Drug & supplement interaction

Chromium + Amobarbital, Ephedrine Sulfate

Amobarbital, Ephedrine Sulfate brand name: Ephedrine & Amytal.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Chromium and Amobarbital, Ephedrine Sulfate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

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Interaction report

Chromium and Amobarbital, Ephedrine Sulfate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Amobarbital, Ephedrine Sulfate and Chromium in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Chromium safety at a glance

Chromium overall Use caution Usually well tolerated at typical supplement doses, but high or long-term doses may pose risks for some people.
Pregnancy Likely Safe When used orally and appropriately in amounts not exceeding adequate intake (AI) levels. The AI for pregnancy is 28 mcg daily for those 14-18 years of age and 3... Read the full pregnancy detail
Breastfeeding Likely Safe When used orally and appropriately in amounts not exceeding adequate intake (AI) levels. The AI for lactation is 44 mcg daily for those 14-18 years of age and 4... Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Amobarbital, Ephedrine Sulfate and Chromium? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Amobarbital, Ephedrine Sulfate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Amobarbital, Ephedrine Sulfate is filed under 5 classifications — including barbiturates, anticonvulsants, alpha-adrenergic agonists. Chromium has documented interactions with 5 drug classes — the most serious being antidiabetes drugs (moderate), insulin (moderate) and levothyroxine (synthroid, others) (moderate) — and none of Amobarbital, Ephedrine Sulfate’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Chromium Does Interact With Other Medications

Chromium has 89 moderate, 89 minor known drug interactions in our database — Amobarbital, Ephedrine Sulfate isn’t one of them. If you take anything else, check it against the full list below.

Moderate 89 Minor 89 No known interaction 2,652 (incl. Amobarbital, Ephedrine Sulfate)
Taking anything else?

Check Another of Your Medications Against Chromium

Covers the 2,830 medications we’ve checked against Chromium. Pick one to open its full report.

What to actually watch for

What Chromium Itself Has Been Linked To

This is not an interaction — nothing below involves Amobarbital, Ephedrine Sulfate. It is the side-effect record for Chromium on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Chromium, this list is the first place to look. 8 entries are worth acting on rather than waiting out — marked below.

  • Severe muscle breakdown Worth acting on Additional detail

    “Acute rhabdomyolysis has been reported for a previously healthy 24-year-old female who ingested chromium picolinate 1200 mcg over a 48-hour time period. Also, chromium polynicotinate has been associated with leg pain and paresthesia in patients taking the supplement to prevent weight gain during smoking cessation.”

    Chromium · Natural Medicines adverse-effect record, reported in muscle breakdown.

    2 sources cited
    1. 42786. Martin, W. R. and Fuller, R. E. Suspected chromium picolinate-induced rhabdomyolysis. Pharmacotherapy 1998;18(4):860-862. DOI
    2. 42643. Parsons, A., Ingram, J., Inglis, J., Aveyard, P., Johnstone, E., Brown, K., Franklin, M., and Bermudez, I. A proof of concept randomised placebo controlled factorial trial to examine the efficacy of St John's wort for smoking cessation and chromium to pr
  • Low blood sugar Worth acting on Additional detail

    “Orally, cases of hypoglycemia have been reported for patients taking chromium picolinate 200-1000 mcg daily alone or 200-300 mcg two or three times weekly in combination with insulin. Chromium picolinate has also been associated with weight gain in young females who do not exercise and in those following a weight-lifting program.”

    Chromium · Natural Medicines adverse-effect record, reported in hypoglycemia.

    3 sources cited
    1. 42672. Bharmal, S. V., Moyes, V., Ahmed, S., and Grossman, A. Hypoglycaemia: possible mediation by chromium salt medication. Hormones.(Athens.) 2010;9(2):181-183. PubMed
    2. 42783. Bunner S and McGinnis R. Chromium-induced hypoglycemia. Psychosomatics 1998;39(3):298-299. PubMed
    3. 1938. Mohamedshah FY, Moser-Veillon PB, Yamini S, et al. Distribution of a stable isotope of chromium (53Cr) in serum, urine, and breast milk in lactating women. Am J Clin Nutr 1998;67:1250-5. PubMed
  • Heart failure / Wheezing / Shortness of breath Worth acting on Additional detail

    “Another form of chromium, called hexavalent chromium, is unsafe. This type of chromium is a by-product of some manufacturing processes. Chronic exposure can cause liver, kidney, or cardiac failure, pulmonary complications, anemia, and hemolysis.”

