Drug & supplement interaction

Reishi Mushroom + Alectinib Hydrochloride

Alectinib Hydrochloride brand name: Alecensa.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Reishi Mushroom and Alectinib Hydrochloride 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. Additionally, although there is no interaction, the label for Alectinib Hydrochloride states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Reishi Mushroom and Alectinib Hydrochloride

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 Alectinib Hydrochloride and Reishi Mushroom 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.

Reishi Mushroom safety at a glance

Reishi Mushroom overall Use caution Generally well tolerated short-term, but long-term safety is not well studied.
Pregnancy Avoid Not enough safety data, so it is best avoided during pregnancy.
Breastfeeding Avoid Not enough safety data, so it is best avoided while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Alectinib Hydrochloride and Reishi Mushroom? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Alectinib Hydrochloride

Interactions in our licensed database are recorded against drug classes, not just single drug names. Alectinib Hydrochloride is filed under 3 classifications — photosensitizing drugs, hepatotoxic drugs, oral drugs. Reishi Mushroom has documented interactions with 3 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), antidiabetes drugs (moderate) and antihypertensive drugs (moderate) — and none of Alectinib Hydrochloride’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

Reishi Mushroom Does Interact With Other Medications

Reishi Mushroom has 375 moderate known drug interactions in our database — Alectinib Hydrochloride isn’t one of them. If you take anything else, check it against the full list below.

Moderate 375 No known interaction 2,455 (incl. Alectinib Hydrochloride)
Taking anything else?

Check Another of Your Medications Against Reishi Mushroom

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

What to actually watch for

No Interaction Found — But Data Suggests Reishi Mushroom and Alectinib Hydrochloride May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Liver problems Worth acting on Additional detail

    Reishi Mushroom

    “One case of hepatotoxicity and one case of fatal fulminant hepatitis have been reported in patients who had used reishi mushroom powder for 1-2 months. There is a case report of a 61-year-old male with hypereosinophilia associated with hepatic nodules following the use of reishi mushroom powder for about 2 months. Symptoms resolved after discontinuation of the product.”

    Reishi Mushroom · Natural Medicines adverse-effect record, reported in hepatitis.

    2 sources cited
    1. 70766. Wanmuang, H., Leopairut, J., Kositchaiwat, C., Wananukul, W., and Bunyaratvej, S. Fatal fulminant hepatitis associated with Ganoderma lucidum (Lingzhi) mushroom powder. J Med Assoc Thai. 2007;90(1):179-181.
    2. 108312. Kogure T, Koiwai A, Fukushi D, et al. Hypereosinophilia with hepatic nodule formation caused by Ganoderma lucidum. Intern Med 2021;60(24):3897-3903.

    Alectinib Hydrochloride

    Listed in the ADVERSE REACTIONS section of the FDA label for Alectinib Hydrochloride. Read the label on DailyMed ›

  • Stomach upset / Nausea Additional detail

    Reishi Mushroom

    “Orally, reishi mushroom can cause dryness of the mouth, throat, or nasal cavity, nausea, stomach upset, and, more rarely, diarrhea (12,70779,91438,108309).”

    Reishi Mushroom · Natural Medicines adverse-effect record, reported in diarrhea.

    4 sources cited
    1. 12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
    2. 70779. Jin, X., Ruiz, Beguerie J., Sze, D. M., and Chan, G. C. Ganoderma lucidum (Reishi mushroom) for cancer treatment. Cochrane.Database.Syst.Rev. 2012;6:CD007731.
    3. 91438. Zhao H, Zhang Q, Zhao L, Huang X, Wang J, Kang X. Spore Powder of Ganoderma lucidum Improves Cancer-Related Fatigue in Breast Cancer Patients Undergoing Endocrine Therapy: A Pilot Clinical Trial. Evid Based Complement Alternat Med. 2012;2012:809614.
    4. 108309. Pazzi F, Adsuar JC, Domínguez-Muñoz FJ, García-Gordillo MA, Gusi N, Collado-Mateo D. Ganoderma lucidum effects on mood and health-related quality of life in women with fibromyalgia. Healthcare (Basel) 2020;8(4):520. PubMed

    Alectinib Hydrochloride

    Listed in the ADVERSE REACTIONS section of the FDA label for Alectinib Hydrochloride. Read the label on DailyMed ›

  • A skin rash reported in 3.5% of FDA reports for Alectinib Hydrochloride Additional detail

    Reishi Mushroom

    “Orally, reishi mushroom can cause itching, rash, and other skin reactions (12,5479).”

