NEW DELHI : Many people today use more than one system of medicine at the same time. A patient may take a prescription medicine for diabetes or high blood pressure, while also using an Ayurvedic preparation, herbal supplement or homoeopathic remedy. Often, neither doctor is aware of the complete list of medicines the patient is taking.
This practice, sometimes referred to as “mixopathy”, is not limited to one state or community. Across India, people commonly combine different forms of treatment, believing that a herbal or traditional product will either complement their prescription medicine or have fewer side effects because it is considered “natural”.
But doctors warn that natural does not automatically mean safe.
Herbal products can contain biologically active substances that may interact with prescription medicines. In some cases, they can increase the effect of a medicine and raise the risk of side effects. In other situations, they can reduce the effectiveness of a prescription drug, potentially leaving an illness poorly controlled.
According to Dr Seema Dhir, Unit Head and Senior Consultant, Internal Medicine, Artemis Hospitals, patients need to be particularly careful about combining herbal and allopathic medicines without medical supervision.
WHAT IS MIXOPATHY, AND WHY IS IT A CONCERN?
Mixopathy broadly refers to the use of medicines or treatments from different systems of medicine together, often without coordinated medical supervision.
For example, a person may be taking prescribed medicines for diabetes and blood pressure but also start an herbal product recommended by a friend or purchased over the counter. Another patient may continue taking a prescription medicine while consulting an Ayurvedic or homoeopathic practitioner without telling them about the other treatment.
The problem is not simply that patients are using different forms of treatment. The bigger concern is that healthcare providers may not know about the complete combination.
“Patients often combine treatments without informing either doctor,” Dr Dhir explains.
This can make it difficult for doctors to understand whether a new symptom is caused by the disease, a prescription medicine, a herbal product or an interaction between two or more substances.
HERBAL MEDICINES CAN INTERACT WITH PRESCRIPTION DRUGS
One of the most common misconceptions is that herbal products cannot cause drug interactions.
Some herbs contain active compounds that can affect the way medicines work inside the body. These interactions can change how quickly a drug is absorbed, broken down or eliminated.
For instance, some herbal products may increase the risk of bleeding when taken along with blood-thinning medicines. This can potentially make an existing bleeding risk more serious.
Other herbal products may interfere with medicines used to control diabetes, high blood pressure, epilepsy or heart disease. If the effect of a prescribed medicine is reduced, the patient’s condition may no longer remain adequately controlled.
The opposite can also happen. An interaction may increase the concentration or effect of a medicine, potentially increasing the risk of adverse effects.
This is why doctors need to know about every product a patient is taking, even if it is not considered conventional medicine.
THE LIVER CAN ALSO PLAY A ROLE
The liver plays an important role in processing many medicines.
Some herbal supplements can affect the enzymes involved in drug metabolism. This can change the amount of a prescription medicine that remains in the bloodstream.
If a medicine is broken down more slowly, its levels may increase and potentially cause toxicity. If it is broken down more quickly, the medicine may become less effective.
This can create a difficult situation for doctors. A patient may appear to be taking the prescribed medicine correctly, but the treatment may not be working as expected because another product is interfering with it.
WHY PATIENTS OFTEN DO NOT TELL THEIR DOCTORS
A major challenge is the communication gap between patients and healthcare providers.
Many people do not consider herbal products, supplements or traditional medicines to be “medicines” and therefore do not mention them during a consultation.
Some patients may also assume that their doctor will not consider the information important. Others may be consulting different practitioners and may not realise that every healthcare provider needs to know about the complete medication history.
This can become particularly important when a patient develops an unexpected side effect.
Without knowing that the patient is taking a herbal supplement or another traditional medicine, a doctor may not immediately identify a possible interaction.
Similarly, if a patient’s blood sugar, blood pressure or another medical condition suddenly becomes difficult to control, the doctor needs to consider whether another medicine or supplement could be affecting the treatment.
