Posts Tagged ‘Pharmaceutical drug

09
Sep
13

Risks of Mixing Drugs with Herbal, Dietary and Energy Supplements


??????????????In the past several decades, the number of people taking herbal, dietary and energy supplements has increased exponentially. Whereas, prior to the late 1980s, most patients were unlikely to be supplementing with anything other than multivitamins, now a doctor must expect the majority of the population to have read about their condition on the Internet and be using whatever complementary remedies they think might help, with or without expert guidance. Once seen as natural and harmless, it is now clear that herbal supplements, dietary supplements and energy supplements can interact with conventional medications just as conventional medications can interact with each other.

It is important to note that many complementary medicines are quite safe to take alongside most forms of pharmaceutical drugs, and a cup of nettle or chamomile tea together with your morning pill of whatever form is not going to have any deleterious effect. However, a little awareness goes a long way and it is good to know of the more serious risks of mixing conventional drugs with supplementary remedies.

The risks of taking medications together, whether conventional or complementary, are threefold:

1. The action of the drug, or supplement, may be increased

2. The action of the drug, or supplement, may be reduced

3. The rate and degree at which the drug or supplement is absorbed or eliminated may be altered.

Medications are prescribed at a certain dose in order to achieve a specific effect, so increasing or reducing the effectiveness of a medicine is potentially risky, especially in the case of life sustaining treatments. Many conventional medicines are based on chemicals that are also found in plants, so herbal medicines taken for a particular disease may have the same action as a pharmaceutical taken for the same reason and can result in an effective overdose.

One example of this is aspirin, which was originally derived from plants and herbal anti-inflammatories containing salicylic acid, the active ingredient of aspirin. Such herbs include willow bark, meadowsweet and wintergreen.  Salicylic acid is toxic in large quantities, so these herbs should clearly be avoided if taking aspirin.

Other examples of interactions that increase the effect of medications include taking kelp with drugs for hypothyroidism and herbal diuretics such as dandelion, globe artichoke and celery seed with diuretic drugs. Niacin (vitamin B3), calcium and/or magnesium taken in combination with hypotensive pills can lead to a greater than expected drop in blood pressure. Except under expert guidance, the blood thinner Warfarin should never be taken with a medication that decreases blood clotting, whether conventional or complementary, due to the risk of hemorrhage. Supplements such as cayenne, garlic, feverfew, willow bark, St John’s wort and the drug aspirin all fall into this category. Hawthorn berries increase the action of digoxin on the heart, with potentially fatal effects, and the adaptogen herb Siberian ginseng (Eleutherococcus) also increases digoxin levels in the blood.

Examples of drug and supplement combinations that can decrease the effectiveness of either are taking supplements that stimulate the immune system such as zinc, Astragalus and Echinacea with corticosteroids intended to suppress the immune system, as they are working in opposite directions. Also, remedies with a hyperglycemic (blood sugar raising) action such as celery seed, Bupleurum, rosemary and Gotu kola can counteract the hypoglycemic (blood sugar reducing) work of diabetic drugs. High doses of vitamins A, C and K can all decrease the anticoagulant activity of Warfarin.

If the absorption or elimination of a drug or supplement is altered due to taking something else at the same time, its effectiveness may be at risk. The drug may either be absorbed too quickly or excreted before it has a chance to work. Diuretic remedies are particularly problematic, because of increased elimination, and herbs with this effect include juniper, dandelion, celery seed and licorice. These are certainly to be avoided when taking lithium. Grapefruit juice, while not really a supplement, is also a concern when taken with several drugs, such as hypotensives and the immunosuppressant Cyclosporine, since it reduces the breakdown of the medicine in the body.

