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Health


6 SUPPLEMENTS THAT DON’T ALWAYS MIX WITH PRESCRIPTION DRUGS


OVER-THE-COUNTER VITAMINS, HERBS AND MINERALS AREN’T WITHOUT POTENTIAL RISKS

--------------------------------------------------------------------------------

By

Constance Sommer,

 

AARP
En español
Published April 06, 2022
/Updated June 05, 2023
Ganna Prykhodko / Getty Images
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Turmeric, ginseng, a probiotic, even vitamin C — all of these, when taken in
packaged form, are supplements. Some have lined store shelves for decades.
Others are ancient cures processed and packaged for 21st-century consumers.



Whatever their history, supplements are everywhere these days, and consumers are
eating them up, spending billions each year on capsules, powders and gummies.
More than half of adults age 20 and older have taken one in the past 30 days,
data from the National Health and Nutrition Examination Survey found — and that
percentage increases with age. About 80 percent of women over age 60 take
dietary supplements, the same report shows.

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But what many adults don’t realize is that taking some of these supplements
alongside prescription drugs and other medicines can have dangerous and even
life-threatening effects. A number of supplements can enhance, diminish or
negate a prescription drug in ways that can be consequential and unpredictable,
says Laura Shane-McWhorter, a clinical professor of pharmacology at the
University of Utah.



Still, federal research shows about 34 percent of survey participants —
representing roughly 72 million people in the United States — take some kind of
dietary supplement along with a prescription medication.



Wondering which supplement-prescription pairings can be risky? Here are six
popular supplements and their known effects on some common medications.




1. ST. JOHN’S WORT



Derived from a flowering shrub native to Europe, St. John’s wort is often taken
to treat mild to moderate depression, or to reduce menopausal symptoms such
as hot flashes. But it has numerous drug interactions and can reduce the potency
of birth control pills and hormone replacement therapy, Shane-McWhorter says. It
can also interfere with omeprazole (Prilosec), alprazolam (Xanax), certain
statins and some antihistamines, Mayo Clinic reports.



What’s more, St. John’s wort can render the COVID-19 antiviral
treatment Paxlovid powerless. “If a person is being treated with Paxlovid and is
taking St. John’s wort, that means essentially that the Paxlovid may not work,”
Shane-McWhorter says.




2. COQ10



Coenzyme Q10 (CoQ10) is an antioxidant produced by our bodies to promote cell
growth and maintenance; the levels of it in our body can decrease as we age.



In supplement form, it’s taken by way of capsules, tablets and syrups for
numerous conditions, including heart disease, diabetes and migraine. But CoQ10
can also interfere with the ability of blood thinners to do their job, which is
to prevent blood clots from forming. As a result, “people could have a
breakthrough blood clot,” Shane-McWhorter says.




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3. TURMERIC



The ancient spice has been shown to have many health benefits, from improving
memory to lowering inflammation and even decreasing the risk of heart disease.
It also has anticoagulant effects, which means you don’t want to mix turmeric
supplements with a blood thinner or even, possibly, aspirin, due to the risk of
internal bleeding, Shane-McWhorter says.

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Ginkgo biloba (an herb) and vitamin E are two other dietary supplements that can
thin the blood, according to the Food and Drug Administration (FDA). So taking
them with an anticoagulant can augment the effect. 



Cooking with turmeric? It’s still fine to use in the kitchen, Shane-McWhorter
says. “When products are used as foods, we don’t think it’s that much of an
issue at all,” she adds.


THE FDA AND DIETARY SUPPLEMENTS 


Unlike its role for over-the-counter medications and prescription drugs, the
Food and Drug Administration is not in charge of making sure dietary supplements
are safe before they hit store shelves. Similarly, the agency doesn’t review
supplements for effectiveness before consumers can purchase them. The FDA can,
however, take action if a product is found to have a false or misleading label
or contain an unsafe ingredient.


4. PROBIOTICS



Full of beneficial bacteria, probiotics are often taken to aid digestion
and improve gut health. But don’t take one within two hours of taking an
antibiotic, or you could reduce the effectiveness of the prescription
medication, Shane-McWhorter says.




5. VITAMIN C



Vitamin C occurs naturally in citrus fruits, strawberries, broccoli and
tomatoes, among other foods. It’s also consumed as a supplement for a myriad of
reasons, ranging from warding off the common cold to preventing cancer.



But high-dose vitamin C supplements may reduce the effectiveness of some types
of cancer chemotherapy, says Courtney Rhodes, a spokeswoman for the FDA. It can
also interfere with niacin and statins and affect estrogen levels, according to
Mayo Clinic.




6. MILK THISTLE



A flowering plant related to daisies, milk thistle is taken as a supplement to
promote liver and heart health. It may also lower blood sugar, which could be a
concern for someone who’s on diabetes medication. When combined with insulin, it
can be “like taking a little bit too much” glucose-lowering medication,
Shane-McWhorter says.



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BOTTOM LINE: TALK TO YOUR DOCTOR



Ideally, to head off trouble, patients would be talking to their doctors about
the supplements they are taking. But these conversations don’t happen as often
as they should, says Derjung Mimi Tarn, M.D., a professor of family medicine at
University of California, Los Angeles.



A study led by Tarn and her colleagues in 2015 found that fewer than 50 percent
of patients disclose the use of dietary supplements, and even among those who
do, only about one-third of the supplements taken are mentioned to doctors.



One reason for the disconnect: Patients may not realize the over-the-counter
herbs or extra vitamins they’re working into their daily pile of pills count as
anything that needs to be discussed with a doctor, so they leave them off the
list when their provider asks, Shane-McWhorter explains. It’s also not uncommon
for consumers to confuse “natural” with “safe” and fail to fully recognize the
potency of some of these products.



To help avoid any health hazards that can arise from mixing supplements and
medications, it’s important to ask your doctor about possible adverse reactions
before starting any new medication or supplement, Tarn says. “Greater awareness
of the importance of discussing supplement use is needed in both providers and
patients,” she adds.



The FDA suggests bringing a list of everything you take — over-the-counter
medicines (pain pills, allergy relief, etc.), dietary supplements and
prescription drugs — with you to your next routine appointment to make sure your
information is up to date. And be sure to keep track of the dosages and how many
times a day you take them.



Also, if you’re planning a surgery, don’t be surprised if your doctor asks you
to stop taking dietary supplements two or three works before the procedure to
avoid changes in heart rate, blood pressure or bleeding risk.



Interested in learning more? The National Institutes of Health has
a database where you can search for a supplement and find links to verified
sources with information about the product and its interactions. And Herbs at a
Glance is an alphabetical listing of herbs and botanicals, with information on
their uses and safety concerns, from the National Center for Complementary and
Integrative Health, a division of the NIH.



For those willing to pay, Shane-McWhorter recommends the Natural
Medicines database, where subscribers can use the interaction checker and the
effectiveness checker to learn more about particular supplements. 



Editor’s Note: This story, originally published April 6, 2022, has been updated
with new information.


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MEMBERS ONLY
Restaurants

Corner Bakery Cafe

10% off dine-in and carry-out orders

learn more
See more Restaurants offers >
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MEMBERS ONLY
Health & Wellness

AARP® Prescription Discounts provided by Optum Rx®

Free Rx discount card for use at over 66,000 pharmacies nationwide

learn more
See more Health & Wellness offers >
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AARP MEMBERSHIP

Join or Renew Today

Save 25% when you sign up for automatic renewal

Learn More
See more Health & Wellness offers >
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234
 * 
 * 
 * 
 * 


 * Health & Wellness
   
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