These Are the Supplements You Should Avoid Taking With Medication

As we age and with new (or more) chronic health conditions, it is common to require prescription drugs. Many people also use over-the-counter products and supplements to meet their health needs.

The use of dietary supplements and medicines is common, especially among older people, but taking certain medicines and supplements together can have dangerous and even life-threatening consequences, experts say. I’m here.

The National Center for Complementary and Integrative Medicine (NCCIH) says many people combine supplements with prescription or over-the-counter (OTC) drugs without realizing the potential interactions.

“Combining certain dietary supplements and medicines can result in a variety of adverse effects, including decreased drug efficacy, increased risk of drug toxicity, and unanticipated side effects.” Daniel Crumble Smith, RDNCertified registered dietitian. top nutrition coachingsaid Berrywell.

Here are some potentially dangerous combinations that professionals should be aware of and avoid if you are taking any medications or supplements.

Combinations of supplements and drugs that may make them less effective

Dr. Marilyn TanHe, who holds double board certification in endocrinology and internal medicine and is also a clinical associate professor at Stanford University School of Medicine, told Verywell that some supplements and vitamins can affect the absorption and metabolism of prescription drugs. . Some, like vitamin K, counteract the effects of certain drugs.

Here are some possible interactions to watch out for:

• Vitamin B6 and levodopa. Take vitamin B6 with Levodopa, which is used to treat Parkinson’s disease, may make the drug less effective. However, some levodopa drugs also contain carbidopa, which can interfere with interactions.
• Vitamin K and blood thinning medicine. Vitamin K can counteract the effects of blood-thinning drugs such as warfarin, making them less effective. If you are taking blood-thinning medications, talk to your doctor before taking vitamin K supplements or increasing your dietary intake of vitamin K.
• Drugs that replace iron or calcium and thyroid hormones. Certain supplements such as iron and calcium can interfere with the absorption of thyroid hormone replacement drugs such as: Levothyroxine. It is best to take these supplements and thyroid hormone replacements at least 4 hours apart.

Potentially Harmful Combinations of Supplements and Drugs

Some combinations of supplements and drugs can cause adverse side effects or symptoms, says Crumble-Smith.

• Vitamin C and antacids containing aluminum. Vitamin C neutralizes stomach acid and enhances the absorption of aluminum from antacids (medicine like Tams) that help relieve heartburn and indigestion. However, taking vitamin C and antacids together can lead to toxic levels of aluminum in the body. Therefore, they should be taken at least 2 hours apart.
• Vitamin E and blood thinning medicine. Vitamin E may increase the risk of bleeding when taken with blood-thinning drugs such as warfarin. If you are taking blood thinners, consult your doctor before starting vitamin E.
• St. John’s wort and various medicines. St. John’s wort supplements may interact with many medications, including antidepressants, oral contraceptives, and blood thinners. St. John’s wort can make these medicines less effective and can cause harmful effects when mixed.
• Goldenseal and blood clotting drugs. Goldenseal supplements may interact with some medications, such as clotting agents. This interaction can reduce the body’s ability to clot blood, resulting in bleeding and bruising. Given the seriousness of the interactions, it is often recommended to avoid concomitant use of Goldenseal and blood-clotting agents.
• A drug that makes ginkgo leaves and blood smooth. ginkgo Taking supplements with blood-thinning drugs, such as warfarin or aspirin, may increase the risk of bleeding.
• Licorice root and diuretic or blood pressure medicine. Supplements containing licorice root can interact with diuretics and blood pressure medications to exacerbate side effects and cause serious problems such as potassium imbalance in the body and fluctuations in blood pressure.

Talk to your doctor or pharmacist if you are taking prescription drugs and thinking about trying supplements.

What to do if you ingest these combinations

If you have been prescribed medication and plan to use supplements, timing is everything. For example, Tan said thyroid hormone drugs should be taken on an empty stomach and separated from supplements by at least four hours, especially if the supplement contains calcium or iron.

“Other endocrine drugs, such as Fosamax for osteoporosis and Libersus for diabetes, should be taken on an empty stomach and separated from other drugs by at least 30 minutes,” Tan added.

To avoid potential interactions, Crumble-Smith recommends discussing the details of dosing timing with your healthcare provider. As a general rule of thumb, wait at least two hours between taking supplements and medications.

When to check with your healthcare provider

Your health care provider can advise you on combinations to avoid and how to use supplements and drugs safely.

In general, if you’re thinking of trying something new, it’s never a bad idea to let your provider know. This is because we do not always know the risks that may be involved.

“Supplements may seem harmless, but it’s very important to consult a medical professional if you’re considering taking a new supplement,” says Crumble-Smith. “This is especially true if you are currently taking medication.”

How to see interactions yourself

When you pick up your medicine, you can also ask your pharmacist about combinations of medicines and supplements. Pharmacists are trained to know about drug interactions, including possible drug interactions with dietary supplements. You also have access to comprehensive databases and tools that allow you to check potential interactions.

A pharmacist can give advice on how to use supplements safely, how to check for interactions, how to suggest when to take them, or how to suggest alternatives. In some cases, your pharmacist may suggest dose adjustments to help avoid interactions.

Crumble-Smith said it’s important to give your pharmacist a complete list of everything you’re taking, from prescription drugs to over-the-counter products to supplements, and this information is the one that pharmacists make the most accurate assessment of. said to help.

There are also several databases and online tools from reputable resources that you can use to check yourself for possible drug-supplement interactions.

• medline plus: This website is sponsored by the National Institutes of Health (NIH) and maintained by the US National Library of Medicine. A lot of information about medicines is provided, including potential interactions between medicines.
• National Center for Complementary and Integrative Medicine (NCCIH): The NCCIH website provides general advice on the safe use of supplements and provides overviews of specific herbs and supplements.
• Drugs.com Interaction Checker: This website is a comprehensive resource for reviewing drug, herb and supplement interactions. Enter the name of any medication or supplement you take to see known interactions.

Crumble-Smith said these resources can provide useful information but are not a substitute for professional medical advice.

“Always talk to your healthcare provider or pharmacist before starting, stopping, or changing any medication or supplement,” she said.