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eCAM Advance Access published online on December 5, 2007
eCAM, doi:10.1093/ecam/nem150
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© 2007 The Author(s).
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Dietary Supplement Polypharmacy: An Unrecognized Public Health Problem?

Nicole L. Nisly1, Brian M. Gryzlak2, M. Bridget Zimmerman2 and Robert B. Wallace2

1Department of Internal Medicine, Carver College of Medicine, University of Iowa and 2Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA

Excessive and inappropriate use of medications, or ‘polypharmacy’, has been recognized as a public health problem. In addition, there is growing use of dietary supplements in the United States; however, little is known about the patterns of supplement use. Recent reports in the literature of cases of excessive or inappropriate use of herbal dietary supplements leading to the term ‘polyherbacy’. The clinical vignettes described in this article highlight the need for further research on the nature and extent of multiple and inappropriate dietary supplement use or ‘dietary supplement polypharmacy’. Clinical interviewing and population surveys both address this issue in complementary ways, and provide a further understanding of dietary supplement use patterns.

Keywords: complementary and alternative medicine – dietary supplements – drug interactions – herbals – polypharmacy

For reprints and all correspondence: Nicole L. Nisly, MD, Complementary and Alternative Medicine Program, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA. Tel: +1-319-353-8583; Fax: +1-319-356-3086; E-mail: nicole-nisly{at}uiowa.edu

Received March 8, 2006; accepted June 14, 2007


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