So many times, we pop dietary supplements along with prescribed medication, thinking we will recover from a condition faster. That such supplements are harmless and do not interfere with your drug. However, this could not be further from the truth.
As an internal medicine specialist, Dr Suranjit Chatterjee often encounters patients who are unaware of the potential interactions between their supplements and prescribed medications. “It’s crucial to understand that certain supplements can indeed affect how your body absorbs, metabolizes and eliminates medication, potentially altering their effectiveness and safety.” Excerpts:
HOW CAN DIETARY SUPPLEMENTS IMPACT DRUG EFFECTS?
Dietary supplements, including vitamins, minerals, herbs and amino acids, can either enhance or diminish the effects of the medication. Here are a few ways in which they do so.
1. Altered Absorption: Some supplements can change the way medications are absorbed in the digestive tract. For instance, calcium supplements can bind to certain antibiotics, reducing their absorption and effectiveness. Similarly, fiber supplements might slow down the absorption of medications, delaying their action.
2. Metabolic Interference: The liver is a key organ in metabolising both medications and supplements. Some supplements can either induce or inhibit liver enzymes, affecting the metabolism of medications. For example, St. John’s Wort, or what we call Choli Phulya and a popular supplement for depression, induces liver enzymes that can decrease the effectiveness of medications such as birth control pills and certain antidepressants.
3. Renal Excretion: Supplements can also influence how quickly medications are excreted by the kidneys. For instance, cranberry supplements, often used for urinary tract health, can alter the urine’s acidity, potentially affecting the excretion of certain medications and leading to higher or lower levels in the bloodstream.
WHICH COMMON SUPPLEMENTS SHOULD WE WATCH OUT FOR?
Vitamins E: Vitamin E can increase the risk of bleeding when it’s taken with blood-thinning medications. If you are taking a blood thinner, ask your provider before you start taking vitamin E.
Vitamin K: This can counteract the effects of blood-thinning medications, leading to an increased risk of blood clots.
Vitamin B6: Taking vitamin B6 can work at cross purposes with Levodopa, a medication for Parkinson’s disease.
Vitamin C: This increases the absorption of aluminum from antacids that otherwise neutralize stomach acid and help relieve heartburn or indigestion. Taking it together with antacids can lead to toxin buildup. They should be taken at least two hours apart.
Iron or calcium supplements: These can interfere with the absorption of thyroid hormone replacement medications like levothyroxine. It’s best to take these supplements and thyroid medications at least four hours apart
Fish oil: High doses of Omega-3 fatty acids found in fish oil supplements can have blood-thinning effects, which might enhance the effects of anticoagulant medications and increase the risk of bleeding.
SHOULD NOT ONE HAVE DIETARY SUPPLEMENTS AT ALL?
Given the potential risks, it’s essential to inform your healthcare provider about all the supplements you are taking, including over-the-counter vitamins and herbal products. Your doctor can help identify possible interactions and adjust your medication or supplement regimen accordingly.
Before starting any new supplement, especially if you are on medication for chronic conditions such as heart disease, diabetes, or depression, discuss it with your healthcare provider. They can provide guidance on safe use, appropriate dosages, and monitor for any adverse effects.