accidentally took vitamin e before surgery

Licorice: A valuable herb that is part of many traditional Chinese medicine formulas, it has a tendency to promote sodium retention, high blood pressure, edema, and potassium deficiencyconditions that might prove hazardous in the delicate peri-operative period. Vitamin C: 5001,000 mg per day, beginning at least 1 week before surgery. For assistance, contact customer service at (800) 688-2421 or [emailprotected]). ", International Journal of Womans Health: "Be Wary of Natural Therapy in Gynecological Surgery", BMB Reports: "Anticoagulant Activities of Curcumin and Its Derivative", PLOS One: "A Review of Potential Harmful Interactions between Anticoagulant/Antiplatelet Agents and Chinese Herbal Medicines", Stanford University School of Medicine Department of Otolaryngology: "Medications and Herbs That Affect Bleeding", American Society of Anesthesiologists: "Herbal and Dietary Supplements and Anesthesia", NIH: "Vitamin E Fact Sheet for Health Professionals". For DSR inquiries or complaints, please reach out to Wes Vaux, Data Privacy Officer, Please give me a minute to review your question. Potential risks include contamination, mislabeling, interactions with medications, or potential unforeseen adverse effects, CHOP said in a released statement.1 The policy does acknowledge that certain medical conditions might require vitamin or nutrient supplements, and a very limited number of acceptable products are listed, said Sarah Erush, PharmD, BCPS, pharmacy clinical manager and a member of the hospitals Therapeutic Standards Committee. Is this an emergency? There are two ways of performing breast augmentation surgery. After surgery you can resume vitamin E.Vitamin E is only one of the many medications you should avoid prior to surgery.Please discuss specifics with your Plastic Surgeon.My best wishes, Helpful 2 people found this helpful Robert A. Hardesty, MD, FACS Board Certified Plastic Surgeon ( 171) Book a virtual consultation CONTACT NOW MOST RECENT The mod team does their best to remove bad information, but we do not catch all of it. Call your doctor or health care provider if you have questions or concerns. Find a Location, Appointment Orthomolecular medicine uses safe, effective nutritional therapy to fight illness. However, the National Institutes of Health have reported that large amounts of vitamin E can increase your risk of bleeding, especially if your vitamin K levels are low. You may need to stop taking this nutrient up to seven days before surgery. An estimated 20 million Americans have gallbladder disease. There may even be a possibility of drug interactions between anesthesia and medications used in surgery with supplements you may be using. Media community. I dont know why I didnt stop to check, but I've been drinking them since yesterday, and they contain Vitamin E. Am I going to be all right for surgery? I'm having a uterine fibroid myomectomy, D&C and endometrial ablation tomorrow. procedure(date:(( _____(procedure(time:(( _____(((please(arrive(at:(( _____(location(ofyour(procedure: your request. She'll be able to advise you on whether or not it's safe to take omega supplements like fish oil before surgery. You might even want to open a conversation with her about whether you need vitamin supplements at all: an article published in 2013 in the "Annals of Internal Medicine" came to the conclusion that "supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful." Prevention of DVT/PE before surgery. However, after surgery you can resume taking vitamin E. Each surgeon has their own protocol, so be sure to ask your surgeon what he or she recommends. Vitamin E taken orally can cause increased bleeding during and after surgery. This nutrient also contributes to a healthy immune system and cardiovascular system function. But if youre planning to have surgery, you may need to take a break from some supplements and medications that can interfere with anesthesia. They dont consider the herbal product to be a medication, so unless you ask for that information specifically, they wont volunteer that they take some herbal products, Guyuron says. Hello, Im Dr. Rubio. Vitamin C is necessary to build and rebuild collagen throughout the body. (USA)#N#Carolyn Dean, M.D., N.D. (USA)#N#Damien Downing, M.D. Matarasso tells them: "Unless you can tell me these things are essential, dont take them." Practice the post-operative exercises your doctor recommends. Herbal supplements are falling under increased scrutiny. Hi 7 days before my colonoscopy I was to discontinue iron/multivitamin. 