September 15, 2016

Problems When Patients Hide Supplements – Part 7

Part 7 of 7 parts.

The clinician should use the clinical encounter to inquire about supplement use and take the opportunity to discuss the benefits and risks of supplements, when/whether they should be taken, and how they compare with prescription and over-the-counter medications. On the basis of the medical history, the clinician should determine whether supplement use is an important issue for a certain patient's health. For example, appropriate supplement use should be discussed with patients for whom the following situations apply:
  1. Consuming fewer than 1600 calories per day;
  2. Vegans, vegetarians, and anyone eliminating an entire food group from their diet;
  3. Pregnant and breast-feeding women;
  4. Postmenopausal women and those with heavy menstruation;
  5. Chronic diarrhea;
  6. Food allergies and food intolerances; and
  7. Surgical removal of portions of the digestive tract or bariatric bypass surgery.

Additionally, oncology patients should be warned about the possibility that antioxidative supplements, such as vitamins C and E, can interfere with anticancer medications.

One way to become aware of potential issues with supplement use is through health information technology. Not only can numerous educational programs on supplements be found online, but many search engines also can cross reference different types of medicines, and many of them can easily check for interactions between supplements and other medications. Most office electronic medical record (EMR) systems have software that flags interactions between active ingredients in drugs and supplements. However, given the variability of dietary supplements in the marketplace, EMRs are not foolproof.

For more information about dietary supplements, and herbal medications, look to this for vitamins and minerals under articles. Then look to this for Complementary and Alternative Medicine Guide. Both are good resources for reading about natural medicines that conflict with prescription drugs. Most of the time, these are found near the bottom of the article.

For the first one above I have selected the mineral magnesium and you will need to be down about two thirds of the article under drug interactions to see the problems that it can cause.

For the second one above I have selected the herb Cranberry and about two fifths of the way down at Possible Interactions you will discover problems with Warfarin, Aspirin, and other medications.

This is the reason for the seven parts of this blog series and why we need to be aware of them and not ignore them just because they are natural. Your doctor does need to be aware of these natural drugs.

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