    Chromium · Natural Medicines adverse-effect record, reported in anemia.

    6 sources cited
    1. 9141. Lanca S, Alves A, Vieira AI, et al. Chromium-induced toxic hepatitis. Eur J Intern Med 2002;13:518-20. PubMed
    2. 11786. Food Standards Agency. Medicines and Healthcare products Regulatory Agency (MHRA). Expert Group on Vitamins and Minerals. Available at: http://cot.food.gov.uk/sites/default/files/vitmin2003.pdf.
    3. 42572. Gibb, H. J., Lees, P. S., Pinsky, P. F., and Rooney, B. C. Lung cancer among workers in chromium chemical production. Am J Ind.Med 2000;38(2):115-126. DOI
    4. 42573. Gibb, H. J., Lees, P. S., Pinsky, P. F., and Rooney, B. C. Clinical findings of irritation among chromium chemical production workers. Am J Ind.Med 2000;38(2):127-131. PubMed
    5. 42699. Xiang, J., Sun, Z., and Huan, J. N. Intensive chromic acid burns and acute chromium poisoning with acute renal failure. Chin Med.J.(Engl.) 7-5-2011;124(13):2071-2073.
    6. 42614. Hisatomi, K., Ishii, H., Hashiguchi, K., Seki, M., Ide, M., Sugiyama, K., Ishimoto, H., Nakayama, S., Mukae, H., and Kohno, S. Interstitial pneumonia caused by inhalation of fumes of nickel and chrome. Respirology. 2006;11(6):814-817. PubMed
  • Seizures Worth acting on Additional detail

    “Orally, chromium picolinate may cause headache, paresthesia, insomnia, dizziness, and vertigo. Vague cognitive symptoms, slowed thought processes, and difficulty driving occurred on three separate occasions in a healthy 35-year-old male after oral intake of chromium picolinate 200-400 mcg.”

    Chromium · Natural Medicines adverse-effect record, reported in cluster headache.

    6 sources cited
    1. 6860. Trent LK, Thieding-Cancel D. Effects of chromium picolinate on body composition. J Sports Med Phys Fitness 1995;35:273-80.
    2. 10309. Davidson JR, Abraham K, Connor KM, McLeod MN. Effectiveness of chromium in atypical depression: a placebo-controlled trial. Biol Psychiatry 2003;53:261-4.. PubMed
    3. 14325. Kleefstra N, Houweling ST, Jansman FG, et al. Chromium treatment has no effect in patients with poorly controlled, insulin-treated type 2 diabetes in an obese Western population: a randomized, double-blind, placebo-controlled trial. Diabetes Care 2006;29: PubMed
    4. 42594. Pittler, M. H. and Ernst, E. Dietary supplements for body-weight reduction: a systematic review. Am.J.Clin Nutr. 2004;79(4):529-536. PubMed
    5. 42751. Huszonek, J. Over-the-counter chromium picolinate. Am J Psychiatry 1993;150(10):1560-1561. PubMed
    6. 2659. McLeod MN, Gaynes BN, Golden RN. Chromium potentiation of antidepressant pharmacotherapy for dysthymic disorder in 5 patients. J Clin Psych 1999;60:237-40. PubMed
  • A low platelet count Worth acting on Additional detail

    “Anemia, hemolysis, and thrombocytopenia were reported in a 33 year-old female taking chromium picolinate 1200-2400 mcg daily for 4-5 months. The patient received supportive care, blood product transfusions, and hemodialysis and was stabilized and discharged a few days later. Lab values were normal at a one-year follow-up.”

    Chromium · Natural Medicines adverse-effect record, reported in anemia.

