When Supplements Become Dangerous

It’s important to remember that Supplements are powerful, which is why we take them of course.

But what we don’t often think about is their potential interaction with prescription medications we are also taking.  Based on the meds I am taking, my MD probably couldn’t tell me what Supplements to avoid, unless they were obvious ones. Do your research!

Supplements can increase the effect of some medications or inhibit the effectiveness of others. They may interact in a way that is less than desirable, so it’s important to tell you doctor when you are thinking of adding supplements, and if she/he isn’t sure about interactions, turn to the a reliable internet source, or better yet, an Anthroposophic or CAM practitioner.

Based on an article I read in an AARP publication, I did a little more research and am going to list some common Supplements and possible interactions here.

Aloe

Aloe Vera

Major interaction: Digoxin (Lanoxin)

When taken by mouth, aloe latex is a type of laxative called a stimulant laxative. Stimulant laxatives can decrease potassium levels in the body. Low potassium levels can increase the risk of side effects of digoxin (Lanoxin).
Taken orally, aloe vera may also interact with blood sugar-lowering medicine used to treat Diabetes.

Bitter Orange

This supplement contains chemicals that can speed heart rate and increase blood pressure to dangerous levels.

  • There have been reports of fainting, heart attack, and stroke in healthy people after taking bitter orange supplements alone or combined with caffeine. People should avoid taking bitter orange supplements if they have a heart condition or high blood pressure, or if they are taking medications (such as MAO inhibitors), caffeine, or other herbs/supplements that speed up the heart rate.
  • Due to lack of safety evidence, pregnant women or nursing mothers should avoid products that contain bitter orange.
  • Bitter orange oil used on the skin may increase the risk of sunburn, particularly in light-skinned people


GinkgoGingko Biloba

Ginkgo biloba interactions include bleeding when combined with Warfarin, raised blood pressure when combined with a Thiazide diuretic and coma when combined with the anti-depressant Trazodone (Desyrel, Oleptro, Beneficat, Deprax, Desirel, Molipaxin, Thombran, Trazorel, Trialodine, Trittico, and Mesyre).


Ginseng

Major Interaction: Warfarin (Coumadin)

Warfarin (Coumadin) is used to slow blood clotting. American ginseng has been reported to decrease the effectiveness of Warfarin (Coumadin). Decreasing the effectiveness of warfarin (Coumadin) might increase the risk of clotting. Do not take American ginseng if you take warfarin (Coumadin).

Moderate Interaction: Medications for depression (MAOIs) and Anti-diabetes drugs

American ginseng might stimulate the body. Some medications used for depression can also stimulate the body. Taking American ginseng along with these medications used for depression might cause side effects such as anxiousness, headache, restlessness, and insomnia.  Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.

American ginseng might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking American ginseng along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. Medication dose might need to be changed.  Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.


Kava

In March 2002, the U.S. Food and Drug Administration (FDA) issued an advisory to consumers of the potential risk of severe liver injury from the use of dietary supplements containing kava (also known as kava kava or Piper methysticum). Reports from health authorities in Germany, Switzerland, France, Canada, and the United Kingdom have linked kava use to at least 25 cases of liver toxicity, including hepatitis, cirrhosis, and liver failure, prompting some of these countries to remove kava from the market.

Avoid driving and operating heavy machinery while taking kava because the herb has been reported to cause drowsiness.

Licorice Root

  • In large amounts, licorice containing glycyrrhizin can cause high blood pressure, salt and water retention, and low potassium levels, which could lead to heart problems. DGL products are thought to cause fewer side effects.
  • The safety of using licorice as a supplement for more than 4 to 6 weeks has not been thoroughly studied.
  • Taking licorice together with diuretics (water pills), corticosteroids, or other medicines that reduce the body’s potassium levels could cause dangerously low potassium levels.
  • People with heart disease or high blood pressure should be cautious about using licorice.
  • When taken in large amounts, licorice can affect the body’s levels of a hormone called cortisol and related steroid drugs, such as prednisone.
  • Pregnant women should avoid using licorice as a supplement or consuming large amounts of licorice as food, as some research suggests it could increase the risk of preterm labor.

Melatonin

Major Interaction: Sedative medications (CNS depressants)

Melatonin might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking melatonin along with sedative medications might cause too much sleepiness. Some sedative medications include clonazepam (Klonopin), lorazepam (Ativan), phenobarbital (Donnatal), zolpidem (Ambien), and others.

