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Supplements

Supplements are pharmacologically active substances — even when sold over-the-counter.

This section connects supplement mechanisms to:

  • clinical effects
  • adverse effects
  • drug interactions
  • lab interference

If it changes physiology, it can change labs, interact with drugs, and cause toxicity.

When to Use This Section

  • A patient asks: “Can I take this with my meds?”
  • Unexplained LFT elevation, INR instability, CK elevation, or BP changes
  • A patient using supplements for weight loss, sleep, libido, pain, or “immune boosting”

High-Risk Supplements (Clinically Important)

These supplements show up commonly and have meaningful adverse effects or interactions:

  • St. John’s Wort → CYP induction → ↓ efficacy of many drugs (esp. antidepressants, contraceptives, transplant meds)
  • Kava → hepatotoxicity risk (consider LFT monitoring)
  • Kratom → opioid-like effects; dependence/withdrawal; seizure risk
  • Red Yeast Rice → statin-like (lovastatin analog) → similar risks as Statins
  • High-dose Biotin → lab interference (TSH/free T4, troponin, others)
  • Yohimbine / stimulant blends → HTN, tachycardia, anxiety; arrhythmia risk

Supplement Categories

1) Metabolic / Weight Loss

Often overlaps with obesity/diabetes pharmacology (GLP-1s, SGLT2s, metformin, etc.).

Common supplements:

  • Berberine
  • Cinnamon
  • Chromium
  • Green tea extract
  • Garcinia cambogia
  • Fiber (psyllium, glucomannan)

→ Weight Loss Supplements

2) Cardiovascular / Lipids / Blood Pressure

Often taken alongside lipid therapy and BP medications.

Key pharma links:

Common supplements:

  • Omega-3 fatty acids (EPA/DHA)
  • Red yeast rice
  • CoQ10
  • Garlic
  • Beetroot/nitrates
  • Magnesium

→ Cardiovascular Supplements

3) Sleep / Anxiety / Mood

Common supplements:

  • Melatonin
  • Valerian
  • L-theanine
  • Ashwagandha
  • 5-HTP (serotonergic interaction potential)
  • Kava (high risk)

→ Sleep & Mood Supplements

4) Pain / Inflammation

Common supplements:

  • Turmeric / curcumin
  • Omega-3 fatty acids
  • Glucosamine / chondroitin
  • Capsaicin (topical)
  • Boswellia
  • Willow bark (salicylate-like)

→ Pain & Inflammation Supplements

5) Immune / “Cold & Flu”

Common supplements:

  • Vitamin C
  • Zinc
  • Elderberry
  • Echinacea
  • Vitamin D

→ Immune Supplements

6) GI / Microbiome

Common supplements:

  • Probiotics
  • Peppermint oil
  • Ginger
  • Fiber
  • Digestive enzymes

→ GI Supplements

7) Sexual Health / Testosterone / Performance

Common supplements:

  • DHEA
  • Tribulus
  • Tongkat ali
  • L-arginine / citrulline
  • Yohimbine (high risk)

→ Sexual Health Supplements

8) Vitamins & Minerals (Deficiency-Driven Use)

Common supplements:

  • Vitamin D
  • Iron
  • B12 / folate
  • Magnesium
  • Calcium
  • Zinc

→ Vitamins & Minerals

Add your PharmAtlas links here once confirmed (to avoid wrong namespaces):

Evidence & Safety Legend

Label Meaning
Effective Good evidence for clinically meaningful benefit
Maybe Mixed evidence, small effect, or benefit only in select populations
Not proven No convincing benefit in high-quality studies
High risk Significant adverse effects, contamination risk, or major interactions
supplements/start.1771094453.txt.gz · Last modified: by andrew2393cns