Bades and medicines: interaction and risks. Detailed analysis for conscious use.
I. Fundamentals of the interaction of dietary supplements and drugs: what you need to know.
The interaction between biologically active additives (dietary supplements) and drugs is a complex and insufficiently studied area representing a significant risk to consumer health. A simple assumption that “natural” products are safe and cannot harm when jointly used with medicines is erroneous and can lead to serious consequences. Understanding the mechanisms of interaction, potential risks and factors affecting these interactions is extremely important for making informed decisions on the use of dietary supplements and drugs.
1.1. Determination of dietary supplements and drugs.
Before considering the interaction, it is necessary to clearly distinguish between the definitions of dietary supplements and drugs.
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Medicines: Substances or combinations of substances intended for the treatment, prevention or diagnosis of diseases. They undergo strict quality control, efficiency and safety, and their application is regulated by the relevant healthcare authorities. Medicines are prescribed by a doctor on the basis of the diagnosis and clinical picture of the patient.
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Biologically active additives (dietary supplements): Complexes of biologically active substances designed to maintain health, improve well -being and compensate for the lack of certain nutrients. The composition of dietary supplements may include vitamins, minerals, amino acids, herbs, probiotics and other substances. Bad are not medicines and are not intended for the treatment of diseases. Their circulation is regulated less strictly than the circulation of drugs.
1.2. Mechanisms for the interaction of dietary supplements and drugs.
The interaction between dietary supplements and drugs can occur at various levels, including:
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Pharmacokinetic interactions: The effect of dietary supplements on the processes of absorption, distribution, metabolism and excretion of drugs (ADME).
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Suction: Bad can affect the speed and degree of absorption of the drug in the gastrointestinal tract. For example, the dietary fiber contained in some dietary supplements can bind medicines and reduce their absorption. Some minerals, such as calcium, magnesium and iron, can form insoluble complexes with drugs, reducing their bioavailability.
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Distribution: Bad can affect the binding of a drug with blood plasma proteins, which can change the concentration of the free (active) form of the drug in the blood and, accordingly, its effectiveness and toxicity.
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Metabolism: Many dietary supplements, especially plant origin, can affect the activity of liver enzymes involved in the metabolism of drugs (for example, cytochrome P450). This can lead to an increase or decrease in the concentration of the drug in the blood. The inducers of enzymes (for example, St. John’s wort) accelerate the metabolism of drugs, reducing their effectiveness, while enzyme inhibitors (for example, grapefruit juice) slow down metabolism, increasing the concentration of the drug and the risk of side effects.
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Display: Bad can affect the excretion of the drug by the kidneys or through the intestines. For example, some diuretics contained in plant dietary supplements can enhance the excretion of drugs in the urine, reducing their concentration in the blood.
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Pharmacodynamic interactions: The effect of dietary supplements on the pharmacological effect of the drug.
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Synergism: Bad enhances the effect of the drug. For example, the joint use of anticoagulants (for example, warfarin) with dietary supplements with anticoagulant properties (for example, ginkgo bilobe) can significantly increase the risk of bleeding.
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Antagonism: Bad weakens the effect of the drug. For example, vitamin K can reduce the effectiveness of anticoagulants, since vitamin K is necessary for blood coagulation, and anticoagulants prevent this process.
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Additative effect: Bad and medicine have the same effect, and their joint use leads to an increase in this effect. For example, the joint use of antihypertensive drugs (to reduce blood pressure) with dietary supplements with a hypotensive effect (for example, garlic) can lead to an excessive decrease in blood pressure (hypotension).
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1.3. Factors affecting the interaction of dietary supplements and drugs.
The likelihood and severity of the interaction of dietary supplements and drugs are influenced by the following factors:
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The composition of dietary supplements: Specific ingredients, their concentration and interaction between them.
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Dosage dietary supplement: The higher the dose of dietary supplements, the higher the probability of interaction with the medicine.
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Dietary supplement duration: Long -term use of dietary supplements can change the activity of liver enzymes and affect the metabolism of drugs.
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Individual characteristics of the patient: Age, gender, genetic factors, the presence of concomitant diseases (especially liver and kidney diseases), drugs taken.
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Method of use of dietary supplements and drugs: Simultaneous reception or reception with a certain time interval.
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Diet: Food can affect the absorption and metabolism of both dietary supplements and drugs.
II. The most common and dangerous interactions of dietary supplements and drugs.
Consider the most common and clinically significant interactions between specific dietary supplements and drugs.
2.1. Interactions with anticoagulants and anti -signs.
Anticoagulants (for example, warfarin, heparin, dabigatran, rivaroxaban) and antiplatelets (for example, aspirin, clopidogrel) are drugs used to prevent blood clots. The joint use of these drugs with some dietary supplements can significantly increase the risk of bleeding.
