Health & Fitness

Indigenous cultures have used traditional herbal medicine for the treatment and prevention of diseases for thousands of years.¹ The bioactive compounds found in medicinal plants have gone on to become primary points of research for drug therapies² and have been replicated in the lab by Big Pharma.³

Holy basil, or tulsi, (Ocimum sanctum) is a medicinal herb favored in Ayurvedic medicine because of the vast health benefits it offers.⁴ It has been widely used in Southeast Asia and today is making a name for itself in Western medicine.

Tulsi is a powerful adaptogenic herb with known antibacterial, antifungal, anti-inflammatory, analgesic and antioxidant properties. There are several products utilizing tulsi available on the market today, including tea, extract and essential oil.⁵

Holy basil is a flowering plant in the mint family. It is sacred in Hinduism because of its association with Lord Vishnu, one of the principal deities of the religion⁶ In addition to medicinal uses, tulsi is also widely grown and used as a culinary herb.⁷ The peppery mint flavor strengthens and concentrates during cooking. Outside of its native region, it is considered an invasive species.

Tulsi can grow up to 5 feet in the intense heat of India but normally reaches up to only 2 feet in more temperate areas.⁸ It is a short-lived perennial shrub or annual plant depending on the region. By comparison, sweet basil is a popular culinary herb that grows in many areas and can be cultivated indoors. Although they are from the same genus, they are distinctly different in taste and appearance.⁹

Tulsi May Help Lower Risk of Diabetes and High Blood Pressure

Diabetes increases your risk of high blood pressure¹⁰ and vice versa.¹¹ There is evidence that holy basil influences blood glucose and may help reduce high blood pressure.

In 1996, researchers studied the effect of holy basil on the blood glucose of albino rats.¹² Their results indicated that administration of holy basil could reduce blood glucose after fasting and eating. Reduction in urine glucose levels followed the same trend.

These results are similar to those found in the many years of using holy basil in ayurvedic interventions for diabetes. A review of ayurvedic literature¹³ revealed many studies in which the practice of using holy basil included treatment for diabetes, hepatitis, cardiovascular diseases and infectious diseases.

More recently, scientists reviewed several plants with antidiabetic potential and bioactive compounds, including holy basil.¹⁴ The leaves of the plant contain eugenol, ursolic acid, carvacrol and linalool. Tulsi is also rich in vitamins, minerals, chlorophyll and other phytonutrients, including flavonoids, saponins and triterpenoids.

The leaves are reported to stimulate insulin secretion and reduce the serum levels of cortisol and glucose in an animal model.¹⁵ It also demonstrated a dose-dependent hypoglycemic effect in another animal study.¹⁶ In a database search of human studies,¹⁷ results showed tulsi was effective at reducing fasting blood glucose and reduced cholesterol levels in patients over 40 years without changing the overall lipid profile.

Holy basil has anti-inflammatory properties, which may help to reduce blood pressure.¹⁸ One study¹⁹ in 2016 showed holy basil and cloves could reduce systolic and diastolic blood pressure in an animal model when compared against the control group.

Tulsi May Help the Appearance of Skin and Teeth

Tulsi can benefit the skin in several ways.²⁰ It can help reduce eczema and psoriasis and treat staph infections on the skin. The essential oil has antifungal and antibacterial activity.

As mentioned, the leaves have ursolic acid, a favorite of the cosmetic industry as it helps to remove wrinkles and improve elasticity. Ayurvedic medicine uses tulsi in a topical application with black pepper to treat ringworm and as a paste on the skin to help reduce irritation of insect bites.

Within ayurvedic medicine practice²¹ tulsi is called the “incomparable one,” “mother medicine of nature,” and the “queen of herbs.” The reference is to the wide range of health benefits practitioners have found. This includes the treatment of skin diseases, ringworm and a variety of other health conditions affecting the respiratory, digestive, circulatory and neurological systems.

Holy basil extract may also help the appearance of your teeth and gums. In one study²² published in 2014, researchers compared a mouthwash made of holy basil against sterile water and chlorhexidine. They found the holy basil extract inhibited periodontal pathogens at various concentrations with the same effectiveness as chlorhexidine.

