Bleeding risks of dietary supplements after surgery and anticoagulant use spotlighted

Posted 03 January 2023

After identifying the 47 most popular dietary-supplement ingredients in the U.S., researchers reviewed the literature on the risks of bleeding they pose to patients postoperatively and while taking anticoagulant medications. [Hatfield J and others. Dietary supplements and bleeding. Baylor University Medical Center Proceedings. 35:802–807, 2022]

They found:

  • Garlic and hawthorn supplementation is strongly associated with surgical bleeding.
  • Cordyceps sinensis, echinacea, and aloe vera were each associated with surgical bleeding in just one case report.
  • Ginkgo biloba, chondroitin-glucosamine, melatonin, turmeric, bilberry, chamomile, fenugreek, milk thistle, and peppermint are associated with bleeding risk for patients taking anticoagulants.
  • Fish oil, ginseng, and saw palmetto are not linked to bleeding.
  • Evidence for overall bleeding risk of St. John’s wort, ginger, ginkgo biloba, or cranberry supplementation is conflicting.

Source: Consumer Health Digest #23-01, January 1, 2023

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Placebo Beats Supplements for Arthritis Pain

Posted 27 January 2017

New York Times

Nicholas Bakalar Jan. 26, 2017

Many people take glucosamine and chondroitin supplements for arthritis pain, but a controlled trial has found no evidence that the combination works. In fact, in this study, the placebo worked better.

Spanish researchers randomized 164 men and women with knee osteoarthritis to take a single daily dose of 1,500 milligrams of glucosamine and 1,200 of chondroitin, or an identical looking placebo. The study is in Arthritis & Rheumatology.

The researchers used a scale that shows 10 faces with increasingly pained expressions and asks patients to say which picture matches their degree of pain. People who took the medicines had a 19 percent reduction in pain scores after six months on the regimen. But those who took the placebo had a 33 percent reduction.

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Nycomed-Dona – does it work?

Posted 16 August 2012

A consumer laid a complaint against print advertisements promoting Nycomed’s “DONA” range of products formulated to treat osteoarthritis (OA). The advertisements appeared in the Sunday Times during March 2012. The complainant submitted that “… based on current scientific evidence, it is impossible to make such a definitive statement about reduction of pain, inflammation and swelling”. He added that “None of the evidence supplied supports the claim that Glucosamine Sulphate will ‘prevent further progression of OA’.”  

The ASA agreed feeling that the evidence was insufficient. 

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Glucosamine and/or chondroitin: No help

Another assessment of studies, i.e., a meta-analysis, finds no benefit of glucosamine and/or chondroitin, on joint pain or narrowing of joint space: "Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged." 

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Glucosamine and chondroitin

"In 2006, the New England Journal of Medicine published a $12.5 million study saying that, for most people, glucosamine and chondroitin do not soothe knee pain much better than a placebo."

"Try telling that to patients who swear that the supplements have helped their aching knees or backs — a position that the study's lead researcher, Daniel Clegg of the University of Utah School of Medicine, finds himself in often."

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