Medication, herbal remedies may not mix

Published 10:33 am Wednesday, February 29, 2012

By Dr. J. Michael Ponder

Approximately 40 percent of all Americans take some type of dietary or herbal supplement, according to the American Council on Science and Health.

Although these supplements are usually taken to improve health, using supplements — especially if you are taking certain medications — may actually put your health at risk.

Over the years, the popularity of certain herbal supplements has grown — in some cases, as a substitute for over-the-counter or prescription medications, and in others, to promote the healthful benefits these products promise.

Dietary supplements take many forms, and include vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes or organ tissues. They can also be extracts or concentrates, tablets, capsules, softgels, gelcaps, liquids, or powders.

Among the primary concerns of dietary and herbal supplements are their content, possible side effects and potential to interact with other medications. Before taking a supplement, it’s important to talk with your doctor or pharmacist about possible side effects, especially if taking other medications.

First and foremost, health care consumers should remember that dietary and herbal supplements are not regulated by the Food and Drug Administration, as other over-the-counter and prescription medications are. Therefore, supplements are not subject to the same requirements that FDA-approved medications must meet for consumer safety.

Also, the quality and ingredients may vary widely according to the manufacturer. This includes not just herbal supplements such as St. John’s Wort, Echinacea and ginseng, but also vitamins and other common substances found in your medicine cabinet — vitamin E, folic acid, calcium, and zinc supplements, for example.

Supplements can interact with other medications in a variety of ways. Sometimes, a drug and a supplement may have similar effects on the body — so, taking both at the same time can have a doubly strong effect.

For example, taking a prescription blood thinner, as well as a supplement that also inhibits blood coagulation, such as vitamin E or fish oil, could cause abnormal bleeding. In other instances, the supplement and the drug may counteract each other, reducing the effectiveness of the medication.

A supplement can also interact with over-the-counter medications, such as aspirin, a cold medicine or cough syrup, or with substances such as alcohol or caffeine.

On their own, herbal and dietary supplements can cause serious health risks for people with existing chronic conditions, such as diabetes or heart disease. Even in a healthy person, taking certain supplements — or too much of a particular supplement — can cause serious problems such as heart, nervous system, liver or kidney damage.

Safety regarding supplements and medications is important for everyone, but especially the elderly, due to physiological changes related to the aging process — and the fact that the elderly take more medications than the general population.

Other individuals with higher risk include women who are or may become pregnant, nursing mothers, individuals with chronic health conditions, patients who will be undergoing diagnostic tests, and anyone who is taking any type of prescription or over-the-counter medication.

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If you do choose to take dietary supplements, heed these precautions:

  • Watch out for false statements like, “A quick and effective ‘cure-all,’ “can treat or cure diseases,” “totally safe” or “has no side effects.”
  •  Remember that the term “natural” does not always mean safe.
  •  Do not assume that even if a product may not help you, it at least won’t hurt you.
  •  When searching for supplements on the Internet, research websites of respected and well known health or government organizations, rather than doing blind searches.
  •  Ask your doctor for help in distinguishing between reliable and questionable information.
  •  Do not take supplements that provide more than the “Tolerable Upper Intake Level” of any vitamin or mineral unless your doctor has specifically advised you to do so. If you don’t know the UL (or if none has been established for a particular nutrient), don’t take more than 100 percent of the daily allowance.
  •  Do not take supplements that contain any of these particularly risky ingredients: chaparral, comfrey, ephedra (ma huang), gamma butyrolactone, germander, lobelia, wormwood, or yohimbe.
  •  Do not use dietary supplements as a substitute to treat a health problem. See your doctor first, have your problem diagnosed properly, and then ask your doctor whether treatment with dietary supplements is appropriate.