Dietary Supplements: What your doctor needs to know (Hint: Everything)

Dietary supplements are seen as kind of homely, quaint, benign. Almost the stuff of fairy tales – like Peter Rabbit’s mother giving him chamomile for his upset stomach.

But she was probably totally oblivious to the fact that if the little chap was taking aspirin he might have bled to death.

OK, maybe a little hyperbolic, but the message is, natural remedies and supplements can have significant interaction with medicines – like chamomile interacting with aspirin (or other so called NSAIDs) to increase the risk of bleeding.

The problem is, as reported by the New England Journal of Medicine, 70% of patients don’t tell their doctor when they are using some form of integrative therapy – which often involves supplements.

I talk in Managing Your Doctor about another example. About Ma Huang.

I am not very informed about supplements (as is the case with many doctors, so you are liable to have to coach yours) but I know about this from the story of a patient whose heart kept racing. An ECG and Holter monitor didn’t help. The tests didn’t show any arrhythmia or abnormality.

The diagnosis only became apparent when the patient told his doctor, in enthusiastic terms, he was drinking this special, super, Chinese tea.

The tea was Ma Huang, which contains ephedra, which is a strong stimulant that razzes you up, but can also can razz up your nervous and cardiovascular systems -  to the point of causing high blood pressure, irregular heart beat, even seizures and heart attack in susceptible subjects.

This brought to my attention what “natural” products can do.

There are many interactions with different supplements. Probably the biggest threat is interference by many of them with the action of the blood thinner warfarin (more commonly known by its brand name Coumadin), either increasing its effect (increasing the risk of bleeding), or decreasing it (risking blood clots).

St John’s Wort can speed the metabolism of antidepressants and birth control pills. Antioxidants can diminish the effects of cancer therapy.

Or better still check it out for yourself, and bring to your doctors attention any potential interactions, by going to somewhere like the NIH website of The Office of Dietary Supplements, at:

Or go to the AARP site: - which allows you to check specific interactions with medicines (though I found it a bit limited in what drugs and supplements are included).

Again, it's your health, so don't leave it to chance.

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