    Reishi Mushroom · Natural Medicines adverse-effect record, reported in pruritus.

    2 sources cited
    1. 12. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
    2. 5479. Singh AB, Gupta SK, Pereira BM, Prakash D. Sensitization to Ganoderma lucidum in patients with respiratory allergy in India. Clin Exp Allergy 1995;25:440-7.

    Alectinib Hydrochloride

    Listed in the ADVERSE REACTIONS section of the FDA label for Alectinib Hydrochloride, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Diarrhea Additional detail

    Reishi Mushroom

    Recorded for Reishi Mushroom in the same Natural Medicines adverse-effect record shown under Stomach upset / Nausea above.

    Alectinib Hydrochloride

    Listed in the ADVERSE REACTIONS section of the FDA label for Alectinib Hydrochloride. Read the label on DailyMed ›

  • Headache Additional detail

    Reishi Mushroom

    “Orally, reishi mushroom can cause dizziness. Other rare symptoms include insomnia and headache.”

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

    3 sources cited
    1. 91438. Zhao H, Zhang Q, Zhao L, Huang X, Wang J, Kang X. Spore Powder of Ganoderma lucidum Improves Cancer-Related Fatigue in Breast Cancer Patients Undergoing Endocrine Therapy: A Pilot Clinical Trial. Evid Based Complement Alternat Med. 2012;2012:809614.
    2. 70776. Chu, T. T., Benzie, I. F., Lam, C. W., Fok, B. S., Lee, K. K., and Tomlinson, B. Study of potential cardioprotective effects of Ganoderma lucidum (Lingzhi): results of a controlled human intervention trial. Br.J.Nutr. 2012;107(7):1017-1027.
    3. 70779. Jin, X., Ruiz, Beguerie J., Sze, D. M., and Chan, G. C. Ganoderma lucidum (Reishi mushroom) for cancer treatment. Cochrane.Database.Syst.Rev. 2012;6:CD007731.

    Alectinib Hydrochloride

    Listed in the ADVERSE REACTIONS section of the FDA label for Alectinib Hydrochloride. Read the label on DailyMed ›

Reported for Reishi Mushroom but not commonly for Alectinib Hydrochloride: sore throat, a stuffy or runny nose, dry mouth and dizziness.

Effects for Alectinib Hydrochloride come from the ADVERSE REACTIONS section of its FDA label; effects for Reishi Mushroom come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 7,249 voluntary FDA FAERS reports for Alectinib Hydrochloride that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

How to take them

Some Alectinib Hydrochloride Products Have a Food Rule — Reishi Mushroom Should Not Break It

At least one FDA label for a product containing Alectinib Hydrochloride says to take it with food. If you take Reishi Mushroom on an empty stomach out of habit, keep them separate — and take Alectinib Hydrochloride with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Alectinib Hydrochloride products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Administer ALECENSA with food.

From the Dosage and Administration section of the FDA label we read for Alectinib Hydrochloride — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Overlapping uses

What Alectinib Hydrochloride Is Prescribed For, and What Reishi Mushroom Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Alectinib Hydrochloride is a prescription medicine with approved uses on its FDA label. Reishi Mushroom is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Alectinib Hydrochloride is prescribed for: Alecensa (alectinib) is used in adults with non-small cell lung cancer (NSCLC) whose tumors test positive for a gene change called ALK (anaplastic lymphoma kinase). An FDA-approved test must confirm this ALK positivity before treatment begins. Alecensa is approved for two situations: as an adjuvant treatment (treatment after surgery to remove the tumor) for patients whose tumors were at least 4 cm or had spread to nearby lymph nodes, and as a treatment for metastatic NSCLC — cancer that has spread beyond the lung to other parts of the body.

Reishi Mushroom has been studied for:

  • Lung cancer studied, not established Reishi Mushroom has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Reishi Mushroom for lung cancer

    Small clinical studies suggest that oral reishi mushroom does not reduce the size of lung tumors.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Alectinib Hydrochloride on your own; if you are taking Reishi Mushroom for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Alectinib Hydrochloride

This page covers Reishi Mushroom only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Alectinib Hydrochloride page lists 74 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Alfalfa (moderate).

By severity: 4 major · 60 moderate · 10 minor.

