About 41 percent of seniors age 60 to 69 use some form of alternative or complementary medicine, including herbal therapies, according to Centers for Disease Control & Prevention (CDC) data.
Herbal supplements, which include ginkgo biloba, St. John’s wort, ginseng and echinacea, may have some advertised health benefits, but they also may lead to adverse drug interactions if a senior is taking other medication.
The elderly typically take more medications for multiple chronic conditions, so taking supplements that aren’t prescribed may come with additional risks. Here’s what you need to know about these products:
Not All Supplements are Safe
Unlike over-the-counter and prescription medications, the U.S. Food and Drug Administration (FDA) does not review the safety of herbal or dietary supplements before they go on the market. That means the claims these products make in commercials or online — like giving you more energy or providing relief from chronic pain — may not always be true.
However, it’s the responsibility of the FDA and other federal authorities to prevent certain products from being sold if they are found to be unsafe, but that typically only happens after multiple reports of problems with a product. For example, in 2016 the Drug Enforcement Administration temporarily banned the chemicals contained in kratom, a popular herbal supplement used to treat chronic pain and post-traumatic stress disorder. Officials feared patients were using the supplement to wean themselves off prescription pain medication without seeing a doctor for help, which they considered a potential public health threat.
Talk to Your Doctor
If you’re unsure about the safety of the supplements you’re taking, talk to your doctor. Unfortunately, previous research shows that too many patients don’t. One national health survey found that 50 percent of adults questioned about their use of complementary or alternative therapies didn’t openly admit using these therapies to their health care provider.
If you’re open and honest your doctor, he or she can clearly explain to you the potential risks of the medicine you’re taking, suggest another approach or other medications that may be effective in treating your condition or any pain you may have. Often, taking a specific supplement isn’t necessary because dietary and lifestyle changes may produce better results.
The Risk of Adverse Drug Interactions
Research shows that many people with chronic conditions take herbal supplements, even though they aren’t completely knowledgeable about the effect of these products. One study published in the Journal of the American College of Cardiology found 64 percent of patients attending a cardiovascular clinic who had the heart condition atrial fibrillation or reduced blood flow to their heart (ischemic heart disease) reported using alternative therapies with their prescription medication. Fifty-eight percent of them took supplements that had a high risk for negative drug interactions. The study also found that most patients underreport adverse drug interactions due to alternative therapies and part of the reason is because they may not think these therapies contributed to their health problems in the first place.
Herbal supplements like St. John’s wort, ginkgo biloba, goldenseal, kava, ephedra and garlic are most likely to cause adverse drug interactions, especially if you take high blood pressure, anti-blood clotting, diabetes or heart medications. As doctors, we not only worry about adverse drug interactions in the elderly, we also worry that these supplements may interfere with the effectiveness of your prescribed medication and that patients who are self-medicating for a chronic condition or disease may not be getting the best treatment, which causes their condition to progress and get worse.
You need to be careful when taking supplements because they may have the exact opposite effect of what you intended.
How to Stay Safe
First, check the label on the bottle of your supplement or have your caregiver do so. Compare the amount of vitamins and minerals in each serving to the recommended daily allowance. Also, review the National Academy of Sciences’ (NAS) recommendations for vitamins and minerals intake. If you are taking more than the recommended amount, then it’s best to cut back. Sticking to well-known brands also is a good way to prevent potentially harmful side effects and adverse drug interactions.
To be clear, some supplements may be safe when used in combination with other medications. However, you can’t know this unless you have a conversation with your doctor. Your doctor can make suggestions for which supplements are safe to use and the right daily dose you should take.
It’s also important to remember that just because a supplement may say “natural” on the label doesn’t mean it’s always good for you. For many supplements, there isn’t much scientific evidence about their effectiveness. So, when in doubt talk to your doctor and don’t take the risk of consuming these products. It may not be worth it.