Know before you mix medications and supplements

Herbal and dietary supplements are increasingly being used by consumers who are looking for non-pharmaceutical products to maintain their health and wellness. Herbal supplements are classified by the Food and Drug Administration (FDA) as part of a general group of "dietary supplements." However, they are not reviewed or regulated prior to being marketed to the public, and there are no consistent standards for dosage. Unlike pharmaceutical companies, manufacturers who produce herbal supplements are not required to perform studies on effectiveness, dosage or safety.

According to the National Institutes for Health’s National Center for Complementary and Alternative Medicine, a 2007 survey showed that “17.7 percent of American adults had used "natural products" (i.e., dietary supplements other than vitamins and minerals) in the past 12 months.” The most popular forms of herbal and dietary supplements people take regularly are vitamins, fish oil, flaxseed, glucosamine, Echinacea and ginseng.

Many people assume that because a remedy is “natural”, then it must be safe. However, some herbal supplements can cause potentially dangerous interactions with medications. Also, because herbal supplements are not regulated by the FDA, consistency and quality may differ from brand to brand – and even from batch to batch. There are also no standards for growing or harvesting herbs used in some supplements, which may mean exposure to dangerous pesticides.

Before taking herbal supplements, do your research to find brands that that come from organic sources, are minimally processed and have a reputation for providing high quality products. Integrative physicians and naturopathic doctors often prescribe high quality and “pharmaceutical grade” supplements to their patients. They can provide you with valuable guidance regarding recommended brands, dosing and potential interactions with pharmaceutical drugs. More anecdotally, your local health food store may have someone knowledgeable on staff who can recommend reputable products.

It is important to inform your doctor if you’re considering adding herbal supplements to your wellness regimen or have a health condition that requires treatment. The NCCAM recommends that you let your health care provider know if you are:

• Thinking about replacing your regular medication with one or more dietary supplements.
• Taking any medications (whether prescription or over-the-counter), as some dietary supplements have been found to interact with medications.
• Planning to have surgery. Certain dietary supplements may increase the risk of bleeding or affect the response to anesthesia.
• Pregnant or nursing a baby, or are considering giving a child a dietary supplement. Most dietary supplements have not been tested in pregnant women, nursing mothers, or children.

As with any medication – herbal or pharmaceutical – if you experience troublesome side effects, stop taking the product and contact your doctor immediately. For current information from the Federal Government on the safety of particular dietary supplements, check the "Dietary Supplement and Safety Information" section of the FDA Web site or the "Alerts and Advisories" section of the NCCAM Web site.