Naturalean with 7-Keto Ingredients & Drug Interactions
by Enzymatic Therapy
What is this page for?
First and foremost: checking Naturalean with 7-Keto against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Naturalean with 7-Keto is a dietary supplement by Enzymatic Therapy with 8 active ingredients. Its ingredients are commonly taken for mental focus and alertness, coping with stress, fatigue and sleep loss.Based on those ingredients, 318 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Inositol, Manganese, Asparagus (Asparagus officinalis) rhizome extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Naturalean with 7-Keto by Enzymatic Therapy
Ask about any prescription or over-the-counter medication and we check it for interactions with Naturalean with 7-Keto by Enzymatic Therapy — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Naturalean with 7-Keto by Enzymatic Therapy
Four independent checks of what is known — a summary of the available information, not a grade of the product itself.
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
The stated purpose hasn't been mapped to our evidence data yet.
Why this rating?
- We haven't mapped this product's purpose to our evidence data yet — it'll be graded on the next content refresh.
Every active ingredient lists its own amount on the label.
Why this rating?
- The label discloses an exact amount for 8 of its 8 active ingredients.
- No proprietary blends here — you can verify the dose of every single component.
The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.
Why this rating?
- 7 of the 8 matched ingredients can interact with medications — Iodine, Manganese, Asparagus, Inositol, Choline, among others.
- The most serious interaction on file is rated Moderate.
- Some involve high-stakes drug classes: diabetes medications; lithium; Parkinson's medications.
- For scale: 318 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.
Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.
Why this rating?
- We hold adverse-effect (side-effect) data for 8 of the 8 matched ingredients.
- Pregnancy & breastfeeding safety ratings cover 8 of 8.
- General safety write-ups exist for 8 of 8.
- Remember: this measures how much safety information exists. Thin data is not the same as being safe.
HelloPharmacist summaryFully disclosed formula with no assessable stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
Assessment coverage: 8 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2013.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Naturalean with 7-Keto, straight from the product label.
| Brand | Enzymatic Therapy |
|---|---|
| Net contents | 30 Capsule(s) |
| Market status | Off market |
| Date entered into DSLD | Sep 25, 2013 |
| DSLD ID | 25312 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Naturalean with 7-Keto by Enzymatic Therapy, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| L-Tyrosine | 100 mg | -- |
| Inositol | 50 mg | -- |
| Choline Bitartrate | 50 mg | -- |
| Iodine | 100 mcg | 67% |
| 7-Keto DHEA Acetate | 100 mg | -- |
| Copper | 500 mcg | 25% |
| Manganese | 500 mcg | 25% |
| Asparagus (Asparagus officinalis) rhizome extract | 100 mg | -- |
Other ingredients: Vegetable Capsule, Magnesium Stearate, Silicon Dioxide
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Brand IP Statement(s)
With a sensible diet and regular exercise, the 7-KETO in Naturalean with 7-KETO(R) accelerates the loss of body fat while maintaining muscle tissue integrity.
7-KETO(R) is a registered trademark of Humanetics Corporation.
General Statements
Burns fat, not muscle
WEIGHT LOSS
ETI is an FDA-registered Drug Establishment.
This product contains natural ingredients; color variations are normal.
Naturally increase your metabolism Naturalean with 7-Keto dietary supplement: ~Burns fat, not muscle, and promotes long-lasting weight loss. ~Not a stimulant; won't keep you awake at night. ~7-Keto is an improved metabolite of DHEA combined with 7 other ingredients to support thyroid function and metabolism. DHEA is an important adrenal hormone. DHEA levels tend to decline with aging and adrenal stress. Naturalean with 7-KETO contains high quality micronized DHEA for enhanced absorption and bioavailability.
Safe, Natural, Significant Weight Loss ~No Crash Diets or Artificial Stimulants ~Not an Appetite Suppressant ~Clinically Shown to Burn Fat and Promote Weight Loss
Clinically-studied 7-KETO is an improved, safe metabolite of DHEA.
FDA Statement of Identity
DIETARY SUPPLEMENT
FDA Disclaimer Statement
THIS STATEMENT HAS NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION. THIS PRODUCT IS NOT INTENDED TO DIAGNOSE, TREAT, CURE, OR PREVENT ANY DISEASE.
Suggested/Recommended/Usage/Directions
Recommendations: One or two capsules daily.
