Herbs to increase blood pressure: which ones are used

Persistently low blood pressure is generally defined as below 90/60 mmHg in adults, but the key criterion is the presence of symptoms such as severe weakness, dizziness, pre-syncope, and decreased exercise tolerance. For symptomatic hypotension, non-drug measures are primarily used, addressing the underlying causes rather than "stimulating" blood pressure with herbs. [1]

Before using herbal stimulants on your own, it's important to ensure that episodes are not related to dehydration, blood loss, arrhythmia, medications, or endocrine disorders. Identifying the cause and basic safety measures are described in current European blood pressure guidelines. [2]

Even a short-term increase in blood pressure by 5-10 mmHg in susceptible individuals can be accompanied by increased heart rate, deterioration in control of existing hypertension, and drug interactions. Therefore, any "pressor" plants are considered primarily as potential triggers of adverse reactions. [3]

How plants increase blood pressure

Plant-based sympathomimetics activate adrenergic receptors or increase norepinephrine levels. Classic examples include ephedra alkaloids and p-synephrine from bitter orange peel. They constrict blood vessels, increase heart rate, and raise blood pressure, especially when combined with caffeine. [4]

Adenosine receptor antagonists from caffeine-containing plants temporarily increase blood pressure and vascular tone. The acute increase is typically observed within 30-120 minutes after consuming doses of approximately 200-300 mg of caffeine. In real life, this effect is enhanced by energy drinks containing taurine and herbal stimulants. [5]

Glycyrrhizin from licorice mimics the action of mineralocorticoids and retains sodium, leading to edema, hypokalemia, and increased blood pressure. Even seemingly small amounts can increase blood pressure in sensitive individuals. [6]

Drug interactions constitute a separate group of risks. For example, St. John's wort induces drug-metabolizing enzymes, alters the concentrations of antihypertensive drugs, and, when combined with certain antidepressants, can provoke hypertensive reactions associated with serotonin syndrome. [7]

Table 1. Key plants and compounds with pressor effect

Plant or compound	Basic substances	Mechanism of pressure increase	Evaluation of effects in humans	Main risks
Ephedra	Ephedra alkaloids	Sympathomimetic	Increased blood pressure and heart rate; supplements banned by US regulators	Stroke, arrhythmia, heart attack, ban on the sale of ephedra supplements
Bitter orange	p-Synephrine	Sympathomimetic	Increased blood pressure and heart rate, especially with caffeine	Cardiovascular events, no proven benefit for weight loss
Caffeine-containing plants	Caffeine	Adenosine antagonist	A sharp rise of several mmHg.	Increased heart rate, arrhythmia, insomnia, anxiety
Licorice	Glycyrrhizin	Pseudomineralocorticoid effect	Clinically significant increase in blood pressure with regular use	Hypokalemia, edema, arrhythmia; mandatory label warnings in the EU
Yohimbe	Yohimbine	Alpha 2 antagonist	Increased blood pressure and pulse, narrow therapeutic window	Anxiety, tachycardia, seizures, serious CV events

[8]

Detailed profiles and evidence

Ephedra: High Risks and Banned in Supplements

Ephedra has historically been used as a stimulant, but in supplements it is considered unsafe. Since 2004, the sale of supplements containing ephedrine alkaloids has been banned in the United States, as the risk of adverse events is considered "unreasonable" for any recommended use. This risk has been linked to increased blood pressure, tachycardia, stroke, and other serious complications. [9]

This decision is supported by publications in official registries and reviews documenting cardiovascular complications associated with ephedra use. Its use as a "natural blood pressure tonic" is medically unjustified and unsafe. [10]

Bitter orange and p-synephrine: increased blood pressure without proven benefit

P-synephrine is often found in "fat burners." According to independent assessments and reviews, long-term use can increase diastolic pressure by several mmHg, and its combination with caffeine enhances the pressor effect. Regulatory limits and warnings are being discussed in several countries. [11]

The French agency ANSES recommends not exceeding 20 mg of p-synephrine per day and not combining it with caffeine. However, there is no evidence of clinically significant weight loss with p-synephrine. [12]

