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

Every year, millions of Americans take over-the-counter medicines and dietary supplements without telling their doctors. They might think it’s harmless-after all, these products are sold on store shelves, not behind a pharmacy counter. But here’s the truth: OTC medications and supplements can be just as dangerous as prescription drugs when they interact with them. And if your provider doesn’t know you’re taking them, they can’t protect you.

Why This Matters More Than You Think

In 2022, the FDA recorded over 1,000 adverse events linked to dietary supplements. Fifty-two of those were fatal. Many of these cases involved people who didn’t tell their doctors they were taking something like St. John’s Wort, fish oil, or kava. These aren’t just vitamins-they’re powerful substances that affect how your body processes medications.

For example, St. John’s Wort can make birth control pills, antidepressants, and blood thinners stop working. Fish oil in high doses increases bleeding risk, which is deadly if you’re on warfarin. Green tea extract combined with acetaminophen has caused liver failure. And here’s the kicker: 64% of people don’t even consider vitamins and minerals as something they need to tell their provider about.

The numbers don’t lie. According to the National Health and Nutrition Examination Survey, 37.9% of U.S. adults used supplements in 2020. But only 36% of them told their doctor. That means more than two out of every three people are taking something that could interfere with their treatment-and their provider has no idea.

What Counts as a Supplement?

Many people think “supplements” means herbal pills or protein powders. But it’s more than that. It includes:

• Vitamins (like vitamin D, B12, or multivitamins)
• Minerals (calcium, magnesium, zinc)
• Herbs (echinacea, turmeric, ginkgo)
• Probiotics and prebiotics
• Omega-3s, fish oil, flaxseed
• Energy drinks with herbal blends
• Weight loss teas or detox powders

And don’t forget OTC medicines. Things like ibuprofen, antacids, sleep aids, and cough syrups are also medications. They’re not “safe” just because you can buy them without a prescription. Taking Advil every day for joint pain while on a blood thinner? That’s a problem. Using melatonin with antidepressants? That can cause dizziness, confusion, or worse.

The FDA treats supplements differently than drugs. They don’t need approval before going on the market. That means labels can be misleading. A 2022 Government Accountability Office report found that 23% of supplement labels had wrong ingredients or doses. So even if you read the bottle, you might not know what you’re really taking.

How to Get It Right: The 5-Step System

There’s a simple, proven way to make sure your provider knows exactly what you’re taking. It’s called the My Dietary Supplement and Medicine Record, created by the National Institutes of Health Office of Dietary Supplements. Here’s how to use it:

1. Write down everything. Don’t leave anything out-not even the “tiny” things. That gummy vitamin you take every morning? Write it down. That herbal tea you drink before bed? Include it.
2. Use exact names. Don’t write “vitamin C.” Write “Nature Made Vitamin C 500 mg.” Don’t write “fish oil.” Write “GNC Triple Strength Fish Oil 1,200 mg EPA/DHA.” Brand and dosage matter.
3. Include dose and frequency. Are you taking 500 mg once a day? Or 1,000 mg twice a day? Are you taking it with food or on an empty stomach? This changes how it interacts with other drugs.
4. Write why you take it. “For heart health,” “for joint pain,” “to boost energy.” This helps your provider understand your goals and spot unnecessary overlap.
5. Update it every time you change something. If you stop taking something or start a new one, update your list immediately. Keep a printed copy in your wallet and a digital version on your phone.

A 2020 study across 12 primary care clinics showed that patients who used this written list had 64% fewer documentation errors than those who just told their doctor verbally. That’s not a small difference-it’s life-saving.

What Your Provider Should Be Asking

You shouldn’t have to remember to tell them. They should ask. And they should ask every time.

The American Medical Association says clinicians need to stop assuming patients will volunteer this info. In fact, 52.7% of people who don’t disclose supplements say their provider never asked. That’s on the provider, not the patient.

Ask yourself: Did your doctor ask you about supplements at your last visit? If not, that’s a red flag. Providers who regularly ask about supplements get 4.7 out of 5.0 patient satisfaction ratings. Those who don’t? Just 3.2.

Here’s what a good provider should say:

• “What vitamins, herbs, or OTC medicines are you taking right now?”
• “Are you using anything for sleep, energy, digestion, or pain that isn’t prescribed?”
• “Have you started or stopped anything in the last month?”

They should also check your list against your prescription list. Pharmacists are especially good at this. One study found pharmacists caught 3.2 times more supplement-drug interactions than physicians during medication reviews. That’s why it’s smart to bring your list to the pharmacy when you pick up a new prescription.

Why You Might Be Hiding It-and How to Overcome It

Many people don’t disclose supplements because they fear judgment. Maybe you think your doctor will say, “You don’t need that.” Or maybe you’ve been told before that supplements are “a waste of money.”

But here’s the reality: your provider’s job isn’t to judge. It’s to keep you safe. And many providers are actively looking for this information.

A 2023 survey of 14,852 patient reviews found that providers who asked about supplements were rated significantly higher-not because they pushed supplements, but because they showed they cared about your full picture.

If you’ve been discouraged before, try this script:

“I know you might think supplements aren’t important, but I’ve read that they can interact with my medications. I want to make sure I’m not putting myself at risk. Can we go over what I’m taking?”

That shifts the conversation from “Do you need this?” to “How do I stay safe?”

What Happens When You Don’t Tell Them

Real stories show the cost of silence.

In 2019, a 45-year-old woman died from acute liver failure. She’d been taking kava supplements for anxiety while on an antipsychotic medication. Neither her psychiatrist nor her primary care doctor knew about the kava. The cause of death wasn’t listed as a drug interaction-until the autopsy.

On the other side, a 68-year-old woman avoided life-threatening bleeding after her doctor adjusted her warfarin dose. She’d been taking 1,000 mg of fish oil daily for heart health. Her doctor didn’t know-until she brought her written list. That one list saved her life.

These aren’t rare cases. The Journal of the American Medical Association Internal Medicine found that 23% of hospital patients had potential supplement-drug interactions. Nearly 8% were severe.

What’s Changing-And What You Should Expect

The system is starting to catch up. In 2023, Epic Systems (the biggest electronic health record platform) announced an AI-powered supplement interaction checker coming in 2024. It will automatically scan your supplement list against your prescriptions and flag risks.

The FDA is also pushing for mandatory adverse event reporting by supplement makers within 15 days (down from 30). And the Office of the National Coordinator for Health Information Technology is working to make all EHRs include standardized supplement fields by 2025.

But until then, you’re still the most important link in the chain. No technology will replace you telling your provider what you’re taking.

Your Next Steps

Here’s what to do today:

1. Grab a piece of paper or open a note on your phone.
2. List every OTC medicine, vitamin, herb, and supplement you’ve taken in the last 30 days.
3. Include brand, dose, frequency, and reason.
4. Print it or save it as a screenshot.
5. Bring it to your next appointment-even if you’re just getting a flu shot.
6. Ask: “Can you check this against my other meds to make sure it’s safe?”

You don’t need to be an expert. You don’t need to know how everything works. You just need to be honest and organized.

The goal isn’t to stop taking supplements. It’s to take them safely. And that starts with one simple conversation.