Some Supplement-Medication Combinations Make Dangerous Mix

Nov. 15, 2010 — -- Long before prescription medications, our ancestors relied solely on certain plants, perhaps even a combination of herbs, anecdotally known to cure what ailed them.

While many of us still swear by the natural ingredients, commonly used in the unnatural form of supplements, our modern impulses may tell us to trust the best of both worlds -- combining prescription medications and supplements.

But too much of a good thing may be bad for you.

Certain combinations of supplements with medications might decrease the chance the medication will work, but many patients don't know it, Jennifer Strohecker, a clinical pharmacist at Intermountain Medical Center in Salt Lake City, Utah said Monday at the American Heart Association annual scientific meeting.

Strohecker and her colleagues surveyed 100 patients on the blood thinner warfarin and found more than two-thirds used supplements, some of which may decrease the effects of the medication and put them at higher risk for internal bleeding or stroke. Yet, only one-third told their doctor they were taking supplements.

Some of the supplements patients reported taking included glucosamine, chondroitin and coenzyme Q10, which could interfere with warfarin, Strohecker said.

It signals a major communication gap between patients and physicians, she said.

In fact, according to the survey, 92 percent of those taking supplements may not have thought to share the information but would have told their doctor, had they only been asked.

"Everybody has a job to do," said Keith Ayoob, director of the nutrition clinic at the Rose R. Kennedy Center at the Albert Einstein College of Medicine in the Bronx, N.Y., who said it's easy for doctors to overlook the potency of supplements.

Many conventional doctors are not well educated in herbs and supplements, said Ayoob.

Still, herbal and diet supplements are among the fastest growing industries, said Strohecker. While she did not discourage patients from taking supplements, she said physicians should educate themselves and their patients about using them safely.

"Patients are using more supplements, so I as a health care provider need to be the information source for my patients," said Strohecker.

Ayoob agreed.

"Patients need to tell and doctors need to ask," said Ayoob.