    1 source cited
    1. 554. Cerulli J, Grabe DW, Gauthier I, et al. Chromium picolinate toxicity. Ann Pharmacother 1998;32:428-31. PubMed
  • Kidney problems Worth acting on Additional detail

    “Orally, chromium picolinate has been associated with at least one report of chronic interstitial nephritis and two reports of acute tubular necrosis. Laboratory evidence suggests that chromium does not cause kidney tissue damage even after long-term, high-dose exposure; however, patient- or product-specific factors could potentially increase the risk of chromium-related kidney damage.”

    Chromium · Natural Medicines adverse-effect record, reported in burns.

    6 sources cited
    1. 554. Cerulli J, Grabe DW, Gauthier I, et al. Chromium picolinate toxicity. Ann Pharmacother 1998;32:428-31. PubMed
    2. 1951. Wasser WG, Feldman NS, D'Agati VD. Chronic renal failure after ingestion of over-the-counter chromium picolinate. [letter]. Ann Intern Med 1997;126:410. PubMed
    3. 14312. Wani S, Weskamp C, Marple J, Spry L. Acute tubular necrosis associated with chromium picolinate-containing dietary supplement. Ann Pharmacother 2006;40:563-6. PubMed
    4. 7135. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
    5. 11787. Mouser JF, Hak EB, Helms RA, et al. Chromium and zinc concentrations in pediatric patients receiving long-term parenteral nutrition. Am J Health Syst Pharm 1999;56:1950-6. PubMed
    6. 42699. Xiang, J., Sun, Z., and Huan, J. N. Intensive chromic acid burns and acute chromium poisoning with acute renal failure. Chin Med.J.(Engl.) 7-5-2011;124(13):2071-2073.
  • Anemia Worth acting on Additional detail

    Recorded for Chromium in the same Natural Medicines adverse-effect record shown under A low platelet count above.

  • Hives Worth acting on Additional detail

    “Orally, chromium-containing supplements may cause acute generalized exanthematous pustulosis, skin rashes, and urticaria. Also, chromium picolinate or chromium chloride may cause systemic contact dermatitis when taken orally, especially in patients with contact allergy to chromium.”

    Chromium · Natural Medicines adverse-effect record, reported in allergic rhinitis (hay fever).

    6 sources cited
    1. 42561. Young P, Turiansky G, Bonner M, and et al. Acute generalized exanthematous pustulosis induced by chromium picolinate. J.Am Acad.Dermatol. 1999;41(5 Pt 2):820-823. PubMed
    2. 42679. Krol, E., Krejpcio, Z., Byks, H., Bogdanski, P., and Pupek-Musialik, D. Effects of chromium brewer's yeast supplementation on body mass, blood carbohydrates, and lipids and minerals in type 2 diabetic patients. Biol.Trace Elem.Res. 2011;143(2):726-737.
    3. 17224. Yazaki Y, Faridi Z, Ma Y, et al. A pilot study of chromium picolinate for weight loss. J Altern Complement Med 2010;16:291-9. PubMed
    4. 6624. Fowler JF Jr. Systemic contact dermatitis caused by oral chromium picolinate. Cutis 2000;65:116. DOI
    5. 90058. De Marchi S, Cecchin E, De Marchi SU. Systemic allergic dermatitis resulting from oral administration of chromium with a food supplement. Contact Dermatitis 2014;70(2):123-5. PubMed
    6. 95096. Guimarães MM, Carvalho AC, Silva MS. Effect of chromium supplementation on the glucose homeostasis and anthropometry of type 2 diabetic patients: Double blind, randomized clinical trial: Chromium, glucose homeostasis and anthropometry. J Trace Elem Med Bi PubMed

Showing the 10 most notable of 29 recorded effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

Everything above comes from the Natural Medicines adverse-effect record for Chromium — expand a row for the licensed statement it rests on. We haven’t matched Amobarbital, Ephedrine Sulfate to its FDA label in our system yet, so we can’t compare its own side-effect list here — the leaflet that comes with your prescription is the authoritative list for Amobarbital, Ephedrine Sulfate.