Caffeine-containing plants: a quick but short-lived boost

Caffeine from coffee, guarana, mate, and combined energy drinks temporarily increases blood pressure and heart rate. Metabolism and sensitivity vary from person to person, and at high doses and in combination with other stimulants, the effect is enhanced and prolonged. The boost is especially pronounced with energy drinks. [13]

The safe daily maximum for most healthy adults is up to 400 mg of caffeine, but those with hypertension or taking antihypertensive medications require stricter limits and discussion with a doctor. [14]

Licorice: The "hidden" pressor factor in teas, candies, and syrups

Glycyrrhizin inhibits the enzyme that breaks down cortisol in the kidneys, leading to sodium and water retention, potassium loss, and elevated blood pressure. Cases of severe hypertension have been reported from regular consumption of licorice tea and candy. Even "small" doses can raise blood pressure in sensitive individuals. [15]

In the European Union, licorice products are required to carry the warning "contains licorice - people with hypertension should avoid excessive consumption" at certain glycyrrhizin concentrations. This reflects the risks recognized by the regulator. [16]

Yohimbe and Yohimbine: A Narrow "Window of Safety" and Pressure Stimulation

Yohimbine is an alpha-2 adrenergic receptor antagonist. Clinical side effects include anxiety, tachycardia, and elevated blood pressure, even at therapeutic doses. Historical attempts to use it for hypotension have been found inconclusive due to its unfavorable safety profile. [17]

Combinations of yohimbine with caffeine, ephedra, or p-synephrine in sports and energy blends are particularly dangerous. Vulnerable groups include people with cardiovascular disease, anxiety disorders, and those with heart rhythm disorders. [18]

Table 2. Dosage guidelines and regulatory frameworks

Substance	What is known about the dose and regulator?	Security commentary
Caffeine	Up to 400 mg per day for most healthy adults	In sensitive individuals and with hypertension, significant increases in blood pressure and pulse are possible, especially with energy drinks.
p-Synephrine	A number of regulators recommend not exceeding 20 mg per day and not combining with caffeine	Long-term use is associated with an increase in diastolic pressure
Glycyrrhizin	The EU has mandatory warnings at certain concentrations in food products.	Even small amounts in sensitive individuals increase blood pressure and the risk of hypokalemia
Ephedrine alkaloids	Ephedra supplements are banned in the United States.	Risk of serious cardiovascular complications
Yohimbine	Narrow therapeutic range; registered drugs in a number of countries require medical supervision	Common effects: anxiety, tachycardia, increased blood pressure

[19]

Myths and common mistakes

The common belief that "hot hibiscus infusion increases blood pressure" is not supported by clinical data. On the contrary, regular consumption of hibiscus has been associated with a reduction in both systolic and diastolic blood pressure in adults in randomized trials. Using hibiscus to raise blood pressure is a mistake. [20]

Adaptogens such as eleutherococcus, rhodiola, and schisandra may provide a subjective "energizing" effect, but there is insufficient standardized evidence for safe and predictable blood pressure increases in healthy adults suitable for self-care. These are not reliable treatments for hypotension. [21]

Table 3. Drug interactions with potential increase in blood pressure

Class of substance	Example of grass	Potential interaction	What does it lead to?
Enzyme inducers	St. John's wort	Reduces concentrations of antihypertensive drugs; in combination with some antidepressants, there is a risk of serotonin syndrome	Hypertensive reactions, hypertension breakthrough
Sympathomimetics	Ephedra, p-synephrine	Combined action with decongestants and stimulants	Marked rise in blood pressure, tachycardia
Caffeine	Coffee, mate, guarana, energy drinks	May reduce the effectiveness of certain antihypertensive strategies and increase blood pressure	Transient pressure rise
Glycyrrhizin	Licorice	Increases sodium retention when taking diuretics; risk of hypokalemia	Increased blood pressure, arrhythmia
Alpha-2 antagonists	Yohimbine	Enhances stimulation with caffeine or p-synephrine	Tachycardia, rise in blood pressure

[22]

Practical steps: If you need to temporarily raise blood pressure in an adult with episodic symptomatic hypotension