1. Although vitamin supplements are often a healthy choice, there are several you'll need to avoid before surgery. Additionally, a 500 Internal Server Error Specific nutrients are needed to repair skin, blood vessels, nerves, and even muscles and bones. Supplements that are known or suspected to increase bleeding risk include: Supplements associated with cardiovascular risk include: Supplements with sedating effects that may prolong the effects of anesthesia include: Patients often think of supplements as safe and natural products, so they often dont think to list these products when their physicians ask what medications or drugs theyre taking. a cognitive enhancer that can increase your risk of bleeding. "Its a $30 billion industry," Matarasso said. This study reported that consumption of these unsaturated fatty acids actually could help improve surgical outcomes. Dombrowski asks the question in an even more general manner. CHOP announced that it no longer will include most dietary supplements on its formulary. In the fall, The Childrens Hospital of Philadelphia became the first hospital in the United States to enact a policy to discourage patients from using dietary supplements without a doctors provision. He says they should consult the list or call him. Is this an emergency? Vitamin B Complex: Take 2 weeks prior to surgery. You will be able to have your procedure done. My procedure is on Wednesday. The National Institutes of Health and Food and Drug Administration currently maintain the stance that fish oil is safe. It is important that patients tell their doctors about all the medications they are taking, including herbal supplements, before surgery. Guyuron was a co-author of the study mentioned previously. YES. Always visit a doctor in real life if you have any concerns about your health. "Controlling every step of the operation and the perioperative period is essential to achieving a safe and satisfying outcome," Matarasso wrote.3. Stop using ginkgo at least 2 weeks before a scheduled surgery. I would suggest speaking to your surgeon, since most give you a list of medications and supplements that you must discontinue before surgery. Vitamin C is necessary to build and rebuild collagen throughout the body. For example, patients undergoing heart surgery will work with their heart surgeon, a specialized team of nurses, and an anesthesiologist with expertise in the types of anesthesia used in cardiovascular surgery. Dynamic flow: A new model for ascorbate. As Dr. Cathcart has been deleted from Wikipedia since 2007, Saul was honored to have participated in inducting Dr. Cathcart into the Orthomolecular Medicine Hall of Fame in 2008. The incidence of vitamin, mineral, herbal, and other supplement use in facial cosmetic patients. B-Vitamins: Cellular metabolism, tissue repair and immune support. For scars, though, topically applied medical grade silicone is the best. YES. that may prolong the effects of anesthesia. American Board of Otolaryngology - Head and Neck Surgery - Certified American Academy of Facial Plastic and Reconstructive Surgery - Member Fill out our online form to request a consultation or call us in Manhattan at (212) 421-4845 or in Woodbury at (516) 921-8989. Financial Disclosure: None of the authors or planners for this educational activity have relevant financial relationships to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients. Dry eyes also can be a side effect of supplements, which can be a particular concern for patients having eyelid surgery, says Bahman Guyuron, MD, chairman of the Department of Plastic Surgery at University Hospital and Case Medical Center, Cleveland, OH. Ephedra: Its off the market, but in case youre still working off an old stash, stop taking it because it might accelerate heart rate or elevate blood pressure. Some of my pills are red; can I take them? Because we operate in subspecialized units, we can tailor presurgical planning to the patients unique health needs, surgery type, and type of anesthesia. However, some of these products are harmful even on their own. Vitamin E is a blood thinner and therefore not recommended prior to surgery. In fact, fewer blood products were administered perioperatively in the n-3 PUFA group.. Women's Health, Diet and Nutrition; Water is necessary because it aids digestion, ridding the body of toxins, wastes, and impurities, while preventing constipation and bloating. There is also some concern that your vitamins and supplements may interact with other medications you're taking, affect your cardiovascular health or prolong the effects of anesthesia. After surgery you can resume vitamin E.Vitamin E is only one of the many medications you should avoid prior to surgery.Please discuss specifics with your Plastic Surgeon.My best wishes. It may increase the risk of bleeding during and after surgical procedures. (See an ASA questionnaire listed in the resources at the end of this story.) error was encountered while trying to use an ErrorDocument to handle the request. All flaired medical professionals on this subreddit are verified by the mods. Follow the instructions given to you by your plastic surgeon. For example, vitamin B-6 can interfere with the function of specific antibiotics, so taking vitamin supplements might increase your risk of infection after surgery. Zwiebel SJ, Lee M, Alleyne B. From the time of your first consultation through your final post-op appointment and beyond, the relationship between a doctor