Precautions
If pregnant, nursing, or taking prescription drugs, consult your healthcare practitioner prior to use.
Formulation
Contains no sugar, salt, yeast, wheat, gluten, corn, soy, dairy products, artificial coloring, artificial flavoring, or preservatives.
Seals/Symbols
LABORATORY TESTED PURITY, SAFETY & PERFORMANCE
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Naturalean with 7-Keto by Enzymatic Therapy label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Naturalean with 7-Keto by Enzymatic Therapy
These are the 8 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
L-Tyrosine
Interacts with21 drugs
L-tyrosine is an amino acid your body uses to make brain chemicals like dopamine and norepinephrine. Some studies suggest it may help mental performan...
L-Tyrosine monograph & interactionsInositol
Interacts with86 drugs
Inositol is a sugar alcohol made naturally in the body and found in many foods, and it is sold as a supplement (often myo-inositol) mainly for PCOS, m...
Inositol monograph & interactionsCholine Bitartrate
Interacts with16 drugs
Choline is an essential nutrient your body needs for liver function, brain health, and nerve signaling, and many people get enough from foods like egg...
Choline Bitartrate monograph & interactionsIodine
Interacts with7 drugs
Iodine is an essential mineral your body needs to make thyroid hormones, and most people get enough from iodized salt, dairy, and seafood. Supplements...
Iodine monograph & interactions7-Keto DHEA Acetate
No knowninteractions
7-keto-DHEA is a lab-made metabolite of the hormone DHEA that is marketed mainly for weight loss and a faster metabolism. Unlike DHEA, it is not thoug...
7-Keto DHEA Acetate monograph & interactionsCopper
Interacts with31 drugs
Copper is an essential trace mineral your body needs in small amounts for making red blood cells, supporting nerves and bones, and helping enzymes wor...
Copper monograph & interactionsManganese
Interacts with83 drugs
Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get...
Manganese monograph & interactionsAsparagus (Asparagus officinalis) rhizome extract
Interacts with76 drugs
Asparagus is a nutritious vegetable that is safe and healthy to eat as part of a normal diet. Most of its claimed medicinal benefits, such as use as a...
Asparagus (Asparagus officinalis) rhizome extract monograph & interactionsOther (inactive) ingredients: Vegetable Capsule, Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.
Naturalean with 7-Keto by Enzymatic Therapy Drug Interactions
Naturalean with 7-Keto contains 8 ingredients, and 7 of them have known drug interactions. Altogether they interact with 318 medications. Here’s the picture, then you can look up your own drug.
Want to check YOUR meds against Naturalean with 7-Keto?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Naturalean with 7-Keto interact with 318 drugs. Click any drug to see the details.
7 of the 8 ingredients in Naturalean with 7-Keto interact with drugs. Each result below shows which ingredient is responsible. Inositol Manganese Asparagus (Asparagus officinalis) rhizome extract Copper L-Tyrosine Choline Bitartrate Iodine
AcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
InositolAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Inositol + Acarbose interactionAcepromazineAtravet
How Acepromazine interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
ManganeseAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Read the full Manganese + Acepromazine interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Pamabrom, PyrilamineMidol Max Strength PMS, Pamprin, Pamprin ES
How Acetaminophen, Pamabrom, Pyrilamine interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Acetaminophen, Pamabrom, Pyrilamine interactionAcetazolamideAk-Zol, Diamox
How Acetazolamide interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Acetazolamide interactionAcetohexamideDymelor
How Acetohexamide interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
InositolAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Inositol + Acetohexamide interactionAcetophenazineTindal
How Acetophenazine interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
ManganeseAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Read the full Manganese + Acetophenazine interactionAlbiglutideTanzeum
How Albiglutide interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
InositolAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Inositol + Albiglutide interactionAlogliptinNesina
How Alogliptin interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
InositolAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Inositol + Alogliptin interactionAlogliptin, MetforminKazano
How Alogliptin, Metformin interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
InositolAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Inositol + Alogliptin, Metformin interactionAlogliptin, PioglitazoneOseni
How Alogliptin, Pioglitazone interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
InositolAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Inositol + Alogliptin, Pioglitazone interactionAmiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
How Amiloride, Hydrochlorothiazide interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Amiloride, Hydrochlorothiazide interactionAmiodaroneCordarone, Pacerone
How Amiodarone interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
IodineAmiodarone (cordarone) Moderate
Interaction Summary
Combining iodine with amiodarone might cause excessively high iodine levels.
