How to Share Over-the-Counter and Supplement Use Accurately with Your Provider

Every year, thousands of people end up in the hospital because of something they didn’t tell their doctor. Not because they were hiding anything, but because they didn’t think it mattered. That something? The vitamin D pill they take every morning. The fish oil for their joints. The herbal tea they drink to sleep. Or even that pain reliever they grab off the shelf when their back flares up. These aren’t prescription drugs. They’re over-the-counter (OTC) medicines and dietary supplements. And yet, they can be just as dangerous as pills your doctor writes a script for-if no one knows you’re taking them.

Why Your Doctor Needs to Know What’s in Your Medicine Cabinet

The FDA doesn’t require dietary supplements to be proven safe before they hit the shelves. Unlike prescription drugs, which go through years of testing, supplements are regulated under a different system. They can be sold as long as they don’t make false claims about curing diseases. That means a product labeled "natural" or "herbal" might still contain powerful ingredients that interfere with your blood pressure meds, blood thinners, or antidepressants.

In 2022, the FDA recorded over 1,000 adverse events linked to supplements-including 52 deaths. Many of these cases involved people who didn’t tell their providers they were taking something like St. John’s Wort (which can make antidepressants useless), kava (which can damage the liver when mixed with certain medications), or high-dose fish oil (which increases bleeding risk when taken with warfarin).

A 2021 study in JAMA Internal Medicine found that nearly one in four hospital patients had a potential interaction between their prescription drugs and something they were taking without telling anyone. Nearly 8% of those were severe enough to cause real harm. And yet, only 36% of supplement users ever mention them to their doctor.

Most People Don’t Think Supplements Count as Medicine

Here’s the problem: most people don’t see supplements the same way they see pills from the pharmacy. They think, "It’s just a vitamin." Or, "It’s natural, so it’s safe." Or worse, "My doctor didn’t ask, so it’s not important." A 2022 survey found that 52.7% of people who didn’t disclose supplement use said their provider never asked. Another 28% believed their provider didn’t need to know. And 19% said they were afraid their doctor would judge them or tell them to stop.

This mindset is dangerous. The FDA’s own guidelines say that ingredients in supplements can be active in the body-and they can cause problems when combined with other substances. For example, green tea extract taken with acetaminophen has caused liver failure. Comfrey, often sold as a "natural" remedy for bruises, can cause severe liver damage when taken with certain antibiotics or painkillers.

And it’s not just herbal products. Even common OTC pain relievers like ibuprofen or naproxen can interact with blood pressure medications, kidney drugs, or blood thinners. People don’t always realize these are drugs too.

What Exactly Should You Tell Your Provider?

It’s not enough to say, "I take a multivitamin." You need to be specific. Here’s what to include for every product:

• Exact product name: Not just "vitamin C," but "Nature Made Vitamin C 500mg Tablets"
• Dosage: "500 mg twice a day," not "one pill daily"
• Frequency: "Every morning," "only when I feel a cold coming on," "three times a week"
• Purpose: "For bone health," "to help with fatigue," "for immune support"

The National Institutes of Health (NIH) offers a free form called My Dietary Supplement and Medicine Record. It’s simple. You print it out, fill it in, and bring it to your appointment. Studies show that using a written list reduces documentation errors by 64% compared to just telling your doctor verbally.

Don’t forget the OTC stuff too. That cold medicine with pseudoephedrine? The antacid you take after dinner? The sleep aid with diphenhydramine? All of it counts.

How to Make Sure Your Provider Actually Listens

Many doctors are overwhelmed. They might not ask about supplements unless you bring it up. That’s why you need to be the one to start the conversation.

At your next visit, say something like:

> "I want to make sure you know everything I’m taking-even the vitamins and OTC meds. I’ve been using [list them]. Can we check if any of these might interact with my other medications?" Pharmacists are often better at catching supplement interactions than physicians. If you get your prescriptions filled at a pharmacy, ask your pharmacist to review your full list during your next refill. One study found pharmacists identified 3.2 times more potential interactions than doctors during medication reviews.

And if your provider brushes you off? Push back. You’re not being difficult-you’re protecting your health. Providers who routinely ask about supplements have patient satisfaction ratings nearly 50% higher than those who don’t.

What to Look for on Supplement Labels

Supplement Facts labels are not the same as Drug Facts labels. That’s a common mix-up. Drug Facts (on OTC medicines like Tylenol or Advil) tell you the active ingredient, purpose, warnings, and dosage. Supplement Facts (on vitamins, herbs, protein powders) list ingredients by weight but rarely explain what they do or how they interact.

The FDA requires manufacturers to list the amount of each ingredient per serving. But here’s the catch: there’s no legal limit on how much of an ingredient can be in a single serving. Some supplements contain 10 times the amount of a nutrient that’s considered safe for daily use.

If you see a label that says "Proprietary Blend," be extra careful. That means the manufacturer won’t tell you how much of each ingredient is in the mix. It’s a red flag.

What Happens When You Don’t Tell Your Provider

There are real stories behind the numbers.

In 2019, a 45-year-old woman died from acute liver failure. She’d been taking kava supplements for anxiety. Her psychiatrist had no idea. The interaction with her antipsychotic medication caused irreversible damage.

On the other side, a 68-year-old woman in Texas avoided a life-threatening bleed after her doctor discovered she was taking 1,000 mg of fish oil daily. Her blood thinner dose was adjusted. She’s alive today because she brought her supplement list.

A 2021 case study in the Journal of Patient Safety showed that when patients shared their full supplement list, doctors were able to prevent 89% of potential interactions before they caused harm.

How to Keep Track of Everything

You don’t need to remember everything. Just write it down.

Keep a small notebook in your purse or wallet. Or use your phone’s notes app. Every time you start or stop something, update it. Include:

• Product name and brand
• Dose and how often you take it
• Why you started taking it
• Where you bought it

Update it every time you refill a bottle or buy something new. Bring it to every appointment-even if you think it’s "just a vitamin." Some clinics, like Mayo Clinic, now require all patients to submit a supplement list during intake. Since 2020, they’ve seen a 37% drop in supplement-related adverse events.

What’s Changing in 2025

The system is slowly improving. In 2023, the Office of the National Coordinator for Health Information Technology launched a project to standardize supplement data in electronic health records. By 2025, all certified EHR systems-including Epic and Cerner-will have dedicated fields for supplements.

Epic’s 2024 update will include AI-powered screening that checks your supplement list against your prescriptions and flags dangerous combinations before your doctor even sees you.

But none of that matters if you don’t speak up.

Final Checklist: What to Do Before Your Next Appointment

• Grab every bottle you take-prescription, OTC, and supplement
• Write down the exact name, dose, frequency, and reason for each
• Include anything you take occasionally, like herbal teas or protein powders
• Bring the list to your appointment-even if you’re not sure it’s important
• Ask: "Could any of these interact with my other meds?"

You don’t need to be an expert. You just need to be honest. Your provider isn’t judging you. They’re trying to keep you safe.

Frequently Asked Questions