7 Supplements to Avoid With Obstructive Hypertrophic Cardiomyopathy

Dietary supplements cover a wide range of products, including vitamins, herbs, and minerals, many of which may be beneficial to your health. However, some supplements may not be safe if you are living with obstructive hypertrophic cardiomyopathy (oHCM).
“Many people assume that if something is ‘natural,’ it must be safe,” says Mariko Harper, MD, medical director of the Hypertrophic Cardiomyopathy Center at Virginia Mason Franciscan Health in Seattle. “But supplements can affect heart rate, blood pressure, hydration, and rhythm stability.”
Supplements can also change the way certain medications work, potentially reducing their effectiveness or increasing the risk of side effects.
“For individuals with health conditions like HCM, it’s important to talk with your doctor before continuing or starting any supplements,” says Azmey Matarieh, MD, a cardiologist at Advocate Health in Elgin, Illinois. “Many of these products can interact with medications you need to take to manage the condition.”
Here are seven supplements that can be risky when you have oHCM.
1. Caffeine Pills
2. Pre-Workouts
Dr. Harper cautions patients with oHCM about using these products. “Supplements containing caffeine concentrates, guarana, bitter orange, yohimbine, or ‘pre-workout’ shots or drinks can raise heart rate and blood pressure and may increase the risk of palpitations or arrhythmias,” she says.
3. Ginkgo Biloba
But when you have HCM, you need to be cautious with this supplement because it can raise blood pressure, says Cynthia Kos, DO, a cardiologist with the Advanced Heart Failure Center at Hackensack Meridian Health’s Jersey Shore University Medical Center in Neptune, New Jersey. “It may also interact with blood-thinning medications,” she says.
4. Calcium
“Calcium is an essential part of our diet, but too much calcium for those with HCM can be dangerous,” says Matarieh. “Calcium supplements can contribute to the buildup of arterial deposits, making it more difficult for blood to adequately flow and heightening the risk of cardiovascular events.”
5. Vitamin E
But the information regarding its role in heart health can be a little confusing. Is it beneficial or not? The answer depends on whether it comes from diet or supplements.
“A healthy dose of vitamin E comes from eating things like fruits, vegetables, nuts, and fish,” says Matarieh. “Vitamin E supplements can thin the blood and interact negatively with certain medications, including cholesterol medicines.”
6. St. John’s Wort
But St. John’s wort doesn’t mix well with several drugs that people might take for oHCM. “This herbal remedy is known to interact with many medications, including those commonly prescribed for heart conditions like anticoagulants, beta-blockers, and calcium channel blockers,” says Dr. Kos. “These interactions can reduce the effectiveness of the prescribed drugs.”
7. Licorice Root
While it is generally considered safe, it may not be a good choice for people with heart conditions. “This supplement can have an impact on heart function and blood pressure,” says Kos.
A component of licorice called glycyrrhizin, or glycyrrhizic acid, can cause irregular heartbeat and cardiac arrest, particularly if you have large amounts over a long period of time. Small amounts of glycyrrhizin have also been linked to severe adverse effects in people who eat a lot of salt or who have heart or kidney conditions.
Resources We Trust
- Mayo Clinic: Hypertrophic Cardiomyopathy
- Cleveland Clinic: Can You Have Caffeine if You’ve Got Hypertrophic Cardiomyopathy?
- U.S. Food and Drug Administration: Spilling the Beans: How Much Caffeine Is Too Much?
- National Center for Complementary and Integrative Health: St. John’s Wort
- University Hospitals: Pre-Workout Supplements: Are They Worth Taking?
- Beverages, coffee, brewed, prepared with tap waterplain, nonfat. USDA Food Data Central. April 1, 2019.
- Spilling the Beans: How Much Caffeine Is Too Much? U.S. Food and Drug Administration. August 28, 2024.
- Caffeine Tablets. DailyMed. October 16, 2025.
- Caffeine: What It Is and What It Does. Cleveland Clinic. March 21, 2025.
- Can You Have Caffeine if You’ve Got Hypertrophic Cardiomyopathy? Cleveland Clinic. February 24, 2026.
- Pre-Workout Supplements: Are They Worth Taking? University Hospitals. May 2, 2025.
- Ginkgo. National Center for Complementary and Integrative Health. February, 2025.
- Myung S-K et al. Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials. Nutrients. January 26, 2021.
- Calcium. National Institutes of Health: Office of Dietary Supplements. September 14, 2023.
- What Can Vitamin E Do for You? Cleveland Clinic. July 24, 2024.
- Zeng Q et al. Association Between Dietary Vitamin E Intake and Incident Cardiovascular Disease, Cardiovascular, and All-Cause Mortality: A Prospective Cohort Study Using NHANES 2003–2018 Data. International Journal of Cardiology Cardiovascular Risk and Prevention. March 2025.
- What You Need To Know About Vitamins and Supplements for Heart Health. Cleveland Clinic. October 9, 2025.
- U.S. Preventive Services Task Force. Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer. JAMA. June 21, 2022.
- St. John’s Wort. National Center for Complementary and Integrative Health. May 2025.
- Licorice Root. National Center for Complementary and Integrative Health. April 2025.

Cheng-Han Chen, MD, PhD, FACC, FSCAI
Medical Reviewer
Cheng-Han Chen, MD, PhD, is the medical director of the structural heart program at MemorialCare Saddleback Medical Center in Laguna Hills, California, and director of structural a...

Roxanne Nelson, RN
Author
Roxanne Nelson is a registered nurse (RN) and a medical and health writer. Her work has been published by a range of outlets for both healthcare professionals and the general publi...