Adjunctive Therapy with Supplements: What is it and how does it help me?

by Sean M. Crosetti, MBA, PharmD, Crosetti Health & Wellness
 

    Technically speaking, adjunctive therapy is when additional treatments are used to enhance the effectiveness of the main or primary treatment.  With a prescriptive treatment, this could be additional prescription medications or the addition of supplements as part of the therapy.  
     Often, it is the introduction of supplements to help the treatment be most effective and to reduce or eliminate negative side effects. 
It is safe to say if you are not on a prescription medication, you know someone who is taking a medication regularly to help maintain a healthy life.  
     Almost everyone knows about side effects of medications and how they can lead the prescriber to change the medication or add another prescription medication to keep those side effects in check.  In many cases, the side effects are the result of a deficiency of nutrients and enzymes in the body.  
     Instead of adding another prescription medication to mask the side effects of the original treatment, using adjunctive therapy, the deficient nutrients are replenished back to the necessary concentrations by adding dietary supplements, which eliminates the side effects.
     How does a medication cause a deficiency of a nutrient?  That is an interesting conversation.  All medications work on the body through increasing or decreasing one of these pathways: Absorption, Production, Transport, Metabolism, Excretion, or Storage. The idea behind this is that a change in the body’s pathway(s)  has become detrimental to the body’s health; therefore, a medication is prescribed to return the altered pathway back to its healthy and steady state.
     Once that healthy steady state is obtained, then all that is left is to monitor for the need to adjust dosing.  Well, the body is an amazing machine that is able to use the same “tools” in several different ways.  An example of this is with the anti-cholesterol class of drugs called Statins: 
     [Atorvastatin (Lipitor®), 
     Fluvastatin (Lescol. ®), 
     Lovastatin (Mevacor®),
     Pravastatin (Pravachol®),
     Rosuvastatin (Crestor®),
     Simvastatin (Zocor®)]. 
     These medications work to reduce the amount of cholesterol your body produces by blocking a specific enzyme; coupled with dietary changes, cholesterol levels decrease. Now that same enzyme being blocked for cholesterol production is also used in the body to produce the important antioxidant coenzyme Q10 (CoQ-10). 
     Therefore, the introduction of a statin could lead to a decrease in CoQ-10 production.  This could lead to a CoQ-10 deficiency (muscle aches, fatigue, systemic inflammation, cardiac issues, and/or mental fogginess).   Symptoms slowly grow as stores of nutrients are depleted.  Adjunctive therapy helps replenish the Metabolic Reserve (nutrients your body has stored) and restore the capacity of the Physiologic Resilience (your body’s natural resilience to short term change). 
     This type of therapy is not only used to replace depleted essential vitamin/nutrients but also to introduce additional nutrients to allow the treatment to be most beneficial.  There are times where a prescribed medication provides greater benefit if taken with a supplement. 
     For example, if you are prescribed a medication to help with low bone density in the Bisphosphonate class: 
     [Risedronate (Actonel),
     Alendronate (Fosamax), Ibandronate
     (Boniva), Zoledronic Acid (Reclast)], you should also start Calcium supplements.  This class of medications works by reintroducing Calcium into your bones so by adding additional Calcium to your body, the better the medication can benefit you. 
     Not all prescriptive medications need adjunctive therapy.  The best way to identify when adjunctive therapy with supplements would benefit you is to be open with your healthcare providers (physicians, nurse practitioners, pharmacists, chiropractors, therapists, etc.) about any changes that concerns you. 
     Remember when discussing your health with these providers to tell them about all the medications and supplements you are taking.  Not only list the prescribed medications but the vitamins/supplements/over-the-counter items you are taking with the frequency listed as well, and do not shy away from asking about this type of therapy. 
     Sean M Crosetti, MBA, PharmD, is Pharmacist in Charge and Owner of Crosetti Health & Wellness in Grain Valley. Crosetti Health & Wellness is located at 510 N. Main in Grain Valley. www.crosettis.com