Across South Africa, an estimated 60-80% of the population uses traditional medicine at some point, whether alongside or instead of conventional treatment. For many patients, traditional healers (izangoma, izinyanga, amaxhwele) are a trusted first point of contact for illness, and indigenous plant remedies remain deeply woven into everyday health-seeking behaviour. Rather than treating this as a parallel system, modern healthcare has a real opportunity to bring traditional medicine into the fold as a genuine part of the care model, supported by good evidence, safety monitoring, and mutual respect between traditional and conventional practitioners.

A rich and living pharmacopoeia

Southern Africa's flora has produced some of the world's most recognisable botanicals. A few of the better-studied examples include:

• Pelargonium sidoides ("Umckaloabo"): probably the best-commercialised example, now sold internationally in complementary products for upper respiratory tract symptoms.
• Harpagophytum procumbens ("devil's claw"): widely used and researched for musculoskeletal pain.
• Sceletium tortuosum ("kanna" or "kougoed"): used traditionally by the San and Khoikhoi people for mood, stress relief, and social/spiritual purposes; now one of the more clinically developed examples, with a standardised extract studied in placebo-controlled human trials for anxiety and stress reactivity.
• Aloe ferox ("bitter aloe", Cape aloe): the bitter latex is a long-used traditional laxative, now a common ingredient in over-the-counter pharmacy laxatives and digestive products.
• Agathosma betulina (buchu): traditionally used as a diuretic, and for urinary tract and digestive complaints, and one of the most commercially developed South African botanicals, appearing in pharmacy products for bladder and kidney support.
• Aspalathus linearis (rooibos): familiar in both traditional and consumer wellness contexts.

Many of these plants have travelled the same path: originating in traditional healer practice as part of a broader diagnostic and treatment approach, and (through research and commercialisation) moving into standardised forms on pharmacy shelves. That journey is itself a working model of integration, not a replacement of one system by the other.

Where the science stands, and why integration is achievable

Some of Southern Africa's traditional botanicals already have a real foothold in evidence-based practice. Devil's claw and Pelargonium sidoides, for instance, are backed by a reasonable body of clinical research on specific, standardised extracts. Sceletium tortuosum's primary alkaloid, mesembrine, has been characterised as a serotonin reuptake inhibitor with additional PDE4-inhibiting activity, and a standardised extract has undergone placebo-controlled human trials for anxiety and stress reactivity, a good example of indigenous knowledge and modern pharmacology validating each other.

Commercialisation and pharmacy availability are also exactly why interaction awareness matters. Devil's claw has documented antiplatelet and mild anticoagulant-potentiating effects, relevant for patients on warfarin or other anticoagulant therapy. Aloe ferox, used chronically as a stimulant laxative, can contribute to electrolyte loss (particularly potassium), which matters for patients on diuretics or digoxin, where hypokalaemia increases toxicity risk. Sceletium's serotonergic mechanism raises a related consideration: as with any serotonin reuptake inhibitor, its combination with prescribed SSRIs, SNRIs, or MAOIs warrants clinical awareness.

Why full disclosure to your healthcare provider matters

Integration only works if it's built on complete information. A doctor or pharmacist can only account for a herbal remedy's effects if they know it's being used. Patients often stay silent, assuming a remedy is irrelevant ("it's just a tea") or fearing judgement, and that silence is where risk creeps in.

The fix: every medicine, supplement, and traditional remedy belongs in the conversation, every time.

For patients

• Tell your doctor or pharmacist about every remedy you use (herbal, traditional, or over-the-counter) at every consultation. It matters most when using chronic medication (antiretrovirals, anticoagulants, diabetes, or heart medication carry the highest interaction risk).
• Traditional and conventional care can work together with the right guidance. Don't stop a prescribed medicine for a traditional remedy without discussing it first.
• Be cautious of strong claims, especially around serious conditions like cancer or HIV, where a product promises a cure or replacement for conventional treatment.
• Source matters. Products from a registered pharmacy or recognised traditional health practitioner carry far less uncertainty than those from informal markets.

For healthcare providers

• Ask, don't assume. Make traditional and herbal medicine use a routine part of every medication history, not just intake.
• Flag interaction-prone patients: those on the medication classes above, or any narrow-therapeutic-index drug, warrant particular attention given documented interaction pathways.
• Engage as a collaborator, not a gatekeeper. Treating traditional remedy use as part of the overall care plan (including, where relevant, communicating with the traditional practitioner involved) builds trust and improves disclosure.
• Loop in pharmacist colleagues for interaction checks and dosing guidance as this field matures.

Closing thought

South Africa's traditional medicine landscape isn't a footnote to conventional healthcare; for the majority of patients, it already is healthcare. The path forward is integration: bringing traditional remedies into structured, evidence-based, safety-monitored care, built on open communication and genuine collaboration between traditional and conventional practitioners. Done well, this isn't a compromise between two systems; it is a more complete model of care for the patients both are meant to serve.

