Explore the Evidence Based Medicine

I’ll regularly review the research on medicines, supplements, and health technologies that people often ask me about.
I’ll then share simple summary tables that include:

  • How much they seem to help (effect size)

  • How strong and reliable the research is (level of evidence)

  • The most common side effects

  • Effect size means how big the benefit is — for example, whether a treatment helps a little, a moderate amount, or a lot compared with no treatment or another option.

  • Level of evidence means how trustworthy the research is — for example, whether it comes from a few small, early studies or from many large, well-done studies.

Key points:

  • Many supplements and medications have significant interactions with anticoagulants, antiplatelets, CNS-active drugs, and hypoglycemics.[1-4][7]

  • Renal, hepatic, and cardiovascular side effects are common with several agents, especially lithium, thiazolidinediones, and some herbal products.[5][7]

  • Polypharmacy and older age increase the risk of major drug-supplement interactions.[6][8]

  • Reliable drug interaction resources (e.g., Micromedex, Lexicomp) should be consulted for patient-specific risk.[9]

So please talk with your doctor to avoid any complications and can help you choose the supplements that are most likely to help you, while avoiding safety concerns with your medical condition or interactions with your medications.

References

  1. Evaluation of Documented Drug Interactions and Contraindications Associated With Herbs and Dietary Supplements: A Systematic Literature Review.

Tsai HH, Lin HW, Simon Pickard A, Tsai HY, Mahady GB. International Journal of Clinical Practice. 2012;66(11):1056-78. doi:10.1111/j.1742-1241.2012.03008.x.

2. Food Supplement Vitamins, Minerals, Amino-Acids, Fatty Acids, Phenolic and Alkaloid-Based Substances: An Overview of Their Interaction With Drugs.

Lopes M, Coimbra MA, Costa MDC, Ramos F. Critical Reviews in Food Science and Nutrition. 2023;63(19):4106-4140. doi:10.1080/10408398.2021.1997909. Leading Journal

3. Common Herbal Dietary Supplement-Drug Interactions. Asher GN, Corbett AH, Hawke RL. American Family Physician. 2017;96(2):101-107.

4. Is the Clinical Relevance of Drug-Food and Drug-Herb Interactions Limited to Grapefruit Juice and Saint-John's Wort?. Mouly S, Lloret-Linares C, Sellier PO, Sene D, Bergmann JF. Pharmacological Research. 2017;118:82-92. doi:10.1016/j.phrs.2016.09.038. Leading Journal

5. Adverse Effects of Nutraceuticals and Dietary Supplements. Ronis MJJ, Pedersen KB, Watt J. Annual Review of Pharmacology and Toxicology. 2018;58:583-601. doi:10.1146/annurev-pharmtox-010617-052844. Leading Journal

6. Concurrent Use of Drugs and Supplements in a Community-Dwelling Population Aged 50 Years or More: Potential Benefits and Risks. Peklar J, Henman MC, Kos M, Richardson K, Kenny RA. Drugs & Aging. 2014;31(7):527-40. doi:10.1007/s40266-014-0180-6.

7. An Evidence-Based Systematic Review of Herb and Supplement Interactions by the Natural Standard Research Collaboration. Ulbricht C, Basch E, Weissner W, Hackman D. Expert Opinion on Drug Safety. 2006;5(5):719-28. doi:10.1517/14740338.5.5.719.

8. Changes in Prescription and Over-the-Counter Medication and Dietary Supplement Use Among Older Adults in the United States, 2005 vs 2011. Qato DM, Wilder J, Schumm LP, Gillet V, Alexander GC. JAMA Internal Medicine. 2016;176(4):473-82. doi:10.1001/jamainternmed.2015.8581.

9. Evaluation of Resources for Analyzing Drug Interactions. Patel RI, Beckett RD. Journal of the Medical Library Association : JMLA. 2016;104(4):290-295. doi:10.3163/1536-5050.104.4.007.

Supplements and Medications which can help with Neurogenesis and Metabolism