Eighteen, to be exact: Adverse effects of dietary supplements

Dr. Richard Nathan, a dental surgeon in San Francisco, wrote in January about a patient who needed a tooth extracted and minor periodontal surgery. She told Dr. Nathan that she was taking two drugs, for cholesterol and blood pressure, neither of which he said would present a problem to safe surgery and normal healing.

Thus, Dr. Nathan was perplexed when the patient returned five days later unhealed, with an unattached flap of tissue, severe bleeding and an infection.

"Based on my 30 years of experience, it looked as though the patient was an out-of-control diabetic or had a severely compromised immune system," he said. "Neither was the case. However, when I asked the patient again what medications she was taking, she admitted that she was on multiple – 18 to be exact – over-the-counter supplements, for a total of 43 pills and capsules a day."

Six of these – green tea, grapeseed, ginkgo biloba turmeric, salmon oil and vitamin E, he said, "are known to increase bleeding due to inhibition of platelet aggregation," the first step in forming a clot. Within a week after discontinuing all supplements, her mouth began to heal normally.

Advice: Ask your pharmacist if your dietary supplements might have unwanted side effects.

Browse for related stories in the index at the very bottom of this page, or read a zinc supplement story.

Thanks to Jane Brody for the source article in Tuesday's issue of the New York Times.