A small study published this week in the British Journal of General Practice highlights the health risks people are exposed to when taking herbal medicines and other nutritional supplements along with prescription drugs.
The study found that around a third of older people in the UK surveyed used herbal remedies or supplements alongside medicines prescribed by their doctor.
Most combinations were not harmful, but a significant proportion were. For example, some study subjects prescribed calcium channel blockers for high blood pressure also took supplements containing St. John’s wort, an herb that can reduce the effectiveness of calcium channel blockers. Admitted.
Potentially Dangerous Interactions
Many people do not know that herbal “medicines” and other over-the-counter nutritional supplements can cause side effects and drug interactions.
People age 65 and older are at particularly high risk of experiencing potentially harmful interactions from combining such products with prescription drugs. Not only are they more likely to have been prescribed medication by their doctor, but a large percentage also use alternative medicine products.
A 2017 review of 22 studies conducted in countries around the world, including the United States, found that the combination of prescription drugs and herbs and other nutritional supplements is “significant” among older adults. .
Across the nine US studies included in this review, the proportion of older adults taking supplements ranged from 9.5 percent to 88.3 percent, depending on which herbal or dietary supplements were included. .
research content
For the new study, researchers surveyed a randomly selected group of 149 British adults aged 65 and over. They were patients at her two clinics. One was in the countryside and he had one in the city. All participants were taking at least one prescription drug.
The survey asked people to list any “herbal medicines” or dietary supplements they may be using. The researchers then looked at which people were at risk for interactions between those products and prescription drugs.
People in the study took an average of three prescription medications. The most common were used to treat heart disease and high blood pressure, including statins, beta blockers, and calcium channel blockers.
One-third of participants also used herbal products and other nutritional supplements that were not prescribed by a doctor. Women were almost twice as likely as men to do so. The number of herbal products or supplements taken by participants ranged from 1 to 8, with an average of 3.
The herbal products represented 36 herbs (taken alone or in combination). The most commonly used were evening primrose oil, valerian, nithol herbals (a combination of hops, valerian, gentian, and passionflower), and garlic.
Eight out of 10 study participants took nutritional supplements such as vitamins and minerals. At the top of that list were cod liver oil, glucosamine, multivitamins, and vitamin D.
Main findings
Half of the potential interactions identified in the study were not thought to pose a health concern. However, 21 of the combinations raised uncertain concerns and six were found to pose potential or serious health risks.
Combinations identified in the study as particularly risky include:
- Taking calcium supplements in combination with levothyroxine, a prescription drug used to treat thyroid dysfunction. Calcium may reduce the effectiveness of levothyroxine.
- Use peppermint capsules with lansoprazole. Lansoprazole is a drug (proton pump inhibitor) used to treat conditions characterized by hyperacidity, such as gastroesophageal reflux disease (GERD). Lansoprazole can dissolve the protective coating on the capsule. The compounds in peppermint relax the sphincter between the stomach and esophagus, allowing stomach acid to flow back into the throat and mouth.
- Take the herb St. John’s wort with amlodipine, a prescription drug (calcium channel blocker) used to treat high blood pressure. St. John’s wort may reduce the effectiveness of amlodipine (and other calcium channel blockers).
- The dietary supplement glucosamine is taken with metformin, a prescription drug used to treat type 2 diabetes. Some research suggests that glucosamine may increase blood sugar levels.
- Take an omega-3 fish oil supplement along with bisoprolol, a prescription drug (beta-blocker) used to treat high blood pressure. Research has raised concerns that this combination may lower blood pressure too much.
- Taking ginkgo biloba with rabeprazole, a prescription drug (proton pump inhibitor) used to treat heartburn, stomach ulcers, and gastroesophageal reflux disease. Research shows that ginkgo biloba may make proton pump inhibitors less effective.
please tell your doctor
Of course, there are caveats to this study. It was small and only attended by British adults. The study also did not confirm whether the people in the study actually experienced any side effects or harm from combining prescription drugs with herbs or other nutritional supplements. Still, the findings should serve as a reminder to all of us that “alternative” or “natural” health products are not without risks.
“Some patients don’t consider it. [herbal medicinal products] and dietary supplements as medicines,” the study authors wrote. “Even if they are asked, they don’t necessarily remember to reveal it.”
“This highlights the need for healthcare professionals to directly ask and inquire about their use. [herbal medicinal products] “The study then names the supplements that pose the highest risk of interaction,” they added.
Also, volunteer the information if your doctor doesn’t ask.
FMI: The full text of the study can be read on the British Journal of General Practice website.