THE PROBLEM GOES BEYOND MAHARASHTRA
The concern around mixing different systems of medicine is not restricted to Maharashtra.
Patients across India may use multiple healthcare systems during the same period. Someone may consult an allopathic doctor for a chronic condition and simultaneously use Ayurvedic, homoeopathic, or herbal products.
This can become especially complicated when there is no communication between the practitioners.
The patient may believe that using different treatments provides additional protection or improves recovery. However, without coordination, the combination can make treatment more difficult to manage. The important issue is therefore not simply which system of medicine a patient chooses. It is whether the healthcare provider knows everything the patient is taking and whether the combination is appropriate.
QUALITY AND STRENGTH CAN VARY IN HERBAL PRODUCTS
Another concern is the variation in herbal products available in the market.
Unlike a prescription medicine where the active ingredient and dose are generally clearly defined, some herbal products can have variations in their ingredients, concentration and purity.
This can make it difficult to predict exactly how a particular product will behave when combined with a prescription medicine.
Even when two products have the same name, their composition may not always be identical depending on the manufacturer, formulation and preparation. This uncertainty makes self-medication particularly risky for people who are already taking medicines for chronic diseases.
PEOPLE TAKING BLOOD THINNERS NEED PARTICULAR CAUTION
Patients taking medicines that affect blood clotting should be especially careful before adding herbal products or supplements.
Some herbs can affect bleeding or clotting pathways. When combined with medicines that already increase bleeding risk, the overall effect may become difficult to predict.
Patients should therefore not assume that a herbal product is safe simply because it was purchased from a health store or recommended by someone they know. Any new supplement or herbal preparation should be discussed with the treating doctor, particularly when the patient is already taking regular medication.
CHRONIC DISEASE PATIENTS SHOULD BE MORE CAREFUL
People living with diabetes, high blood pressure, epilepsy and heart disease often take medicines regularly for years.
This makes the possibility of drug interactions particularly important.
A person may start a herbal supplement for a completely different reason and continue taking it for months without realising that it could interfere with their regular treatment. For chronic disease patients, even a small change in the effectiveness of a medicine can have consequences if it continues over a long period.
Patients should therefore maintain an updated list of all medicines and supplements they use and share it during medical consultations.
DO NOT STOP PRESCRIBED MEDICINES ON YOUR OWN
Concerns about mixopathy should not lead patients to suddenly stop their prescribed medicines. If someone is already using an herbal, Ayurvedic or homoeopathic product along with allopathic medicines, the safest approach is to discuss the complete combination with a qualified healthcare professional.
Doctors can then assess the medicines, supplements, doses and possible interactions and decide whether any changes are needed. Stopping medicines suddenly, particularly medicines used for certain chronic conditions, can itself create health risks.
WHAT PATIENTS SHOULD TELL THEIR DOCTOR
Patients should provide their healthcare provider with a complete medication history.
This should include:
- Prescription medicines
- Herbal medicines and supplements
- Ayurvedic preparations
- Homoeopathic medicines
- Vitamins and nutritional supplements
- Over-the-counter medicines
- Products taken occasionally for specific symptoms
Patients should also mention how frequently they take each product and why they started using it. this information can help doctors identify potential interactions and understand unexpected symptoms or treatment failure.
NATURAL DOES NOT ALWAYS MEAN RISK-FREE
The growing use of herbal and traditional remedies highlights the need for better communication between patients and healthcare providers.
The issue is not about declaring one system of medicine safe and another unsafe. It is about recognising that substances from different sources can interact with each other.
As Dr Dhir points out, patients should not begin combining herbal and prescription medicines without medical advice.
The simplest safety rule is also one of the most important: tell your doctor about everything you take.
A product being labelled herbal or natural does not mean it is free from active ingredients, side effects or drug interactions. When multiple treatments are being used together, knowing the complete medication history can make the difference between a treatment that works safely and one that creates an avoidable health risk.