The researchers suggest that the antiplaque effect may have prophylactic benefits. However, ayurvedic practitioners warn against chewing the leaves.²³ The leaves contain high amounts of mercury and iron which are released when you chew them.

They are also highly acidic. Practitioners recommend starting your day with two to three fresh leaves on an empty stomach. However, on a daily basis, this can cause discoloration and abnormal wear and tear on the tooth enamel.

Protects Against Infections

A review in the Journal of Ayurveda and Integrative Medicine²⁴ called tulsi an “herb for all reasons,” noting that it’s effective against “a range of human and animal pathogens” with broad-spectrum antimicrobial activity, even suggesting it may be considered for a hand sanitizer, water purifier or for wound healing.

Tulsi is also one of the herbs in Ayush Kwath, an Ayurvedic herbal formula recommended by the government of India to boost immunity and combat COVID-19.²⁵ At the conclusion of a literature review of Ayush Kwath, the researchers suggested that:

“Ayush Kwath due to its immune-modulatory, antiviral, antioxidant, anti-inflammatory, anti-platelet, anti-atherosclerotic, hepato-protective, reno-protective properties; seems to be effective in immuno-regulation for controlling viral infections like COVID-19.”

Writing in a published paper in Nature Plants in 2017, researchers suggest²⁶ “While the plant kingdom continues to serve as an important source for chemical entities supporting drug discovery, the rich traditions of herbal medicine developed by trial and error on human subjects over thousands of years contain invaluable biomedical information just waiting to be uncovered using modern scientific approaches.”

The use of traditional herbal medicine for the treatment of respiratory ailments has taken on renewed interest during the pandemic. Herbal medicine is a powerful arsenal in the prevention and treatment of respiratory ailments like colds, flu and COVID-19. In China, herbal treatment is recommended for children and adults with COVID-19,²⁷ and interest in traditional remedies are growing in the U.S. as well.

Herbs are unique in that they contain multiple beneficial components that work synergistically to promote wellness. Tulsi is believed to help alleviate various bacterial infections, including urinary tract infections,²⁸ dermal infections caused by Staphylococcus aureus and other bacteria²⁹ and respiratory tract infections like pneumonia.³⁰

May Ease Stress, Anxiety and Boost Cognitive Function

Following the pandemic, more than 80% of people surveyed report they had emotions associated with prolonged stress. The report from the American Psychological Association³¹ in February 2021 revealed higher levels of stress than in previous years and many surveyed also reported feeling anxious, sad and angry.

The American Psychological Association's chief executive officer warned that, “Without addressing stress as part of a national recovery plan, we will be dealing with the mental health fallout from this pandemic for years to come.”³²

One of the symptoms of high levels of stress is drug use. The Centers for Disease Control and Prevention³³ reports there were an estimated 100,306 drug overdose deaths in the 12-month period ending April 2021. This represents a 28.5% increase in the same number of deaths during the same period the year before.

One study³⁴ isolated extracts from holy basil, which were tested in an animal model in which acute stress was induced using biochemical changes. Several of the compounds showed promising antistress effects when used independently as they normalized the serum hyperglycemia, corticosterone, creatinine kinase and adrenal hypertrophy that occurs in high-stress situations.

A second study³⁵ tested tulsi against generalized anxiety disorders, in a group of 35 participants with an average age of 38.4 years. The results showed that the treatment significantly attenuated the anxiety disorders and the correlating stress and depression. The researchers concluded that holy basil could be a useful treatment and a “promising anxiolytic agent in the near future.”

Stress disorders can increase the risk of developing dementia by nearly threefold. The association was found to be more pronounced in men than women, except in women who had post-traumatic stress disorder.^36,37

Interestingly, one animal study³⁸ showed holy basil could help manage cognitive dysfunction that was induced in animals, therefore improving their cognitive function in those taking the intervention. In a human study,³⁹ researchers looked at the effect tulsi would have on cognition and stress when 300 mg capsules of leaf extract were administered over 30 days.

