Multi-Vitamins Question

My count is dropping while on Promacta. My doctor made me send him the label for my multivitamin that I'm currently taking. I have taking a multivitmain with iron, which he told me stop and buy one without iron, which I've done. But, now, after looking at the label for the current one, he called me this morning and told me to stop taking them ASAP. He told me there's too many "natural" herbs in there and he doesn't know how it will react with Promacta. Here's a copy of the label...at the end, it says it has ginger and licorice (which I heard is bad for platelets...) Any ideas?

Super Nutrition - Women's Blend Iron Free
- 180 Vegetarian Tablets
Supplement Facts
Serving Size: 6 Tablets
Servings Per Container: 30

Amount Per Serving % DV

Vitamin A (Vitamin A Palmitate) 5000 IU 100%

Vitamin C (Ascorbic Acid) 1000 mg 1666%

Vitamin D (Vitamin D3) 1000 IU 250%

Vitamin E (Natural Vitamin E Succinate) 400 IU 1000%

Vitamin K (Phytonadione) 80 mcg 100%

Thiamine (Vitamin B1) 68 mg 4533%

Riboflavin (Vitamin B2) 66 mg 3882%

Niacin (Low flush, fast release Vitamin
B3) 80 mg 400%

Niacinamide (Non-flushing Vitamin B3) 60 mg 300%

Pyridoxine (Vitamin B6) 200 mg 10000%

Folate (=Folic Acid & Folacin) 1000 mcg 250%

Cyanocobalamin (Vitamin B12) 200 mcg 3333%

Biotin (d-Biotin) 600 mcg 200%

Pantothenic Acid (Calcium Pantothenate) 150 mg 1500%

Calcium (Carbonate & Citrate) 1000 mg 100%

Iodine (From Kelp) 225 mcg 150%

Magnesium (Oxide & Glycinate) 600 mg 150%

Zinc (Oxide & Citrate) 30 mg 200%

Selenium (Selenite) 250 mcg 357%

Copper (Glycinate) 2 mg 100%

Manganese (Sulfate & Citrate) 10 mg 500%

Chromium (Complexed**) 250 mcg 208%

Molybdenum (Trioxide) 150 mcg 200%

Potassium (Chloride & Succinate) 99 mg 3%



Other Ingredients
No nutritional claims made for these ingredients.


Amount Per Serving

Acerola (Berries) 60 mg

Beta Carotene 12000 IU

Betaine (HCl) 100 mg

Bioflavonoids (From Citrus) 100 mg

Boron (From Krebs Cycle Boron) 3 mg

Choline (Bitartrate) 100 mg

DMG (Di-Methyl-Glycine) 10 mg

Fatty Acid (Stearic Acid) 290 mg

Fiber (Cellulose & Microcellulose) 525 mg

GLA (From Borage) 100 mg

Ginkgo (8:1 Whole Leaf Extract) 60 mg

Glutamic Acid (HCl Form) 30 mg

Hesperidin (From Citrus) 25 mg

Inositol (Meso-inositol) 25 mg

PABA (Para-Amino Benzoic Acid) 66 mg

L-Phenylalanine 50 mg

Rose Hips (From Roses)† 60 mg

Rutin (From Eucalyptus) 34 mg

Silica (Silicon Dioxide) 213 mg

Sea Trace Minerals (From Kelp) Traces

L-Tyrosine 10 mg

Vitamin E Mixed Tocopherols (Gamma) 3 mg
(Alpha, Beta, Delta) 2 mg

Vitex (5:1 Extract)‡ 100 mg


Greenfood Blend Included
Alfalfa l.†, spirulina h.†, chlorella h.
and iceland moss 500 mg

Nutritional Herb-Flower Petal Blend Included
Nutritional Herbs:
White atractylodes rt., rehmannia rt.,
pau d'Arco rt., peony rt., watercress
h., rosemary l.†, nettle l.†, cramp
bark., turmeric rh.†, marshmallow
rt.†, ligusticum l., flax seed,
strawberry l., partridge berry rt.,
dandelion rt.†, wild yam rt.†, licorice
rt.†, ginger rt.
Flower Petals of:
Red rosebuds, bouganvillea,
chrysanthemum, hawthorn, heather,
hibiscus, magnolia, yarrow, lavender,
red clover† and passion flowers 750 mg

Not all ingredients in Super Nutrition blends are available as organic. Certified Organic Greenfoods and Herbs have † after the name. All organic ingredients are organically grown and processed in accordance with the California Organic Foods Act of 1990.
** Chromium complexed as chromium polynicotinate (Nichrome) and chromium picolinate (Chromax II).
Note: Plant cellulose tablet coating contains citrus and vanilla flavoring.
‡ Vitex Agnus Castus


Vegetarian, Hypoallergenic, Gluten Free
Contains no gluten, wheat, yeast, buckwheat, sugar, pollen, dairy, corn or soy residues or any hidden additives.

