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Safety measures and risks linked to medications and supplements: an overview

By Mary Pettigrew

What’s in your medicine cabinet? The majority of us probably have some prescription medications, some over-the-counter medications and maybe a few bottles of vitamins or other dietary supplements on hand. How much do you really know about what you’re taking? Have you ever considered the possibility there could be risks associated with taking medications along with certain dietary supplements? Without question, there can be serious health risks involved. 

According to Robert Mozersky, a medical officer with the FDA, there are some dietary supplements that may increase the effect of medications while other supplements may decrease it. Absorption, metabolism, or excretion of medications can affect the potency. Sometimes too much or too little. To avoid potential problems, discuss everything you’re taking with your doctors. Also, don’t take vitamins and medications together at the same time. 

Here’s an example of this that recently affected me personally. I had my lab work done about four months ago and the panel showed my B12 levels to be extremely low. Per my neurologist, it turns out that my taking high doses of Prilosec (antacid) as prescribed by my GI doctor and ORAL Vitamin B12 pills, the antacids won’t allow the Vitamin B12 to be absorbed as it should. The solution was for me to switch to sublingual (under the tongue) B12 drops for successful absorption. I wouldn’t have known to ask about this and am thankful my neurologist addressed the issue with me.

Most MS patients are encouraged to take B12 and vitamin D supplements on a regular basis. There is a reason for this based on the tendency for people with MS to be chronically deficient in both. Patients don’t always talk with their doctors about taking additional vitamin and mineral supplements, but they really should. The same advice applies with all over-the-counter medications and other dietary supplements. Better to be safe than not.

There are other dangers to consider when it comes to energy supplements, essential oils, herbals, holistic products, and the like. Some examples include (but not limited to):
  • St. John’s Wort = risks with anti-depressants, heart disease, transplants, etc.
  • Fish Oils = bleeding risks with surgery
  • Ginko Biloba = interferes with the processing of some prescription drugs 
  • Goldenseal = same as above
  • Garlic Supplements (Extracts) = same as above
  • Kava = same as above 
  • Aspirin and other NSAIDS = blood thinning
  • Calcium and vitamin D = dosages can affect kidney function and kidney stones
  • Essential oils = can be toxic when ingested or even used topically

People often migrate towards “holistic” alternatives to western medicine. Some may be okay to try, others may not. The key is to research the product thoroughly and then discuss further with your doctors before buying anything. Use common sense to ensure the safety of your health and overall wellbeing.
Just because a product is touted as “natural,” that does not always mean it to be safe. The FDA has enforcement procedures in place to ensure safety, but not effectiveness. Also, the FDA will take action if products are unsafe, mislabeled, misleading or if they make claims to diagnose, treat, cure, or prevent disease. Unfortunately, there are many manufacturers who still find ways to market their ineffective, fraudulent products to the public. This is critical area in need of more attention and one where we must do our best to advocate for ourselves and for others. Consumers must do their homework and when in doubt, they must continue to have open discussions with their doctors. 

Discussion points to have with your health care provider:
  • Keep a list of all medications (prescription and over-the-counter) and dietary supplements you’re currently taking and share with your doctors.
  • Make sure your doctors are aware of any changes to your medications or supplements (adds or deletions).
  • Be specific as to how you are taking medications and supplements (dosage, frequency, separate or mixed, etc.).
  • Rule out possible interactions between any of the medications you take.
  • Clarify whether you should take medications or vitamins with or without food.
  • Discuss any allergies, side effects, or unpleasant issues that may arise. 

According to Robert Mozersky, FDA medical officer, “The bottom line is, before you take any dietary supplement or medication – over-the-counter or prescription – discuss it with your healthcare professional.”