When you get a new prescription, most doctors don’t talk about dietary supplements. If a conversation does take place, it probably focuses on the potentially dangerous interactions that can occur when people take a prescription medication and a supplement.*
The other side of the story: While some supplements can cause dangerous interactions with certain drugs, the reverse is also true—certain supplements can actually boost the effectiveness of a prescription drug and/or reduce its side effects. In some cases, this beneficial effect may allow you to take a lower dose of the drug…or even discontinue it at some point.
If you are interested in using a supplement as part of a medication regimen, always discuss this with your doctor. Medical supervision is necessary to ensure that you are using the combination safely.
Medication-supplement pairings that often work well…
• Diabetes medication and alpha-lipoic acid. Alpha-lipoic acid is an endogenous (made in the body) antioxidant that helps transform blood sugar (glucose) into energy. It is found in foods such as red meat and liver, though it is difficult to get enough from food to work effectively with your medication for type 2 diabetes.
When taken in the larger doses that are found in supplements, alpha-lipoic acid lowers blood sugar and may reduce pain, itching and other symptoms caused by diabetes-related nerve damage (neuropathy). For diabetic neuropathy, I typically recommend 400 mg to 500 mg of alpha-lipoic acid, twice daily. For general antioxidant benefit, 100 mg to 300 mg daily is usually sufficient.
If you’re taking a diabetes medication that lowers blood sugar, such as metformin (Glucophage) or glyburide (DiaBeta), the addition of alpha-lipoic acid may allow you to use a smaller drug dose. If your glucose levels are stabilized through diet and regular exercise (without medication), you may want to take alpha-lipoic acid indefinitely.
Caution: Taking too much alpha-lipoic acid with a diabetes drug could lead to excessively low blood sugar, which can cause anxiety, sweating, shakiness and/or confusion. Alpha-lipoic acid also may interact with chemotherapy drugs and thyroid medication such as levothyroxine (Synthroid). Talk to your doctor before taking alpha-lipoic acid with any prescription medication.
• Cholesterol medication and CoQ10. Coenzyme Q10 (CoQ10) is a critical component of the energy-producing mitochondria of the cells in your body. It is found in foods such as meat and fish. CoQ10 levels decline as we grow older. Cholesterol-lowering statin drugs also deplete CoQ10.
Food generally does not provide a therapeutic amount of CoQ10. When taken in supplement form, CoQ10 (100 mg to 200 mg daily) helps prevent the muscle pain that can occur as a side effect of statin medication. Research shows that CoQ10 itself has a mild cholesterol-lowering effect and may reduce the risk for cardiovascular disease.
Caution: CoQ10 may increase bleeding risk when taken with aspirin, warfarin (Coumadin) and other blood thinners. Talk to your doctor before taking CoQ10 with any prescription medication.
• Antidepressant medication and vitamin B-12. Vitamin B-12 is required for red blood cell formation and neurological function. This vitamin is naturally present in animal foods, such as clams, beef liver, red meat and eggs.
It’s well-known that vitamin B-12 levels decline with age—largely due to a loss of the stomach acid that is needed to absorb this vitamin. Strict vegetarians also tend to have low levels of B-12.
In a recent study, patients with a vitamin B-12 deficiency who took an injectable form of the vitamin—1,000 micrograms (mcg) weekly for six weeks—while also taking an oral antidepressant reported a significantly greater reduction in depression symptoms than those taking the oral medication alone.
Oral vitamin B-12 supplements (100 mcg daily for adults under age 50) or sublingual (under-the-tongue) tablets (1,000 mcg daily for adults over age 50) can be used to help make antidepressants more effective. No adverse effects have been linked to excess vitamin B-12 intake from food or supplements in healthy adults. However, when higher doses than those described above are used (to treat a severe B-12 deficiency or anemia, for example), the treatment should be supervised by a doctor.
• Blood pressure medication and magnesium. Magnesium is an extremely versatile mineral. It promotes the health of your heart and blood vessels and regulates the effects of calcium and other important nutrients in the body. Healthy adults can usually get plenty of magnesium from nuts, green vegetables and whole grains.
However, in order to get enough magnesium to help lower blood pressure, people with hypertension usually need a supplement (400 mg to 500 mg, twice daily). Magnesium citrate is the most absorbable form of the mineral.
Many blood pressure drugs relax and dilate the arteries, which allows blood to circulate with less force. Combining magnesium with a blood pressure-lowering medication can result in even lower blood pressure, which may allow you to take a reduced dose of the drug. When adding magnesium to a blood pressure medication regimen, check your blood pressure daily at home until your doctor says it’s stable.
Caution: Taking too much magnesium with a blood pressure drug may lead to low blood pressure. Symptoms include fatigue and light-headedness. Magnesium supplements can also cause diarrhea, so you may need a lower dose.
*To see if a drug you have been prescribed may interact with a supplement you are taking, ask your doctor.
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