Read the full Iodine + Amiodarone interactionAmitriptyline, PerphenazineEtrafon, Etrafon-A, Etrafon-Forte, Triavil
How Amitriptyline, Perphenazine interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
ManganeseAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Read the full Manganese + Amitriptyline, Perphenazine interactionAmmonium ChlorideAmmonium Chloride
How Ammonium Chloride interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Ammonium Chloride interactionAmphotericin, TetracyclineMysteclin-F
How Amphotericin, Tetracycline interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
ManganeseTetracycline Antibiotics Moderate
Interaction Summary
Theoretically, manganese might reduce the absorption of tetracycline antibiotics.
Read the full Manganese + Amphotericin, Tetracycline interactionAntidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) InhibitorGlyxambi
How Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
InositolAntidiabetes Drugs Moderate
Interaction Summary
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Read the full Inositol + Antidiabetes, Dipeptidyl Peptidase-4 (dpp-iv) Inhibitor interactionAripiprazoleAbilify, Abilify Maintena, Abilify Mycite
How Aripiprazole interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
ManganeseAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Read the full Manganese + Aripiprazole interactionAripiprazole LauroxilAristada, Aristada Initio Kit
How Aripiprazole Lauroxil interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
ManganeseAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Read the full Manganese + Aripiprazole Lauroxil interactionAsenapineSaphris, Secuado
How Asenapine interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
ManganeseAntipsychotic Drugs Moderate
Interaction Summary
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Read the full Manganese + Asenapine interactionAtenolol, ChlortalidoneAtenixCo, Tenoret 50, Totaretic
How Atenolol, Chlortalidone interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Atenolol, Chlortalidone interactionAtenolol, ChlorthalidoneTenoretic
How Atenolol, Chlorthalidone interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Atenolol, Chlorthalidone interactionAzilsartan, ChlorthalidoneEdarbyclor
How Azilsartan, Chlorthalidone interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Azilsartan, Chlorthalidone interactionBenazepril, HydrochlorothiazideLotensin HCT
How Benazepril, Hydrochlorothiazide interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Benazepril, Hydrochlorothiazide interactionBendroflumethiazideAprinox, Naturetin, Neo-NaClex
How Bendroflumethiazide interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Bendroflumethiazide interactionBendroflumethiazide, NadololCorzide
How Bendroflumethiazide, Nadolol interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Bendroflumethiazide, Nadolol interactionBendroflumethiazide, PotassiumCentyl K, Neo-NaClex-K
How Bendroflumethiazide, Potassium interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Bendroflumethiazide, Potassium interactionBendroflumethiazide, Rauwolfia SerpentinaRauzide
How Bendroflumethiazide, Rauwolfia Serpentina interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Bendroflumethiazide, Rauwolfia Serpentina interactionBenserazide, LevodopaMadopar, Prolopa
How Benserazide, Levodopa interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
L-tyrosineLevodopa Moderate
Interaction Summary
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Read the full L-tyrosine + Benserazide, Levodopa interactionBenzthiazideExna
How Benzthiazide interacts with Naturalean with 7-Keto — through 1 ingredient. Tap an ingredient for the detail:
Asparagus (asparagus Officinalis) Rhizome ExtractDiuretic Drugs Moderate
Interaction Summary
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Read the full Asparagus (asparagus Officinalis) Rhizome Extract + Benzthiazide interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Naturalean with 7-Keto with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Inositol
Antidiabetes Drugs
Theoretically, taking inositol with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that inositol lowers blood glucose levels and glycated hemoglobin (HbA1c) levels in patients with diabetes.
Manganese
Antipsychotic Drugs
Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Hallucinations and behavioral changes have been reported in a patient with liver disease who was taking haloperidol and manganese. Researchers speculate that taking manganese along with haloperidol, phenothiazine-derivatives, or other antipsychotic medications might increase the risk of manganese toxicity in some patients.
Quinolone Antibiotics
Theoretically, manganese might reduce the absorption of quinolone antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced quinolone absorption have been reported between quinolones and other multivalent cations, such as calcium and iron.
Tetracycline Antibiotics
Theoretically, manganese might reduce the absorption of tetracycline antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced tetracycline absorption have been reported between tetracyclines and other multivalent cations, such as calcium and iron.