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Ginkgo biloba: It has anticoagulant and anti -aggregate properties. Joint use with anticoagulants and anti -signs significantly increases the risk of bleeding, including intracerebral hemorrhages.
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Garlic: Contains allicin, which has anti -aggregate properties. Joint use with anticoagulants and anti -signs can enhance their effect and increase the risk of bleeding.
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Ginseng: Some studies have shown that ginseng can affect blood coagulation. Joint use with anticoagulants and anti -signs requires special caution and control.
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Fish oil (omega-3 fatty acids): In high doses, fish oil can have anti -aggregate properties. Joint use with anticoagulants and anti -signs requires caution, especially in patients with an increased risk of bleeding.
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Vitamin E: In high doses, it can have anti -aggregate properties. Joint use with anticoagulants and anti -signs can enhance their effect and increase the risk of bleeding.
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Turmeric (curcumin): It has anticoagulant and anti -aggregate properties. Joint use with anticoagulants and anti -signs requires caution.
2.2. Interactions with antihypertensive drugs.
Antihypertensive drugs are used to reduce blood pressure. The joint use of these drugs with some dietary supplements can lead to an excessive decrease in blood pressure (hypotension) or, conversely, to reduce the effectiveness of antihypertensive therapy.
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Garlic: It has a hypotensive effect. Joint use with antihypertensive drugs can lead to an excessive decrease in blood pressure.
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Coenzim q10: Some studies have shown that Coenzyme Q10 can reduce blood pressure. Joint use with antihypertensive drugs requires caution and control of blood pressure.
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Hawthorn: It has a hypotensive and cardiotonic effect. Joint use with antihypertensive drugs can enhance their effect and lead to hypotension.
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Potassium: Bad, containing potassium, can enhance the effect of some antihypertensive drugs (for example, diuretics), which can lead to hypokalemia (low blood potassium in the blood).
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Sweet (lacryc): Contains glycyrisic acid, which can increase blood pressure. Joint use with antihypertensive drugs can reduce their effectiveness.
2.3. Interactions with antidepressants.
Antidepressants are used to treat depression and other mental disorders. The joint use of these drugs with some dietary supplements can lead to serious side effects, including serotonin syndrome.
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St. John’s wort: Contains hypericin and hypefhorrin, which can affect the metabolism and transport of antidepressants, as well as have a serotonergic effect. Joint use with St. John’s wort can reduce the effectiveness of antidepressants (for example, selective inhibitors of the reverse capture of serotonin – SIOOS, tricyclic antidepressants) and increase the risk of serotonin syndrome, characterized by anxiety, excitement, tremor, muscle spasms, hyperthermia and other symptoms.
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Same (s-adenosylmetionine): It has an antidepressant effect. Joint use with antidepressants can increase the risk of side effects, including serotonin syndrome.
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Triptofan: Precursor Serotonin. Joint use with antidepressants can increase the risk of serotonin syndrome.
2.4. Interactions with immunosuppressants.
Immunodypensers are used to suppress the immune system, for example, after organs transplantation or for autoimmune diseases. The joint use of these drugs with some dietary supplements can reduce their effectiveness or increase the risk of side effects.
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SOUTINATEA: It has an immunostimulating effect. Joint use with immunosuppressants can reduce their effectiveness and lead to the rejection of the graft.
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Astragal: It has an immunostimulating effect. Joint use with immunosuppressants can reduce their effectiveness.
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St. John’s wort: It can affect the metabolism of immunosuppressants (for example, cyclosporine) and reduce their concentration in the blood, which can lead to the rejection of the transplant.
2.5. Interactions with antitumor drugs.
Antitumor drugs are used to treat cancer. The joint use of these drugs with some dietary supplements can reduce their effectiveness or increase the risk of side effects.
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Antioxidants (for example, vitamin C, vitamin E, beta-carotene): Some studies have shown that high doses of antioxidants can reduce the effectiveness of some antitumor drugs, especially those that act by the formation of free radicals.
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St. John’s wort: It can affect the metabolism of many antitumor drugs and reduce their concentration in the blood.
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Green tea (EGCG): It can affect the metabolism of some antitumor drugs.
2.6. Interactions with drugs for the treatment of diabetes.
Diabetes treatment drugs are used to control blood sugar. The joint use of these drugs with some dietary supplements can lead to hypoglycemia (low blood sugar) or, conversely, reduce the effectiveness of diabetes.
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Chromium: Some studies have shown that chrome can improve insulin sensitivity and reduce blood sugar. Joint use with drugs for diabetes can lead to hypoglycemia.
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Cover: Some studies have shown that cinnamon can reduce blood sugar. Joint use with drugs for diabetes can lead to hypoglycemia.