This article is intended for general informational purposes only and does not constitute medical advice or promote any specific product, brand, or therapeutic claim. Patients should consult a healthcare provider before combining traditional remedies with prescribed medication.

iDexis, a fully licensed compounding pharmacy, is aware of recent media reports concerning the alleged seizure and recall of products compounded by the company, as well as related public health concerns.

A number of these reports are inaccurate and require clarification.

These publications have appeared more than a month after the matter was argued before the Gauteng High Court and following the granting of an interim interdict against iDexis.

The company has instructed its legal representatives to apply for leave to appeal the judgment. iDexis has been advised that several of the findings have final effect and are therefore appealable. An application for leave to appeal has accordingly been lodged.

Products Handed to Inspectors

During an inspection conducted at iDexis's fully licensed Pretoria premises on 11 May 2026, a number of compounded products were voluntarily handed to inspectors representing the South African Health Products Regulatory Authority (SAHPRA) and/or the South African Pharmacy Council (SAPC) following requests that the products be made available for inspection.

To the company's knowledge, neither SAHPRA nor the SAPC has, to date, conducted or disclosed the results of any testing performed on those products.

By contrast, independent testing commissioned by iDexis found no evidence of any breach of sterility. The company therefore maintains that the products were safe for use and that appropriate compounding procedures were followed. This position is supported by an independent expert report that has already been provided to both SAHPRA and the SAPC.

Regulatory History

iDexis is concerned by what appears to be a developing public narrative suggesting that SAHPRA and the SAPC only recently became aware that the company was compounding the GLP-1 and GIP products that later became the subject of litigation involving Novo Nordisk.

That narrative is inconsistent with the regulatory history.

The company's legal representatives informed SAHPRA of iDexis's specific compounding activities several years ago. Thereafter, both SAHPRA and the SAPC conducted inspections at the company's premises.

Those inspections resulted in favourable grading by the SAPC, and neither regulator raised material objections regarding the company's compounding activities prior to the inspections conducted in May 2026.

The compounding of GLP-1 and GIP products was taking place at the premises during those earlier inspections and was capable of being observed by inspectors. Accordingly, any suggestion that these activities were concealed from, or only recently discovered by, the regulatory authorities is rejected.

As previously indicated, we respect the court and we have ceased compounding GLP-1 and GIP products after the judgment was handed down. We remain committed to conducting our business lawfully and with due regard for public health and safety.

Ongoing Legal Processes

Appeals have also been lodged against the relevant findings and decisions of SAHPRA and the SAPC. 

iDexis remains committed to exhausting the internal remedies prescribed by law. Should those processes fail to resolve the disputes fairly and lawfully, the company intends to pursue the appropriate relief before courts of competent jurisdiction.

The company remains of the view that certain public statements and publications attributed tovSAHPRA and the SAPC are inaccurate, materially prejudicial, and have caused significant harm to its business and reputation.

Concerns Regarding Regulatory Consistency

iDexis is also concerned that it appears to have been singled out, notwithstanding that a number of compounding pharmacies throughout South Africa are understood to be compounding similar products.

The company is further aware of information suggesting that one such pharmacy may be associated with an individual who performs inspection functions for SAHPRA. This raises legitimate concerns regarding consistency, transparency and potential conflicts of interest. iDexis reserves all of its rights in this regard.

Commitment to Patients and Healthcare Professionals

iDexis does not intend to litigate these matters through the media. However, continued media enquiries and the repetition of inaccurate allegations have made it necessary to place the company's position on record.

No further statements will be made at this stage.

iDexis remains committed to the quality and safety of its compounded medicines and to serving the interests of patients, healthcare practitioners and retail pharmacies.

The company will continue to apply the highest appropriate quality standards, pursue available legal remedies through the prescribed processes, and take all necessary steps to vindicate its position and restore its reputation within the South African compounding pharmacy sector.

Kind regards,

Ruaan Louw (Managing Director - iDexis)

Allergies are a common immune condition in which the body's defence system mistakenly identifies a harmless substance, such as a food protein, pollen grain, or insect venom, as a threat. This immune response produces the itching, swelling, and inflammation typical of an allergic reaction. In more severe cases, it can spread systemically and become life-threatening, a condition known as anaphylaxis.

Notably, this immune response does not occur on first contact with a substance. Allergies typically develop in two stages. The first is sensitisation, which occurs on initial exposure to an allergen: the immune system encounters the substance, wrongly flags it as dangerous, and begins producing specific IgE antibodies against it. This stage usually causes no visible symptoms, so a person can become sensitised without ever knowing it.