Asparagus (Asparagus officinalis) rhizome extract
Diuretic Drugs
Theoretically, asparagus root might increase diuresis and electrolyte loss when used with diuretic drugs.
Animal studies show that asparagus root extracts have diuretic effects. This effect has not been reported in humans.
Lithium
Theoretically, asparagus root might cause diuresis, reducing lithium clearance.
Animal studies show that asparagus root extracts have diuretic effects. Theoretically, this might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
Copper
Penicillamine (Cuprimine, Depen)
Theoretically, taking copper with penicillamine might decrease the absorption of penicillamine; separate dosing by at least 2 hours.
Copper chelates penicillamine, which decreases its absorption and may reduce its clinical effects.
Contraceptive Drugs
Theoretically, taking copper with contraceptive drugs might increase the levels and toxic effects of copper.
A meta-analysis of clinical studies suggests that chronic use of oral contraceptives increases serum copper levels by a mean of 57 mcg/dL. In most people, this resulted in levels above the normal reference range for copper.
L-Tyrosine
Levodopa
Theoretically, tyrosine might decrease the effectiveness of levodopa.
Tyrosine and levodopa compete for absorption in the proximal duodenum by the large neutral amino acid (LNAA) transport system. Advise patients to separate doses of tyrosine and levodopa by at least 2 hours.
Thyroid Hormone
Theoretically, tyrosine might have additive effects with thyroid hormone medications.
Tyrosine is a precursor to thyroxine and might increase levels of thyroid hormones.
Choline Bitartrate
Atropine
Theoretically, choline might decrease the effects of atropine in the brain.
Animal research shows that administering choline one hour before administering atropine can attenuate atropine-induced decreases in brain levels of acetylcholine. Theoretically, concomitant use of choline and atropine may decrease the effects of atropine.
Iodine
Amiodarone (Cordarone)
Combining iodine with amiodarone might cause excessively high iodine levels.
Amiodarone contains 37.3% iodine and can increase iodine levels. Concomitant use with iodine might increase the risk of having excessive iodine levels and adversely affecting thyroid function. Monitor thyroid function.
Antithyroid Drugs
Iodine might alter the effects of antithyroid drugs.
Iodine in high doses has been reported to cause both hyperthyroidism and hypothyroidism, depending on the individual's past medical history. Taking iodine while using antithyroid drugs could alter the effects of the antithyroid drugs.
Lithium
Combining iodine with lithium might have additive hypothyroid effects.
Lithium can inhibit thyroid function. Several case reports suggest that concomitant use of lithium and potassium iodide can reduce thyroid function in otherwise healthy adults. Monitor thyroid function.
Brand information
Manufacturer and brand details for Naturalean with 7-Keto, from the product label.
Enzymatic Therapy
- Name
- Enzymatic Therapy, Inc.
- City
- Green Bay
- State
- WI
- ZipCode
- 54311
- Phone Number
- 1-800-783-2286
- Web Address
- enzy.com
Naturalean with 7-Keto by Enzymatic Therapy: Common Questions
Does Naturalean with 7-Keto by Enzymatic Therapy interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Not sure if Naturalean with 7-Keto is safe with your meds?
Our pharmacists answer your medication & supplement questions — free.
Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.
The Full Monographs Behind Naturalean with 7-Keto’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Tyrosine
Interacts with 21 drugsL-tyrosine is an amino acid your body uses to make brain chemicals like dopamine and norepinephrine. Some studies suggest it may help mental performance during short-term stress, sleep loss,...
Read the full Tyrosine monograph → Herb & supplement monographInositol
Interacts with 86 drugsInositol is a sugar alcohol made naturally in the body and found in many foods, and it is sold as a supplement (often myo-inositol) mainly for PCOS, mood, and metabolic concerns. The stronge...
Read the full Inositol monograph → Herb & supplement monographCholine
Interacts with 16 drugsCholine is an essential nutrient your body needs for liver function, brain health, and nerve signaling, and many people get enough from foods like eggs, meat, and fish. Supplements may help...
Read the full Choline monograph → Herb & supplement monographIodine
Interacts with 7 drugsIodine is an essential mineral your body needs to make thyroid hormones, and most people get enough from iodized salt, dairy, and seafood. Supplements help when you are truly deficient, but...
Read the full Iodine monograph → Herb & supplement monograph7-keto-dhea
7-keto-DHEA is a lab-made metabolite of the hormone DHEA that is marketed mainly for weight loss and a faster metabolism. Unlike DHEA, it is not thought to convert into estrogen or testoster...
