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Nutritionals (herbals and vitamins) are very popular these days and, whereas they may provide many positive benefits, they are not completely "harmless" and should be taken with caution. Many of the people that take nutritionals, believe that the word "natural" implies that the product is safe. However, given the quality of the product and each individual's specific situation, this is not always true. That is, nutritionals are NOT always safe to consume and can cause negative interactions when mixed with other nutritionals and/or prescription drugs.

For example, several studies have shown Ginkgo Biloba to improve cognition (memory and recall) and that it may be useful in the early stages of Alzheimer's Disease. However, it is not an innocuous drug. Ginkgo Biloba inhibits platelet function and thus may prolong bleeding. As a result, it should not be used by those taking anticoagulants such as Coumadin (Warfarin) or Heparin. Also, Ginkgo should be used with caution by those taking NSAID's, such as Aspirin, Ibuprofen and Motrin. These drugs also inhibit platelet function which may increase the risk for bleeding.

Another concern would be using Ginkgo with certain antidepressants called MAO inhibitors. That includes Nardil, Parnate and possibly St. John's Wort. MAO inhibitors have been associated with dangerously low blood pressure in toxic instances. Since St. John's Wort may have MAO inhibiting activity, and since Ginkgo Biloba could lower blood pressure by increasing blood flow, they should not be used together until further reliable information on safety becomes available.

"Natural" Does Not = Safe"

Webster's Dictionary defines "natural" as something that is planted or growing by itself, not cultivated/introduced artificially (e.g. grass), or not artificial (as in form or construction). Most nutritionals are not prepared in this manner, and the word "natural" is not defined as, nor does it imply safety. Users need to be aware that nutritionals can be just as dangerous as prescription drugs, and possibly more dangerous. They are largely misunderstood, and in comparison to prescription drugs, nutritionals can be dangerous in more ways than one.

The manufacturing of nutritionals is a relatively unregulated process. Sometimes the production process can vary in herbal composition, manufacturing method, and in the additives used to put the nutritional into the pill form. This can affect the nutritional's purity, dissolution (the rate at which the herb or vitamin dissolves into solution so that it may enter the body), it's efficacy (the maximum possible effect), and the potency (the dose needed to reach maximum effect).

Whereas the following advice may seem overly cautious, we recommend that older adults should not take nutritionals (herbals; vitamin supplements) without first consulting a doctor or pharmacist. Given the fact that many older adults tend to take a variety of prescription drugs, negative interactions can and do occur when certain prescription drugs and "natural" nutritionals are mixed. Sometimes the use of a particular nutritional may be substantiated, in which case the user should still consult their doctor or pharmacist. Patients need to be assertive and ask their doctor about side effects, drug interactions, correct dosing, and the correct type of formulation (brand) to use. It is very important to keep in mind that doctors and pharmacists don't have all of the answers, and that there is a great deal of information we don't currently have which is necessary to justify a nutritional's use.

Click here for a list of some of the more popular herbal supplements along with individual reviews.

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