“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Clinical Pearl Wednesday #168

Pills and vitamins on white background

It’s always a good idea to regularly review with patients all of the supplements and vitamins they are taking, not just to be sure you catch any possible interactions but because many patients do not realize they are taking multiple varieties of many ingredients.  Once, I found a patient taking 4 different types of B vitamins, resulting in massive daily overdoses of many B vitamins, including B12.  However, only 2 of the supplements were “labeled” as a B vitamin.  All the others were INCLUDED in other supplements or named differently, like “stress tabs.”  One of the supplements was marketed and sold as an electrolyte drink mix, yet contained more than the B complex vitamin product quantities. 

Sometimes, having patients “brown bag” everything they take can be an excellent method of reviewing meds, vitamins, and supplements.  This method encourages patients to bring all bottles in a brown lunch bag into the office for at least one visit per year.  You can also have them use a shoe box, storage container, or even their purse.  

It’s essential to review the actual listing on the back of the label since many products contain multiple ingredients, thus causing duplicates of some.  

Remember, too, that B vitamins, iron, and many hormones need to be stopped a few days PRIOR to blood draws to minimize their impact on the blood tests; note that biotin will skew about 150 different lab tests.  

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