Read the full 7-keto-dhea monograph → Herb & supplement monographCopper
Interacts with 31 drugsCopper is an essential trace mineral your body needs in small amounts for making red blood cells, supporting nerves and bones, and helping enzymes work. Most people get enough copper from fo...
Read the full Copper monograph → Herb & supplement monographManganese
Interacts with 83 drugsManganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get enough from a normal diet. Supplements m...
Read the full Manganese monograph → Herb & supplement monographAsparagus
Interacts with 76 drugsAsparagus is a nutritious vegetable that is safe and healthy to eat as part of a normal diet. Most of its claimed medicinal benefits, such as use as a diuretic or for urinary health, come fr...
Read the full Asparagus monograph →Sources & How We Checked
Naturalean with 7-Keto's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 106 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Tyrosine 4 references
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- van Spronsen FJ, van Rijn M, Bekhof J. Phenylketonuria: tyrosine supplementation in phenylalanine-restricted diets. Am J Clin Nutr 2001;73:153-7. PubMed
Inositol 14 references
- Palatnik A, Frolov K, Fux M, Benjamin J. Double-blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorder. J Clin Psychopharmacol 2001;21:335-9.. PubMed
- Allan SJ, Kavanagh GM, Herd RM, Savin JA. The effect of inositol supplements on the psoriasis of patients taking lithium: a randomized, placebo-controlled trial. Br J Dermatol 2004;150:966-9. PubMed
- Machado-Vieira R, Viale CI, Kapczinski F. Mania associated with an energy drink: the possible role of caffeine, taurine, and inositol. Can J Psychiatry 2001;46:454-5. PubMed
- Kamenov Z, Kolarov G, Gateva A, Carlomagno G, Genazzani AD. Ovulation induction with myo-inositol alone and in combination with clomiphene citrate in polycystic ovarian syndrome patients with insulin resistance. Gynecol Endocrinol 2015;31(2):131-5. PubMed
- Matarrelli B, Vitacolonna E, D'Angelo M, et al. Effect of dietary myo-inositol supplementation in pregnancy on the incidence of maternal gestational diabetes mellitus and fetal outcomes: a randomized controlled trial. J Matern Fetal Neonatal Med 2013;26(1 PubMed
- Mukai T, Kishi T, Matsuda Y, Iwata N. A meta-analysis of inositol for depression and anxiety disorders. Hum Psychopharmacol 2014;29(1):55-63. PubMed
- Farren M, Daly N, McKeating A, Kinsley B, Turner MJ, Daly S. The Prevention of Gestational Diabetes Mellitus With Antenatal Oral Inositol Supplementation: A Randomized Controlled Trial. Diabetes Care. 2017;40(6):759-63. PubMed
- Zheng X, Liu Z, Zhang Y, et al. Relationship Between Myo-Inositol Supplementary and Gestational Diabetes Mellitus: A Meta-Analysis. Medicine (Baltimore). 2015;94(42):e1604. PubMed
- Crawford TJ, Crowther CA, Alsweiler J, Brown J. Antenatal dietary supplementation with myo-inositol in women during pregnancy for preventing gestational diabetes. Cochrane Database Syst Rev. 2015;(12):CD011507. PubMed
- Maurizi AR, Menduni M, Del Toro R, et al. A pilot study of D-chiro-inositol plus folic acid in overweight patients with type 1 diabetes. Acta Diabetol. 2017;54(4):361-65. PubMed
- Leppink EW, Redden SA, Grant JE. A double-blind, placebo-controlled study of inositol in trichotillomania. Int Clin Psychopharmacol. 2017;32(2):107-14. PubMed
- Lam S, Mandrekar SJ, Gesthalter Y. A Randomized Phase IIb Trial of myo-Inositol in Smokers with Bronchial Dysplasia. Cancer Prev Res (Phila). 2016;9(12):906-14.
