some forms of treatment-related nausea.

Peppermint oil has also been studied for symptoms associated with irritable bowel syndrome, although it is not appropriate for everyone—for example, it may worsen reflux in some people.

Sleep and stress

Certain botanicals have been studied for sleep, stress, and related concerns.

Chamomile is commonly used as a calming botanical and has a long history of traditional use.

Ashwagandha has also been studied for stress and sleep, although it can have clinically relevant effects and is not appropriate for everyone.

These examples highlight why botanical medicine should be individualized. A botanical that may be appropriate for one person may be inappropriate for another based on their medications, medical conditions, or treatment goals.

Metabolic health

Some botanicals are being studied for their potential effects on glucose metabolism, insulin sensitivity, lipids, and other aspects of metabolic health.

Berberine, a compound found in several plants, is one example that has received significant research attention for metabolic health.

However, berberine is not simply a "natural alternative" to medication. It can have physiological effects and may interact with medications, making individualized assessment important.

Inflammation and other areas of health

Turmeric and its constituent curcumin have been widely studied for their potential effects on inflammatory pathways.

While research is promising in some areas, evidence varies depending on the condition, formulation, and dose. The fact that a botanical affects a biological pathway does not automatically mean that taking it will produce a meaningful clinical benefit.

This distinction between mechanistic research and demonstrated clinical benefit is important when evaluating herbal medicine.

What about botanical medicine during cancer treatment?

Botanical medicine can sometimes be incorporated into integrative oncology care, but this is an area where careful assessment is particularly important.

People undergoing cancer treatment may be interested in botanicals to support symptoms such as nausea, digestive concerns, sleep difficulties, stress, or other aspects of quality of life.

Some botanicals have been studied in these contexts. For example, ginger has evidence supporting its use for certain types of nausea, including nausea associated with cancer treatment.

However, botanicals can also interact with cancer medications.

A plant compound may affect drug-metabolizing enzymes, transport proteins, blood clotting, immune function, or other physiological pathways. These interactions may potentially alter the effects of medications or treatments.

This means that a botanical that is generally considered safe for a healthy person may not be appropriate during chemotherapy, targeted therapy, immunotherapy, radiation, surgery, or other cancer treatment.

"Natural" does not mean "interaction-free."

For patients receiving cancer treatment, I therefore consider the specific botanical, dose, formulation, treatment regimen, timing, and available evidence before recommending it.

Botanical medicine should complement—not replace—conventional cancer treatment.

What are some examples of medicinal botanicals?

Here are a few examples of botanicals you may encounter in clinical practice:

Botanical	Common areas of interest	Important considerations
Ginger	Nausea, digestive support	Can affect bleeding risk at higher doses; individual assessment is important
Peppermint	Digestive symptoms, IBS	May worsen reflux in some people
Chamomile	Relaxation, sleep, digestive support	Potential allergy and medication considerations
Ashwagandha	Stress, sleep	Can affect thyroid function and may not be appropriate in certain conditions
Berberine	Blood glucose and metabolic health	Can interact with medications and affect glucose metabolism
Curcumin/turmeric	Inflammatory conditions	Evidence varies by condition and formulation; potential medication interactions

These are only examples. The appropriate botanical—and whether a botanical is appropriate at all—depends on the individual and the clinical goal.

What about medicinal mushrooms?

Medicinal mushrooms are another area of growing interest in natural and integrative medicine, particularly in cancer research.

Unlike medicinal herbs, mushrooms are fungi rather than plants. However, medicinal mushrooms are often discussed alongside botanical medicine because they are used in many of the same clinical and traditional medicine contexts.

Several mushrooms have been investigated for their potential effects on immune function and other biological pathways, including:

• Turkey tail (Trametes versicolor)

• Reishi (Ganoderma lucidum)

• Maitake (Grifola frondosa)

• Shiitake (Lentinula edodes)

• Cordyceps species

Research into medicinal mushrooms has explored areas including immune function, inflammation, and cancer care. Some mushroom-derived compounds have been studied alongside conventional cancer treatments, and certain mushroom preparations have been investigated in clinical trials.

However, it is important to distinguish research into a mushroom or one of its isolated compounds from evidence that a particular mushroom supplement will provide a clinical benefit.

The type of mushroom, part used, extraction method, concentration of active compounds, dose, and quality of the product can all influence its effects. Research findings from one preparation cannot necessarily be applied to every mushroom supplement available commercially.

Medicinal mushrooms and cancer care

Medicinal mushrooms are of particular interest in integrative oncology research. For example, turkey tail has been investigated in clinical research involving cancer patients, while maitake has been studied for its potential effects on immune function.