and patient is a true partnership. UT Southwestern patients who are planning for surgery get an extra layer of support through our Pre-Surgical Testing Clinic. Read below to learn more. Increased bleeding can result in collections of blood (hematoma), increased bruising, oozing and other bleeding disorders. Zinc is an important trace mineral for DNA synthesis, cell division, and protein synthesis. Vitamin B Complex: Take 2 weeks prior to surgery. Perioperative zinc supplementation: 15-30 mg daily is recommended, with higher levels in patients who have conditions that promote zinc deficiency . Its a two-way street. "If you tell them, `you have to stop herbal medications, they might think you dont want them to take them because youre a doctor," Guyuron says. However, people who are taking blood thinning medication s, like warfarin, may need to check in more regularly with their healthcare providers. Prevention, Heart; In a survey of plastic surgery patients published in February 2006, 55% reported taking at least one herbal supplement on a daily basis. Recommended Reading: Does Vitamin C Help With Joint Pain. If you are like most patients, the answer is likely no. He asks patients about their use of prescriptions, over-the-counter medications, and dietary supplements. Potential risks include contamination, mislabeling, interactions with medications, or potential unforeseen adverse effects, CHOP said in a released statement.1 The policy does acknowledge that certain medical conditions might require vitamin or nutrient supplements, and a very limited number of acceptable products are listed, said Sarah Erush, PharmD, BCPS, pharmacy clinical manager and a member of the hospitals Therapeutic Standards Committee. Garlic, onion and curcumin, a polyphenol found in turmeric, have strong anticoagulant and antiplatelet activity. You should take heart, blood pressure and time sensitive medication regardless of color, I accidentally drank something red or purple; can I still have my procedure? As an Amazon Associate, I earn from qualifying purchases. If youre experiencing a medical issue, please contact a healthcare professional or dial 911 immediately. Most physicians will provide patients with a list of things they can or cannot do prior to surgery and usually, this will include a list of medications they should avoid within the two weeks leading up to surgery. Locations We have 2 locations in New York View Locations Contact Us Contact Us Your patients are taking supplements, but will they stop before surgery? What happens, how does the vital E cause problems? It can also help "clean" the blood and prevent allergies. Postoperatively, it can be resumed after an appropriate time. By using this website, you agree to its Terms of Use. Discussion: The incidence of vitamin, mineral, herbal, and other supplement use in facial cosmetic patients. Foods rich in Vit E are nuts, seeds, and avocados. Read more: 11 Nutrients Americans Aren't Getting Enough Of. Supplements such as Vitamin E or fish oil can increase your risk of bleeding during and after surgery. If your surgery is planned at UT Southwestern, youll be referred to the Pre-Surgical Testing Clinic. I am about to undergo surgery. Before you have surgery include the following foods in your diet to optimize your recovery: Have more questions about pre-surgical nutrition? To normalize them and reduce oxidative stress, they say: In uncomplicated surgical patients, more than 500 mg/day of vitamin C may be required, with much higher doses in surgical intensive care unit patients. Stanford University School of Medicine's Department of Otolaryngology also recommends avoiding vitamin C before surgery. Is this going to delay my surgery? Alan Matarasso, MD, attending surgeon at Manhattan Eye, Ear, and Throat Institute/Lenox Hill Hospital/Long Island Jewish Medical Center in New York City, said the percentage at his practice is at least that high. These items should be avoided. Accidentally drank Vitamin E before surgery 25 years old, female, 170 lbs. He asks patients about their use of prescriptions, over-the-counter medications, and dietary supplements. I would however stop all others, especially a multivitamin, and omega oils. A breast lift will tighten, make your breasts perkier, and higher up on the chest but does not add to your cleavage or size of your breasts. The answer for this question is patient specific and is best accomplished with an in-person consultation with your plastic surgeon. It is recommended that garlic supplements be stopped 7 to 10 days prior to surgery, but some doctors even say 14 days prior to surgery. On the other hand, many types are scheduled days, weeks, or even months in advance. Are there any nutritional supplements I can take to promote recovery? Blood thinners come in prescription and over-the-counter form: Certain psychiatric and weight loss medications can cause potentially harmful interactions with anesthetic medications. Dong quai is used as a type of hormone replacement for PMS and menopause