What Supplements Interact with Ayahuasca? A Pharmacological Safety Guide

Combining certain medications and supplements with ayahuasca, a powerful monoamine oxidase inhibitor (MAOI), can lead to serious and even dangerous interactions [1.2.1]. Understanding what supplements interact with ayahuasca is crucial for safety.

Quick Summary

A comprehensive overview of dangerous interactions between common supplements and ayahuasca. This guide details risks like serotonin syndrome and hypertensive crisis due to the brew's MAOI properties, listing specific herbs to avoid.

Key Points

• MAOI Core Risk: Ayahuasca inhibits the MAO enzyme, which can cause dangerous interactions with many supplements [1.2.1].

• Serotonin Syndrome: Combining ayahuasca with supplements like St. John's Wort or 5-HTP can lead to potentially fatal serotonin syndrome [1.2.2, 1.4.3].

• Hypertensive Crisis: Stimulant herbs like Ginseng or Ephedra can cause dangerously high blood pressure when mixed with an MAOI [1.2.2, 1.3.1].

• Broad Contraindications: Many common herbal supplements, including Kava, Kratom, Yohimbe, and Kanna, must be avoided [1.3.2].

• Discontinuation is Key: Most interacting supplements should be stopped at least 2 to 6 weeks before an ayahuasca ceremony [1.2.5, 1.2.6].

• Full Disclosure: Always inform your ceremony facilitator and consult your doctor about all supplements and medications you are taking [1.2.1].

• Tyramine is a Factor: While mostly related to food, some protein supplements may contain tyramine, which interacts negatively with MAOIs [1.3.7, 1.8.3].

The Critical Role of MAOIs in Ayahuasca Interactions

Ayahuasca is a psychoactive brew traditionally used for spiritual and ceremonial purposes in the Amazon [1.8.6]. It is typically made from two plants: the Banisteriopsis caapi vine and the leaves of the Psychotria viridis shrub. The key to its pharmacology lies in this combination. P. viridis contains N,N-Dimethyltryptamine (DMT), a powerful psychedelic compound. However, when ingested orally, DMT is rapidly broken down in the digestive system by an enzyme called monoamine oxidase (MAO) [1.8.6]. This is where B. caapi comes in; it contains harmala alkaloids, which are potent reversible inhibitors of monoamine oxidase A (MAOIs) [1.8.4]. By inhibiting MAO, the DMT is allowed to cross the blood-brain barrier and exert its psychoactive effects [1.8.6].

This MAOI mechanism is precisely why extreme caution is necessary. MAO enzymes don't just break down DMT; they also metabolize various other substances, including certain neurotransmitters like serotonin and dopamine, as well as compounds found in many foods, medications, and supplements [1.7.4]. When MAO is inhibited, consuming other substances that affect these pathways can lead to dangerously high levels, resulting in potentially life-threatening conditions like serotonin syndrome or a hypertensive crisis [1.5.1, 1.8.4]. For this reason, anyone considering participating in an ayahuasca ceremony must be fully aware of what supplements interact with ayahuasca.

High-Risk Supplements to Avoid Completely

Due to the MAOI effects of ayahuasca, several herbal supplements and over-the-counter products must be strictly avoided. These supplements can have their own MAOI properties, increase serotonin levels, or act as stimulants, creating a high-risk combination.

Serotonergic Supplements: The Risk of Serotonin Syndrome

Serotonin syndrome is a potentially fatal condition caused by excessive serotonergic activity in the central nervous system [1.5.1]. Symptoms range from mild (anxiety, restlessness) to severe (high fever, seizures, delirium) [1.5.3]. Combining an MAOI like ayahuasca with other substances that increase serotonin is extremely dangerous [1.5.2].

• St. John's Wort (Hypericum perforatum): This popular herbal remedy for depression increases serotonin levels in the brain [1.4.3, 1.4.7]. Combining it with ayahuasca creates a high risk of serotonin syndrome [1.2.2]. It is crucial to discontinue St. John's Wort at least two weeks, and sometimes longer, before a ceremony [1.4.2, 1.4.4].
• 5-HTP (5-Hydroxytryptophan): As a direct precursor to serotonin, 5-HTP supplements can significantly elevate serotonin levels [1.5.4]. This interaction is particularly risky and should be avoided [1.4.5].
• SAM-e (S-adenosylmethionine): Another supplement used for mood support, SAM-e can also interact with MAOIs and should be discontinued [1.7.3].
• Tryptophan / L-tryptophan: This amino acid is a precursor to 5-HTP and, subsequently, serotonin. Taking it as a supplement while MAO is inhibited can cause confusion, agitation, and other symptoms of serotonin toxicity [1.3.3].

Supplements with MAOI or Stimulant Properties

Other supplements pose a risk either because they also inhibit MAO (leading to a compounded effect) or because they have stimulant properties that can lead to a hypertensive crisis (dangerously high blood pressure).

