Do you tell your doctor about the supplements you take?

The use of complementary and alternative medicine has been steadily rising since the mid-twentieth century. We are discovering that a healthy lifestyle, a good diet, proper supplementation, exercise and a good attitude go a long way toward preventing disease. More and more we look to naturopathic doctors, acupuncturists, nutritionists, doctors of traditional Chinese medicine, homeopaths, integrated medical doctors, chiropractors and many other licensed health care practitioners for treatment alternatives.

A survey on the use of complementary and alternative medicine in the United States found the use of complementary therapies increased from 34% in 1990 to 42% in 1997. The therapies that increased the most were herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing and homeopathy. The probability of consumers visiting an alternative medicine practitioner increased from 36% in 1990 to 46% in 1997. In 1997, it was estimated that there were 629 million visits to alternative medicine practitioners.

Another study conducted at Harvard Medical School reported that at least 68% of the respondents to a survey had used at least one complementary and alternative medicine therapy in their lifetime. The authors found a pattern in complementary and alternative medicine use with age. Approximately 3 of every 10 pre-baby boomers, 5 of every 10 baby boomers, and 7 of every 10 post-baby boomers reported using some type of complementary and alternative medicine therapy by age 33 years.

With this increased trend in complementary and alternative medicine use, should we expect that patients would disclose their supplement usage to their physician? Should we expect our physician to ask if we are currently taking supplements? You would think yes, but the answer is no. Some patients believe their physician will refuse to treat them or frown upon their use of supplements. Others believe supplements are not a concern when taken with pharmaceutical drugs.

We should be concerned with this breakdown in communication between doctor and patient. The first survey above reported that in 1997 only 38% of patients disclosed their complementary and alternative medicine therapies to their physicians. We should be alarmed when we consider that in the same year an estimated 15 million adults took prescription medications concurrently with herbal remedies and/or high-dose vitamins.

Although we think that herbs are plants and they are ¡°just like food¡±, some herbs are toxic and just as strong as drugs. Did you know Aspirin was originally derived from white willow bark (Salix alba)? Did you know the most common drug used to treat congestive heart failure, digoxin, was originally derived from the foxglove plant (Digitalis purpurea, Digitalis lanata)? Did you know vitamin K can decrease the effect of warfarin, a blood thinner? Some interactions may weaken the effect of a drug, while other interactions may potentiate that drug. Also, some herbs and vitamins, when taken simultaneously with a drug, may decrease its absorption.

Not every herb or vitamin you take will interact with a drug. Many herbs and vitamins can be taken with drugs quite safely. Also, many herbs and vitamins help minimize drug side effects and drug-related nutritional depletions. The best way to know if your supplements interact with the prescription drug you are taking is to ask your physician or licensed health care provider, and be sure to tell them all the supplements you are currently taking. To best manage your health, your health care provider must know all drugs and supplements taken by his or her patient. This way, you can be confident that you are on your way to the road of health and wellness.