Although a comprehensive treatment of the risk of mixing conventional medicines and nutritional and herbal supplements is well outside the intention of this short article, it is hoped that this article serves to communicate the potential problems that may arise and some of the more well-known bad combinations. You should always consult your doctor before taking any combination of drugs and supplements. For further information, there are a number of websites that may prove valuable in flagging most of the riskiest drug-herb-supplement interactions. These include Herb-Drug interactions at i-care.net (http://www.i-care.net/herbdrug.htm), the herb and supplement database at Medline, which includes known drug interactions (http://www.nlm.nih.gov/medlineplus/druginfo/herb_All.html) and a paper on herb-drug interactions published in The Lancet (http://www.ncbi.nlm.nih.gov/pubmed/10675182).

Dr. P. Dubois, CCSP, DC.

 

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21
Nov
12

High Blood Pressure Facts and Fiction


High blood pressure (hypertension) is widespread, affecting approximately 25% of the population.  If the condition remains untreated, it can lead to more serious health problems such as heart disease, stroke and kidney disease. 

However, there are many myths about high blood pressure in the popular press.  So in the following paragraphs we’ll separate fiction from fact to provide you with a more accurate understanding of this common health problem.

Fiction: The lower your blood pressure, the better.

Fact: Low blood pressure can also lead to health problems.  It can cause dizziness or fainting, increasing your risk of falls, and (if it is severe), can even lead to shock and death.

Fiction: Young people do not need to have their blood pressure checked.

Fact: While young people are at lower risk, the U.S. Preventive Services Task Force (USPSTF) advises that everyone have their blood pressure checked from the age of 18.

Fiction: High blood pressure always has symptoms.

Fact: This is not necessarily the case.  While some experience sweating, nervousness and sleep disturbances, approximately one in three adult Americans with high blood pressure have it and are not aware of it.  This is the reason hypertension is sometimes called “the silent killer”.

Fiction: Blood pressure is only high because you are at the doctor’s office.

Fact: Many people get nervous while at the doctor’s office, which can raise blood pressure levels.  However, repeated high readings should be an indication that it is not a situational condition.  Home blood pressure monitors are now easily obtainable.  So take your measurements at home a few times and then share the results with your doctor.

Fiction: If you have high cholesterol, you must have high blood pressure.

Fact: Although the risk factors for both are often the same (poor diet, lack of exercise, etc.), having one does not necessarily mean you have the other.  You should have both your blood pressure and cholesterol checked periodically to ensure that you do not have either.

Fiction: Women do not need to worry about getting high blood pressure.

Fact: Although middle-aged men are more likely to have high blood pressure than women, the numbers begin to even out after a woman reaches menopause.  In fact, African-American women over age 65 have the highest rate of high blood pressure.  Other women at higher risk are those with a history of the disease in their family, those who are on birth control pills, those who are pregnant, and those who are overweight.

Fiction: Over-the-counter medications are always safe for those with high blood pressure.

Fact: Decongestants can both interfere with blood pressure medications and raise blood pressure.  If you are looking for cold and flu remedies, ensure that they do not contain decongestants.

Fiction: Insulin injections cause high blood pressure.

Fact: It was once believed that people taking insulin were at greater risk of hardened arteries and high blood pressure, but this idea has since been disproved.

Fiction: As your blood pressure improves, it’s all right to stop taking your blood pressure medication.

Fact: It is never a good idea to stop taking your blood pressure medication until you have consulted with your doctor.  Suddenly stopping your medication can cause your blood pressure to spike suddenly, stressing the heart, causing an irregular heartbeat and increasing your risk of a heart attack.  It can also cause nausea, vomiting, dizziness and insomnia.  If you decide to discontinue taking your medication, do so slowly, and always under a doctor’s supervision.

 

Dr. P. Dubois, DC, CCSP.

Dr. Dubois, a Swiss physician, and a Triangle Certified Sport Chiropractor has over 20 years of experience in the treatment and prevention of disorders of the musculoskeletal system.Amongst his patients, two world champions in martial arts (gold medalists in 2005 WMJA), one carrier of the Olympic flame in 2004, and numerous soccer players, swimmers and athletes of all levels who benefited from his chiropractic care.

 




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