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

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

This section connects supplement mechanisms to clinical pharmacology.

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

These frequently interact with prescription drug classes:

• St. John’s Wort → CYP induction → ↓ efficacy of SSRIs, SNRIs, TCAs, oral contraceptives, transplant medications
• Kava → hepatotoxicity risk (monitor LFTs)
• Kratom → opioid-like effects; interacts with Opioids
• Red Yeast Rice → statin analog → similar risks as Statins
• High-dose Biotin → interferes with thyroid labs and troponin
• Yohimbine / stimulant blends → sympathomimetic effects; interacts with Antihypertensives

Often used alongside:

• GLP-1 Receptor Agonists
• SGLT2 Inhibitors
• Metformin
• Diabetes Medications

Common supplements:

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

→ Weight Loss Supplements

Commonly taken with:

• Statins
• Antihypertensives
• Antiplatelet Agents
• Anticoagulants

Common supplements:

• Omega-3 fatty acids
• Red yeast rice
• CoQ10
• Garlic
• Beetroot/nitrates
• Magnesium

→ Cardiovascular Supplements

Often combined with:

• SSRIs
• SNRIs
• TCAs

Common supplements:

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

→ Sleep & Mood Supplements

Often used instead of or alongside:

• NSAIDs
• Opioids
• TCAs (neuropathic pain)
• SNRIs (neuropathic pain)

Common supplements:

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

→ Pain & Inflammation Supplements

Common supplements:

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

Note: May interact with Corticosteroids and certain Antibiotics.

→ Immune Supplements

Common supplements:

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

Often taken with:

• Proton Pump Inhibitors
• Laxatives

→ GI Supplements

Often used alongside:

• PDE-5 Inhibitors

Common supplements:

• DHEA
• Tribulus
• Tongkat ali
• L-arginine / citrulline
• Yohimbine

→ Sexual Health Supplements

Often relevant in patients taking:

• Antihypertensives (electrolyte shifts)
• Diuretics
• Statins
• Diabetes Medications

Common supplements:

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

→ Vitamins & Minerals

• Drug Classes
• Full Lecture Series
• PharmAtlas Home