Heart patients, have you told your doctor that you take herbal or vitamin supplements?<\/p>\n
To be safe, let your doctor know. Anything you take into your body has an effect \u2013 whether good or bad \u2013 and herbs and vitamin supplements are no different. They could interact with your prescription medications, possibly worsening your cardiovascular problems or increasing the drugs\u2019 side effects. By that same token, replacing prescription medications with supplements may put you at an even greater risk.<\/p>\n
\u201cSupplements are perceived by some people as being safe, natural and pure, and prescription drugs are looked at as less safe. A lot of people believe that if it comes from nature, then it must be safe. They see all the side effects of prescription drugs listed in ads, and the bottles for over-the-counter supplements aren\u2019t required to list any side effects,\u201d said Perry J. Weinstock, MD, FACC<\/a>, Head of the Division of Cardiovascular Disease and Director of Clinical Cardiology at Cooper University Hospital. \u201cThe herbal supplements that patients consume can have many effects which could result in a negative impact on blood pressure, cholesterol, heart rhythm and blood clotting,\u201d Dr. Weinstock said. Unlike prescription medications, herbal substances are not well-regulated. The U.S. Food and Drug Administration (FDA) considers herbs to be dietary supplements, not drugs, so the FDA does not oversee these products to the same degree as it does with prescription medications. That means the potency, purity and quality of herbs cannot be guaranteed. The strength of a pill from one bottle of echinacea may not be the same as another brand\u2019s version. You don\u2019t have the assurance that what you are buying is entirely safe or the same from batch to batch. Contaminants such as lead, mercury and arsenic have been found in herbal supplements. In addition, you have no way of knowing what dose may be toxic.<\/p>\n \u201cMany of these alternative medicines could act as an additional dose of medication by altering the metabolism of other medications in the blood, which could lead to serious adverse events. In particular, they could interact in the liver, impacting levels of certain very critical medications such as warfarin (Coumadin\u00ae),\u201d Dr. Weinstock said.<\/p>\n Americans are using complementary alternative medicine (CAM) at record levels. Conservative estimates suggest that 29 percent of the U.S. population has used some form of CAM in the past, and at least 12 percent uses herbal medicines annually.<\/p>\n Currently, the CAM marketplace is valued at $24 billion with a growth rate close to 15 percent per year. While herbal and nutritional supplements may have some utility, there is increasing evidence of potentially dangerous interactions when combined with prescription drugs.<\/p>\n In a recent study evaluating 52 supplements for safety, 13 (25 percent) contained traces of steroids and 11.5 percent contained banned stimulants. In 2007, the American Heart Association released updated guidelines for cardiovascular disease-prevention in women and advised that antioxidant supplements such as vitamins C, E and beta carotene, as well as folic acid supplements, are of no benefit for preventing heart disease.<\/p>\n \u201cFor most individuals, these supplements are taken in good faith that the manufacturer\u2019s claims will be delivered but without any valid proof that safe or effective results will occur,\u201d said Mitchell Somma, CT (ASCP), PA-C, a physician\u2019s assistant with the Cooper Heart Institute<\/a> who has authored papers about the benefits and risks of alternative medicines.<\/p>\n \u201cThe problem is a lot of people don\u2019t report their use of herbs or supplements to their doctors,\u201d Somma said. \u201cEither they don\u2019t think of it, or they may not think they need to report it because of a perception that supplements are risk-free and safe.\u201d<\/p>\n One such common but potentially potent supplement is red yeast rice, which people use to lower cholesterol. Made by fermenting red yeast on rice, the supplement contains lovastatin, the same ingredient found in one of the statin drugs lovastatin (Mevacor\u00ae). Statins lower cholesterol.<\/p>\n \u201cPeople think it\u2019s completely safe, but it is, in fact, a statin. It works the same way as the prescription drugs,\u201d Dr. Weinstock said. \u201cRed yeast rice is not necessarily any safer than its prescription counterpart \u2018statins.\u2019 Patients are generally not told that red yeast rice can inflame the liver and muscles similarly to other statins. This is a case in which you should talk with your doctor.\u201d<\/p>\n A good example of a supplement gaining in popularity and causing a crisis occurred a few years ago. People were taking ephedra to lose weight but it caused strokes and heart attacks resulting in several deaths. Because of the extreme health risks, the FDA banned its sale in this country.<\/p>\n Manufacturers of herbal supplements are not required to do extensive testing to support their claims. Prescription medications must have a number of different types of studies, many of which involve large groups of patients before these medications are released into the market. Even after that time, manufacturers continue collecting data about the medication to monitor for side effects and efficacy.<\/p>\n In addition to herbs, taking vitamin supplements isn\u2019t a good idea without first talking to your doctor. A government-sponsored study published in 2005 in the Journal of the American Medical Association<\/em> showed that people taking 400 international units of vitamin E had a 13 percent increased risk of heart failure, a condition in which the heart\u2019s ability to pump blood is weakened. Vitamin E has also been linked to a rise in serious bleeding in the brain, as well as reducing circulating levels of HDL (good) cholesterol.<\/p>\n \u201cWe don\u2019t dislike supplements or universally discourage their use. We know they can be effective, but they often are not subjected to the same rigorous safety testing as prescription medications. Furthermore, some supplements have proven to be quite dangerous,\u201d Somma said. \u201cWe are open to talking about supplements. Tell us what you\u2019re taking and let us figure out together if it\u2019s dangerous.\u201d<\/p>\n Somma points to fish oil supplements as being good for your heart and something that healthcare providers feel comfortable recommending to patients. It reduces triglycerides, one of the substances in the body that together with cholesterol can stick inside artery walls, causing plaque buildup. Fish oil also may reduce the incidence of certain types of abnormal heart rhythms. Thus, fish oil is potentially beneficial. However, fish oil does slightly increase the risk of bleeding. It is strongly advised that patients talk to their doctors before taking any type of non-prescription supplements to minimize the chance of unintended harm.<\/p>\n In addition, recent data has suggested that Vitamin D supplements can be beneficial and safe. Several studies have demonstrated reductions in heart disease and certain types of cancer in vitamin D deficient individuals who were given this supplement. However, too much Vitamin D can be toxic.<\/p>\n If you are going to have surgery, be sure to tell your surgeon and anesthesiologist about any supplements you take. Many of these products can affect blood clotting and the effectiveness of anesthesia, which can produce a potentially deadly situation.<\/p>\n Remember, \u201cJust because a supplement comes from nature doesn\u2019t mean it is safe. Lead and arsenic come from nature, too,\u201d Dr. Weinstock said. \u201cBe careful with whatever you put in your body.\u201d<\/p>\n Below are some commonly used vitamin and herbal supplements, and their known cardiac risks.<\/p>\nSupplement use on the rise<\/h3>\n
Risks and benefits<\/h3>\n