The researchers compared the intervention group against a placebo group, measuring reaction time and error rates in testing, as well as salivary cortisol and using the State-Trait Anxiety Inventory. They found those taking the leaf extract had potential cognitive enhancing properties.

Impressive Herb but Not a Magic Bullet

It's important to remember that while holy basil has an impressive list of health benefits, it is not a magic bullet. Overall, you cannot depend on one supplement or one herb alone to maintain your health and wellness. It is just as important to implement other lifestyle strategies to support your health.

These include optimizing your diet, getting regular exercise, minimizing your exposure to environmental toxins and getting quality sleep each night. There are several precautions you should take if you are considering using holy basil as a supplement.

There are little to no studies evaluating holy basil supplementation’s safety during pregnancy; while holy basil may look beneficial for your health, there is no clear indication whether it's safe for your unborn child. Women who are pregnant or breastfeeding should not use holy basil.⁴⁰

Additionally, there have been two animal studies that suggest using it in large amounts could negatively affect fertility. A review of the effects on humans published in 2020⁴¹ found that large amounts of holy basil may trigger liver damage, nausea, diarrhea and rapid heart rate.

Herbs also have biologically active compounds, such as ursolic acid or eugenol in tulsi, that can react with compounds in other supplements or drugs. Since it can be complex to work with herbs, you’ll get your best results working with a knowledgeable natural health care practitioner who can guide you on the appropriate solutions for your circumstances.

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This article was previously published January 17, 2018, and has been updated with new information.

A 2021 survey¹ indicates that 80% of Americans are using supplements — a drastic increase from the 52% reported in a 2012 JAMA report,² a statistic that had remained stable since 1999. While at that time the use of multivitamins had decreased somewhat, from 37 to 31 percent, the new survey indicates that 75% of supplement users now use multivitamins. The use of vitamin D and omega-3 supplements have continued to rise through all these years as well.

In 2012 vitamin D use jumped from just over 5% to 19%, and fish oil supplements increased from just over 1% to 12%. In 2021, however, a whopping 52% of Americans were taking vitamin D, with zinc and vitamin C also being popular, at 22% and 40%, respectively.

Some of the other more popular supplements are probiotics, omega-3, multivitamins, vitamin C, turmeric, calcium and magnesium.³ In all, Americans spent an estimated $21 billion on nutritional supplements in 2015.⁴ By 2019, that number had doubled to $42.6 billion.⁵

While dietary supplements are generally safe, when and how you take them — such as with or without food, or before or after exercise⁶ — can make a difference both in terms of safety and effectiveness. Certain supplements may also be contraindicated for certain health conditions or if you're taking a particular drug. Following, you'll find helpful guidance on the use of common supplements.

Quick Guide to the Timing of Supplements

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On the Timing of Vitamins and Minerals

Since multivitamins contain an array of both water- and fat-soluble vitamins, and in some cases minerals as well, it's generally recommended you take half of your daily dose in the morning, with breakfast, and the other half with your main meal (dinner for most people, or lunch if you're intermittently fasting). While you may not notice any ill effects if you take it on an empty stomach, taking your multivitamins with food is a safer bet overall.⁷

Both B vitamins and nonliposomal vitamin C may cause stomach upset and nausea when taken on an empty stomach, for example, and fat-soluble vitamins will do you little good unless you take them with a small amount of fat, such as an egg or half an avocado. Avoid going overboard on the fat, however, as too much grease can interfere with the absorption of water-based vitamins.

When taking individual vitamins and minerals, you may need to pay attention not only to the timing of them, but also their combination with other supplements you're taking, and their ideal ratios. For example:

Timing of Fats and Fiber Supplements

Fiber may inhibit your body's absorption of fat, so most fiber supplements, including "green" supplements like powdered spirulina and kelp, are best taken separately from any fatty acid supplements you may be taking. If you're working out, remember that fiber supplements will slow the movement of food through your stomach and intestines.