Short-term non-drug treatments are generally safer than stimulants. Useful in the absence of contraindications include: drinking a glass of water, rising slowly, isometric leg exercises, eating a small salty snack, and wearing elastic thigh-high stockings. These approaches maintain blood volume and reduce orthostatic dips. For frequent episodes, an in-person examination is recommended. [23]

If you are considering a herbal stimulant, minimize the risk: avoid combinations of several stimulants, avoid products containing ephedra and yohimbe, do not combine p-synephrine with caffeine, be aware of "hidden" licorice in teas and candies, and monitor your blood pressure before and 60-120 minutes after use. If you experience headaches, palpitations, or chest pain, discontinue use and seek medical attention. [24]

Table 4. Comparison of caffeine-containing sources by typical caffeine content

Source	Portion	Typical caffeine range
Filtered coffee	200 ml	80-150 mg
Energy drink	250 ml	80-160 mg per jar, plus supplements
Mate tea	200 ml	30-80 mg
Guarana in capsules	1 serving	100-200 mg or more in terms of caffeine

Caution: Actual content varies by brand and formulation, and energy drinks often contain multiple stimulants at once.[25]

Table 5. Who is contraindicated to take "herbs that increase blood pressure"

Situation	Why is it prohibited?
Diagnosed hypertension or uncontrolled tachycardia	Risk of worsening blood pressure control and arrhythmias
Ischemic heart disease, history of stroke	Sympathomimetics increase myocardial oxygen demand
Pregnancy and lactation	Insufficient safety data, risk to the fetus and infant
Chronic kidney disease, hypokalemia	Licorice worsens electrolyte imbalances
Taking antidepressants, antiarrhythmics and a number of antihypertensive drugs	High risk of interactions and hypertensive reactions

[26]

Security Control: Home Monitoring and Labels

Use a verified upper arm blood pressure monitor and keep a diary. Measure your blood pressure while sitting after 5 minutes of rest, 2-3 times at 1-2 minute intervals, and record the average reading. Test new herbal remedies in small increments and never combine them with other stimulants. [27]

Read labels. In the European Union, licorice products are required to carry a warning for people with hypertension at certain glycyrrhizin concentrations. High-caffeine beverages must be specifically labeled. This helps avoid hidden sources of "pressor" substances. [28]

Table 6. How to read the label: "red flags"

Marker on the packaging	What does it mean	What to do
"Contains Licorice" or Glycyrrhiza Extract	Glycyrrhizin and increased blood pressure are possible.	Avoid in hypertension, limit in sensitive individuals
Citrus aurantium, Citrus spp., p-synephrine	Sympathomimetic, especially in fat burners	Do not combine with caffeine, monitor blood pressure
Yohimbe, Yohimbine	A strong stimulant with a narrow safety window	Avoid, especially in CVD
Guarana, Yerba Mate, Caffeine	Adenosine antagonist, acutely increases blood pressure	Calculate your total daily caffeine intake
"Energy", "Burn", "Pre-workout"	Often a mixture of stimulants	Avoid combinations and "cocktails"

[29]

Table 7. What to choose instead of stimulants if you are prone to hypotension

Target	Step-by-step option
Quickly relieve dizziness	A glass of water, isometric contractions of the thigh and lower leg, slowly rise
Preventing morning slump	Getting up slowly, having a breakfast with sufficient salt content unless contraindicated, and wearing elastic stockings
Prevention of daytime episodes	Eating regularly, drinking enough fluids, and exercising your calf muscles and thighs
When to see a doctor	Frequent fainting spells, fainting spells, heart palpitations, chest pain, and a sharp deterioration in exercise tolerance

[30]

Brief conclusions

1. Sympathomimetics of plant origin, caffeine and glycyrrhizin from licorice actually and predictably increase blood pressure, but the price of this effect is risks to the heart and dangerous interactions. [31]
2. Ephedra is banned in supplements in the US, and yohimbe and p-synephrine carry a risk of raising blood pressure, especially when combined with caffeine. These supplements are not recommended for self-help. [32]
3. Hibiscus and many popular “heart” teas do not increase, but rather decrease, blood pressure, and are therefore not suitable as “pressors.” [33]
4. Symptomatic hypotension is initially treated non-drug-based and the underlying cause is identified. Any herbal stimulants require an individual risk assessment and blood pressure monitoring. [34]