From our pharmacist’s overview on the Alectinib Hydrochloride page

“Alectinib (Alecensa) treats ALK-positive lung cancer, and because your liver already has to tolerate this drug, check this page before adding any supplement, not after. Of the 74 ingredients on file, 38 can add stress to the liver, and three of the four major-rated entries (beer, wine, and Siberian cocklebur) are the clearest examples…”

Reviewed by 2 · Jul 18, 2026

Open the Alectinib Hydrochloride interaction page

How much people look this up

Where Reishi Mushroom and Alectinib Hydrochloride 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 Reishi Mushroom
Top 10%

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

29 days ago today
Medication Alectinib Hydrochloride
Top half

#1,372 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 Reishi Mushroom reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Reishi Mushroom and Alectinib Hydrochloride records this page draws on were last updated July 10, 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 Reishi Mushroom

What is Reishi Mushroom?

Reishi Mushroom
  • Immune support
  • Fatigue and general well-being
  • Stress and sleep
  • Inflammation
  • Heart and cholesterol health

Reishi is a traditional Asian mushroom widely used to support the immune system and overall wellness. Human evidence for most of its claimed benefits is limited or low-quality, so it should not replace proven treatments. It is generally well tolerated for short-term use, but check with your pharmacist or doctor before starting, especially if you are pregnant, nursing, or take other medicines.

Ganoderma lucidum · Ganodermataceae · Fruiting body, mycelium, and spores · Capsules, tablets, powders, extracts, teas, and tinctures

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

Reishi Mushroom: dosing

There is no official standardized dose for reishi. Doses vary a lot depending on whether you use the whole mushroom, a powder, or a concentrated extract.The best approach is to follow the directions on the product label and not exceed them. A pharmacist can help you decide if a product and dose are appropriate for you. If you notice any side effects, stop and check with a healthcare professional.

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

Read the full Reishi Mushroom monograph & all interactions
Medication

About Alectinib

What Is Alectinib Used For?

Brand name: Alecensa

Alecensa (alectinib) is used in adults with non-small cell lung cancer (NSCLC) whose tumors test positive for a gene change called ALK (anaplastic lymphoma kinase). An FDA-approved test must confirm this ALK positivity before treatment begins.

Alecensa is approved for two situations: as an adjuvant treatment (treatment after surgery to remove the tumor) for patients whose tumors were at least 4 cm or had spread to nearby lymph nodes, and as a treatment for metastatic NSCLC — cancer that has spread beyond the lung to other parts of the body.

Most-Reported Side Effects for Alectinib Hydrochloride

From FAERS, the FDA’s public side-effect reporting system (7,249 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Fatigue 518 reports
Constipation 445 reports
Rash 257 reports
Dyspnea 234 reports
Disease progression 210 reports
See full Alectinib drug information
Keep checking

Other Drugs & Reishi Mushroom

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

0Major
375Moderate
0Minor
2,454No known interaction
375 Moderate 2,454 No interaction
Moderate

375 interactions

Showing 60 of 375 moderate interactions — see all 375 on the Reishi Mushroom page.

No interaction 2,454 drugs checked — show the list

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

Showing the 60 most looked-up of 2,454 medications checked with no known interaction — see the full Reishi Mushroom list.

See the full Reishi Mushroom interactions page
See every supplement checked against Alectinib Hydrochloride, ranked by severity
Evidence & sources