The tiny bit I know about promacta (eltrombopag) is that you shouldn't take calcium anywhere near it, and the ingredients you have listed include a pretty hefty dose of calcium

I take my multivitamins at 10am and Promacta around 9:30pm or 10pm. My hema is not liking the fact that anything is called "super" and that some natural herbs that he doesn't know how it can react to Promacta. I've been taking the same brand, but with iron...he asked me to stop when my counts started to drop, which I've done. I will stop taking any multivitamins until my next CBC's.

I am also taking biotin, 2500mg a day for my hair and nails...

Slammed:

Holy cow - Is all of that in one pill?

I've never had a doctor tell me to stop taking Vitamins, but the ones I take are because I've had low levels of that particular Vitamin at one time or another. Mine are not combined, so I end up taking a handful. I wouldn't want any with any supplemental herbs or additives. Some supplements can be downright dangerous and he's right, you don't know if they are interacting with Promacta. Something as simple as grapefruit juice can interact with certain drugs and cause them to be toxic. These are the things that nobody tells you. Keep in mind, that second list of ingredients are NOT Vitamins.

I found this for Ginkgo:

Ginkgo interacts with many medicines. Before taking it, talk with your healthcare provider if you take any medications.

Ginkgo seeds contain substances that might kill the bacteria and fungi that cause infections in the body. The seeds also contain a toxin that can cause side effects like seizure and loss of consciousness.

www.webmd.com/vitamins-supplements/ingredientmono-333-GINKGO.aspx?activeIngredientId=333&activeIngredientName=GINKGO

Have you had your Vitamin levels tested? If not, I would ask for that and go from there. Supplement only the ones that you need. Some Vitamins can also become toxic if you take it and don't need it, so monitoring is a good idea. Many people with autoimmune disorders have low Vitamin levels, so I wouldn't be surprised if you did have a few, but you should find out what they are and only supplement those.

Another one for Ginkgo:

The herb is generally well tolerated, but due to multiple case reports of bleeding, it should be used cautiously in patients on anticoagulant therapy and those with known blood clotting disorders, or prior to some surgical or dental procedures.

Bleeding has been associated with the use of ginkgo taken by mouth, and caution is advised in patients with bleeding disorders or those taking drugs, herbs, or supplements that may increase the risk of bleeding. Dosing adjustments may be necessary. Ginkgo should be stopped prior to some surgical or dental procedures. Reports of bleeding range from nose bleeds to life-threatening bleeding in several case reports. In some of these reports, ginkgo has been used with other agents that may also cause bleeding.

Contamination with the drug colchicine has been found in commercial preparations of Ginkgo biloba .

Ginkgo may increase the risk of stroke.

www.mayoclinic.com/health/ginkgo-biloba/NS_patient-ginkgo/METHOD=print

I didn't bother looking up any others. This one was enough. Were you taking this prior to your ITP diagnosis?

Sandi,

Yes, I've been taking this brand for many years, before I had ITP. I just switched to the iron-free one. The label is for 6 pills. I've been tested for vitamin deficiency, the only thing I'm lacking in is iron. I'm anemic.

Wow, the Ginkgo is very scary! Thank you very much for this information! I didn't even know this...no wonder my dr told me to stop ASAP. I also noticed that I've started on ginseng...which I just found out TODAY that it's not good for someone with low platelets...so I'm stopping that too. Let's see what happens with my count for my next CBC's.

No herbal supplements, please! Those are not regulated by the FDA and there is no telling what is in those. I know a lot of people who swear by echinacea (example)and believe it's totally harmless. Wrong! For some people, echinacea can cause serious problems. Here are some echinacea facts. These can apply to almost any herbal supplement out there. People tend to think that herbals are 'natural' (because the bottle says so) and therefore, safe. Not true. Herbals can jump start autoimmune conditions in predisposed individuals.

