Medications and Herbal Remedies May Not Mix
Take care to avoid medication and supplement interactions
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, simply 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, their possible side effects, and their potential to interact with other medications. Before taking a supplement, it’s important to talk with your health care provider or pharmacist about any possible side effects these supplements can have, especially if you are taking other medications.
“First and foremost, consumers should remember that dietary and herbal supplements are not regulated by the Food and Drug Administration (FDA), as other
over-the-counter and prescription medications are, says Nicole Davis, M.D., family medicine. “Therefore, supplements are not subject to the same requirements that FDA-approved medications must meet for consumer safety. Also, the quality and ingredients in supplements 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 items in your medicine cabinet such as vitamin E, folic acid, calcium, and zinc supplements.”
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. “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,” says Dr. Davis. 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.
To learn more and click on “Health Resources” and “Interactive Tools,” and take the Dietary Supplement Quiz, Vitamins Quiz or the Alternative and Complimentary Medicine Quiz.
Supplement Savvy
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” (UL) 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.
Nicole Davis, M.D., is board certified in family medicine and is in practice at Chestnut Hill Family Care Associates in Wyncote and Ft Washington.
Chestnut Hill Hospital (CHH) is a community-based, university-affiliated, teaching hospital committed to excellent patient-centered care. CHH provides a full range of inpatient and outpatient, diagnostic and treatment services for our neighbors in northwest Philadelphia and eastern Montgomery County. More than 300 board-certified physicians comprise the medical staff and support medical specialties including minimally invasive laparoscopic and robotic surgery, cardiology, gynecology, oncology, orthopedics, urology, family practice and internal medicine. Our comprehensive services include primary care practices, two women’s centers and an off-site physical therapy center. CHH is affiliated with university-hospitals in Philadelphia for heart, stroke and cancer care, as well as our hospitalist and residency programs. Chestnut Hill has 164-beds and is accredited by the Joint Commission. To learn more about CHH, Visit.