Elderly at risk from supplement-drug interactions
users of dietary supplements, but warns they may be exposed to
dangerous interactions with prescription drugs if they do not
discuss them with their doctor, writes Jess Halliday.
Carried out at Northern Illinois University and published in the July issue of the Journal of the American Medical Association, the survey drives home the message that the aging population is a key target for supplement makers.
Statistics from the US Census Bureau show that 45 and 64 year-olds are America's largest age group, making up 23.6 percent of the population. People aged 65 and over make up 12.4 percent.
Negative media reports about drugs used to treat common afflictions of the elderly, such as Vioxx and other COX2 inhibitors for inflammation and statins for high cholesterol, have led this important slice of the population to cast about for natural alternatives.
Of the 69 people surveyed, 35 (51 percent) said they used supplements, including glucosamine and fish oil for joint health, garlic to control cholesterol and gingko biloba for cognitive function. Almost 25 percent of these did so without the knowledge of their doctor.
But if safety is a top priority for those taking supplements, the survey data shows that some may be gravely misguided.
Twenty-six people (36 percent) said they combine dietary supplements with prescription drugs and, most worryingly, six of these (23 percent) said they did so without medical supervision.
"Given that there is increased risk of drug-supplement interaction among elderly persons, it is important that health-care professionals be aware that older patients may be supplementing their prescribed medications with herbal preparations," wrote the researchers.
If patients are unwilling or unaware of the need to discuss supplement use with their doctor, doctors may need to start taking the lead in asking each and every patient about supplement use.
Examples of supplements and drugs that may interact include gingko biloba with anticoagulants, and garlic with the platelet-inhibiting drug Tiplopidine and the anticoagulant Warfarin. Higher doses of certain drugs may be required if used in combination with glucosamine.
The latest survey results are broadly consistent with research published by Packaged Facts, a publishing division of MarketResearch.com, last October. It showed that people aged 65-74-years-old are 30 percent more likely than the average American to use vitamins.
A study conducted at Ohio State University also found that 71 percent of over-50s said they had turned to at least one of six forms (herbal medicine, acupuncture, chiropractor, massage therapy, breathing exercises or meditation) in 2000, and 63 percent said they had done so because they were not satisfied with the mainstream healthcare they were receiving.
This trend indicates that doctors could be opening their minds to other kinds of treatment options beyond drugs. Rather than just providing the caveats on supplements and other complementary and alternative therapies, they should be aware that, used in the right circumstances, supplements can be a useful way of tackling certain health conditions. Taking a blinkered approach might mean patients miss out on the potential benefits.