There are concerns about the quality of some echinacea products on the market. Echinacea products are frequently mislabeled, and some may not even contain echinacea, despite label claims. Don’t be fooled by the term “standardized.” It doesn’t necessarily indicate accurate labeling. Also, some echinacea products have been contaminated with selenium, arsenic, and lead.

“Auto-immune disorders” such as such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), a skin disorder called pemphigus vulgaris, or others: Echinacea might have an effect on the immune system that could make these conditions worse. Don’t take echinacea if you have an auto-immune disorder.

Some medications are changed and broken down by the body. Echinacea might change how the body breaks down some medications. Taking echinacea along with some medications might increase the effects and side effects of some medications. Before taking echinacea, talk to your healthcare provider if you are taking any medications that are changed by the body.

Some medications changed by the body include lovastatin (Mevacor), clarithromycin (Biaxin), cyclosporine (Neoral, Sandimmune), diltiazem (Cardizem), estrogens, indinavir (Crixivan), triazolam (Halcion), and many others.
Some medications are changed and broken down by the liver.
Echinacea might decrease how quickly the liver breaks down some medications.
Taking echinacea along with some medications might increase the effects and side effects of some medications. Before taking echinacea, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some of the medications that are changed by the liver include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others.
Medications that decrease the immune system (Immunosuppressants) interacts with ECHINACEA
Echinacea can increase the immune system. Taking echinacea along with some medications that decrease the immune system might decrease the effectiveness of medications that decrease the immune system.
Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.

www.webmd.com/vitamins-supplements/ingredientmono-981-ECHINACEA.aspx?activeIngredientId=981&activeIngredientName=ECHINACEA

Have you been tested for Autoimmune Hemolytic Anemia? I'm asking because people who have both AIHA and ITP have a see saw effect with platelet and iron levels. If platelets go up, iron levels drop and vice versa. I'm not understanding his concern of your iron intake at this point if you are anemic. It shouldn't hurt anything to take iron with ITP unless AIHA is involved.

I'm with your doctor - don't like "Super".

My MD did tell me to stop taking my multi-vitamin because of the E in it - now I just take a few supplements instead of a multi.

Sandi wrote: For some people, echinacea can cause serious problems.
On the label of the Echinacea [just Echinacea, nothing else in it] I bought years ago it said do not take this product if you have an autoimmune disease.

My hema tells me to try to eat right and I "shouldn't" need any supplements...I try to eat right, but the temptations of chips and sweets wins often for me!

Sweets are fine, as long as you make sure you get your fruits and veggies in there too! Some people have problems absorbing vitamins from food (I do), but if your levels were tested, you're okay. It's good to have that done periodically though. Things can change.

Definitely will try to eat more veggies and fruits!

I really don't have the patience for it because it's so time consuming but my boyfriend is really good about juicing. He doesn't eat a lot of fruits or veggies so he juices them and drinks them twice a day. I think he has only had one cold this whole year and he's an optometrist so he is always in people's faces so maybe he is on to something possibly?

I do shots of wheatgrass and barley grass everyday in the morning. But, I definitely need to eat more veggies and fruits. Wished I had the time or the patience to grow my own stuff. Now, that would be awesome!

I think he has only had one cold this whole year and he's an optometrist so he is always in people's faces so maybe he is on to something possibly?


I read this wrong three times. I thought it said that he was an 'optimist so he is always in peoples faces....". Lol.

I don't know that juicing would keep a person from catching a cold, but it is good for you. My problem with juicing is having to go to the store constantly for the fruit and vegetables since they go bad so fast.

I've been juice when I can but looking at my blood work it looks like I need B12 and Iron. RBC 2.88, HBG 8.6, HCT 26.2 are all low and RDW 15.5, MPV 11.5 are high. My EO% is low due to taking my Xanax because of a complaining co-work that is pregnant. Thinking of starting to take a multi-Vitamin to help.

Amber with your count doing what it does [correct me if my memory is wrong - but aren't you in the hospital a lot with really low counts] I'd stay away from them.

Before my MD told me to stop taking the multi-vitamin because of the E in it I would have veins break, it would hurt and then there would be a good bruise - after stopping the multi this stopped.

