Discussing dietary supplement use with your doctor can help prevent dangerous reactions, experts say

Don't keep your doctor in the dark
NUTRITION NOTES OFFERS ADVICE ON DIETARY SUPPLEMENTS

By Karen Collins, R.D. SPECIAL TO MSNBC http://www.msnbc.com/news/286182.asp#BODY

July 2,1999 — Herbal products are more popular than ever, yet surveys show that 70 percent of patients do not reveal use of supplements to their physicians. Whether this is because they are afraid of receiving discouraging remarks, or because they think of herbal products as irrelevant to medical care because they are natural, keeping this information secret is dangerous.

RESEARCH SHOWS that some herbal products interact with medications or medical conditions, so it's important for doctors to know a complete list of health-related products used in order to diagnose problems and prescribe medications properly. For example, continued use of the products ginkgo biloba, ginger, garlic or feverfew can increase the effects of "blood-thinning" medications, causing dangerous bleeding tendencies. On the other hand, ginseng can decrease these medicine's effectiveness, leading you and your doctor to think you are receiving more protection from blood clots than you really are. Immunostimulant products (such as echinacea, astragalus and licorice) should not be taken with immune-suppressing medications (corticosteroids and cyclosporin) or by those with autoimmune diseases (rheumatoid arthritis and lupus). Tannic acids in herbs such as St. John's wort and saw palmetto can partially block absorption of iron from supplements or food.

Doctors decry supplement claims

Some herb products (such as chamomile and yarrow) can cause allergic reactions, especially in those allergic to ragweed. Ginseng can cause increased blood pressure and decreased blood sugar reactions. Some products may cause premature uterine contractions and cross the placenta to the baby, so women who are pregnant or are thinking of becoming pregnant should not use any herbal treatments. If you use an herbal product that can interact with a medical condition or medicine but have not had a bad reactions yet, don't be fooled into believing you are safe forever. Part of what makes use of herbal products confusing is their inconsistent formulation. The herbal products industry acknowledges that because of lack of legal standardization, content of active ingredients (and therefore chance of both desirable and undesirable effects) varies from brand to brand, and even within the same brand. One study found that only 25 percent of ginseng products actually contained any detectable ginseng. Clearly the world of herbal products needs more study to better understand the benefits they offer and the ways to avoid their potential risks. Although legally marketed as foods instead of drugs, these products can have very real interactions with health conditions and medicines. So don't keep your doctor in the dark if you use or change your use of such products.

Karen Collins is a registered dietitian with the American Institute for Cancer Research in Washington, D.C.

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