*UPDATE* – Natural Medicines database

	Here are just a few of the hundreds of updates we’ve made to Natural Medicines Comprehensive Database this month. You can learn more about these and thousands of other natural medicines by accessing the Database. Plus you can get fully accredited continuing education credits. • Chromium can be added to the list of supplements that interact with levothyroxine (Synthroid, others). New research shows that taking chromium picolinate 1000 mcg with levothyroxine 1000 mcg reduces levothyroxine levels by about 17%. Researchers suspect that chromium binds levothyroxine in the gut and reduces absorption. Keep in mind that calcium and iron can also reduce levothyroxine absorption. Advise patients to take levothyroxine at least 30 minutes before or 3-4 hours after taking these supplements. To see a complete list of potential interactions between supplements and levothyroxine, use our Natural Product / Drug Interaction Checker. • Rx Essentials is a new line of supplements promoted for “drug-induced nutrient depletion.” There are five different formulas, each targeted for patients taking medications for arthritis, cholesterol, depression, diabetes, or heartburn. Most of these formulas contain vitamins B6, B12, and folic acid. The formula for arthritis also contains vitamin C and vitamin D. The cholesterol formula has coenzyme Q10. The depression formula has vitamin D and the heartburn formula has vitamin D and calcium. Many drugs do affect nutrient levels and in a few cases this can be significant… diuretics and potassium, digoxin and magnesium, phenytoin and vitamin D, orlistat and fat-soluble vitamins. In other cases, the clinical significance of depletion is unclear. For example, some research shows that coenzyme Q10 decreases statin-induced muscle pain, but other research shows no benefit. In most cases, there isn’t enough data to know if the nutrient depletion is clinically significant. Patients who have a healthy diet and take a multivitamin might not need anything more. You can get detailed scientific data on hundreds of nutrient depletion issues in each nutrient monograph in Natural Medicines Comprehensive Database. Or get our comprehensive nutrient depletion chart. Over 25% of people with insomnia turn to natural medicines. Get the latest scientific information on melatonin, valerian, lavender, and other commonly used products in our new course, Natural Medicines in the Clinical Management of Insomnia.