Supplements Heart Patients Should Avoid Without Guidance

Many Indians reach for a bottle of supplements thinking they're harmless, a bit of fish oil for the heart, a herbal tonic for energy or vitamin tablets to fill gaps. But for people with heart disease, the wrong supplement at the wrong dose or combined with certain heart medicines can do real harm. Some herbs change how drugs are broken down in the body so a medicine becomes too weak or too strong. This is especially dangerous with blood thinners and some heart-failure or anti-arrhythmic drugs. Along with this, dietary supplements are not regulated the way medicines are: potency varies, labels can be wrong and some products are contaminated with undeclared drugs or heavy metals. That unpredictability matters when margins of safety are small, as in heart disease. Keep reading as we list supplements you must avoid as a heart patient.

Avoid these supplements if you are a heart patient

1. Supplements that change blood clotting

Supplements such as ginkgo, high-dose garlic, fish oil (high doses) can increase bleeding risk, particularly when combined with blood thinners such as warfarin, dabigatran, apixaban or antiplatelet drugs (aspirin, clopidogrel). Studies and large cohort analyses show increased bleeding events when herbal extracts like ginkgo are combined with anticoagulants. If you're on a blood thinner, don't add these without physician approval.

2. Potassium supplements

Patients with heart failure often take ACE inhibitors, ARBs, MRAs or certain diuretics, all of which can raise potassium. According to studies, extra potassium pills or potassium-rich herbal salts may lead to hyperkalaemia which is dangerously high potassium. This can cause arrhythmias and sudden cardiac events. If your potassium or kidney function isn't monitored, avoid supplements that raise potassium.

3. High-dose vitamins

Large randomised and cohort data suggest that high-dose vitamin E does not prevent heart disease and may increase risk of heart-failure events in people with reduced heart function. “More is better” does not apply to every vitamin, especially at pharmacologic doses. Stick to doses recommended by a physician.

4. Any supplement taken alongside warfarin

Warfarin's effect is sensitive to many foods and herbs. Reviews list dozens of herbs and supplements that either potentiate or inhibit warfarin's effect leading to bleeding or clotting. If you're on warfarin, always clear new supplements with your anticoagulation clinic or cardiologist.

5. Stimulant herbs and weight-loss products

Stimulants raise heart rate and blood pressure and have been linked to heart attacks, stroke and sudden death. Regulatory authorities banned ephedra because of its cardiovascular toxicity but illegal or imported products may still surface. Avoid stimulant “fat burners” and traditional tonics promising quick energy/weight loss.

Measures to always follow for your safety

• Tell every clinician about every pill, powder or tonic you take including Ayurvedic, Siddha, home remedies and imported pills.
• Don't stop prescribed heart medicines to “try” a supplement without your doctor's approval.
• Ask a pharmacist about interactions as many hospitals have drug-interaction checks.
• Prefer tested brands (look for independent lab seals) but remember even tested products can interact with drugs.
• Avoid mega-doses of single vitamins or minerals unless a deficiency was proven by blood tests.
• If you have heart failure, are on blood thinners, or have kidney disease, be extra cautious, ask before taking anything new.

Supplements can help with genuine deficiencies, but for heart patients they're a two-edged sword. The most dangerous problems are interactions with heart medicines, unpredictable potency/contaminants, and supplements that directly affect heart rate, blood pressure, clotting or potassium levels. Never self-prescribe supplements if you have heart disease; work with your cardiologist and pharmacist so benefits if any outweigh real risks.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your doctor for more information. NDTV does not claim responsibility for this information.

References

Warfarin and food, herbal or dietary supplement interactions — NCBI — 2021.

Effect of omega-3 fatty acids on cardiovascular outcomes (meta-analysis) — NCBI — 2021.

Vitamin E supplementation and the risk of heart failure in women — NCBI / PMC — 2012.

Hyperkalemia: causes and risks (review) — NCBI — 2023.

Ginkgo biloba and bleeding risk with antiplatelet/anticoagulant drugs — NCBI — 2008; and large cohort analyses 2015.

Pharmacokinetic interactions between cardiovascular medicines and plant products — NCBI (review) — 2019.

Coenzyme Q10 for heart failure: systematic review — NCBI — 2021.

Warfarin drug interactions (overview) — NCBI — 2023.