Look at the label real good and see what is in any multi that could cause an ITPer problems.

Been in the hospital twice this year and platelets for a month 2 months ago and come to find out the lab and the hospital was horrible and was not do the labs right. So as of now doing find and just on Promacta... I was told to increase iron intake by food.

Yea, my hema told me too if I eat right, I shouldn't need any vitamins.

Sandi,


Ha ha optimism might help you stay healthy too....who knws

Yeah but it wouldn't make you be in someone's face! That's what I couldn't figure out! :woohoo:

Slammed!

I could not agree with your hema any more! She/he is right! Balanced diet. That was one hell of a label that was posted and I learned something from the post. Wow! I got the book, The Anti Inflammatory Diet and I do try to go by what it suggest. It cant hurt. I am not a total vegetarian but I do not eat a lot of meat and little fish and chicken. It works for me. I have only missed about 7 days of work in my life. 2 with knee surgeries, 4 with a double hernia surgery, and one with a reaction to a bee sting. I had the flu once around 1990 and but I worked through it. I am just never sick and that is part of my issue with ITP and my dealing with it. Anyway, you hang in there. It sounds like you have real good hema to me. I was impressed!

Jeff

amberyard wrote: Been in the hospital twice this year and platelets for a month 2 months ago and come to find out the lab and the hospital was horrible and was not do the labs right. So as of now doing find and just on Promacta... I was told to increase iron intake by food.

I love cooked spinach!

Jeff

I've been taking this multivitamins since college...I found it at Whole Foods...and looks healthy...so I've been taking it ever since. I would have never thought something that supposed to be "healthy" and "natural" harming me...this is definitely is a learning experience.

Jeffrey, I too don't eat much red meat, fish, or chicken. I once went to a nutritionist and he told me that I need to eat organic beef at least twice a week. Like you, I try to stay fit no matter what. I average around 13 miles or so a day, 7 days a week. I started running trying to lose the pounds that I gained from my two pregnancies. So, eating right and staying in shape is very important to me.

I am very impressed with everyone attitude on this forum...thank you for being so helpful and inspiring!

Slammed:

Here are some good articles:

www.slate.com/articles/health_and_science/medical_examiner/2013/02/curing_chemophobia_don_t_buy_the_alternative_medicine_in_the_boy_with_a.2.html

www.slate.com/articles/health_and_science/medical_examiner/2012/11/herbal_supplement_dangers_fda_does_not_regulate_supplements_and_they_can.html

www.fda.gov/ForConsumers/ConsumerUpdates/ucm050803.htm

The term 'natural' can be misleading. Many supplements are contaminated with heavy metals and pesticides. They are not regulated by the FDA and there could be anything mixed in there. These 'natural' supplements are usually plant based, but some plants are toxic when taken for a long time and can interact with medications. Most medications are also plant-based, but that doesn't make them harmless. Who says they are healthy and natural? The words on the bottle?

I'm impressed that your Hemo looked into this. Kudos to him!

Slammed wrote: I've been taking this multivitamins since college...I found it at Whole Foods...and looks healthy...so I've been taking it ever since. I would have never thought something that supposed to be "healthy" and "natural" harming me...this is definitely is a learning experience.

Jeffrey, I too don't eat much red meat, fish, or chicken. I once went to a nutritionist and he told me that I need to eat organic beef at least twice a week. Like you, I try to stay fit no matter what. I average around 13 miles or so a day, 7 days a week. I started running trying to lose the pounds that I gained from my two pregnancies. So, eating right and staying in shape is very important to me.

I am very impressed with everyone attitude on this forum...thank you for being so helpful and inspiring!

Slammed!Your running miles put me to shame right now! I am so impressed! WOW! I was training for my first Ultra (a 50 miler) when my right knee decided to take some time off. Yesterday evening I went out for 4 mile run. My first real run since the surgery. It was fun and felt good but my time stunk. The knee definitely needs more rehabbing. I think I liked having the Doors (rock music for you young ones!) blaring in my ears as much as the run! Anyway, I am on a 1150 calorie diet right now going 60/40 protein to carb and trying to burn a net loss of 3,000 calories every other day. It has been working for about 3 weeks now. I have also found that the prednisone "after party" is one that will hang onto weight very stubbornly. I also found that I lost a fair amount of muscle mass with the pred. I am back on the P90X for that. I have not rechecked my mets but I definitely suspect that they are reduced. BTW I am going for another Vo2 Max soon. Have you ever done one? It is a bit intimidating. At least is was for me.