- Wozniak J, Faraone SV, Chan J, et al. A randomized clinical trial of high eicosapentaenoic acid omega-3 fatty acids and inositol as monotherapy and in combination in the treatment of pediatric bipolar spectrum disorders: a pilot study. J Clin Psychiatry. PubMed
- Vitale SG, Corrado F, Caruso S, et al. Myo-inositol supplementation to prevent gestational diabetes in overweight non-obese women: bioelectrical impedance analysis, metabolic aspects, obstetric and neonatal outcomes - a randomized and open-label, placebo-
Choline 14 references
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- Cho E, Willett WC, Colditz GA, et al. Dietary choline and betaine and the risk of distal colorectal adenoma in women. J Natl Cancer Inst 2007;99:1224-31. PubMed
- Schmidt, C., Abicht, A., Krampfl, K., Voss, W., Stucka, R., Mildner, G., Petrova, S., Schara, U., Mortier, W., Bufler, J., Huebner, A., and Lochmuller, H. Congenital myasthenic syndrome due to a novel missense mutation in the gene encoding choline acetyl
- Tamminga, C., Smith, R. C., Chang, S., Haraszti, J. S., and Davis, J. M. Depression associated with oral choline. Lancet 10-23-1976;2(7991):905. PubMed
- Wood, J. L. and Allison, R. G. Effects of consumption of choline and lecithin on neurological and cardiovascular systems. Fed.Proc. 1982;41(14):3015-3021.
- Growdon, J. H. and Gelenberg, A. J. Choline and lecithin administration to patients with tardive dyskinesia. Trans.Am.Neurol.Assoc. 1978;103:95-99.
- Smith, C. M., Swash, M., Exton-Smith, A. N., Phillips, M. J., Overstall, P. W., Piper, M. E., and Bailey, M. R. Choline therapy in Alzheimer's disease. Lancet 8-5-1978;2(8084):318. PubMed
- Morrison, L. M. and W. F. Gonzales. Choline in coronary atherosclerosis. Amer.Heart J. 1950;39:729.
- Christie, J. G. Blackburn 1. M. Glen A. I. M. Zeisel S. Shering A. & Yates C. M. Effects of choline and lecithin on CSF choline levels and on cognitive functioning in patients with presenile dementia of the Alzheimer type. Nutrition and the brain 1979;5
- Sidhu N, Davies S, Nadarajah A, et al. Oral choline supplementation for postoperative pain. Br J Anaesth 2013;111(2):249-55. PubMed
- Wozniak JR, Fuglestad AJ, Eckerle JK, et al. Choline supplementation in children with fetal alcohol spectrum disorders has high feasibility and tolerability. Nutr Res. 2013;33(11):897-904. PubMed
- Wozniak JR, Fuglestad AJ, Eckerle JK, et al. Choline supplementation in children with fetal alcohol disorders: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2015;102(5): 1113-25.
- Ross RG, Hunter SK, McCarthy L, et al. Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk. Am J Psychiatry. 2013;170(3):290-8. PubMed
- Food and Nutrition Board, Institute of Medicine. Choline. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B-6, Vitamin B-12, Pantothenic Acid, Biotin, and Choline. Washington D.C.: National Academy Press; 1998:390-422.
Iodine 26 references
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- Goodman GA, Rall TW, Nies AS, Taylor P. The Pharmacological Basis of Therapeutics, 9th ed.
- Ghent WR, Eskin BA, Low DA, Hill LP. Iodine replacement in fibrocystic disease of the breast. Can J Surg 1993;36:453-60.
- Potassium iodide for nuclear exposure. Pharmacist's Letter/Prescriber's Letter 2001;17(12):171214.
- 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.
