This can be a confusing topic because there are so many formulations out there, and the clinician may see a guideline that says maybe incorporate capsaicin or glucosamine chondroitin, SAMe, avocado, soybean extract, fish oil, or other supplements, but doesn’t offer insight into actually getting the right formulation to the patient. There are databases and free things like PubMed to really key in on the formulations that really are worth recommending versus formulations that don’t have much evidence behind them. These resources can also be helpful in identifying potential drug interactions when using supplements. As a general ballpark, antidepressants, either conventional or over the counter, sedatives, sleep agents like valerian, anything with a blood thinning effect, like gingko, those are really ones to be more cautious about. Part of the issue is we don’t always have a full list of everything the patient is taking so when we’re trying to figure out what may be a potential interaction, we need to figure out everything that’s on the table or have the patient let us know.
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