Heart and Vascular Health
32.4K views | +1 today
Follow
Heart and Vascular Health
Media, News & Topics on prevention, diagnosis & treatment of cardiovascular disease
Your new post is loading...
Your new post is loading...
Scooped by Seth Bilazarian, MD
Scoop.it!

Overuse of Herbal and Dietary Supplements

Overuse of Herbal and Dietary Supplements | Heart and Vascular Health | Scoop.it

Herbal and dietary supplement use is prevalent. Medication reconciliation should include a careful review of herbal and dietary supplements, including medical and nonmedical harms and benefits. The use of shared decision-making is recommended to integrate these findings into a patient-centered treatment plan. A case of an 80 year old man taking 50 supplements (over $35,000 annually) is reviewed and a teaching point about herbal and dietary supplements is discussed.

Seth Bilazarian, MD's insight:

This case study presents an example of the excessive and inappropriate use of dietary supplements, which can present challenges akin to those recognized in polypharmacy. The strategy highlighted for the physician to review the literature and then present the case regarding risk & benefits and costs to the patient regarding supplements is certainly reasonable but frequently ineffective since patients often are committed to "natural" therapies and believe they are safe and effective.  Furthermore, patients often think physicians are inclined to discredit these therapies.  In my practice, the use of fish oil supplements is the best example of a therapy with no demonstrated cardiovascular benefit and possible harm, There is $12 billion spent annually on fish oil alone.

more...
No comment yet.
Scooped by Seth Bilazarian, MD
Scoop.it!

Ask Well: CoQ10 Drug Interactions?

Ask Well: CoQ10 Drug Interactions? | Heart and Vascular Health | Scoop.it

Coenzyme Q10, or CoQ10 as it is often called, is commonly taken in supplement form to counteract the muscle pain and weakness associated with cholesterol-lowering statin drugs. 

Statins do appear to lower levels of CoQ10, a substance that is naturally produced in almost every cell in the body, where it helps convert food to energy and acts as an antioxidant. Organs that have particularly great energy demands, like the heart and the brain, contain the highest concentrations of it, said Dr. Robert Bonakdar of the Scripps Center for Integrative Medicine in California.

There is no doubt that coenzyme Q10 has several important roles in the body. But those who take it should do so carefully, because in some cases it can blunt or amplify the effects of other drugs, particularly those that are used to control blood sugar and blood pressure.

In roughly half of people who take it, CoQ10 has a relaxing effect on blood vessels that can lower blood pressure levels, said Dr. Roxanne Sukol, a preventive medicine specialist at the Cleveland Clinic’s Wellness Institute. But it takes about eight weeks for this effect to kick in, she said, and those who are already on blood pressure medications and choose to take CoQ10 should do so under the guidance of a doctor.

Taking CoQ10 can lower blood sugar levels as well, which can be problematic for people with diabetes and anyone using medication to control hyperglycemia.

It can also interact with blood thinners, so people who use drugs like aspirin or warfarin should be particularly cautious, Dr. Sukol said.

Seth Bilazarian, MD's insight:

Another example of how the unknowns of "safe: and "natural" therapies have risks that can be unknown and difficult to identify and evaluate since there is no formal testing of these naturopathics.

My recommendation: Eat a well balanced diet enriched with fresh fruits and vegetables and skip the vitamins.

more...
Tina Bilazarian's curator insight, November 5, 2013 5:51 PM

Never enough info for intelligent decisions.