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As I have become more involved
in using functional nutritional therapy in my practice, I
have come to realize that many people are still confused
about the safety and effectiveness of various dietary
supplements. Because these products are “natural”,
many feel they are always safe to use. Although
supplements and herbs can be safer than pharmaceutical
drugs, they can still function as drugs in the body and
should be used with caution and respect.
It is estimated that over
80% of the world’s population and 60 million Americans
use some form of complementary and alternative medicine
(CAM). However, although many believe CAM compliments
their current traditional healthcare, most do not inform
their physicians that they are taking these products. And,
many providers don’t ask or discuss CAM use with their
patients, although one survey of 181 cardiologists found
that half of them took antioxidant vitamins, themselves.
What many people don’t
realize is that there is no regulatory agency in charge of
the supplement industry. Herbal products are not tested
for purity, effectiveness and safety as drugs are. In
1994, the Dietary Supplement Health and Education Act
(DSHEA) was enacted that requires the FDA to prove beyond
any doubt that a supplement is unsafe before removing it
from the market. Other than regulating what can be
included on the label, they are unable to enforce any
other regulation.
There is no incentive for
supplement companies to conduct research because they are
unable to patent ‘natural’ products. Those marketing
herbs and other supplements save millions of dollars not
spent on research, or worse, yet, conduct their own
“research”, which often does not include rigorous
controls. Although there are many excellent and reputable
supplement companies on the market, the typical consumer
is unlikely to know who the credible ones are. Many
independent sales representatives only know what the
company tells them, and are as unaware as the consumer.
Even if the supplements are
pure and not harmful by themselves, problems arise when
combined with drugs. Dietary supplements may compete with
drugs, leading to toxicity or treatment failure of that
drug. An estimated 4 million people are at risk for
herbal-prescription drug interactions. Here is a list of
the most common interactions between supplements and
drugs:
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Warfarin
(Coumadin) is used to prevent blood clotting for those
at risk for deep vein thrombosis, stroke, or heart
attack. Supplements that can change bleeding time
controlled by this drug include flaxseed oil and fish
oil supplements, goldenseal, saw palmetto, feverfew,
garlic, ginseng, and willow bark, just to name a few.
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Digoxin
is another heart medication. Ginseng has been noted to
falsely elevate blood digoxin levels. Some herbs that
will affect drug effectiveness include senna,
licorice, aloe, cascara, hawthorne, foxglove,
goldenseal and guar gum.
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Phenytoin
is a drug used for seizures. Herbal interactions to be
aware of include ginkgo biloba, white willow, lemon
balm, skull cap, kava kava, and valerian root, to name
a few. It is also important to know that Folate
supplementation is necessary with Phenytoin, but
excess Folate can be harmful.
-
It’s
important to take calcium supplements and vitamin D
two hours apart from taking either Phenytoin or
Digoxin in order to not interfere with these drug’s
effects.
Of particular concern
are interactions with the herb St. John’s Wort,
which is taken by 7.5 million Americans as a
depression remedy. This herb can cause serious
consequences when taken with drugs such as Prozac,
Zoloft, or Paxil, as well as warfarin, cyclosporine,
and oral contraceptives. This herb may also interact
with Digoxin, chemotherapy drugs, and other drugs,
causing treatment failure. Some of these interactions
are serious enough that if St. John’s Wort were a
drug, the government would restrict marketing, make it
a prescription-only item, or require label warnings.
So, what can one do??
Anyone taking a dietary
supplement should first do their homework. Know exactly
what the purpose of a particular supplement is for and
learn all known interactions. There are many excellent
informational websites on the internet. A good rule of
thumb is to look for a site that does not offer products
for sale!
It’s also important to
inform your healthcare professional what supplements you
are taking, in order to avoid potential supplement-drug
interactions that could put you at medical risk. Although
many credible professionals sell products, there are just
as many who sell products but don’t really understand
the physiology of the human body and are just out to make
money. Supplement sales is a very popular ‘easy’ way
to make money today!
It’s just as important to
do one’s homework when looking for a complementary care
practitioner. Although this is only one set of criteria,
the best recommendation is to look for one or any of
these: A pharmacist or registered dietitian who is
educated in medicinal herbs, a physician who specializes
in functional medicine, or an MD, OD, ND, DC, PharmD or RD
who also has the CCN credential.
Don’t be afraid to take
supplements. They serve a very beneficial purpose. But do
know why you’re taking each supplement, just as you
should know why you take any prescription medications. Be
an informed consumer and take responsibility for your
health and wellbeing.
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About
The Author
Marjorie
Geiser has been teaching health, fitness
and nutrition since 1982. She is a
nutritionist, registered dietitian,
certified personal trainer and life coach.
As the owner of MEG Fitness, Marjorie’s
goal for her clients is to help them
incorporate healthy eating and fitness
into their busy lives. To learn more about
the services Margie offers, go to her
website at www.megfit.com
or email her at Margie@megfit.com. |
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