Supplements Flashcards
Fish Oil/Omega-3 FA
Decreases hepatic secretion of VLDL and increases VLDL clearance, lowers TGs by 30% w/statins (does NOT affect LDL)
Treatment option for patients who can’t take niacin due to gout or flushing reaction
Fish Oil SE
Fishy taste (decrease by freezing)
GI side effects
Increase risk of bleeding with anticoagulants
Interactions with “G” herbs: ginger, garlic, ginkgo, ginseng
Pregnancy limit to 12 oz/wk
Fiber
If 51% whole graincan say that reduces risk of heart disease
Blond Psyllium (10-12 grams)
Oat Bran
Niacin
1200-3000 mg/day may lower LDL and TG, and increase HDL, but no significant decrease in all cause mortality
Can give aspirin before to avoid flushing
Niacin SE
Side effects: flushing, increase uric acid (gout), increase blood sugar, headache, hepatoxicity
Plant Sterols and Stanols
Inhibits about 50% of intestinal cholesterol absorption (decrease TG and LDL, no effect on HDL)
Can be found in butters and juices
Plant Sterols SE
Diarrhea and steatorrhea
Takes 2-3 wks
Interactions with beta carotene and Vit. E and Zetia
Flaxseed
Good source of linolenic acid
40-50 g/d to decrease LDL
Flaxseed SE
Diarrhea
Increased risk of bleeding with anticoagulants
Interactions with “G” herbs: ginger, garlic, ginkgo, ginseng
Red Yeast Rice
Active ingredient resembles a statin (inhibits HMG CoA reductase)
May contain Citrinin (renal toxicity)
Red Yeast Rice SE
GI upset, heartburn, flatulence
Many DDIs
Calcium
800-1200 mg/d increases weight loss
Ca SE
Belching, flatulence
Hoodia Gordonii
Raspberry flavored yogurt drink that causes weight loss
Hoodia Gordonii SE
Nausea and skin issues
Ephedra
Significant weight loss
Ephedra SE
Dizziness, N/V, palpitations, HTN, MI, arrhythmias, sudden death DO NOT RECOMMEND! Risk outweighs benefit
Bitter Orange
Was created in response to ephedra ban: contains 1-6% of synephrine (related to ephedrine) and often also contains caffeine
Bitter Orange SE
Dizziness, N/V, palpitations, HTN, MI, arrhythmias, sudden death DO NOT RECOMMEND! Risk outweighs benefit
Chromium
May reduce oxidative stress
May reduce blood glucose, HbA1c, FFA
Chromium SE
HA, insomnia, irritability, mood changes & sleep disturbance
Vomiting, diarrhea, & hemorrhage
Vanadium
Stimulates glycogengenesis, inhibits lipolysis
Vanadium SE
GI upset, tongue discoloration (green tongue)
Interactions with “G” herbs and anticoags
Garlic
Allicin is the active ingredient; inhibits hepatic cholesterol synthesis; relaxes smooth muscle (vasodilation=decrease BP); also used for dyslipidemia
Garlic SE
Halitosis, body odor, heartburn, GI upset
DDIs: anticoagulant /antiplatelet; CYP3A4 and CYP2E1
Coenzyme Q-10
Used for CHF
preventing myopathy
Coenzyme Q-10 SE
GI upset, heartburn, appetite loss
DDIs with anticoagulants
Dietary Supplement and Health Education Act (DSHEA) of 1994
Evaluate vitamins, herbals, etc more like food rather than medicationproducts can’t be on same shelf as OTC drugs
o Two key players: Manufacturers (need to ensure product is safe and that label is not misleading) and FDA (pull products if bad