Vitamins, Supplements and Medications–A Dangerous Mix?

Joy Pape, FNP-C, CDCES

A patient was referred to me by her nephrologist (kidney doctor) because she had diabetes, obesity and extremely high blood pressure. These together can, and often do, cause other complications such as chronic kidney disease.

When we first reviewed her health history and medications, she did not tell me the vitamins and supplements she was taking. After a few visits, and having developed a trusting relationship, she started telling me about those.

When we reviewed her list of supplements, I told her I could not recommend vitamins and supplements for her without first discussing these with her specialist because of her kidney disease. She responded, “Kidney disease? I don’t have kidney disease.” I gently told her, “Yes, you do. Your kidney doctor was the person who referred you to me. People don’t usually have kidney doctors unless they have kidney problems.”

Kidney disease changes the way one’s body uses and breaks down certain foods and other substances. And some medications can change the way a person’s body with kidney disease uses certain vitamins and minerals.

She knew we were having problems lowering her blood pressure. We looked at labels which listed some ingredients of her supplements. She was taking one that had licorice in it. Unbeknownst to many, licorice can raise blood pressure, which was most likely one of the causes of her kidney disease.

I often will not recommend supplements to people who have certain diseases, especially kidney disease, without checking with my patient’s personal specialist.

To be clear, I am not at all against taking vitamins and supplements if, in my professional opinion, they are right for my patients. In fact, I often recommend them.

The National Center for Complementary and Integrative Health (NCCIH) tells us:
“Many Americans take dietary supplements along with prescription or over-the-counter medications. Sometimes, taking medications and supplements together may have unintended effects, including:
• Increasing the medication’s effects
• Decreasing the medication’s effects
• Interacting with the medication in harmful ways

That’s why you should talk with your health care providers about all dietary supplements and medications you take.”

True, not all health care professionals are aware of all the beneficial effects and adverse side effects. Many are and those who aren’t will most likely tell you they are not and therefore cannot offer recommendations.

I recommend The National Center for Complementary and Integrative Health (NCCIH)’s website to learn more about talking with your health care providers, the different ways supplements and medications can interact, and how to read and understand labels on supplements—then test your knowledge.
kidney.org/atoz/content/vitamineral
www.nccih.nih.gov/health/know-science/
how-medications-and-supplements-
can-interact/introduction

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Joy Pape, FNP-C, CDCES, CFCN is a board-certified family nurse practitioner and diabetes care & education specialist, and obesity specialist who believes in and practices holistic health and healing. Joy practices at Weill Cornell’s Comprehensive Weight Control Center and has a private practice in the West Village.