I often get referrals for patients who have questions about supplements.  Some will ask me “Should I take all theses supplements?”  There are definitely some scenarios where I think supplements may be a good options and worth taking, but often times I think patients are just wasting their money.  Here’s a scenario of a poly-supplement patient and some things that I would look at.

A 63 year old male has a PMH of BPH, OA, GERD, Atopic dermatitis, diabetes and hypertension.  His current medication list including supplements includes:

• Atorvastatin 40 mg daily
• Metformin 500 mg BID
• Cinnamon 1,000 mg once daily
• Glucosamine/chondroitin 500 mg TID
• Vitamin E 400 units per day
• Multivitamin once daily
• Vitamin C 500 mg daily
• Ferrous sulfate 325 mg daily
• Lisinopril 10 mg daily
• B12 500 mg daily
• Red yeast rice 200 mg daily
• Omeprazole 20 mg daily

The first supplement I would target as potentially duplicate therapy would be the red yeast rice.  There is some evidence that red yeast rice has a statin component in it.  When comparing red yeast rice to statins as far as reducing risk of MI and other issues, the statin is obviously going to have a lot better research behind it.  I would recommend discontinuing the red yeast rice.

This patient is also on numerous supplements that will likely be contained within their multivitamin.  Vitamin E, C, folic acid, B12 will all likely be contained within the multivitamin.  I would make a point about 2 things however.  Omeprazole and metformin can reduce B12 levels.  Assessing for possible deficiency would be important.  The other point; vitamin C might be utilized to aid in absorption of iron.  Assessment of both of these with iron stores as well as hemoglobin would be important.

Cinnamon is often tried for diabetes.  I would look at blood sugars and see if the patient has noticed a difference since starting it.

Glucosamine can sometimes be beneficial for osteoarthritis.  If the patient isn’t sure if it is helping (which many seem to be), I would recommend a trial off for a few months and tell patient to restart if pain increases.

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