Such an important topic, as many supplements are OTC and unregulated. In our practice, we first explore if supplements being used were recommended by a HCP who has training and experience with supplements, herbals, homeopathy or essential oils or if a pt has added “supplements” themselves.
We investigate the intent of the “supplements” and evaluate which may safely remain in a patients’ regimen in relation to treatment. Sometimes, pts make choices of supplements based on what they think they need without real guidance or input as to how the supplements may interact with one another or prescribed medications. As Mollie pointed out some supplements especially poly supplements can interfere with oral targeted therapies or set up a renal or hepato –toxic situation in respect to immune checkpoint inhibitors. Additionally, the growing access to CBD (cannabidiol) oil and ingestion of CBD which is a powerful CYP450 3A 4&5 inhibitor can interfere with other oral agents causing toxicity with prescribed medications.