Patient Education When Products Are Marketed as Natural

When a patient calls a product natural, the word alone leaves open whether the product has been tested, what each tablet or capsule contains and whether the FDA has reviewed it. If the patient thinks of the product as a tea or a supplement rather than a drug, a question about “medications” may never bring it up.

Who takes a product history, and how it is documented, depends on the worker’s role and the facility’s policy. This article is for clinical staff who collect that history under such a policy, and nothing here replaces it. The goal is narrow: get the product named, record the amount and timing, and leave the patient knowing what is and is not established about it.

Open-ended wording may surface more than a list of brand names. Questions like these are one place to start:

1. “Besides prescriptions, what do you take for pain, energy, sleep, mood or stress, including anything from a store, a website or a friend?”

2. “Can you show me the package, or a photo of it? I would like to write down the name and the dose.”

3. “How often do you take it, and when was the last dose?”

4. “Have you ever felt unwell when you skipped a day?”

The last two questions give the care team the timing of the last dose and any symptoms between doses, which can matter for products that act on the central nervous system. Document the answers in the patient’s own words and record the product name exactly as printed. A neutral, non-judgmental tone makes it easier for the patient to answer honestly.

Some products are not the whole plant. The FDA describes 7-hydroxymitragynine (7-OH) as a minor constituent of kratom, under 2 percent of the total alkaloids in natural leaf, and says it has substantially greater mu-opioid receptor potency than mitragynine, the plant’s main alkaloid, according to the FDA’s kratom information page. Its July 29, 2025 announcement called 7-OH a concentrated byproduct of the plant and said it is not lawful in dietary supplements.

For the plant itself, NIH’s National Center for Complementary and Integrative Health (NCCIH) reports that the FDA has not approved kratom as safe and effective for any medical purpose, that combining kratom with other drugs has been linked to deaths and severe adverse effects, that long-term use of large doses has been reported to cause serious liver problems in some people, and that regular users may have withdrawal symptoms when they stop.

One such product, 7OHMZ tablets, is the subject of a class action. A published summary of the lawsuit sets out allegations about the tablets’ marketing: that they were sold as natural and safe, and that consumers were not warned of the risk of a substance use disorder. These are allegations, not findings, and they say nothing about what any patient believed. The patient’s own view is worth asking about directly: “Do you think of this as a medicine, a supplement or something else?”

Keep the explanation short and factual. The FDA’s kratom page says it has warned consumers not to use kratom because of risks that include liver toxicity, seizures and substance use disorder, and that no kratom drug products are FDA-approved. One way to share this is to attribute it to the FDA rather than present it as your own opinion, and to offer it without blame. A patient who relied on a label that said natural may be surprised by it, so allow time for questions. Then ask the patient to explain the main points in their own words, which shows what came across and what needs repeating.

Practical points for the chart:

• Record the brand, product form, the strength printed on the label, how much the patient says they take at a time, how often, and the last dose. The label strength and the amount the patient reports taking are not the same thing.
• Note any withdrawal-type symptoms the patient describes, using their words, and pass them on according to your facility’s process.
• Flag possible interactions with sedatives, opioids or other central nervous system medicines for pharmacist or physician review.
• Treat a planned change in use, such as the patient wanting to stop, as a prescriber conversation, and do not advise stopping or continuing on your own authority.

Severe or rapidly worsening symptoms are a different situation. Those call for urgent assessment under your facility’s escalation protocol, not a wait for a prescriber appointment.

The FDA page also encourages health care professionals and consumers to report adverse reactions through MedWatch. A report with the product name and, if the package shows it, the lot number is useful once the patient is stable and being cared for. It is a way to report the event, not a first response to it.