Case history
Tracy*, age 49, presented with uncontrolled blood pressure in excess of 220/160mmHg, type 2 diabetes and had suffered a stroke due to mitochondrial disease.
She came to me because her GP had exhausted all avenues of conventional treatment and suggested that she may wish to look at supplements to help improve her condition but that she would need to research these herself.
Her prescribed medication included eight different blood pressure medications, including two unlicensed medicines, a statin, aspirin, diclofenac, tramadol, morphine, metformin and omeprazole.
Her health problems are thought to be due to a genetic condition leading to the death of cell mitochondria and build up of lactic acid. There is no cure for this condition but several supplements have been found to help with symptoms and improve quality of life.
Most days Tracey was incapable of holding a conversation and often showed signs of dementia. When she came to me for advice she was keen to try anything that could help her.
Supplement interactions
Whilst researching her condition and possible supplements, several issues came to light. The first was the potential for interactions given the volume of prescribed medication. The second issue was the medications that were potentially toxic to mitochondria including NSAIDs and more importantly statins.
Whilst there were a number of interactions between the recommended supplements and prescribed medication it was important to assess these interactions with a common sense approach. The key supplement recommended was CoQ10 to improve mitochondrial function and energy metabolism. This was even more important given that she was on a statin that the GPs would not discontinue due to her blood pressure and previous stroke.
Finding the right approach
The problem was that CoQ10 interacts with several blood pressure medications and can cause a reduction in blood pressure. Many practitioners would take the approach that an interaction of this nature means that the supplement should not be given. However the common sense approach in this case would be to give the CoQ10 as the blood pressure reading is so high a reduction would be seen to be beneficial. The GP was informed of the plan and agreed to monitor the patient more closely.
The results
Within a month of taking 200mg of CoQ10 daily there had been a moderate reduction in blood pressure and a dramatic effect on energy levels and cognitive function. Tracey’s GP commented that it had been months since he had been able to have such a coherent conversation with her.
My 20 years experience as a pharmacist enabled me to take a more measured approach to this case looking not just at the interactions but also at the interaction between prescribed medication and the patient. Whilst many practitioners would be reluctant to make recommendations, it is clear that just that one supplement had a huge effect on the patient. She now has this supplement prescribed by her GP.
Basic Pharmacology and Drug Nutrient Interactions course
One of the reasons I developed the pharmacology course for Integrative Health Education is to take a practical look at interactions between drugs and nutritional supplements and give practitioners the skills and confidence to recommend supplements to clients on medication safely. It also aims to give practitioners hints and tips on how to assess a client’s medication with respect to how it interacts with the client on a cellular level.
*Client’s name changed to protect her identity.
Upcoming Basic Pharmacology and Drug Nutrient Interactions courses:
