Should I Take All These Supplements?

I often get referrals for patients who have questions about supplements.  Some will ask me “Should I take all theses supplements?”  There are definitely some scenarios where I think supplements may be a good options and worth taking, but often times I think patients are just wasting their money.  Here’s a scenario of a poly-supplement patient and some things that I would look at.

A 63 year old male has a PMH of BPH, OA, GERD, Atopic dermatitis, diabetes and hypertension.  His current medication list including supplements includes:

  • Atorvastatin 40 mg daily
  • Metformin 500 mg BID
  • Cinnamon 1,000 mg once daily
  • Glucosamine/chondroitin 500 mg TID
  • Vitamin E 400 units per day
  • Multivitamin once daily
  • Vitamin C 500 mg daily
  • Ferrous sulfate 325 mg daily
  • Lisinopril 10 mg daily
  • B12 500 mg daily
  • Red yeast rice 200 mg daily
  • Omeprazole 20 mg daily

The first supplement I would target as potentially duplicate therapy would be the red yeast rice.  There is some evidence that red yeast rice has a statin component in it.  When comparing red yeast rice to statins as far as reducing risk of MI and other issues, the statin is obviously going to have a lot better research behind it.  I would recommend discontinuing the red yeast rice.

This patient is also on numerous supplements that will likely be contained within their multivitamin.  Vitamin E, C, folic acid, B12 will all likely be contained within the multivitamin.  I would make a point about 2 things however.  Omeprazole and metformin can reduce B12 levels.  Assessing for possible deficiency would be important.  The other point; vitamin C might be utilized to aid in absorption of iron.  Assessment of both of these with iron stores as well as hemoglobin would be important.

Cinnamon is often tried for diabetes.  I would look at blood sugars and see if the patient has noticed a difference since starting it.

Glucosamine can sometimes be beneficial for osteoarthritis.  If the patient isn’t sure if it is helping (which many seem to be), I would recommend a trial off for a few months and tell patient to restart if pain increases.

 Love the blog? Get a free gift simply for following! Over 4,000 medication loving healthcare professional have taken advantage of this!

 

2 Comments

  1. Isaya John

    Great!

    Reply
  2. Ernie

    Hi Eric as usual great blog thanks!

    I have 3 CGP question that I am not sure of the answers, can you or someone help:

    Q1) A husband and wife came in to the pharmacy to fill a husbands new Rx donepezil for mild Alzheimers, the wife is the primary caregiver of the husband. As the pharmacist in retail store who do you call over to the counseling session:
    a) the patient only
    b) the patient and the wife
    c) the wife only

    Which of these answers is correct?

    Q2) Which of the following found in advanced directive?
    a) Healthcare proxy
    b) Last meal allowed to have before death
    c) Financial Power of Attorney

    Q3) Patient has history of Bipolar disorder. Patient has been on Lithium 300mg TID for the past 6 month with no complications. Labs reviel
    Scr = 1.4
    Albumin = 3.2
    Serum Lithium = 0.4
    What is the MOST appropriate thing to do?
    a) Continue current therapy
    b) Increase lithium dose
    c) Decrease lithium dose

    Reply

Trackbacks/Pingbacks

  1. Which Supplement Should I Take? Questions to Consider When Patients Want to Take Supplements - Med Ed 101 - […] a drug interaction screen is important to maximize the safety of any new supplement. Here’s a classic case scenario…

Submit a Comment

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Written By Eric Christianson

November 8, 2017

Free PDF – Top 30 Medication Mistakes

Enjoy the blog?  Over 6,000 healthcare professionals follow the blog, why aren't you? Subscribe now and get a free gift as well!

Categories

Free PDF – Top 30 Medication Mistakes

Enjoy the blog?  Over 6,000 healthcare professionals follow the blog, why aren't you? Subscribe now and get a free gift as well!

Buy on Amazon

Categories

Explore Categories