Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
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Safe Amounts of Supplements

Thursday, 15 Dec 2011 09:15 AM

Question: I am a 55-year-old male, 6' tall, 190 pounds, with a moderately intense cardio (elliptical) and weight training program. Unfortunately, I also suffer from atrial fibrillation from unknown causes, which arose at the same time I came down with a flu-like virus. A camera view of my arteries shows I'm in excellent shape with no blockages, arterial disease, or plaque build-up.
I take all of the following once a day: Diltiazem 90 mg, Carvedilol 12.5 mg, Digoxin 125 mcg, and Lisinopril 2.5 mg. I also take an 81 mg aspirin twice a day (the second dose is a substitute for warfarin) and 1,000 IU of vitamin D-3 twice a day.
Is it safe for me to supplement with magnesium 500 mg (twice a day), 1,000 mg of vitamin C (three times a day), 50 mg of zinc and 800 IU of vitamin E daily, 500 mg of quercetin (twice a day), 125 mg of CoQ-10 daily, and 1,000 mg of CLA daily?
Also, do you recommend L-carnitine and fish oil supplementation?

Dr. Hibberd's Answer:
You must continue with all the medications that your doctor has advised. You are doing well to follow a regular exercise routine as well. The Institute of Medicine has determined upper daily limits for nutrients that are commonly used as supplements as well as the UL — the upper limit and the highest amount you can take without risk. The RDA for vitamin C is 90 mg (UL is 2,000 mg) 11 mg for zinc (UL is 40 mg), and 22.4 IU for vitamin E (UL is 1,500 IU).
Vitamin E supplementation alone has not been shown to be of benefit. In fact, those who took over 800 units of vitamin E as a daily supplement had higher rates of stroke and heart attack than the non-supplemented group. Isolated vitamin E supplementation is no longer recommended unless under the guidance of your physician.
CoQ-10 is often needed by those on lipid medications to reduce nuisance aches, and is normally used with L-carnitine by some anti-aging professionals to enhance vascular health. Quercetin may enhance the effect of aspirin (or warfarin) and increase your risk for bleeding. Therefore, I advise that you ask your own doctor if you should consider this supplement. Fish oil supplements if taken along with aspirin may increase bleeding time, so, in your case, taking a fish oil supplement should only be on the advice of your doctor.
I recommend you review your supplements with your physician. They are not balanced, and you may have problems with your present regimen.

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