Should I be taking vitamins? Am I taking too many?

One of the most common questions you get when you visit your doctor is: What medications are you taking?

Patients often list their prescribed medications without mentioning the vitamins or supplements they also take.

According to a 2016 survey by the Council for Responsible Nutrition, 70 percent of adults between the ages of 18 and 34 use supplements – that’s up from 65 percent in 2015.

That percentage is likely even higher today, especially with the concerns about catching COVID-19.

It is important to include over-the-counter supplements and vitamins in discussions with your doctor because, in many cases, they might cause negative interactions with your prescriptions or increase your risk of developing a health problem.

Here are some of the common vitamins and supplements and the interactions they might cause:

• Too much vitamin A is associated with an increased risk of osteoporotic fractures.
• Excessive vitamin E intake has been associated with increased all-cause mortality when taken at or above a dose of 400 units daily.
• Too much vitamin B-12 may cause skin conditions such as acne and rosacea, as well as headache, dizziness and diarrhea.
• Excessive calcium intake may decrease absorption of medication taken for osteoporosis, interfere with the effectiveness of certain blood pressure medications, and increase the mortality rate in patients with severe kidney disease.
• The herb fenugreek has been found to adversely affect diabetes medications and blood thinners, and may cross-react with peanut, cashew and sumac berry, which could be very dangerous for patients with food allergies.
• Green tea extract has been found to counteract sleep medications like Ambien.
• The herbal supplement St. John’s Wort can interact with many medications including: birth control, blood thinners like Warfarin, HIV medications, certain eye drops used to treat glaucoma, heart medications like digoxin, medication used to prevent rejection of transplanted organs, and some antidepressant medications.
• Many diet supplements include ephedra, which has been linked to hypertension, myocardial infarction aka heart attack, stroke and seizures.

This is only a partial list of interactions from some common vitamins and supplements. There are likely other medication interactions with supplements and excess vitamin levels that have yet to be discovered, due to inadequate research or conflicting data.

We should also keep in mind that manufacturers of over-the-counter vitamins and supplements are not regulated by the Food and Drug Administration. There could be significant variation in the actual levels of ingredients in over-the-counter vitamins and supplements. Over-the-counter vitamins and supplements could also contain additional substances or additives that may lead to unexpected reactions or illness.

Obviously, adequate levels of vitamins and minerals are important for maintaining good health. However, we should remember that just because some is good, more is not always better. This is especially true for vitamins and minerals.

The best bet is to always talk to your doctor about all your vitamins and supplements.

How to talk to your doctor

When you are going for your annual primary care physical or your free Medicare Annual Wellness Visit, it is a good idea to pack up everything you take – all the prescription and non-prescription medications – and bring them with you to your doctor’s office.

This will allow your provider to inspect each label for both the dose of what you are taking and any additives that might be included in a specific brand.

You can then talk about potential negative interactions between the vitamins and the prescriptions you are taking.

There is no reason to be embarrassed about the number of medications you are taking, and you will likely find the conversation about vitamins and supplements to be very eye-opening and educational.

Beebe Primary Care providers are accepting new patients. To schedule today, call 302-645-3332.

For more information about Beebe Primary Care and Medicare Annual Wellness visits, go to beebehealthcare.org.