It's only on subsequent exposure to the same substance that these IgE antibodies, now primed and waiting, trigger immune cells to release histamine and other chemical mediators, producing the classic allergic reaction. This two-step process explains why someone can eat a food or use a product for years without issue, then suddenly react to it.

Understanding the main types of allergies and the broad treatment approaches used to manage them can help patients recognise symptoms earlier and engage more confidently with their own care.

Types of Allergies

Allergic rhinitis, commonly known as hay fever, occurs when the lining of the nose becomes inflamed in response to airborne allergens such as pollen, dust mites, mould spores, or pet dander. It typically presents with a runny or blocked nose, sneezing, and itchy or watery eyes. It may be seasonal (tied to specific pollen seasons) or perennial (with symptoms persisting year-round due to ongoing exposure to indoor allergens).

Food allergies develop when the immune system reacts to specific proteins found in foods such as peanuts, tree nuts, shellfish, eggs, milk, or wheat. Reactions vary widely, from mild itching or hives to anaphylaxis, involving throat swelling and a dangerous drop in blood pressure.

Skin allergies can appear as hives (urticaria), eczema (atopic dermatitis), or contact dermatitis. These may result from direct skin contact with a trigger, such as certain metals or fragrances, or occur as part of a wider allergic response to something eaten or inhaled.

Insect sting allergies, most often linked to bee or wasp stings, cause localised swelling and discomfort in most people, but in sensitised individuals can trigger a rapid, whole-body allergic reaction. Because these reactions can escalate quickly, this category is considered one of the higher-risk forms of allergy.

Drug allergies occur when a person's immune system reacts to a specific medication, with symptoms ranging from a mild skin rash to a severe systemic reaction. Because the consequences can be serious, keeping an accurate and up-to-date record of known drug allergies is an essential part of safe healthcare and pharmacy practice.

Prevention: The First Line of Defence

Before considering treatment, it's worth stressing that avoiding a known trigger is, in most cases, the single most effective way to manage an allergy. Medication can control symptoms once a reaction has started, but prevention reduces how often that reaction happens and lowers the risk of it becoming severe.

Practical prevention varies by allergy type: avoiding a specific food and checking ingredient labels carefully, using allergen-proof covers on bedding and reducing humidity to limit dust mite exposure, monitoring pollen counts and keeping windows closed during high-pollen periods, being cautious around known insect habitats if venom-sensitive, and ensuring drug allergies are clearly recorded on medical files to prevent accidental re-exposure.

Working with a healthcare provider to properly identify specific triggers, through allergy testing where appropriate, is what makes meaningful prevention possible.

Treatment Options

Treatment decisions should always be made with a healthcare provider, but management of allergies generally falls into a few broad categories.

Antihistamines act by blocking the action of histamine, the chemical mediator largely responsible for the itching, swelling, and rhinorrhoea characteristic of an allergic reaction. They are generally used as first-line treatment for mild to moderate symptoms such as allergic rhinitis and hives.

Corticosteroids exert a broader anti-inflammatory effect and are administered in various forms depending on the site of involvement, including intranasal preparations for allergic rhinitis and topical formulations for skin allergies and eczema. In more severe or acute reactions, a short course of oral or injectable corticosteroids may be administered under medical supervision to achieve rapid control of inflammation.

Emergency treatment is critical for anyone at risk of anaphylaxis. This usually means having a fast-acting, self-administered treatment on hand at all times, along with a clear emergency action plan worked out in advance with a healthcare provider.

Conclusion

Allergies range in severity from the localised discomfort of allergic rhinitis to the systemic threat of anaphylaxis, but each presentation stems from the same underlying process: an immune system sensitised during an earlier, often unnoticed, exposure, then primed to react on subsequent contact with the same allergen. Antihistamines, corticosteroids, and related treatments remain effective for controlling symptoms once a reaction has begun, but prevention, through accurate identification of triggers and consistent avoidance, remains the most reliable means of reducing both the frequency and severity of allergic reactions. Anyone experiencing recurrent or worsening symptoms, particularly respiratory difficulty, facial or throat swelling, or involvement of multiple body systems, should seek prompt medical attention. Taken together, accurate allergy testing, informed prevention, and an individualised treatment plan offer the most effective path to long-term symptom control and improved quality of life.

What is BPH?

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland that becomes increasingly common with age, affecting a large proportion of men from their fifties onward. As the prostate enlarges, it can compress the urethra and affect bladder function, giving rise to a cluster of lower urinary tract symptoms (LUTS). These symptoms generally fall into two overlapping categories: voiding symptoms (caused by physical narrowing of the outlet), which may include a weak or interrupted stream, straining to urinate, hesitancy, and a sense of incomplete bladder emptying - and storage symptoms (related to bladder irritability and neuromuscular tone), which may include urinary frequency, urgency, and nocturia (waking at night to urinate). Most men experience some combination of both, though the balance varies considerably from patient to patient, which is part of why no single intervention suits everyone equally.

