Dietary Supplements and Natural Products: Why Full Disclosure to Your Care Team Matters

Every year, millions of people in Australia and around the world take dietary supplements-vitamins, herbs, minerals, or extracts-thinking they’re harmless because they’re "natural." But here’s the hard truth: just because something comes from a plant or a bottle labeled "pure" doesn’t mean it’s safe to use without telling your doctor. In fact, some of the most dangerous drug interactions happen not with prescription pills, but with the supplements you didn’t think were worth mentioning.

What You’re Taking Might Be Hiding in Plain Sight

You might not even call it a supplement. Maybe you grab a garlic capsule for your cold, a ginkgo pill for memory, or St. John’s wort for low mood. You might take glucosamine for your knees or fish oil for heart health. These are all dietary supplements, and under Australian and U.S. regulations, they’re treated like food-not medicine. That means they don’t need to be proven safe or effective before hitting store shelves. The FDA doesn’t approve them. Neither does TGA in Australia. Manufacturers aren’t required to prove they work or that they won’t mess with your blood pressure meds, blood thinners, or antidepressants.

And here’s the kicker: 77% of American adults take at least one supplement. In Australia, numbers are rising fast, with over 60% of adults using them regularly. Yet, studies show only about one-third of people tell their doctor. Why? Because they assume their doctor doesn’t care. Or they think, "It’s just a vitamin." But if you’re on warfarin and you start taking ginkgo biloba, you could bleed internally. If you’re on birth control and using St. John’s wort, you might get pregnant. These aren’t rare cases-they happen daily.

The Silent Gap in Communication

When you walk into a GP’s office, they ask about your medications. They check your prescriptions. They look for allergies. But how often do they ask: "What supplements are you taking?" The answer? Not often enough. Research shows that when doctors don’t ask directly, only 29% of patients volunteer the information. But when they do ask-clearly and without judgment-disclosure jumps to 72%.

In Australia, disclosure rates are better than in the U.S. (around 68%), but they’re still far from perfect. Why? Because many doctors weren’t trained to talk about supplements. Medical schools in Australia and elsewhere spend less than 3 hours total on nutrition and natural products across four years of training. That’s not enough to build confidence. So they skip the question. And patients, sensing that the topic isn’t taken seriously, stay quiet.

But it’s not just about doctors. Patients also assume their pharmacist knows everything. Wrong. Most pharmacists don’t have access to your full supplement list unless you tell them. And if you buy supplements online-over 14% of sales are now online-you might not even know what’s in them. Labels can be misleading. One study found that 80% of supplements labeled as "ginseng" didn’t contain any actual Panax ginseng. Another had toxic levels of lead.

Real Risks, Real Consequences

Let’s get specific. Here are the supplements with the highest risk and lowest disclosure rates:

• St. John’s wort: Reduces the effectiveness of 57% of prescription drugs-including antidepressants, birth control, and HIV meds. A viral TikTok video from a nurse showed a patient who got pregnant despite using birth control because of this herb.
• Ginkgo biloba: Thins the blood. Combine it with aspirin, warfarin, or even ibuprofen, and you risk brain or internal bleeding. A 2022 case study in the AMA Journal of Ethics described a patient who had a stroke after combining ginkgo with warfarin. She didn’t tell her doctor because she thought "it was just natural."
• Garlic and echinacea: Can interfere with HIV medications and immune suppressants used after transplants.
• Green tea extract: Linked to severe liver damage in some users. The FDA has issued multiple warnings.
• Glucosamine/chondroitin: Often taken by diabetics for joint pain. But it can raise blood sugar levels. If you’re on metformin, this could throw your whole regimen off.

The numbers don’t lie. In the U.S., 23,000 people end up in emergency rooms each year because of supplement reactions. In Australia, we don’t track it as closely, but the trend is clear: more people are using them, and more are getting hurt.

What You Need to Tell Your Care Team

You don’t need to be an expert. You just need to be honest. Here’s what to share:

• The exact name: Say "Panax ginseng," not just "ginseng." "Turmeric extract" isn’t enough-say "curcumin 500mg daily."
• The dose and frequency: "I take 1,000 mg of fish oil twice a day."
• Why you’re taking it: "I take magnesium because I have trouble sleeping."
• Where you bought it: "I got it online from a brand called NutraVita."

Don’t wait for your annual checkup. Bring it up at every visit. If your doctor doesn’t ask, ask them: "Do you need to know about the supplements I’m taking?"

How Providers Are Starting to Catch Up

Change is happening. In Australia, some private hospitals now include supplement questions in admission forms. The TGA has started cracking down on false claims. The National Center for Complementary and Integrative Health (NCCIH) offers free training for clinicians-over 14,000 Australian and U.S. doctors have taken it. Electronic health records are finally updating: Epic Systems, the software used by most clinics, is rolling out a supplement module in mid-2024 that will flag dangerous interactions automatically.

But the biggest shift isn’t technological-it’s cultural. Providers who ask open-ended questions like, "What are you using to support your health?"-not just "Are you taking any supplements?"-see far better results. One nurse in Sydney started asking: "What vitamins or natural products are you using that your pharmacist might not know about?" Disclosure in her practice doubled.

What You Can Do Right Now

You don’t need to wait for your doctor to ask. Take control. Here’s how:

1. Make a list: Write down every supplement you take, including brand, dose, and why. Keep it updated.
2. Bring it to every appointment: Even if it’s just for a cold. Put it on your phone as a note. Print it out. Hand it to your doctor.
3. Ask your pharmacist: They can check for interactions. Many pharmacies offer free reviews.
4. Use trusted sources: Look up your supplement on the National Center for Complementary and Integrative Health (NCCIH) or the Therapeutic Goods Administration (TGA) website. Check for warnings.
5. Don’t assume "natural" means safe: Just because it’s sold in a health food store doesn’t mean it’s harmless.

It’s Not About Trusting or Distrusting Supplements

It’s about communication. Supplements aren’t the enemy. Many people benefit from them-vitamin D for low sunlight, omega-3s for inflammation, magnesium for muscle cramps. But when they’re used without awareness, they become hidden risks.

Think of your care team like a team of detectives. If you only give them half the clues, they can’t solve the case. Your blood pressure, your mood, your recovery after surgery-they all depend on knowing the full picture. That includes what’s in your medicine cabinet, your supplement drawer, and your daily routine.

So next time you’re at the clinic, don’t wait. Say it out loud: "I’m also taking [name]." It’s not a burden. It’s your safety.

Final Thought

You wouldn’t hide a prescription from your doctor. Don’t hide a supplement either. It’s not about trust. It’s about safety. The supplement industry is booming, but the system isn’t keeping up. The only thing standing between you and a dangerous interaction is your words. Say them. Write them down. Bring them with you. Your care team can’t help if they don’t know what you’re taking. And in a world where natural doesn’t mean safe, silence isn’t an option-it’s a risk.