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What Every Clinician Should Know About Herb–Supplement–Drug Interactions

May 3, 2012

What Every Clinician Should Know About Herb–Supplement–Drug Interactions (PDF)
Source: Alternative and Complementary Therapies

Any items that a person takes orally on a supplemental basis–whether they be herbs, dietary supplements, other natural products, or functional foods such as energy drinks and nutritional bars–can interact with each other and with medications. We know that these interactions may have harmful or beneficial effects and can increase or potentiate lev- els of other therapeutics and/or decrease levels of other therapeutics. Dietary supplements can also interact with diagnostic test results and laboratory assays.

It is important to note that interactions caused by supplements can be hard to predict due to a lack of clinical research, compared to reactions caused by drugs, because many products are not standardized to specific ingredients or amounts, and herbal constituents may differ depending on what plant parts the constituents are derived from, for instance, petals, seeds, stems, roots, or leaves. Unlike a prescription drug, for which one can definitively draw the chemical structure graphically, measure it, weigh it, and see it under a microscope, this is more difficult when dealing with natural products.

We have all heard that “natural” does not equal “safe,” but this is really true. If something has a therapeutic action in a human body, this substance can also cause a reaction or an interaction. Supplements are not 100% receptor-specific to only have one effect and no other effects, and what might help one person might hurt another person, just like medications do.

But, remember that not all interactions are bad. Some interactions may be beneficial. An example is if one therapy in- creases the benefit of another or affects electrolyte levels or liver-function test results in a beneficial way. One therapeutic might interact with another in a good way in that it decreases a side-effect or allows a dose of another therapeutic to be lowered, and, therefore, a person experiences a lesser side-effect risk from both therapeutics. Also, a socioeconomic benefit may be, if one purchases or perhaps grows a natural ingredient in a garden, that might be more cost-effective than the alternatives. Purchasing without a prescription may keep insurance costs down over time.

I think it is critical that clinicians consider herbs and supplements as therapeutic options. But, whether we are trained about this in medical school or not, I feel that we have a professional responsibility to educate ourselves and our patients or consumers about the potential for various types of interactions.

See: Risks of Mixing Drugs and Herbal Supplements: What Doctors and Patients Need to Know (Science Daily)

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