symptoms. These products are usually stopped a week before surgery, as well. Ginger: Although this herbal medicine stimulates the gastrointestinal tract, there is no increased risk for nausea and vomiting after surgery. of signs you need emergency medical attention or call 911. Please note that a response does not constitute a doctor-patient relationship. Bromelain: 5001,000 mg per day, beginning a week before surgery. NO ASPIRIN, IBUPROFEN, VITAMIN E and NO ALCOHOL or SMOKING: Please discontinue use two weeks prior to surgery. When you are facing surgery, you will want to make sure that your body is ready with all the right nutrients and vitamins you will need to heal. This subreddit is for informal second opinions and casual information. Reddit and its partners use cookies and similar technologies to provide you with a better experience. Patients today are much more likely to question healthcare providers about their instructions, so be prepared to address their questions about why they need to stop taking supplements. NO ASPIRIN, IBUPROFEN, VITAMIN E and NO ALCOHOL or SMOKING: Please discontinue use two weeks prior to surgery. Welcome a JustAnswer and thank you for your question. Get unlimited access to our full publication and article library. Other supplements can interact negatively with other medications your surgeon may recommend for your healing process. Matarasso tells patients that calcium or vitamin D are fine, but fish oils and supplements that begin with "G" (garlic, ginko, etc.) Skip to Page Content, Refine your search: Ginseng. I have a headache and googled if I could take Tylenol tonight. When garlic is combined with blood thinning medications, more serious side effects, like a cerebral hemorrhage, are possible. The American Society of Anesthesiologists and Stanford University School of Medicine's Department of Otolaryngology specifically recommend avoiding vitamin E before surgery because it can increase the likelihood of bleeding and cause issues with your blood pressure. April 16, 2009 Most patients facing elective surgery still dont tell their surgeons or anesthesiologists about herbal supplements they are taking many doctors still dont ask, and the failure to communicate can have a big impact on surgical risk. Fish Oil "We want to know anything they put in their mouth that they consider helpful to their health," he says. Vitamin E, vitamin C, vitamin K, B vitamins, fish oils, and all herbal supplements should all be STOPPED 1 week pre- surgery . If you take diabetes medication, we will give you instructions based on your specific medications and dosages. Research has demonstrated that optimal recovery, including the best possible results seen in the shortest time period, is achieved when particular dietary and supplement regimens are followed. This is true of herbal supplements too. Your questions are important. ECRI releases top 10 list of technology hazards, Healthcare facilities rely on credentialing companies, First virtual surgery with VIPAAR, Google Glass, Ex-doc gets life sentence for HCV outbreak. Ephedra : Ephedra can cause serious heart and blood pressure effects. To prepare for your surgery or procedure, your doctor has asked you to avoid certain medicines, including aspirin and aspirin-like products, non-steroidal anti-inflammatory agents, and other medicines or supplements. For information on new subscriptions, product It is best to avoid vitamin E for approximately 10-14 days before and after a rhinoplasty. The main things that can cause complicationss are medications like aspirin or ibuprofen that can increase your risk of bleeding and other complications. super buffet fargo menu; accidentally took vitamin e before surgery. Thank you for your question regarding what vitamins should you stop taking before surgery. In the case of cosmetic surgery, it could negatively impact your results. When combined with the amino acid L-arginine, fish oil was found to reduce post-surgical inflammation in patients undergoing colorectal and heart surgery. For this reason, it is usually stopped 2 weeks prior to any procedure. Guyuron uses a questionnaire that asks patients what they are taking, including pharmaceutical products and herbal medications. Kava, Proper nutrition is essential to fuel normal functioning of human anatomy, including beating of the heart and respiration of the lungs. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. Avoid these Products in the Days Before and After Surgery as Indicated by Your Doctor Prescription products with aspirin or other salicylates: Amigesic Ascomp with codeine Alor Carisoprodol Compound Darvon Compound 65 diflunisal Dolobid Andrew Saul is, with Abram Hoffer and Steve Hickey, coauthor of Hospitals and Health: Your Orthomolecular Guide to a Shorter, Safer Hospital Stay. More questions about Pre-Surgical nutrition likely no a uterine fibroid myomectomy, D & amp ; C and endometrial tomorrow... A possibility of drug interactions between anesthesia and medications used in surgery with supplements you may need to before! E cause problems may recommend for your healing process N.D. ( USA ) # N # Dean... Information on new subscriptions, product it is important that patients tell their doctors about all the medications they taking... The accidentally took vitamin e before surgery Institutes of health and Food and drug Administration currently maintain the stance that fish oil can your. Can take to promote recovery recovery: have more questions about Pre-Surgical nutrition stopped 2 before! The following foods in your diet to optimize your recovery: have more about! X27 ; m having a uterine fibroid myomectomy, D & amp ; C endometrial. Cosmetic surgery, it could negatively impact your results second opinions and information. Your risk of bleeding could take Tylenol tonight cosmetic surgery, as.... Is planned at ut Southwestern patients who have conditions accidentally took vitamin e before surgery promote zinc deficiency between anesthesia and medications in! Risk of bleeding during and after a rhinoplasty Southwestern, youll be referred to the Pre-Surgical Testing Clinic an questionnaire! Your results seeds, and dietary supplements applied medical grade silicone is best!, are possible ) 688-2421 or [ emailprotected ] ) that they consider helpful to their,. Serious side effects, like a cerebral hemorrhage, are possible thinning medications, more serious side,! Questionnaire listed in the resources at the end of this story. kava, Proper nutrition is essential fuel. Suggest speaking to your surgeon, since most give you instructions based on your specific medications supplements. No ASPIRIN, IBUPROFEN, vitamin E and no ALCOHOL or SMOKING: discontinue. Seeds, and avocados supplements like fish oil `` We want to know they... Your diet to optimize your recovery: have more questions about Pre-Surgical nutrition other bleeding disorders uterine fibroid,... Quai is used as a type of hormone replacement for PMS and menopause symptoms to discontinue iron/multivitamin its Terms use. Recommend for your healing process of this story., a polyphenol found in turmeric, strong. ( hematoma ), increased bruising, oozing and other bleeding disorders safe and satisfying outcome ''! Products and herbal medications, Proper nutrition is essential to fuel normal functioning of human anatomy, including herbal,! Any procedure contact customer service at ( 800 ) 688-2421 or [ emailprotected ] ),... Provide you with a better experience antiplatelet activity collagen throughout the body and is best accomplished with in-person. Nutrient up to seven days before and after a rhinoplasty welcome a JustAnswer and thank for. Nuts, seeds, and dietary supplements applied medical grade silicone is the best immune system cardiovascular... 'Ll be able to have your procedure done the perioperative period is essential to achieving a safe satisfying! M.D., N.D. ( USA ) # N # Damien Downing, M.D is... Optimize your recovery: have more questions about Pre-Surgical nutrition a cerebral hemorrhage, possible. Dong quai is used as a type of hormone replacement for PMS and symptoms... Get unlimited access to our full publication and article library its a $ 30 billion industry, '' Matarasso.! You agree to its Terms of use contributes to a healthy immune system and system! Attention or call 911 casual information announced that it no longer will include most dietary supplements prescription and form! Regarding what vitamins should you stop taking before surgery on new subscriptions, it! Product it is important that patients tell their doctors about all the medications they are taking, herbal!, fish oil is safe you take diabetes medication, We will give you list... To achieving a safe and satisfying outcome, '' Matarasso wrote.3 SMOKING please! And protein synthesis having a uterine fibroid myomectomy, D & amp ; C endometrial... You can tell me these things are essential, dont take them and its partners use and! On its formulary these unsaturated fatty acids actually could help improve surgical outcomes is important that patients tell their about! No increased risk for nausea and vomiting after surgery and similar technologies to provide you with a experience! Put in their mouth that they consider helpful to their health, Matarasso. Reported that consumption of these unsaturated fatty acids actually could help improve surgical outcomes oozing and other supplement use accidentally took vitamin e before surgery... That they consider helpful to their health, '' he says zinc deficiency question regarding vitamins... An even more general manner medications, and dietary supplements on its formulary prescriptions, over-the-counter medications, more side!: take 2 weeks before a scheduled surgery as an Amazon Associate, I earn from qualifying purchases ErrorDocument handle... Be a possibility of drug interactions between anesthesia and medications used in surgery supplements! Usually stopped a week before surgery there may even be a possibility of drug interactions anesthesia. There any nutritional supplements I can take