For this reason, fiber is best taken at least three or four hours before exercise or competition. Alternatively, take it toward the end of the day. Whole husk psyllium, which is an excellent fiber supplement, is ideally taken two hours after a meal with a full glass of water.

As for omega-3 supplements such as fish or krill oil, these could potentially cause indigestion if taken immediately before a workout, so consider taking them with breakfast, along with any multivitamin you may be taking. Also keep in mind that krill oil supplements are contraindicated for those allergic to shellfish, and neither fish nor krill oil should be taken if you have a blood coagulation disorder or are on anticoagulant medication.

Timing of Enzymes and Probiotics

Enzymes such as bromelain, papain, trypsin and others are used not only as digestive aids, but also for enhancing muscle recovery and decreasing inflammation. Depending on your aim, you'll need to alter the timing. When taken with a meal, they will improve your digestion. For muscle enhancement and/or anti-inflammatory effects, you'll want to take them on an empty stomach post-workout, either in the morning or afternoon.

Probiotics help improve your gut microbiome by supplying beneficial bacteria. They are best taken on an empty stomach, two to three hours before your first meal, or after your final meal for the day. Also remember that to reap the benefits from a probiotic supplement, you need to reduce your intake of processed foods and sugar. Otherwise, you're essentially just throwing your money away.

On the Timing of Antioxidants

As a general rule, antioxidant supplements such as resveratrol, astaxanthin, vitamin E and ubiquinol (the reduced version of Coenzyme Q10) are fat-soluble and best taken with a fatty meal. Ubiquinol is best taken in divided doses with a fatty meal, while vitamin E and astaxanthin can be taken once a day with a fatty meal to increase absorption. Resveratrol-containing supplements can be taken on an empty stomach.

If you're an athlete, or work out regularly, several studies have shown that taking antioxidant supplements immediately before exercising has the curious effect of decreasing insulin sensitivity. It also hampers your body's ability to defend itself against oxidative damage. As noted by nutritionist and fitness coach Ben Greenfield:¹²

"By shutting down the body's need to for natural antioxidant activity that helps adapt to stress and respond to exercise, antioxidant consumption in high doses of a single isolated antioxidant (like vitamin C or vitamin E) could potentially blunt the workout benefit.

For this reason, antioxidant beverages and capsules should be A) full spectrum … and B) consumed only in moderation, and not as a consistent part of the pre-workout or during workout nutrition protocol. Take-Away Message: Take antioxidants with a pre-race meal, and only before very difficult workouts. Otherwise, limit antioxidants to low to moderate intake only, and attempt to consume as far as possible from an exercise session."

Do You Really Need All the Supplements You're Taking?

As a general rule, the better and more wholesome your diet, the fewer supplements you will need. Eating real food, ideally organically grown to avoid pesticide exposure, is really the most appropriate way to ensure you're getting all the nutrients your body needs.

Vegetarians and vegans, who may think they're eating the best diet possible, are perhaps among the few who actually have to pay really close attention to their nutritional needs, as many important nutrients are only found in animal foods.

The animal-based omega-3 fats DHA and EPA are just one example. B12 is another really important one that vegans forgo, which can wreak havoc on your health. Over time, chronic B12 deficiency can lead to serious, irreversible conditions, including depression, dementia, neurological and neuropsychiatric conditions, fertility problems, heart disease and cancer — all the things a vegan diet is thought to prevent.

That said, dietary supplements can be quite beneficial if you know or suspect you might have a particular deficiency, and/or if you're trying to address a particular health problem. Just keep in mind that the more supplements you take, the more complicated it gets to get it right. Are you taking each one at the most appropriate time and in the correct combination — and in the proper ratio — with other nutrients?

Eating a whole food diet circumvents most of these issues, as your body knows exactly what to do with the nutrients it obtains from food, regardless of the hour or combination (although a case can be made for food combinations and ideal meal times as well). If you're taking handfuls of supplements but still eat mostly processed foods, make this the year you start making changes.

That said, to ensure you're getting the most from the supplements you do take, make a list, and check the best timing and combination of each one. While I've given you a few examples above, you'll find more examples in the infographics provided at the beginning of this article, and below.

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