- Cabezas C, Bustamante B, Holgado W, Begue RE. Treatment of cutaneous sporotrichosis with one daily dose of potassium iodide. Pediatr Infect Dis J 1996;15:352-4. PubMed
- Sterling JB, Heymann WR. Potassium iodide in dermatology: a 19th century drug for the 21st century-uses, pharmacology, adverse effects, and contraindications. J Am Acad Dermatol 2000;43:691-7. PubMed
- Yarrington CD, Pearce EN. Dietary iodine in pregnancy and postpartum. Clin Obstet Gynecol 2011;54:459-70. PubMed
- Goel, S., Mandhani, A., Srivastava, A., Kapoor, R., Gogoi, S., Kumar, A., and Bhandari, M. Is povidone iodine an alternative to silver nitrate for renal pelvic instillation sclerotherapy in chyluria? BJU.Int 2004;94(7):1082-1085. PubMed
- Teng, W., Shan, Z., Teng, X., Guan, H., Li, Y., Teng, D., Jin, Y., Yu, X., Fan, C., Chong, W., Yang, F., Dai, H., Yu, Y., Li, J., Chen, Y., Zhao, D., Shi, X., Hu, F., Mao, J., Gu, X., Yang, R., Tong, Y., Wang, W., Gao, T., and Li, C. Effect of iodine int
- Crawford, B. A., Cowell, C. T., Emder, P. J., Learoyd, D. L., Chua, E. L., Sinn, J., and Jack, M. M. Iodine toxicity from soy milk and seaweed ingestion is associated with serious thyroid dysfunction. Med J Aust. 10-4-2010;193(7):413-415. PubMed
- Ohkuma, M. Molluscum contagiosum treated with iodine solution and salicylic acid plaster. Int J Dermatol. 1990;29(6):443-445. PubMed
- Connelly KJ, Boston BA, Pearce EN, Sesser D, Snyder D, Braverman LE, Pino S, LaFranchi SH. Congenital hypothyroidism caused by excess prenatal maternal iodine ingestion. J Pediatr. 2012 Oct;161(4):760-2. PubMed
- Kasahara T, Narumi S, Okasora K, Takaya R, Tamai H, Hasegawa T. Delayed onset congenital hypothyroidism in a patient with DUOX2 mutations and maternal iodine excess. Am J Med Genet A. 2013 Jan;161A(1):214-7.
- Murcia M, Rebagliato M, Iñiguez C, Lopez-Espinosa MJ, Estarlich M, Plaza B, Barona-Vilar C, Espada M, Vioque J, Ballester F. Effect of iodine supplementation during pregnancy on infant neurodevelopment at 1 year of age. Am J Epidemiol. 2011 Apr 1;173(7):8 PubMed
- Sang Z, Wang PP, Yao Z, Shen J, Halfyard B, Tan L, Zhao N, Wu Y, Gao S, Tan J, Liu J, Chen Z, Zhang W. Exploration of the safe upper level of iodine intake in euthyroid Chinese adults: a randomized double-blind trial. Am J Clin Nutr. 2012 Feb;95(2):367-73 PubMed
- Speeckaert MM, Speeckaert R, Wierckx K, Delanghe JR, Kaufman JM. Value and pitfalls in iodine fortification and supplementation in the 21st century. Br J Nutr. 2011 Oct;106(7):964-73. PubMed
- Yun SE, Kang Y, Bae EJ, Hwang K, Jang HN, Cho HS, Chang SH, Park DJ. Iodine-induced thyrotoxic hypokalemic paralysis after ingestion of Salicornia herbace. Ren Fail. 2014 Apr;36(3):461-3.
- Iodine Hypersensitivity. Pharmacist's Letter/Prescriber's Letter 2011; 27(5):270504.
- Hammel JA, Selby JC. Pustular eruption in a patient with cancer treated with complementary and alternative medicine. JAMA Dermatology 2017 October; E1. doi: 10.1001/jamadermatol.2017.3749. [Epub ahead of print] PubMed
- Gil GS, Smith BW, Guerra JR, Williams WT. Acute Delirium in a Hypothyroid Patient Precipitated by Iodine Supplements Use. Am J Ther. 2018;25(6):e717-e718. PubMed
- Hamby T, Kunnel N, Dallas JS, Wilson DP. Maternal iodine excess: an uncommon cause of acquired neonatal hypothyroidism. J Pediatr Endocrinol Metab. 2018;31(9):1061-1064. PubMed
- Censi S, Watutantrige-Fernando S, Groccia G, et al. The Effects of Iodine Supplementation in Pregnancy on Iodine Status, Thyroglobulin Levels and Thyroid Function Parameters: Results from a Randomized Controlled Clinical Trial in a Mild-to-Moderate Iodine
- Rovner MS, Wolf BJ, Rubin M, et al. Instillation of 5% Povidone-Iodine Ophthalmic Drops Decreases the Respiratory Rate in Children Undergoing Strabismus Surgery: A Randomized Controlled Trial. J Pediatr Ophthalmol Strabismus. 2019;56(6):378-382. PubMed
- Guenezan J, Garcia M, Strasters D, et al. Povidone Iodine Mouthwash, Gargle, and Nasal Spray to Reduce Nasopharyngeal Viral Load in Patients With COVID-19: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 2021;147(4):400-401. PubMed
- Li F, Wan S, Zhang L, et al. A Meta-Analysis of the Effect of Iodine Excess on the Intellectual Development of Children in Areas with High Iodine Levels in their Drinking Water. Biol Trace Elem Res 2022;200(4):1580-1590. PubMed
7-keto-dhea 2 references
- Davidson M, Marwah A, Sawchuk RJ, et al. Safety and pharmacokinetic study with escalating doses of 3-acetyl-7-oxo-dehydroepiandrosterone in healthy male volunteers. Clin Invest Med 2000;23:300-10..