• Kava (Piper methysticum): While used for anxiety, kava's safety is debated, with concerns about liver toxicity [1.6.2, 1.6.6]. It is consistently listed as a supplement to avoid with ayahuasca [1.2.1, 1.3.2, 1.4.4].
• Kratom (Mitragyna speciosa): Kratom has complex pharmacology, acting on opioid receptors and other systems. It is consistently recommended to be avoided before ayahuasca ceremonies [1.2.6, 1.3.2].
• Ginseng: This herb can have stimulant effects, which are risky when combined with an MAOI [1.2.2, 1.3.1].
• Yohimbe (Pausinystalia johimbe): Yohimbe is a known MAO-A inhibitor and stimulant, making it extremely dangerous to combine with ayahuasca [1.2.6, 1.7.2].
• Ephedra (Ma Huang): A powerful stimulant that can cause a severe hypertensive crisis with MAOIs [1.2.6, 1.3.1].
• Kanna (Sceletium tortuosum): Kanna has its own psychoactive and serotonin-affecting properties and is contraindicated [1.2.1, 1.3.2].
• Rhodiola Rosea: Often used as an adaptogen, it should be avoided before ayahuasca [1.2.6].
• Boswellia: Another herbal supplement that appears on contraindication lists [1.2.1, 1.3.2].

Comparison of Dangerous Supplements

Supplement	Primary Risk with Ayahuasca	Recommended Discontinuation Period	Source(s)
St. John's Wort	Serotonin Syndrome	At least 2-4 weeks prior	[1.2.5, 1.4.2]
5-HTP / Tryptophan	Serotonin Syndrome	At least 2-4 weeks prior	[1.3.3, 1.4.5]
Kava	Unpredictable interactions, potential liver stress	At least 2 weeks prior	[1.2.1, 1.4.4]
Kratom	Unpredictable psychoactive interactions	At least 2 weeks prior	[1.2.6, 1.3.2]
Ginseng	Stimulant effects, risk of hypertensive crisis	At least 1-2 weeks prior	[1.2.2, 1.3.7]
Yohimbe	MAOI and stimulant effects, high risk	At least 4-6 weeks prior	[1.2.6, 1.7.2]

Conclusion: Prioritizing Safety Through Diligence

The pharmacological activity of ayahuasca, specifically its MAO-inhibiting properties, makes it incompatible with a wide range of common supplements [1.2.1, 1.3.1]. The potential for life-threatening conditions like serotonin syndrome and hypertensive crisis is real and must be taken seriously. The lists provided here are not exhaustive, and many supplements contain hidden compounds that can interact dangerously [1.3.6]. Therefore, the safest protocol is to discontinue all non-essential supplements several weeks before a ceremony. Always consult with your primary healthcare provider about safely tapering off any substances and be completely transparent with your ayahuasca facilitator about everything you have taken. This diligence is the cornerstone of a safe and potentially beneficial experience.

For more detailed medical guidelines, an authoritative source is the Temple of the Way of Light: https://templeofthewayoflight.org/resources/ayahuasca-medical-guidelines/

Frequently Asked Questions

Why is St. John's Wort so dangerous with ayahuasca?

St. John's Wort increases serotonin levels in the brain. Ayahuasca prevents the breakdown of serotonin. This combination can lead to a potentially lethal condition called serotonin syndrome [1.4.3, 1.5.2].

How long before an ayahuasca ceremony should I stop taking interacting supplements?

The timeframe varies, but a general guideline is to stop most interacting supplements at least 2 to 4 weeks prior. For substances with stronger effects or longer half-lives, such as certain MAOIs, a washout period of 6 weeks or more may be necessary [1.2.5, 1.2.6].

Can I take 5-HTP to improve my mood before a retreat?

No. 5-HTP is a direct precursor to serotonin and is extremely dangerous to combine with ayahuasca due to the high risk of serotonin syndrome [1.4.5, 1.5.4].

Is it safe to take Kava with ayahuasca?

No, it is not considered safe. Kava is consistently listed on contraindication lists for ayahuasca, and it should be stopped at least two weeks before a ceremony [1.2.1, 1.4.4].

What about common vitamins like Vitamin C or a multivitamin?

While simple vitamins are generally considered safe, many multivitamin formulas can contain added herbs or amino acids like tyrosine. To be completely safe, it is best to simplify all supplement use and discuss every single product with your retreat facilitator and doctor.

Are there any supplements that are safe to take with ayahuasca?

The safest approach is to avoid all supplements. Some sources suggest melatonin is acceptable as the body produces it naturally [1.3.2]. However, you must get approval from the ceremony provider for any substance you plan to take.

Do protein powder supplements interact with ayahuasca?

Some protein extracts or supplements can contain yeast extract or high levels of amino acids like tyrosine, which can interact with MAOIs [1.3.3, 1.3.7]. It is recommended to avoid them as part of the pre-ayahuasca diet to prevent potential adverse reactions.