Jeff

Slammed

I usually take a one a day women's with iron and never had trouble with that. But last February I tried an all natural women's formula that I got at whole foods thinking it would be healthier. But, 2 weeks later I had a relapse of my ITP (after an 18 month remission). I can't be sure that the vitamin caused my relapse but it had something called dong qua in it as well as some other herbs. Now I avoid most things like that. I do take Floridix, an iron supplement that has b vitamins in it.

Jeffrey,

My husband does the P90X and it looks exhausting. I just stick to running. I am going to cut back because I'm getting burned out. I've been doing this for 5 years and it's no fun putting that much milage on my treadmill. I have a love/hate relationship with my treadmill. I love it that it's keeping me in shape, but there are days when I really wish will break down. My husband had to fixed it many times then one day, however, one day, motherboard died. I had that treadmill for 12 years already, so it's time to get another one!

Wow, only 1150 calories a day??!!! I bet you're losing weight with that routine. I really don't know how many calories I'm taking in. 5 years ago, I did lose 95 pounds in 9 months.

Dru,

My hema always joke with me saying I'm the reason why he's getting gray hairs. I'm always trying new things...and he tells me "natural" or "super" makes he nervous. He doesn't know how the herbs or plants extract is going to interact with me or Promacta.

About a month ago, I started to take some ginseng...I don't know if this is a coincidence with the time my platelet started to dropped...but I googled ginseng, I REALLY DO believe, it's the reason why my platelets dropped...along with the stress. I stopped taking my usual ALL natural stuff, except wheatgrass and barley grass. So far, I think it's working. The bruises and petechiae are fading, the gums are look less swollen and red. I'm hope my next CBC is good...

This topic is interesting.
A friend was admitted to hospital last week with stomach/back pains & had various tests done. She has been taking cholesterol medication & recently bought a 'yip yah, you beaut' juicer. Apparently the enzymes in the juice can interfere with the medication. She is much better since stopping the excess 'multi' juice.
Here was I thinking is it sounded a good idea. Better to just stick with my meat & veggies, salad & fruit. As for the chocolate . . . I'm hopeless!

Slammed,

Good for you on ditching the natural and such other stuff! I am on my 15th time through P90X and I have also used Insanity quite a bit. I use my treadmill a bunch too along with the spinner and elliptical. I try to mix it up, but at my age it is just getting harder! LOL My weight is dropping some but I think I may have to up my calories to up the mets to lose more weight. I have dropped about 14 in the last 3-4 weeks. It is just slow and I notice that my body does not react like it did to training since I was on the prednisone. Anyway if you have any tips, send them my way. It is great you and your husband both work out. I think that is pretty cool!


Jeffrey

Jeffrey,

I lost most of my weight by doing the intensity training. I got that from the Biggest Loser trainer. I ran as fast as I can for 1 lap, then walk for 1 lap, do a set of 10's, 2 times a day. That was when the weight really dropped off. At one time, I lost 1 pound a day, for 2 weeks, it was totally awesome. I also do the stairs. Once a week, I walk 17 flights of stairs in my building 3 times a day. I make a co-worker go with me.

I can understand how you feel about your body. You should hear my joints popping all the time. I have lovely blisters on my feet. I wear a pedometer since I'm currently in a walking challenge..so I'm trying to walk more too. I do around 20-25 miles a day...yes, my team is in first place...

When I'm on prednisone, I feel like I can run forever, and my joints feel great! However, I didn't like my road rage or my moodiness...

meredithjane wrote: This topic is interesting.
A friend was admitted to hospital last week with stomach/back pains & had various tests done. She has been taking cholesterol medication & recently bought a 'yip yah, you beaut' juicer. Apparently the enzymes in the juice can interfere with the medication. She is much better since stopping the excess 'multi' juice.
Here was I thinking is it sounded a good idea. Better to just stick with my meat & veggies, salad & fruit. As for the chocolate . . . I'm hopeless!

I definitely agree this is interesting...I am learning still about ITP even though I had it since 2011. I always thought natural is good...now, I'm starting to realize that natural things can in fact harm me.