- Zenk JL, Frestedt JL, Kuskowski MA. HUM5007, a novel combination of thermogenic compounds, and 3-acetyl-7-oxo-dehydroepiandrosterone: each increases the resting metabolic rate of overweight adults. J Nutr Biochem 2007;18(9):629-34. PubMed
Copper 11 references
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Campbell IA, Elmes PC. Ethambutol and the eye: zinc and copper (letter). Lancet 1975;2:711. DOI
- Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
- Kozak SF, Inderlied CB, Hsu HY, et al. The role of copper on ethambutol's antimicrobial action and implications for ethambutol-induced optic neuropathy. Diag Microbiol Infect Dis 1998;30:83-7. PubMed
- 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.
- Cantilena LR, Klaassen CD. The effect of chelating agents on the excretion of endogenous metals. Toxicol Appl Pharmacol 1982;63:344-50.
- Babic Z, Tariba B, Kovacic J, Pizent A, Varnai VM, Macan J. Relevance of serum copper elevation induced by oral contraceptives: a meta-analysis. Contraception. 2013 Jun;87(6):790-800. PubMed
- Qui Q, Zhang F, Zhu W, Wu J, Liang M. Copper in diabetes mellitus: a meta-analysis and systematic review of plasma and serum studies. Biol Trace Elem Res 2017;177(1):53-63.
- Walker-Smith PK, Keith DJ, Kennedy CT, Sansom JE. Allergic contact dermatitis caused by copper. Contact Dermatitis 2016;75(3):186-7. PubMed
- Gallentine A. Third-degree burn on the neuropathic lower extremity in a patient with diabetes while wearing a copper-containing compression sock: a case report. Wound Manag Prev 2021;67(12):26-29. DOI
- Chung KJ, Chin YM, Wong MS, Sanmugam A, Singaravel S, Nah SA. Effectiveness of table salt versus copper sulphate in treating umbilical granuloma: A pilot randomized controlled trial. J Pediatr Surg 2022;57(2):261-265. PubMed
Manganese 21 references
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- Barrington WW, Angle CR, Willcockson NK, et al. Autonomic function in manganese alloy workers. Environ Res 1998;78:50-8. PubMed
- Hauser RA, Zesiewicz TA, Martinez C, et al. Blood manganese correlates with brain magnetic resonance imaging changes in patients with liver disease. Can J Neurol Sci 1996;23:95-8. PubMed
- 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.
- Lee JW. Manganese intoxication. Arch Neurol 2000;57:597-9.. PubMed
- Powers KM, Smith-Weller T, Franklin GM, et al. Parkinson's disease risks associated with dietary iron, manganese, and other nutrient intakes. Neurology 2003;60:1761-6.. PubMed
- McMillan, D. E. A brief history of the neurobehavioral toxicity of manganese: some unanswered questions. Neurotoxicology 1999;20(2-3):499-507.
- Gerber, G. B., Leonard, A., and Hantson, P. Carcinogenicity, mutagenicity and teratogenicity of manganese compounds. Crit Rev Oncol Hematol. 2002;42(1):25-34. PubMed
- Jiang, Y. and Zheng, W. Cardiovascular toxicities upon manganese exposure. Cardiovasc.Toxicol 2005;5(4):345-354. PubMed
- Mehta, R. and Reilly, J. J. Manganese levels in a jaundiced long-term total parenteral nutrition patient: potentiation of haloperidol toxicity? Case report and literature review. JPEN J Parenter.Enteral Nutr 1990;14(4):428-430. PubMed
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- Ho CSH, Ho RCM, Quek AML. Chronic manganese toxicity associated with voltage-gated potassium channel complex antibodies in a relapsing neuropsychiatric disorder. Int J Environ Res Public Health 2018;15(4). pii: E783. doi: 10.3390/ijerph15040783. PubMed
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- Li D, Ge X, Liu Z, et al. Association between long-term occupational manganese exposure and bone quality among retired workers. Environ Sci Pollut Res Int 2020;27(1):482-9. PubMed
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Asparagus 14 references
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- Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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