Special populations

Chromium in Pregnancy & Breastfeeding

Pregnancy Likely Safe

When used orally and appropriately in amounts not exceeding adequate intake (AI) levels. The AI for pregnancy is 28 mcg daily for those 14-18 years of age and 30 mcg daily for those 19-50 years of age.

Pregnancy Possibly Safe

When used orally in amounts exceeding the adequate intake (AI) levels. There is some evidence that patients with gestational diabetes can safely use chromium in doses of 4-8 mcg/kg; however, patients should not take chromium supplements during pregnancy without medical supervision.

Lactation Likely Safe

When used orally and appropriately in amounts not exceeding adequate intake (AI) levels. The AI for lactation is 44 mcg daily for those 14-18 years of age and 45 mcg daily for those 19-50 years of age. Chromium supplements do not seem to increase normal chromium concentration in human breast milk. There is insufficient reliable information available about the safety of chromium when used in higher amounts while breast-feeding.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Everything else you take

See Every Supplement That Interacts With Amobarbital, Ephedrine Sulfate

This page covers Chromium only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amobarbital, Ephedrine Sulfate page lists 132 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Beer (major), Ephedra (major), Gamma-hydroxybutyrate (ghb) (major) and Kava (major).

By severity: 10 major · 110 moderate · 12 minor.

From our pharmacist’s overview on the Amobarbital, Ephedrine Sulfate page

“Ephedrine & Amytal pairs a barbiturate sedative, amobarbital, with the stimulant ephedrine, so the supplements that interact with it pull in two directions at once, and I would treat this list with genuine care. Ten of the 132 ingredients on file are rated major: alcohol and kava can deepen the sedation toward dangerously slowed breath…”

Reviewed by 2 · Jul 18, 2026

Open the Amobarbital, Ephedrine Sulfate interaction page

One more smart check

Taking Chromium as Part of a Dietary Supplement Product? Check It for Interactions

We hold 16,728 real supplement products containing Chromium, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Chromium. Even though Chromium itself has no known interaction with Amobarbital, Ephedrine Sulfate, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Chromium and Amobarbital, Ephedrine Sulfate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Chromium
Top 5%

#17 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Amobarbital, Ephedrine Sulfate
Top 25%

#469 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Chromium reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Chromium and Amobarbital, Ephedrine Sulfate records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Chromium

What is Chromium?

Chromium
  • Blood sugar support in type 2 diabetes
  • Weight loss and appetite control
  • Insulin sensitivity
  • Cholesterol and lipid support
  • General nutritional supplement

Chromium is an essential trace mineral involved in how the body handles sugar and fat. Some studies suggest it may modestly help blood sugar control in certain people with type 2 diabetes, but results are mixed and the effect on weight loss is small and uncertain. For most healthy people who eat a varied diet, supplements are not needed; check with your pharmacist or doctor before starting.

Trace mineral (not a plant) · Capsules, tablets, gummies; common salt forms include chromium picolinate, chromium chloride, and chromium polynicotinate

An interaction check asks whether these two react with each other — it does not ask whether Chromium is a good idea for someone in your situation. Here is what our Chromium record says about it on its own.

Chromium: dosing

There is no single agreed-upon "best" dose of chromium as a supplement, and needs vary from person to person. Health authorities describe general daily intake amounts for adults to prevent deficiency, but these are not the same as the higher doses sometimes used in studies.Because products and strengths differ, it is best to follow the directions on the product label and not exceed the recommended amount. They can help you decide if it is appropriate and at what dose.

From our Chromium monograph — the full record covers uses, side effects and every documented interaction.

Read the full Chromium monograph & all interactions
Keep checking

Other Drugs & Chromium

Browse every other medication we’ve checked against Chromium — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
89Moderate
89Minor
2,651No known interaction
89 Moderate 89 Minor 2,651 No interaction
Moderate

89 interactions

Showing 60 of 89 moderate interactions — see all 89 on the Chromium page.

Minor

89 interactions

Showing 60 of 89 minor interactions — see all 89 on the Chromium page.

No interaction 2,651 drugs checked — show the list

We also checked Chromium against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,651 medications checked with no known interaction — see the full Chromium list.

