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15 Herbal Supplements Quietly Flaring Your Autoimmune Disease (Sjögren's, MCAS, and Long COVID)

Allergy & Immunology
June 10, 2026•6 min read

One of them sent me to the hospital. And it said "natural" on the label.

I know what it feels like to be exhausted at ten or eleven at night, scrolling through your phone, watching someone online talk about how a sixty-dollar adaptogen blend changed their life. I know what it feels like to have fatigue that does not seem to respond to anything your doctors have offered, and to think that maybe this supplement is the thing you have been missing.

I have been there. And in my own attempt to find an answer through a superfood supplement, I ended up in the hospital for a liver biopsy. My liver had sustained significant damage.

I am a physician. I am an immunologist. I understand pharmacology. I still ended up there because the supplement looked safe. It was marketed as natural. Nowhere on the label did it say this may not be appropriate for someone with a dysregulated immune system.

I am sharing this not to frighten you but because the confusion around supplements and autoimmune disease is not a personal failure. It is a gap in the information patients are given. And a 2025 systematic review of nearly 12,000 studies just made that gap impossible to ignore.

What "Immune Support" Actually Means for an Autoimmune Body

When a supplement is marketed as immune support, it typically means the product stimulates immune activity, activating immune cells, increasing inflammatory signaling, and making the immune system more reactive.

For someone with a healthy, well-regulated immune system, that might sound useful. For someone living with Sjögren's disease, MCAS, or long COVID, it is often the opposite of what is needed.

In these conditions, the immune system is not weak or asleep. It is misdirected. It is generating inflammation in the wrong places, responding to signals it should be ignoring, and in the case of MCAS, releasing chemical mediators that are already driving symptoms across multiple body systems. Adding stimulation to that environment does not help the immune system find its way back. It turns up the volume on something that is already too loud.

The 2025 Research That Reframes This Conversation

A 2025 systematic review published in Lupus Science and Medicine screened nearly 12,000 studies on herbal supplements with immunostimulatory properties. The researchers identified 227 such supplements with evidence of immune-activating effects. These are not fringe products. Many of them are bestsellers, and many of them are sitting in the supplement drawers of people living with autoimmune conditions right now.

The review focused on lupus and dermatomyositis. Sjögren's disease, MCAS, and long COVID were not specifically studied, but the immune mechanisms involved overlap significantly. The pathways at issue, including toll-like receptor activation, inflammatory cytokine production, and immune cell amplification, are relevant across a broad range of autoimmune and immune-dysregulated conditions.

The 15 Herbs With the Strongest Evidence for Immune Stimulation

These fifteen were supported by human clinical data, animal studies, and lab research across all three domains:

  • Echinacea

  • Ashwagandha

  • Astragalus

  • Ginseng

  • Spirulina

  • Chlorella

  • Green tea extract

  • Garlic extract

  • Reishi mushroom

  • Licorice

  • Alfalfa

  • Skullcap

  • Mistletoe

  • Indian mulberry

  • Tinospora

Several of these are daily staples for a lot of people. Ashwagandha for stress. Spirulina and chlorella for energy. Echinacea when a cold is coming on. Reishi and astragalus in adaptogen blends. Ginseng in morning supplement stacks. These are not obscure. They are in green powders and immune support capsules on the shelves of every health food store.

Why Blends Make This Harder to Catch

These herbs rarely appear alone. They are built into green powders, adaptogen stacks, energy formulas, and immune support complexes. A single product can contain four or five of these herbs at once. The researchers noted that combining multiple immunostimulatory herbs may amplify effects beyond what any one of them would produce alone. And because they are listed under proprietary blends or in small print, people often consume them without realizing it.

What Is Happening at the Cellular Level

These fifteen herbs share a common mechanism: they activate toll-like receptors, which are alarm signals in the innate immune system. That activation increases production of interleukin-1 beta, interleukin-6, and TNF-alpha, the same inflammatory signals that are already overactive in autoimmune disease and that can directly trigger mast cell mediator release in MCAS. These supplements can push those signals higher and work against the same targets that medications for these conditions are trying to quiet.

Two Things to Do Today

Audit Your Supplement Drawer

Go to wherever your supplements live (cabinet, counter, Amazon subscription list) and cross-reference everything against the fifteen herbs above. Check single-ingredient supplements first, then flip every blend and read the full ingredient list, not just the front label. Pay close attention to green powders, adaptogen blends, energy formulas, and anything labeled immune support or immune boost.

Write down what you find. That list goes to your next clinical appointment.

This is not a call to throw everything out without medical guidance. Your doctor, nurse practitioner, or physician assistant needs to weigh in on what is appropriate for your specific situation. What this audit gives you is a starting point for a conversation that may not have happened yet. If you have been experiencing unexplained flares and you are taking any of these supplements, that connection is worth exploring.

Bring It to Your Next Appointment

You do not need to walk in saying something is wrong. You can say: "I have been reading about immunostimulatory herbal supplements and their effects in autoimmune disease. Can we look at my full supplement list and identify anything worth reconsidering?"

That is a reasonable clinical question. The 2025 paper is open access, and the link is in the resources below. You can bring it with you if helpful. Your supplement list should be reviewed at every appointment alongside your prescriptions, and now you have the language to make sure that happens.

If You Reached for Supplements Because Conventional Medicine Felt Slow

That is not something to feel ashamed of. I made the same choice. The wellness industry is very good at filling the gap that conventional medicine leaves open, and the products look safe because they are labeled as natural.

What changes now is that you have the research and a specific list of things to look for. Save this before your next supplement order. And if someone in your life is navigating Sjögren's, MCAS, long COVID, or any other autoimmune condition and doing the same late-night supplement scroll, send this to them.

Let's Keep the Conversation Going

Have you ever had an unexplained flare that may have been connected to a supplement? Has a provider ever reviewed your supplement list alongside your prescriptions? Share in the comments. These patterns matter and I read every response.

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