DEAR MAYO CLINIC: As I’ve gotten older, docs have positioned me on extra drugs, resembling for blood stress and ldl cholesterol. Additionally, as I age, I’ve chosen to take some dietary supplements which might be supposed to enhance my reminiscence, scale back ldl cholesterol and forestall most cancers. Ought to I fear about these dietary supplements interacting with each other or my drugs?
ANSWER: With age come extra power well being situations. Additionally, some individuals could develop deficiencies in sure nutritional vitamins as they age. Fortunately, an array of prescription and over-the-counter drugs, in addition to dietary dietary supplements and nutritional vitamins, can be found to alleviate signs, sluggish the development of many age-related power well being situations and assist individuals preserve good well being.
Over time, although, retailer cabinets have change into crowded with lots of of natural dietary supplements and different dietary enhancers that make varied claims about supporting bodily and psychological well being and performance.
The phrase utilized by many to explain taking a number of prescription and over-the-counter drugs, and dietary and natural dietary supplements, is “polypharmacy.” Though it has many definitions, the broadest definition of polypharmacy is the simultaneous use of a number of drugs or dietary supplements to deal with a number of medical situations in a single affected person.
The problem is that with age come extra medical situations. And with these situations come extra well being care suppliers to deal with them. Until sufferers guarantee each supplier has an up-to-date medicine and complement listing, suppliers could not precisely know what sufferers take or talk about dangers associated to these drugs and dietary supplements. As individuals take an increasing number of drugs and dietary supplements, the possibilities for interactions enhance.
For instance, take into account a affected person who was prescribed a statin to decrease ldl cholesterol. Nevertheless, after seeing an commercial that promotes pink yeast rice as being good for managing ldl cholesterol, she started taking it. Purple yeast rice naturally incorporates lovastatin, a naturally occurring statin. With out realizing, this affected person started duplicating remedy with the atorvastatin her well being care supplier had prescribed. She started experiencing leg cramping, muscle soreness and elevated liver perform assessments from this drug interplay.
Whereas you will need to speak along with your supplier and pharmacist about what you’re taking to keep away from an excessive amount of medicine, it’s also vital to keep away from a deficit.
Think about vegetarian or vegan sufferers who’re newly recognized with Sort 2 diabetes. Typically these individuals take a B-12 complement as a result of they don’t eat meat. Nevertheless, commonplace remedy for a Sort 2 diabetic is a medicine referred to as metformin, which might deplete B-12 in some sufferers. So now having began the metformin, these individuals require extra B-12 supplementation than earlier than. To complicate issues, in the event that they have been already taking or begin an anti-reflux, anti-ulcer medicine resembling omeprazole, which lowers abdomen acid manufacturing, B-12 deficiency can additional worsen, since B-12 is dependent upon abdomen acid for absorption.
There are different examples of complement or prescription interactions. As an example, taking calcium with a vitamin D complement for osteoporosis, and a multivitamin containing vitamin D, could elevate calcium within the urine sufficient to extend the chance of forming kidney stones. Taking a narcotic ache reliever for acute or power ache when already taking an anti-anxiety medicine like alprazolam may end up in a lack of consciousness. Even worse could be if individuals drink an alcoholic beverage having each alprazolam and a narcotic of their system.
Natural dietary supplements can pose a threat in polypharmacy sufferers as a result of additionally they could have an effect on the metabolism of a medicine or different dietary supplements. Resveratrol, which is present in grape skins, is usually taken as an antioxidant complement. Some proof means that it might sluggish the metabolism of sure frequent drugs and trigger unintended effects. Gingko biloba, which is used for reminiscence, can have an anti-platelet impact, growing the chance of extreme bleeding in these sufferers already taking anticoagulants resembling warfarin or apixaban.
When taking a number of prescription drugs or over-the-counter medication, and dietary supplements, evaluation them at the least yearly. Searching for out a specialty pharmacy or a polypharmacy pharmacist is good, because the pharmacist can determine doable drug interactions or opposed drug reactions brought on by the varied parts and may companion along with your well being care suppliers to keep away from future points. Additionally, converse to the pharmacist anytime you’re prescribed a brand new medicine so you’ll be able to evaluation present prescriptions and dietary supplements to determine any potential issues.
— Michael Schuh, Pharm.D., Division of Pharmacy, Mayo Clinic, Jacksonville, Florida
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Q and A: Can drugs and dietary supplements work together with each other? (2021, October 14)
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