See the full Chromium interactions page
See every supplement checked against Amobarbital, Ephedrine Sulfate, ranked by severity
Evidence & sources

Chromium References

The 53 references that drive our Chromium monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Cerulli J, Grabe DW, Gauthier I, et al. Chromium picolinate toxicity. Ann Pharmacother 1998;32:428-31. PubMed
  2. Urberg M, Zemel MB. Evidence for synergism between chromium and nicotinic acid in the control of glucose tolerance in elderly humans. Metabolism 1987;36:896-9. PubMed
  3. Mohamedshah FY, Moser-Veillon PB, Yamini S, et al. Distribution of a stable isotope of chromium (53Cr) in serum, urine, and breast milk in lactating women. Am J Clin Nutr 1998;67:1250-5. PubMed
  4. Wasser WG, Feldman NS, D'Agati VD. Chronic renal failure after ingestion of over-the-counter chromium picolinate. [letter]. Ann Intern Med 1997;126:410. PubMed
  5. Mertz W. Interaction of chromium with insulin: a progress report. Nutr Rev 1998;56:174-7. PubMed
  6. Anderson RA. Chromium, glucose intolerance and diabetes. J Am Coll Nutr 1998;17:548-55. PubMed
  7. McLeod MN, Gaynes BN, Golden RN. Chromium potentiation of antidepressant pharmacotherapy for dysthymic disorder in 5 patients. J Clin Psych 1999;60:237-40. PubMed
  8. Fowler JF Jr. Systemic contact dermatitis caused by oral chromium picolinate. Cutis 2000;65:116. DOI
  9. Trent LK, Thieding-Cancel D. Effects of chromium picolinate on body composition. J Sports Med Phys Fitness 1995;35:273-80.
  10. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
  11. Rabinovitz H, Friedensohn A, Leibovitz A, et al. Effect of chromium supplementation on blood glucose and lipid levels in type 2 diabetes mellitus elderly patients. Int J Vitam Nutr Res 2004;74:178-82. PubMed
  12. Lanca S, Alves A, Vieira AI, et al. Chromium-induced toxic hepatitis. Eur J Intern Med 2002;13:518-20. PubMed
  13. Kockler DR, McCarthy MW, Lawson CL. Seizure activity and unresponsiveness after hydroxycut ingestion. Pharmacotherapy 2001;21:647-51.. PubMed
  14. Davidson JR, Abraham K, Connor KM, McLeod MN. Effectiveness of chromium in atypical depression: a placebo-controlled trial. Biol Psychiatry 2003;53:261-4.. PubMed
  15. Food Standards Agency. Medicines and Healthcare products Regulatory Agency (MHRA). Expert Group on Vitamins and Minerals. Available at: http://cot.food.gov.uk/sites/default/files/vitmin2003.pdf.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Chromium and Amobarbital, Ephedrine Sulfate Together: Common Questions

Is it safe to take Chromium with Amobarbital, Ephedrine Sulfate?
We do not list a known interaction between Chromium and Amobarbital, Ephedrine Sulfate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
How was the Chromium and Amobarbital, Ephedrine Sulfate combination checked?
Interactions in our licensed database are recorded against drug classes. Amobarbital, Ephedrine Sulfate is filed under 5 classifications, and Chromium has documented interactions with 5 drug classes — none of Amobarbital, Ephedrine Sulfate's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Chromium interact with any other medications?
Yes. Chromium has 178 documented drug interactions in our database — Amobarbital, Ephedrine Sulfate is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Amobarbital, Ephedrine Sulfate interact with any supplements?
Yes. Amobarbital, Ephedrine Sulfate has documented interactions with 132 supplements in our database — Chromium is not one of them. The Amobarbital, Ephedrine Sulfate interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Chromium monograph Uses, safety profile, and every drug interaction in one place Amobarbital, Ephedrine Sulfate supplement interactions Every supplement checked against Amobarbital, Ephedrine Sulfate, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 53 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Amobarbital, Ephedrine Sulfate and Chromium?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.