Nutraceutical support for BPH-related symptoms works through several distinct mechanisms: hormonal, anti-inflammatory, antioxidant, and mild muscle relaxation. Because these ingredients act differently, patients may benefit differently depending on their symptom presentation. And, trialling a nutraceutical option under practitioner guidance (as an adjunct to conventional management) is a reasonable thing to consider.

Beta-sitosterol

How it works: Beta-sitosterol partially inhibits 5-alpha-reductase, the enzyme that converts testosterone into DHT - the hormone most responsible for prostate growth. It works via the same pathway as finasteride, though considerably less potently. It may also have some anti-inflammatory activity in prostate tissue.

Clinically, this means that beta-sitosterol is more likely to help with weak stream, straining, and incomplete emptying than with urgency or frequency, since it targets hormone-driven prostate growth (the growth of which creates a physical blockage) rather than bladder muscle tone. Its effect on DHT is milder than finasteride's, so expect a smaller improvement, not an equivalent one.

Clinical evidence: A review pooling four placebo-controlled trials in 519 men found beta-sitosterol was well tolerated and improved urinary symptom scores and flow in men with mild to moderate BPH; symptom scores improved by almost 5 points more than placebo, with better flow and less residual urine. It did not reduce prostate size compared with placebo, and long-term safety data remain limited.

Saw palmetto

How it works: Saw palmetto's fatty acids and plant sterols act through several routes at once: mild DHT reduction (similar principle to beta-sitosterol), a modest relaxing effect on the bladder neck muscle (same direction as alpha-blockers, much milder), and some anti-inflammatory activity.

Clinically, this means that due to multiple mechanistic pathways, Saw Palmetto may provide benefit for a broader symptom range than beta-sitosterol: the DHT-reduction component may aid the same outlet-narrowing symptoms (weak stream, straining, incomplete emptying) as beta-sitosterol, while the muscle-relaxing component adds potential coverage of urgency, hesitancy, and bladder neck-related obstruction. In principle, this makes it a candidate for patients with a more mixed symptom picture rather than one dominated by a single pattern. Real-world results vary largely between products, tracking with extract concentration and standardisation.

Clinical evidence: A review of 27 studies found saw palmetto alone provided little or no benefit for BPH symptoms, and two NIH-funded trials showed no improvement over placebo. That said, newer, more concentrated extracts have outperformed older, less standardised versions in head-to-head trials, suggesting product quality and standardisation play a meaningful role. Not all saw palmetto products are equivalent.

Lycopene

How it works: Lycopene is a potent antioxidant that protects prostate cells from oxidative damage. It also appears to interfere with growth signals that drive cell proliferation, calm inflammation, and support normal cell-to-cell communication, a process that tends to break down in abnormal cell growth.

Clinically, this means that lycopene may provide slower, cellular-level effects rather than acting on bladder muscle tone or urine flow directly. Lycopene is better positioned for long-term risk reduction than for relieving day-to-day urinary symptoms; it shouldn't be expected to noticeably improve flow the way beta-sitosterol or an alpha-blocker might. It has value as a supportive treatment.

Clinical evidence: The stronger body of evidence relates to prostate cancer risk reduction rather than day-to-day BPH symptoms, and trials on urinary symptoms specifically show only modest benefit. Because of this, lycopene is best used as a supporting ingredient within a broader treatment plan.

Why targeting multiple pathways makes sense

Because beta-sitosterol, saw palmetto, and lycopene each act on different aspects of BPH pathology - hormonal, anti-inflammatory/muscle tone, and oxidative/cellular, respectively - there's a sound rationale for combination treatments. Further, adding nutraceuticals onto prescription treatment may provide additional symptom support. Nutraceuticals have a place in a well-rounded, individualised patient treatment plan.

Conclusion

BPH is not a uniform condition, and symptoms vary from one patient to the next. Beta-sitosterol, saw palmetto, and lycopene each offer a distinct, evidence-supported mechanism, and understanding which symptom pattern each is more likely to influence allows for a more considered, individualised approach rather than a one-size-fits-all recommendation.

Disclaimer: None of the ingredients discussed here have been shown to reduce prostate size, and their supporting evidence relates to general wellness use rather than treatment of a diagnosed medical condition. As with any supplement regimen, patients should be encouraged to discuss nutraceutical options with their treating practitioner or pharmacist, particularly where they are also using prescription therapy such as an alpha-blocker or 5-alpha-reductase inhibitor, or undergoing routine PSA monitoring. Used thoughtfully and under guidance, nutraceuticals can be a reasonable adjunct within a broader, personalised approach to prostate health.