St Louis’s highly-regarded physician, George Grossberg, professor of geriatric psychiatry at St Louis University School of Medicine, has written The Essential Herb-Drug-Vitamin Interaction Guide .

Unlike most titles which are full of hype and hyperbole, this book really is an “essential” one for those who use medications and supplements together. When he realized that many of his patients were taking over-the-counter herbs, vitamins and supplements while also taking prescription medications, he began to wonder if their primary care doctors were aware of the harm these supplements can cause when mixed with prescriptions. After researching this question, he concluded that more often than not his patients and their primary care doctors were unaware of the dangers of the common practice of combining different kinds of meds to find relief from headaches, back pain, arthritis, insomnia, depression, menstrual difficulties, menopausal symptoms, and sexual difficulties.

Here are a few examples of dangerous combos from the book :

1. Using Echinacea to ward off a cold while on Tylenol can severely damage your liver

2. St John’s wort can relieve depression but also weaken the effectiveness of birth control pills and cause breakthrough bleeding

3. Using ginkgo biloba for memory while also on aspirin or other blood thinners may cause excessive bleeding

4. Taking kava while drinking alcohol may be toxic and can cause depression

5. Diabetics who take panax ginseng can dangerously lower their bood sugar

6. Taking garlic to treat high cholesterol may lower blood pressure

7. Drinking green tea for an upset stomach can lead to false-positive results for some forms of cancer.

The book sounds daunting because it is so full of information, but it is a reference book, so relax. It is organized in alphabetical order by herb. It provides detailed information for each supplement, including recommended dosages, contraindicated drugs, history and usage, lab test results that may be altered by use of a supplement as well as lists of diseases that supplements may worsen.

“If you’re taking an herb, beware the medicine,” Grossberg warns.

“If you’re taking chaparral, comfrey, Echinacea, kava kava, or skullcap, an alarm bell should ring if your doctor prescribes a statin drug for your elevated cholesterol. Mixing Lipitor with any of these herbs can trigger potentially fatal liver damage.

“If you’re taking chamomile, feverfew, garlic, ginger, or passion flower, beware of using NSAIDS for your arthritis pain. Combining NSAIDS with any of these herbs can cause intestinal bleeding.

“If you’re taking borage seed oil, fennel oil, ginkgo biloba, St. John’s wort or wormwood, think twice before taking antidepressants. When antidepressants are mixed with any of these herbs, your risk of seizures can increase markedly.

“If you’re taking aloe, buckthorn, cascara, Chinese rhubarb, licorice, or senna, beware if your doctor prescribes Vascor for your angina. Adding Vascor to any of these herbs can trigger an irregular heartbeat, which is a potentially fatal condition.”

Grossberg is quick to point out that this is not an “anti-herb” or “anti-medicine” book.

He just wants to see “both types of remedies used properly, safely and efficaciously, whether taken alone or together.”

Dr. George Grossberg, co-author of “The Essential Herb-Drug-Vitamin Interaction Guide,” published by Broadway Books, will speak as part of the “Missouri’s Own” program, moderated by KMOX 1120’s Charlie Brennan. The program takes place on Friday, Nov. 9 at 1 p.m.

Admission: $12 or free with festival series ticket.