These areas of research are promising, but the evidence is still developing, and medicinal mushrooms should not be considered a replacement for conventional cancer treatment.

For someone undergoing cancer treatment, the question is not simply whether a mushroom has been studied in cancer. It is important to consider which mushroom, which preparation, what dose, when it is being used, and alongside which cancer treatment.

This is particularly important because mushrooms and mushroom-derived compounds can have biological effects and may interact with medications or influence immune function and other physiological pathways.

As with other supplements, medicinal mushrooms should therefore be considered as part of an individualized treatment plan rather than assumed to be appropriate simply because they are natural.

Why does the form of an herb matter?

One of the most overlooked aspects of botanical medicine is that the plant itself isn't the whole story.

The clinical effects of a botanical can depend on:

• Which part of the plant is used

• How it was extracted

• The concentration of active constituents

• The dose

• The formulation

• The quality and sourcing of the product

• How long it is taken

For example, a tea made from a plant and a concentrated standardized extract may have very different pharmacological effects.

This is one reason I don't recommend choosing botanical products based solely on the name of the herb or the claims on the front of a bottle.

Are botanical medicines safe?

Botanical medicines can be safe when appropriately selected and used, but they are not risk-free.

Potential concerns include:

• Medication interactions

• Allergic reactions

• Effects on blood clotting

• Effects on blood pressure or blood glucose

• Effects on liver or kidney function

• Interactions between multiple supplements

• Contamination or inaccurate labeling

• Side effects from excessive doses

Safety also depends on the individual.

Someone taking anticoagulants, diabetes medications, thyroid medication, chemotherapy, or other prescription drugs may have very different considerations from someone taking no medications.

This is why a thorough medication and supplement review is an important part of responsible botanical prescribing.

What about herbal supplements?

It's important to distinguish botanical medicine as a clinical practice from simply purchasing an herbal supplement.

Many herbal products are available over the counter, but the quality, concentration, extraction method, and evidence can vary substantially between products.

When considering a botanical supplement, I look at questions such as:

What are we trying to accomplish?

Is there evidence that this botanical can help with that goal?

What dose and formulation have been studied?

Is the product appropriately standardized or characterized?

Could it interact with medications or other supplements?

Is there a safer or better-supported option?

This helps move the conversation away from "What herb should I take?" and toward a more clinically useful question:

"Is there a botanical that makes sense for me?"

Botanical medicine and evidence

Botanical medicine has a long history of traditional use, but traditional use and scientific evidence are not the same thing.

Some botanicals have been extensively studied, while others have much less clinical evidence.

Even when research exists, results may vary depending on:

• The botanical preparation

• Dose

• Patient population

• Health condition being studied

• Duration of treatment

• Outcome being measured

I use the available evidence alongside clinical experience and individual patient factors when considering botanical therapies.

The goal isn't to dismiss traditional knowledge—but also not to assume that a traditional use automatically proves clinical effectiveness.

What happens when you see a naturopathic doctor for botanical medicine?

Botanical medicine usually begins with an assessment rather than a prescription for a particular herb.

Depending on your concerns, this may involve reviewing:

• Your current symptoms

• Medical history

• Medications and supplements

• Diet and lifestyle

• Relevant laboratory testing

• Your goals and priorities

From there, botanical medicine may be one part of your treatment plan.

In some cases, the recommendation may be a single botanical. In others, a combination of approaches may be more appropriate. And sometimes, the most evidence-informed recommendation may be to use a non-botanical intervention instead.

The bottom line

Botanical medicine is much more than simply "taking herbs."

When used appropriately, botanicals can be one useful tool within individualized naturopathic care. Their potential role depends on the specific plant, preparation, dose, clinical goal, available evidence, and the person receiving the treatment.

The goal isn't to find the most herbs you can take. It's to determine whether a botanical can meaningfully contribute to your care—and if so, which one, in what form, and at what dose.

This individualized approach becomes especially important when you are taking prescription medications or undergoing cancer treatment, where potential interactions need to be carefully considered.

Interested in botanical medicine?

If you're interested in exploring whether botanical medicine may be appropriate for you, an individualized consultation can help determine which approaches fit your health history, current treatments, medications, and goals.

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Important note

Botanical medicines can have significant physiological effects and may interact with medications and other supplements. This article is intended for general educational purposes and does not replace individualized medical advice. Do not start, stop, or change a botanical or supplement without discussing it with an appropriate healthcare professional, particularly if you are pregnant, preparing for surgery, taking prescription medications, or undergoing cancer treatment.