Moderate Interaction: 

Birth control pills (Contraceptive drugs)

The body makes melatonin. Birth control pills seem to increase how much melatonin the body makes. Taking melatonin along with birth control pills might cause too much melatonin to be in the body.
Some birth control pills include ethinyl estradiol and levonorgestrel (Triphasil), ethinyl estradiol and norethindrone (Ortho-Novum 1/35, Ortho-Novum 7/7/7), and others.
Caffeine
Caffeine might decrease melatonin levels in the body. Taking melatonin along with caffeine might decrease the effectiveness of melatonin supplements.
Fluvoxamine (Luvox)
Taking fluvoxamine (Luvox) can increase the amount of melatonin that the body absorbs. Taking melatonin along with fluvoxamine (Luvox) might increase the effects and side effects of melatonin.
Medications for diabetes (Antidiabetes drugs)
Melatonin might increase blood sugar. Diabetes medications are used to lower blood sugar. By increasing blood sugar, melatonin might decrease the effectiveness of diabetes medications.  Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
Medications that decrease the immune system (Immunosuppressants)
Melatonin might increase the immune system. Taking melatonin along with medications that decrease the immune system might decrease the effectiveness of medications that decrease the immune system.   Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept)…
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Melatonin might slow blood clotting. Taking melatonin along with medications that also slow clotting might increase the chances of bruising and bleeding.

For Full list Click Here.

St. John’s Wort

  • Research has shown that St. John’s wort interacts with many medications in ways that can interfere with their intended effects. Examples of medications that can be affected include:Photo by Elizabeth J. Czarapata. Click for an enlarged version.
    • Antidepressants
    • Birth control pills
    • Cyclosporine, which prevents the body from rejecting transplanted organs
    • Digoxin, a heart medication
    • Indinavir and possibly other drugs used to control HIV infection
    • Irinotecan and possibly other drugs used to treat cancer
    • Seizure-control drugs, such as phenytoin and phenobarbital
    • Warfarin and related anticoagulants.

Taking St. John’s wort with certain antidepressants may lead to increased serotonin-related side effects, which may be potentially serious.

For more Info Click Here.

Vitamin K

Warfarin (Coumadin) interacts with VITAMIN K: Vitamin K is used by the body to help blood clot. Warfarin (Coumadin) is used to slow blood clotting. By helping the blood clot, vitamin K might decrease the effectiveness of warfarin (Coumadin). Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

Yohimbe

  • Yohimbe has been associated with high blood pressure, increased heart rate, headache, anxiety, dizziness, nausea, vomiting, tremors, and sleeplessness. Yohimbe can be dangerous if taken in large doses or for long periods of time.
  • People should not combine yohimbe with MAO inhibitors as effects may be additive. Yohimbe should be used with caution when taken with medicines for high blood pressure, tricyclic antidepressants, or phenothiazines (a group of medicines used mostly for mental health conditions such as schizophrenia).
  • People with kidney problems and people with psychiatric conditions should not use yohimbe.
  • Women who are pregnant or breastfeeding should not take yohimbe.

Zinc

FDA notified consumers and healthcare professionals to discontinue use of three Zicam Nasal Gel/Nasal Swab products sold over-the-counter as cold remedies because they are associated with the loss of sense of smell that may be long-lasting or permanent. The FDA has received more than 130 reports of loss of sense of smell associated with the use of the three Zicam products.  In these reports, many people who experienced a loss of smell said the condition occurred with the first dose; others reported a loss of the sense of smell after multiple uses of the products.

Conversely, if you are taking any of the following drugs, see cautions below.

Aspirin

Aspirin DEPLETES Folic Acid, zinc, potassium, vitamin C and iron. Avoid higher doses of the following if you take Aspirin. Vitamin E,. Bromelain, Garlic, Ginger, Magnesium, Ginkgo, all which act as blood thinners and thus could cause bleeding.

Ativan

Avoid any herbs that act as a sedative, like Kava Kava, Lemon Balm, Calif. Poppy, St. John’s Wort or Valerian.  Exception: Melatonin.

Lisinopril

This also DEPLETES Zinc, which could lead to an increase in blood Copper levels and foster cancer angiogenesis and progression. Zinc supplements are encouraged if taking this medicine.

Lovastatin

Statins DEPLETE CoQ10, a nutrient needed for healthy muscle, heart and brain function. AVOID Red Yeast supplements with this drug.

Take Fiber supplements 1 – 2 hours away from this med to avoid reducing its absorption.

Niacin taken in large doses with this drug has been reported to cause potentially serious muscle disorders. Bu taking a low dose (500mg) actually enhances the effectiveness of the Statin drug. IT may also be beneficial to take Vitamin E with this drug to prevent the possibility of oxidative damage to LDL cholesterol.

Nadolol

DEPLETES CoQ10. Supplementation is recommended.

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3 thoughts on “When Supplements Become Dangerous

  1. Wonderful information, so few doctors even ask what supplements their patients are taking before prescribing meds. And on the other hand, so few patients know there may be complications in taking supplements when they’re already on meds. Very few would think to ask their doctor if adding an OTC supplement would interact negatively with their meds. Great post!

    1. Thank you!
      When I was going through Chemo, I took about 20 different supplements to support my body and brain! The Oncologist’s nurse took down the names of everything I was taking, but didn’t find half of them in their database, since they were not so common and were recommended by a leading CAM nutritional oncologist. So she would not have been able to advise me about drug interactions, and it didn’t seem to matter to her.
      Scary!
      Thank goodness there are people out there who make this study part of their practice.

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