Warning Supplement Interactions

  • Dealing with cancer, diabetes, heart disease, immune problems, kidney problems, thyroid problems, ulcers, or other health problems? Talk with your doctor before using dietary supplements, and about the potential for harmful interactions.
  • Taking prescription or over-the-counter medication? Supplements-when combined with medications or other treatments-may interfere with or boost their action, even be harmful or life-threatening. See "Food and Medicine"in chapter 22. For example:
  • Folic acid can interact with anticonvulsant medications.
  • Vitamin E, garlic, and gingko biloba may thin blood-dangerous when taken with blood-thinning medication such as Coumadin and aspirin.
  • Ginkgo can interact with some psychiatric drugs and some drugs that affect blood sugar levels.
  • Garlic supplements may interact with drugs used in HIV therapy such as saquinavir, which is a protease inhibitor.
  • The combination of foxglove (the source of digitalis, or digoxin) and cardiac medication is dangerous for those with heart disease.
  • St. John's wort may reduce the effect of heart drugs, antidepressants, antiseizure drugs, anticancer drugs, birth control drugs, certain HIV drugs, and anti-transplant-rejection drugs.
  • Ginseng can lower blood sugar levels, perhaps interfering with diabetes medication. It can also increase caffeine's effects as a stimulant.
  • Calcium can interact with heart medication (such as Digoxin), thiazide diuretics (Thiazide), and antiacids with aluminum and magnesium.
  • Magnesium can interact with thiazide, some cancer drugs, and antiacids with magnesium.
  • Planning for any surgery? Avoid all supplements two to three weeks ahead, according to guidelines from the American Society of Anesthesiologists. Although herbal supplements may seem "innocent," their use can cause complications such as bleeding, heart instability, low blood sugar, blood pressure changes, and other drug interactions. Among those linked to surgical complications: ephedra, garlic, ginkgo, ginseng, kava, St. John's wort, and valerian.
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