Reishi Mushroom References

The 17 references that drive our Reishi Mushroom 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. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Tao J, Feng KY. Experimental and clinical studies on inhibitory effect of ganoderma lucidum on platelet aggregation. J Tongji Med Univ 1990;10:240-3. PubMed
  3. Singh AB, Gupta SK, Pereira BM, Prakash D. Sensitization to Ganoderma lucidum in patients with respiratory allergy in India. Clin Exp Allergy 1995;25:440-7.
  4. Lee SY, Rhee HM. Cardiovascular effects of mycelium extract of Ganoderma lucidum: inhibition of sympathetic outflow as a mechanism of its hypotensive action. Chem Pharm Bull (Tokyo) 1990;38:1359-64. PubMed
  5. Kwok Y, Ng KFJ, Li, CCF, et al. A prospective, randomized, double-blind, placebo-controlled study of the platelet and global hemostatic effects of Ganoderma lucidum (Ling-Zhi) in healthy volunteers. Anesth Analg 2005;101:423-6. PubMed
  6. Wanmuang, H., Leopairut, J., Kositchaiwat, C., Wananukul, W., and Bunyaratvej, S. Fatal fulminant hepatitis associated with Ganoderma lucidum (Lingzhi) mushroom powder. J Med Assoc Thai. 2007;90(1):179-181.
  7. Seto, S. W., Lam, T. Y., Tam, H. L., Au, A. L., Chan, S. W., Wu, J. H., Yu, P. H., Leung, G. P., Ngai, S. M., Yeung, J. H., Leung, P. S., Lee, S. M., and Kwan, Y. W. Novel hypoglycemic effects of Ganoderma lucidum water-extract in obese/diabetic (+db/+db
  8. Chu, T. T., Benzie, I. F., Lam, C. W., Fok, B. S., Lee, K. K., and Tomlinson, B. Study of potential cardioprotective effects of Ganoderma lucidum (Lingzhi): results of a controlled human intervention trial. Br.J.Nutr. 2012;107(7):1017-1027.
  9. Jin, X., Ruiz, Beguerie J., Sze, D. M., and Chan, G. C. Ganoderma lucidum (Reishi mushroom) for cancer treatment. Cochrane.Database.Syst.Rev. 2012;6:CD007731.
  10. Kabir, Y., Kimura, S., and Tamura, T. Dietary effect of Ganoderma lucidum mushroom on blood pressure and lipid levels in spontaneously hypertensive rats (SHR). J Nutr Sci Vitaminol.(Tokyo) 1988;34(4):433-438. PubMed
  11. Kanmatsuse, K., Kajiwara, N., Hayashi, K., Shimogaichi, S., Fukinbara, I., Ishikawa, H., and Tamura, T. [Studies on Ganoderma lucidum. I. Efficacy against hypertension and side effects]. Yakugaku Zasshi 1985;105(10):942-947. PubMed
  12. Gao, Y., Lan, J., Dai, X., Ye, J., and Zhou, S. A Phase I/II Study of Ling Zhi Mushroom Ganoderma lucidum(W.Curt: Fr.) Lloyd (Aphyllophoromycetideae) Extract in Patients with Type II Diabetes Mellitus. International Journal of Medicinal Mushrooms 2004;6. DOI
  13. Jin H, Zhang G, Cao X, and et al. Treatment of hypertension by linzhi combined with hypotensor and its effects on arterial, arteriolar and capillary pressure and microcirculation. In: Niimi H, Xiu RJ, Sawada T, and et al. Microcirculatory Approach to Asi
  14. Klupp NL, Chang D, Hawke F, Kiat H, Cao H, Grant SJ, Bensoussan A. Ganoderma lucidum mushroom for the treatment of cardiovascular risk factors. Cochrane Database Syst Rev. 2015 Feb 17;2:CD007259. PubMed
  15. Zhao H, Zhang Q, Zhao L, Huang X, Wang J, Kang X. Spore Powder of Ganoderma lucidum Improves Cancer-Related Fatigue in Breast Cancer Patients Undergoing Endocrine Therapy: A Pilot Clinical Trial. Evid Based Complement Alternat Med. 2012;2012:809614.

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 Reishi Mushroom and Alectinib Hydrochloride Together: Common Questions

Is it safe to take Reishi Mushroom with Alectinib Hydrochloride?
We do not list a known interaction between Reishi Mushroom and Alectinib Hydrochloride. 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.
Do Reishi Mushroom and Alectinib Hydrochloride have any of the same side effects?
Yes — our sources link each of them separately to 6 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Reishi Mushroom and Alectinib Hydrochloride at the same time of day?
At least one FDA label for a product containing Alectinib Hydrochloride says to take it with food. If you take Reishi Mushroom on an empty stomach out of habit, keep them separate and take Alectinib Hydrochloride with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Alectinib Hydrochloride products can differ — so check the directions on your own box. This is about absorption, not an interaction.
Are Reishi Mushroom and Alectinib Hydrochloride used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Reishi Mushroom in each. That is a conversation for your prescriber, especially if Alectinib Hydrochloride is being adjusted to a target.
How was the Reishi Mushroom and Alectinib Hydrochloride combination checked?
Interactions in our licensed database are recorded against drug classes. Alectinib Hydrochloride is filed under 3 classifications, and Reishi Mushroom has documented interactions with 3 drug classes — none of Alectinib Hydrochloride'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 Reishi Mushroom interact with any other medications?
Yes. Reishi Mushroom has 375 documented drug interactions in our database — Alectinib Hydrochloride 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 Alectinib Hydrochloride interact with any supplements?
Yes. Alectinib Hydrochloride has documented interactions with 74 supplements in our database — Reishi Mushroom is not one of them. The Alectinib Hydrochloride 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

Reishi Mushroom monograph Uses, safety profile, and every drug interaction in one place Alectinib drug information The full plain-English guide to this medication Alectinib Hydrochloride supplement interactions Every supplement checked against Alectinib Hydrochloride, 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 17 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Alectinib Hydrochloride and Reishi Mushroom?

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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.