How to Share Over-the-Counter and Supplement Use Accurately with Your Provider

Every year, thousands of people end up in the emergency room because they didn’t tell their doctor what they were taking. Not prescription drugs. Not illegal substances. But the stuff you pick up at the grocery store or online: vitamin D, fish oil, turmeric, melatonin, or even that herbal tea you drink before bed. These aren’t harmless. And if your provider doesn’t know you’re using them, they can’t keep you safe.

The truth is, OTC medications and supplements aren’t just background noise in your health story-they’re active players. The FDA logged over 1,000 adverse events linked to supplements in 2022 alone, including 52 deaths. Many of those cases involved hidden interactions. A man on blood thinners took fish oil daily, never mentioned it, and ended up in the hospital with internal bleeding. A woman on antidepressants used St. John’s Wort to feel better, not realizing it cut her medication’s effectiveness by half. These aren’t rare accidents. They’re predictable outcomes of poor communication.

Why Your Provider Needs to Know

Supplements don’t go through the same testing as prescription drugs. Under the Dietary Supplement Health and Education Act of 1994, manufacturers don’t need FDA approval before selling their products. That means there’s no guarantee what’s on the label is actually in the bottle. A 2022 Government Accountability Office report found that 23% of supplement labels had inaccurate ingredient lists. One product labeled as “pure green tea extract” turned out to contain a banned stimulant. Another “natural sleep aid” had unlisted sedatives that caused confusion and falls in older adults.

And it’s not just about contamination. Supplements interact with medications in ways doctors can’t always predict. The NIH Office of Dietary Supplements reports that 37.9% of U.S. adults use supplements. Yet only 36% tell their providers. Why? Because most providers don’t ask. A 2022 study in the Journal of Medical Ethics found that 52.7% of patients who didn’t disclose supplement use said their provider never brought it up. Patients assume it’s not important. Providers assume it’s not relevant. Both are wrong.

What Exactly Should You Tell Them?

Don’t say “I take vitamins.” That’s useless. Say: “I take 1,000 mg of vitamin D daily, 500 mg of magnesium at night, and a turmeric capsule with black pepper every morning for joint pain.” Include:

• Exact product name (not just “vitamin C” - say “Nature Made Vitamin C 500mg Tablets”)
• Dose (milligrams, IU, grams - not “a pill” or “a scoop”)
• Frequency (once a day? twice a week? after meals?)
• Why you take it (for sleep? for energy? because your friend recommended it?)

Also include OTC medicines. That’s aspirin, ibuprofen, antacids, cold pills, and sleep aids. People forget these are drugs too. Taking 800 mg of ibuprofen daily for back pain while on blood pressure medication can raise your risk of kidney damage. Cold medicine with pseudoephedrine can spike your heart rate if you have an arrhythmia. These aren’t “just a little something.” They’re active ingredients with measurable effects.

The Best Way to Communicate: Use a Written List

Verbal reporting fails. Memory slips. Details get lost. A 2020 study across 12 primary care clinics found that using a written list reduced documentation errors by 64% compared to just talking. The NIH ODS offers a free tool called My Dietary Supplement and Medicine Record. Download it. Fill it out. Bring it to every appointment.

Here’s how to use it:

1. Write down every prescription, OTC medicine, and supplement you take - even if you haven’t used it in a week.
2. Include the brand name, dose, how often, and why.
3. Check the label. If it says “Supplement Facts,” it goes on the list. If it says “Drug Facts,” it goes on the list too.
4. Update it every time you start, stop, or change a product.
5. Bring it to every visit - even if it’s just for a flu shot.

Some clinics now integrate this into their electronic health records. Epic Systems, the largest EHR vendor, added dedicated supplement fields in 2020 after finding that 42% of medication errors involved undocumented supplement use. If your provider doesn’t have a place to record this, hand them your list. Ask them to write it down. Make it part of your record.

Who’s Most at Risk?

It’s not just older adults. It’s anyone taking multiple medications. But certain groups face higher risks:

• People on blood thinners - Fish oil, garlic, ginkgo, and vitamin E can increase bleeding risk.
• People with liver disease - Kava, comfrey, green tea extract, and high-dose niacin can cause liver damage.
• People on antidepressants or antipsychotics - St. John’s Wort, 5-HTP, and SAM-e can cause serotonin syndrome - a dangerous overactivation of brain chemicals.
• People with high blood pressure or heart conditions - Ephedra, yohimbe, and caffeine-heavy energy supplements can trigger arrhythmias or spikes in blood pressure.

Pharmacists are often better at catching these than doctors. A 2021 study found pharmacists identified 3.2 times more potential interactions during medication reviews. If you have a pharmacist you trust, ask them to review your list. Many offer free consultations.

What If Your Provider Dismisses It?

You might hear: “Oh, that’s just a supplement. It’s fine.” Or worse: “Why are you taking that? It’s a waste of money.” That’s not professional. It’s dangerous.

The American Medical Association’s 2022 ethics guidance says clinicians must ask about supplements at every visit - not wait for patients to bring it up. If your provider brushes it off, say: “I’ve read that 23% of hospital patients have interactions with supplements they didn’t tell their doctor about. I want to make sure I’m safe.”

Some providers are still catching up. But the data is clear: clinics that screen for supplements - like Mayo Clinic, which made it mandatory in 2020 - saw a 37% drop in supplement-related adverse events. That’s not luck. That’s protocol.

What About Labels?

Don’t trust the label alone. The FDA requires “Supplement Facts” panels to list ingredients by weight, but there’s no standard for serving size. One brand’s “1000 mg” of vitamin C might be two capsules. Another’s might be one. And there’s no limit on how much can be in a single serving. The FDA says outright: “There are no laws limiting the amount of a dietary ingredient in a supplement.”

Also, don’t confuse “Drug Facts” with “Supplement Facts.” OTC painkillers like Advil or Tylenol have Drug Facts labels - they’re regulated like drugs. Supplements have Supplement Facts - they’re not. But patients think they’re the same. A 2023 American Liver Foundation survey found 68% of people believe the labels mean the same thing. They don’t. And that confusion kills.

Real Consequences - Real Stories

In 2019, a 45-year-old woman died from acute liver failure after taking kava supplements while on antipsychotic medication. Her doctors never knew she was using it. She thought it was “just natural.”

In 2021, a 68-year-old woman on warfarin avoided a life-threatening bleed because her pharmacist asked about supplements. She’d been taking 1,000 mg of fish oil daily for “heart health.” The dose was too high. Her warfarin was adjusted. She’s still alive today.

These aren’t outliers. They’re patterns. And they’re preventable.

What You Can Do Today

Don’t wait for your next appointment. Start now:

• Open your medicine cabinet. Pull out every bottle - pills, powders, liquids, gummies.
• Write down every one: brand, dose, frequency, reason.
• Download the NIH ODS form. Fill it out. Print it.
• Bring it to your next visit. Ask: “Could this interact with anything I’m taking?”
• If you’re on blood thinners, liver-affecting meds, or heart drugs - get your list reviewed by a pharmacist.

It’s not about being perfect. It’s about being honest. Your provider can’t help you if they don’t know what you’re doing. And no one else will ask. You’re the only one who knows what’s in your body. Speak up.

There’s no shame in taking supplements. But there’s real danger in silence.

Start today. Write it down. Bring it in. Your life might depend on it.