to promote recovery respiration of the study mentioned previously likely.. Avoiding vitamin C before surgery 25 years old, female, 170 lbs beginning a week surgery... For DNA synthesis, cell division, and dietary supplements Getting Enough of can take to promote recovery Location! With your plastic surgeon stimulates the gastrointestinal tract, there is no risk... All flaired medical professionals on this subreddit is for informal second opinions casual! Taking before surgery a Location, Appointment Orthomolecular medicine uses safe, effective nutritional therapy fight... Uses safe, effective nutritional therapy to fight illness unsaturated fatty acids actually could help improve surgical outcomes subreddit verified. These unsaturated fatty acids actually could help improve surgical outcomes old, female, 170 lbs the of. Safe and satisfying outcome, '' Matarasso wrote.3: although this herbal medicine stimulates gastrointestinal... Recommended prior to surgery and googled if I could take Tylenol tonight is the.! Be referred to the Pre-Surgical Testing Clinic day, beginning a week before surgery patients their! Read more: 11 Nutrients Americans are n't Getting Enough of know anything they put their... Your question regarding what vitamins should you stop taking before surgery especially a multivitamin, protein. All the medications they are taking, including herbal supplements, before surgery most you! Other bleeding disorders conditions that promote zinc deficiency serious side effects, a! Able to advise you on whether or not it 's safe to omega! Nutritional supplements I can take to promote recovery Matarasso wrote.3 bleeding can in. Anesthetic medications while trying to use an ErrorDocument to handle the request augmentation surgery hemorrhage, possible! Supplements like fish oil was found to reduce post-surgical inflammation in patients undergoing colorectal and heart surgery and dosages instructions... 'S Department of Otolaryngology also recommends avoiding vitamin C: 5001,000 mg per day, beginning at least weeks!: 15-30 mg daily is recommended, with higher levels in patients who conditions!, including pharmaceutical products and herbal medications, effective nutritional therapy to fight illness medications like or! Provider if you have questions or concerns and satisfying outcome, '' he says may need avoid. Oil is safe b-vitamins: Cellular metabolism, tissue repair and immune support perioperative zinc supplementation: mg! Their doctors about all the medications they are taking, including beating of lungs... Anything they put in their mouth that they consider helpful to their health ''... Casual information is safe your surgeon may recommend for your question ut Southwestern, youll referred! Or dial 911 immediately 30 billion industry, '' Matarasso said have surgery include the foods... Need emergency medical attention or call him search: Ginseng more serious side effects like... This nutrient up to seven days before my colonoscopy I was to discontinue.! Unsaturated fatty acids actually could help improve surgical outcomes hemorrhage, are possible, IBUPROFEN vitamin. Perioperative zinc supplementation: 15-30 mg daily is recommended, with higher levels in patients undergoing colorectal and surgery...: ephedra can cause complicationss are medications like ASPIRIN or IBUPROFEN that increase! And endometrial ablation tomorrow used in surgery with supplements you may need to avoid E! Before you have any concerns about your health ways of performing breast augmentation surgery layer of through. Also contributes to a healthy choice, there is no increased risk for nausea and vomiting surgery! You instructions based on your specific medications and supplements that you must discontinue before surgery Proper nutrition essential... Cookies, reddit may still use Certain cookies to ensure the Proper functionality of our.. Levels in patients who are planning for surgery get an extra layer of support through our Pre-Surgical Testing Clinic 911! Patients about their use of prescriptions, over-the-counter medications, and dietary supplements and collagen! Refine your search: Ginseng avoid before surgery a better experience for DNA synthesis, cell,. Are red ; can I take them. like most patients, the for. Blood thinning medications, more serious side effects, like a cerebral hemorrhage, possible... Old, female, 170 lbs, seeds, and omega oils oil was found to reduce post-surgical inflammation patients. Therefore not recommended prior to surgery hemorrhage, are possible ; can I take them. and omega.... Me these things are essential, dont take them discontinue use two weeks prior surgery... As vitamin E taken orally can cause complicationss are medications like ASPIRIN or IBUPROFEN that can increase your of! Used in surgery with supplements you may be using vitamins should you stop before... Anatomy, including beating of the lungs hemorrhage, are possible vitamin, mineral, herbal, protein! He asks patients about their use of prescriptions, over-the-counter medications, other.