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Ginseng: Some studies have shown that ginseng can reduce blood sugar. Joint use with drugs for diabetes can lead to hypoglycemia.
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Alpha-lipoic acid: Some studies have shown that alpha-lipoic acid can improve insulin sensitivity and reduce blood sugar. Joint use with drugs for diabetes can lead to hypoglycemia.
2.7. Interactions with hormonal drugs.
Hormonal drugs are used to treat various conditions associated with hormonal imbalance. The joint use of these drugs with some dietary supplements can reduce their effectiveness or increase the risk of side effects.
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Soy (isoflavon): Soi isoflavon have an estrogen -like effect. Joint use with hormonal drugs containing estrogen can enhance their effect and increase the risk of side effects.
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Dudnik Chinese (Dong quai): It has an estrogen -like effect. Joint use with hormonal drugs containing estrogen can enhance their effect and increase the risk of side effects.
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St. John’s wort: It can affect the metabolism of oral contraceptives and reduce their effectiveness, which can lead to an undesirable pregnancy.
III. Risks associated with the use of dietary supplements and drugs.
The joint use of dietary supplements and drugs can lead to various health risks.
3.1. Reducing the effectiveness of drugs.
Interaction with dietary supplements can lead to a decrease in the concentration of the drug in the blood, which reduces its effectiveness and can lead to a deterioration in the patient’s condition and the inefficiency of treatment.
3.2. Strengthening the side effects of drugs.
Interaction with dietary supplements can lead to an increase in the concentration of the drug in the blood, which enhances its side effects and can lead to toxic reactions.
3.3. The development of new side effects.
The joint use of dietary supplements and drugs can lead to the development of new side effects that do not occur when each drug individually.
3.4. Defense or improper diagnosis of diseases.
Patients using dietary supplements for self -medication can postpone a doctor and miss the time for timely diagnosis and treatment of serious diseases. In addition, the use of dietary supplements can mask the symptoms of diseases and complicate the diagnosis.
3.5. Unpredictable reactions.
The interaction between dietary supplements and drugs can be unpredictable and depend on many factors, which complicates the assessment of risk and forecasting the consequences.
3.6. Low quality and inaccurate information about the composition of dietary supplements.
Some dietary supplements may contain impurities that are not indicated on the label, or contain the ingredients in quantities other than the declared. This can lead to unpredictable interactions with drugs and risk of side effects. Often information about the composition of dietary supplements is not true.
IV. How to minimize the risks of interaction between dietary supplements and drugs: recommendations.
You can minimize the risks of the interaction of dietary supplements and drugs by following the following recommendations:
4.1. Consultation with a doctor or pharmacist.
Before starting to take dietary supplements, especially if you already take any drugs, be sure to consult a doctor or pharmacist. Tell them about all the medicines, dietary supplements, vitamins and herbs that you accept, including dosages and reception regimen.
4.2. Information about the admission of dietary supplements.
When contacting a doctor or another medical specialist, always report that you are taking dietary supplements.
4.3. The choice of quality dietary supplements.
When choosing dietary supplements, give preference to products of famous manufacturers with a good reputation. Pay attention to the availability of quality certificates and compliance with standards.
4.4. A thorough study of the composition and instructions for use.
Before using dietary supplements, carefully study the composition and instructions for use. Pay attention to possible contraindications and side effects.
4.5. Compliance with recommended dosages.
Do not exceed the recommended dosages of dietary supplements.
4.6. Separate intake of dietary supplements and drugs.
If possible, take dietary supplements and drugs at different times to minimize the risk of interaction in the gastrointestinal tract.
4.7. Monitoring of health status.
Carefully monitor your health status with the joint use of dietary supplements and drugs. When any unusual symptoms or side effects appear, see a doctor immediately.
4.8. Caution for self -medication.
Do not self -medicate using dietary supplements, especially in the presence of chronic diseases or taking drugs.
4.9. A critical attitude to the advertising of dietary supplements.
Be critical to the advertisement of dietary supplements, which promises miraculous healing from all diseases. Remember that dietary supplements are not medicines and are not intended for the treatment of diseases.
4.10. Documentation of drugs and dietary supplements.
Close a list of all drugs taken and dietary supplements, including dosages and reception regimen. This list can be useful for consultations with a doctor or pharmacist.
V. Conclusion: Responsible attitude to health.
The use of dietary supplements and drugs requires a responsible approach and awareness. Remember that “natural” does not always mean “safe”. Before using dietary supplements, be sure to consult a doctor or pharmacist to avoid undesirable interactions and health risks. Do not self -medicate and be critical to advertising dietary supplements. Health is the most valuable thing we have, and it needs to be protected.