Salt substitutes that contain potassium instead of sodium can decrease the effectiveness of the drugs.
CAFFEINE Prescribed to lower blood pressure and treat a weak heart, beta blockers make the heart beat more slowly, reducing its workload. Examples include carvedilol
(Coreg) and metoprolol succinate (Toprol XL, Kapspargo). If taking a beta blocker, Varanasi-
Diaz recommends watching caffeine and other stimulants found in energy drinks, such as green tea extract, guarana, or yerba mate, as these can raise heart rate and blood pressure: the opposite of the drug’s intended effect. “It doesn’t mean don’t drink any
caffeine,” she explains, but be aware of its effect, use moderation, and don’t take your beta blocker with a cup of coffee. When taken in the long term,
the effects of a beta blocker can be unintentionally increased if you take more than 200 mg daily of a CoQ10 supplement, which may be taken to boost heart health or prevent migraines. This could intensify side effects,
especially feeling fatigued. Lower doses of CoQ10 aren’t problematic.
BLOOD PRESSURE DRUGS ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) are two other classes of drugs prescribed to lower blood pressure or treat heart ailments. Some examples include lisinopril
(Prinivil, Zestril) and losartan (Cozaar).
Blood-Thinning Myth W
arfarin (Coumadin) is a long- standing anticoagulant, often called a blood thinner. High-protein diets and
foods rich in vitamin K, including all leafy greens, broccoli, and cabbage, reduce the drug’s effectiveness and increase risk for blood clots. But the idea that these foods should be avoided is a myth. Instead, a doctor can increase the drug dosage to compensate for more vitamin
K-rich foods or increased protein. To make this work, the amounts of these foods in a diet need to be consistent. If the amounts of greens or protein are reduced, a doctor needs to reduce the dose of the drug to avoid the risk of bleeding.
One side effect is reduced ability
of the kidneys to excrete excess potassium. While potassium in foods isn’t typically problematic, salt substitutes that contain potassium instead of sodium can decrease the effectiveness of the drugs. “If those drugs are not as effective, then that can throw off your heart rhythm,” says Varanasi-Diaz, “and potentially the side effect would be arrhythmia — an unregulated heart rhythm.”
FISH OIL “Fish oil could have an additive effect to blood pressure medications,” Varanasi-Diaz says. This could be synergistic or problematic, depending on the situation. Some integrative cardiologists
may recommend fish oil and prescribe a lower dose of a blood pressure medication to account for the supplement amplifying the drug effect. In other cases, it’s possible for blood pressure to drop too low, causing side effects such as dizziness. Drugs for blood pressure are
generally taken in the evening, Varanasi-Diaz points out, and fish oil can be taken in the morning. However, because the drugs stay in the system, it won’t totally eliminate the additive effect. Calcium in dairy products, supplements, antacids, and fortified foods can bind with medications and reduce their absorption and effectiveness.
These are some common examples
and ways to avoid the problem: Antibiotics: Tetracycline antibiotics
for bacterial infections such as acne and pneumonia, and fluoroquinolone antibiotics for respiratory and urinary tract infections, should be taken at least one hour before or two hours after consuming any dairy products — even milk in coffee or tea — or other significant sources of calcium. Varanasi-Diaz cautions that
when antibiotics are less effective, infections can linger. Then, stronger antibiotics may need to be prescribed, and the situation may lead to antibiotic resistance. Low thyroid: Drugs such as
levothyroxine and Armour Thyroid should be taken on an empty stomach in the morning, at least 30 minutes before breakfast — even coffee — and four hours before or after consuming any calcium-rich foods or supplements. Otherwise, the drug can be less effective, leading to lingering symptoms such as lack of energy, a low mood, and weight gain. Osteoporosis: Bisphosphonates,
such as Fosamax, slow down bone loss and increase bone density. They should be taken on an empty stomach, at least 30 minutes before eating any calcium-rich foods or supplements. Type 2 Diabetes: Metformin
reduces absorption of vitamin B12 and can lead to a depletion of the vitamin; symptoms can include confusion, memory lapses, tiredness, weakness, pale skin, nausea, depression, or irritability. Blood levels of B12 should be checked at least annually, but this isn’t always done. As a precaution, Varanasi-Diaz recommends taking 250-500 mg of B12 daily if you take metformin. Alcohol is not recommended
with metformin. The combination can cause blood sugar to drop too low and produce symptoms such as headaches, sweating, anxiety, tiredness, or difficulty concentrating. And it puts stress on the liver.
JANUARY 2026 | NEWSMAX MAXLIFE 91
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