Buyer Beware

If it sounds too good to be true, it almost certainly is.

In a world where cheat codes can help save hours of time in beating a video game, it's only natural to try to look for a magic bullet in other areas of our lives as well—including our health. Who wouldn't want to take advantage of vitamins and herbal supplements instead of eating healthy fruits and vegetables? Or use a sports supplement to build up our muscles instead of hitting the gym?

However, generally, you get what you pay for.

Whether it's alternative therapies or special supplements, everyone should be cautious and do their homework before trying out new things. And that advice goes double for people with hemophilia.

"In a person who has a bleeding propensity, particularly a severe bleeding propensity such as is found in hemophilia A or B, any medication or event that might tip the scale towards a greater risk of bleeding could be catastrophic, says Philip Kuriakose, M.D., Medical Director of the Hemophilia Treatment Center at Henry Ford Hospital in Detroit, Michigan. "I would always be cautious about certain things.

That said, "cautious" is not always the same as "no.

While some treatments are just plain crazy for anyone with hemophilia to even contemplate, others when done in the proper setting might be acceptable. Everyone's health situation is different and no medical advice can be one-size-fits-all, so always check with your doctor before trying anything new (including the suggestions below).

Complementary and Alternative Medicine (CAM)

People with hemophilia will always need conventional medical care but in the right circumstances and with their treatment teams' approval they might be able to consider certain complementary and alternative medicine as well. Some CAM therapies you might have heard of include:

• Acupuncture. "Needle-based acupuncture done outside of a physician's office or hemophilia treatment center is risky and a bad idea, says Dr. Kuriakose. A hemophilia doctor in India, however, has done acupuncture in a few patients with hemophilia and seen improvements with their joint problems.
• Massage. If your joints are in good shape, a general salon-type massage should be all right, but anything more rigorous is worthy of a discussion with your doctor first. Excessive massage manipulation can lead to extra pressure on joints and the potential for injury.
• Yoga. Very basic yoga poses, stretching and breathing exercises are most likely acceptable, but watch out for complicated and/or contorted positions. Not only can they put undue pressure on joints but a misstep and fall could result in injury.
• Herbal Remedies. Herbal remedies should be treated with a great deal of caution. Conclusive research as to their effectiveness is scarce, and they may be dangerous to people with hemophilia.

One herb to definitely stay away from is ginkgo biloba, a leaf extract used for everything from asthma and bronchitis to improving one's memory. Research has shown it can cause a thinning of the blood which can lead to increased bleeding. Your healthcare provider can give you a list of other supplements you should avoid, but some of the more common ones include foxglove, echinacea, ginseng, hydroxycut and golden seal.

Also, keep in mind that, as long as they do not make any health claims, herbal supplements are not regulated by the Food and Drug Administration so the exact contents may be pure guesswork. If you are adamant that you want to try an herbal supplement, be sure to ask your doctor first—and choose a well-known brand.

Vitamins and Minerals

While eating a healthy and varied diet is the best way for anyone to get the vitamins and minerals they need, taking a multivitamin as added "insurance is usually safe. Any other additional vitamin supplements, however, should be approved by your treatment team.

Generally speaking, you want to be sure your diet includes the right amount of the antioxidant vitamins A, C and D to help decrease inflammation in tissues (the gums, for example, can get inflamed and lead to bleeding problems).

Vitamin E is also important at the correct level. However, any food or supplement with too much vitamin E and/or fish oil can affect platelet function, so be sure to watch your intake.

It is also possible to get too much of certain vitamins which can even lead to disease (hypervitaminoses).

Sports Supplements

A wide variety of sports supplements exist on the market including everything from stimulants to steroids to hormones. All are a bad idea, especially for people with hemophilia. Not only are they largely unregulated by the Food and Drug Administration, they're just downright dangerous, with a wide variety of potential side effects. Steroids alone can cause an increased fragility of blood vessels, not to mention heightened risk of high blood pressure, heart disease, liver damage, cancer and mood issues including aggressiveness, depression and suicidal thoughts.

Other supplements include androstenedione (andro) and dehydroepiandrosterone (DHEA), human growth hormone (HGH), creatine and fat burners such as ephedra. All carry serious health risks and should be avoided at all costs.

Over-the-Counter (OTC) Medications

People with hemophilia also need to be careful when it comes to over-the-counter medications. For pain relief, acetaminophen is usually safe to use unless you are allergic to it or have pre-existing liver disease – and be sure not to exceed the dosing recommendations so as to avoid liver damage. Aspirin and ibuprofen should never be taken as they can interfere with clotting.

Generally speaking, cold medicines are acceptable as long as they are not a combination medication that includes pain or fever relief (i.e., aspirin or ibuprofen).

Be sure to read the list of ingredients on any medication before ingesting it because you just never know what might be in it (Alka-Seltzer, for example, contains aspirin).

In looking at your health and lifestyle options, be cautious, always consult your treatment team and keep an open mind, says Dr. Kuriakose. "There are a lot of things we are not aware of, or are just aware of on the fringe, and that doesn't mean things don't work, he says.