7 Supplements You May Want to Avoid If You Have High Blood Pressure

Although dietary supplements are readily available over the counter (OTC), they may not be safe for everyone. Some can raise your blood pressure. And if you’re living with chronic high blood pressure (hypertension), taking these supplements may raise your risk of serious heart complications, such as a heart attack or stroke.

If you have hypertension, speak with a prescriber or pharmacist before starting any dietary supplements or herbal remedies.

Supplements you should avoid if you have high blood pressure

In general, the research available on supplements is more limited than the research on prescription or OTC medications. But it’s clear that several supplements do raise blood pressure.

Supplements that you should avoid if you have high blood pressure include:

• Ephedra (also called ma huang)

• Bitter orange

• Asian ginseng

• Guarana (an ingredient in many energy drinks)

• Licorice root

• Yohimbe

• St. John’s wort

This isn't a complete list of all supplements that may raise blood pressure. It’s a good idea to share a complete medication list with your prescriber and pharmacist. Be sure to include all OTC vitamins and supplements you take. Healthcare professionals can review this list for potential interactions.

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Below, we'll discuss seven supplements you should avoid if you have high blood pressure.

1. Ephedra (ma huang)

Ephedra sinica, also known as ma huang, is a plant with a long history in traditional Chinese medicine. It’s commonly taken for weight loss, asthma, and nasal congestion.

Ephedra is a stimulant that activates your “fight or flight” response. This can cause side effects, such as raised blood pressure, a faster heart rate, and rapid breathing. These effects can be life-threatening in some cases. So in 2004, the FDA banned all ephedra-containing supplements in the U.S.

Even though ephedra-containing products are no longer sold in the U.S., you may come across them when traveling to other countries. If you have hypertension, it’s best to avoid taking ephedra. It can worsen your condition and raise your risk of serious complications, such as a heart attack.

Good to know: The OTC nasal decongestant pseudoephedrine (Sudafed) is derived from the ephedra plant. Pseudoephedrine causes similar side effects to ephedra, including high blood pressure, and isn’t recommended if you have hypertension.

2. Bitter orange

Bitter orange (Citrus aurantium) is made from the Seville orange. Some people take it for gastrointestinal issues, such as nausea, constipation, or heartburn.

Bitter orange contains an ingredient called p-synephrine, a type of stimulant. P-synephrine is similar to ephedra. Because of this, bitter orange has become an ephedra substitute since the FDA’s ban in 2004.

Some studies suggest that bitter orange can raise blood pressure. Other cardiovascular side effects, some of which were fatal, have also been reported. These include:

• Stroke

• Chest pain

• Heart attack

• Fast heart rate

• Abnormal heart rhythms

Other studies have found that bitter orange doesn’t significantly impact blood pressure. But keep in mind that many of these studies were conducted in young, otherwise healthy adults. So they likely don’t reflect bitter orange’s effects if you have hypertension.

Bitter orange is available as an oral supplement. But you may also find it as an ingredient in foods, such as juices or marmalades. Luckily, the amount found in food is unlikely to impact blood pressure.

3. Asian (Panax) ginseng

Panax ginseng, also known as Asian ginseng, is a popular root used in Eastern medicine. It has many potential uses, including improving erectile dysfunction (ED) symptoms. Unlike the supplements listed above, the FDA recognizes Asian ginseng as generally safe for most people.

Asian ginseng can either raise or lower blood pressure. There’s also concern that it could interact with blood pressure medications. It’s possible that taking them together could cause your blood pressure to drop too low.

According to the National Institutes of Health, you should only take Asian ginseng for up to 6 months. The safety of taking it for a longer period of time hasn’t been well studied.

Good to know: There are two types of Asian ginseng — red ginseng and white ginseng. They come from the same root but are processed in different ways. Both can cause changes in blood pressure.

4. Guarana

Guarana is a supplement made from the seeds of the guarana plant (Paullinia cupana). Many people know guarana as a common active ingredient in energy drinks. But it’s also available in other forms, such as oral tablets, capsules, and powders.

Guarana contains caffeine. Caffeine is a stimulant that temporarily increases your blood pressure. But compared to coffee beans, guarana has up to four times the amount of caffeine.

Since guarana contains caffeine, it can raise your blood pressure. In severe cases, it can also lead to complications like a heart attack or cardiac arrest. These serious heart problems have even happened to young adults in their 20s.

So if you have hypertension, you may want to skip the energy drinks, especially if they contain guarana.

5. Licorice root

Licorice (Glycyrrhiza glabra or Glycyrrhiza uralensis) is a root that has a long history of use as a flavoring agent in food and drinks. It’s also been used to treat low blood pressure. Licorice contains an ingredient called glycyrrhizic acid, which can raise blood pressure.

Eating the occasional licorice candy is unlikely to be harmful. But it's a good idea to limit how much you eat. Eating too much licorice can contribute to or worsen hypertension. And it’s a good idea to avoid supplements that contain licorice root, as they pose the same risks.

6. Yohimbe

Yohimbe is a supplement made from the bark of an African tree called Pausinystalia yohimbe. The bark contains an ingredient called yohimbine, which is used for sexual performance, weight loss, and athletic performance.

Before sildenafil (Viagra) came to the market, yohimbine was a popular medication for ED symptoms. Now, yohimbe isn’t typically recommended due to its many side effects, including elevated blood pressure. Other heart-related side effects include:

• Rapid heartbeat

• Heart rhythm changes

• Heart palpitations

• Heart muscle damage

• Heart attack

Despite its drop in popularity, you can still find yohimbe OTC. But keep in mind that many of the supplements don’t specify how much yohimbine is contained in them. If you’re concerned about high blood pressure, avoid taking yohimbe.

7. St. John’s wort

St. John’s wort (Hypericum perforatum) is a popular supplement. It’s mainly used to help relieve depression symptoms.

There are rare reports of St. John’s wort causing high blood pressure. While this side effect isn’t typical, it’s a risk to discuss with a healthcare professional before starting this supplement.

St. John’s wort also interacts with many medications. And in some cases, combining it with an interacting substance can lead to high blood pressure.

For example, you shouldn’t take St. John’s wort if you also take medications that raise serotonin levels, such as many antidepressants. This combination raises your risk of a life-threatening side effect called serotonin syndrome. One symptom of serotonin syndrome is raised blood pressure.

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Written by:

Sheila McAdoo, PharmD

Sheila McAdoo, PharmD, is a licensed pharmacist in Virginia, New York, and the District of Columbia. She has worked in the pharmacy industry for 12 years and currently works as a community pharmacist.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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