Safety matrix
This page is generated from the rules that score your plan. For each curated safety gate — drug classes, conditions, allergies, life stage — it lists which supplements are excluded outright and which are routed to clinician review. The global guards at the top apply to every supplement.
The matrix is built from excludeIf and clinicianReviewIf clauses in the open-source engine. If the engine changes, this page changes with it.
Scope note.Not every rule in the engine is shown here. The engine has scoring gates that aren’t safety gates (e.g. a low ferritin lab boosts iron rather than blocking it), and a long tail of conditional clauses that would be more confusing than useful in a public matrix. The gates below are the ones most relevant to a clinician scanning “will any of this hurt someone like me.” For everything else, the source is the repo.
These four apply to every supplement and override the per-supplement rules below.
Under 18 — pediatric guard
Anyone under 18 is routed to clinician review for every supplement outside a small allow-list (vitamin D3, omega-3, multivitamin, iron, B12, calcium, psyllium, protein, probiotic). The allow-list lives in rules-engine.ts and is not editable per supplement.
80+ — elderly soft guard
Past age 80 the engine routes most non-essentials to clinician review. Polypharmacy norms, frailty, and narrower interaction tolerance push the bar higher. A small allow-list (the pediatric items plus creatine and magnesium) remains available.
Urgent clinical red flag — suppression
If the red-flag screen returns any urgent symptom (chest pain, blood in stool/urine, suicidal thoughts, new neurological symptoms, breast lump, unintentional weight loss, severe persistent headache, persistent fever), the engine demotes everything in the plan and surfaces an urgent banner instead.
Daily aspirin or NSAID — promoted to anticoagulant
If the user reports daily aspirin or NSAID use, the engine synthesises a positive answer for the anticoagulant question downstream, so every supplement that excludes on `blood_thinner_use` also excludes on daily OTC bleeding-risk drugs. This is why the anticoagulant gate above is labelled to include OTC drugs.
Each section is a single safety gate. Excluded means the engine will not include that supplement in any plan for someone matching the gate. Clinician review means the supplement is downgraded and flagged as needing a clinician’s sign-off before use.
Anticoagulants and antiplatelets (incl. daily aspirin/NSAID via OTC promotion)
Why this gate exists: Risk of additive bleeding. Daily aspirin or NSAID use is promoted into this gate inside the engine so the same exclusions apply.
Engine field: blood_thinner_use = yes | not_sure
| Supplement | Action | Evidence |
|---|---|---|
| Aged Garlic Extract | Excluded | Tier C |
| Berberine | Clinician review | Tier B |
| Bromelain | Excluded | Tier C |
| CoQ10 (Ubiquinol) | Clinician review | Tier B |
| Curcumin (Turmeric Extract) | Excluded | Tier B |
| Evening Primrose Oil | Excluded | Tier C |
| Fenugreek | Excluded | Tier C |
| Ginger Extract | Excluded | Tier B |
| Glucosamine Sulfate | Excluded | Tier C |
| Holy Basil (Tulsi) | Excluded | Tier D |
| Krill Oil | Excluded | Tier C |
| Melatonin | Clinician review | Tier B |
| Olive Leaf Extract | Excluded | Tier C |
| Omega-3 EPA/DHA | Excluded | Tier B |
| Panax Ginseng (Korean / Asian) | Excluded | Tier C |
| Pycnogenol (French Maritime Pine Bark) | Excluded | Tier B |
| Reishi | Excluded | Tier D |
| Resveratrol | Excluded | Tier C |
| Vitamin E | Excluded | Tier C |
| Vitamin K2 (MK-7) | Excluded | Tier B |
Daily aspirin or NSAID (direct)
Why this gate exists: A handful of supplements gate directly on the OTC question in addition to the engine-level anticoagulant promotion. Same bleeding-risk concern.
Engine field: daily_aspirin_or_nsaid = yes | not_sure
| Supplement | Action | Evidence |
|---|---|---|
| Berberine | Clinician review | Tier B |
| Fenugreek | Excluded | Tier C |
| Krill Oil | Excluded | Tier C |
| Omega-3 EPA/DHA | Excluded | Tier B |
Polypharmacy (5+ prescriptions)
Why this gate exists: Some supplements are excluded outright at this pill load; many others are routed to clinician review because the interaction surface gets too wide for an algorithm to screen.
Engine field: medication_profile = polypharmacy
| Supplement | Action | Evidence |
|---|---|---|
| 5-HTP | Excluded | Tier C |
| Berberine | Clinician review | Tier B |
| Curcumin (Turmeric Extract) | Clinician review | Tier B |
| Gymnema Sylvestre | Clinician review | Tier D |
| Kava | Clinician review | Tier D |
| L-Tryptophan | Excluded | Tier C |
| L-Tyrosine | Clinician review | Tier C |
| Niacin (Vitamin B3) | Clinician review | Tier B |
| Panax Ginseng (Korean / Asian) | Clinician review | Tier C |
| Psyllium Fiber | Clinician review | Tier B |
| Red Yeast Rice | Clinician review | Tier B |
| Saffron Extract | Clinician review | Tier C |
| SAM-e | Clinician review | Tier C |
| Tongkat Ali (Eurycoma longifolia) | Clinician review | Tier C |
| Vitex (Chasteberry) | Clinician review | Tier C |
Any prescription medication
Why this gate exists: For supplements where the engine can't rule out a pharmacokinetic clash without a full medication list, anyone on a prescription is routed to clinician review. The transparency page describes this as the unlisted_medications fallback.
Engine field: medication_profile = some_rx | polypharmacy
| Supplement | Action | Evidence |
|---|---|---|
| 5-HTP | Excluded | Tier C |
| Berberine | Clinician review | Tier B |
| Curcumin (Turmeric Extract) | Clinician review | Tier B |
| Gymnema Sylvestre | Clinician review | Tier D |
| Kava | Clinician review | Tier D |
| L-Tryptophan | Excluded | Tier C |
| L-Tyrosine | Clinician review | Tier C |
| Niacin (Vitamin B3) | Clinician review | Tier B |
| Panax Ginseng (Korean / Asian) | Clinician review | Tier C |
| Psyllium Fiber | Clinician review | Tier B |
| Red Yeast Rice | Clinician review | Tier B |
| Saffron Extract | Clinician review | Tier C |
| SAM-e | Clinician review | Tier C |
| Tongkat Ali (Eurycoma longifolia) | Clinician review | Tier C |
| Vitex (Chasteberry) | Clinician review | Tier C |
Known-high vitamin D lab status
Why this gate exists: Vitamin D supplementation is excluded when a recent lab puts the user in the high band — the boost gates flip into an exclusion to prevent stacking.
Engine field: lab_vitamin_d_status = high
| Supplement | Action | Evidence |
|---|---|---|
| Vitamin D3 | Excluded | Tier B |
Known-high ferritin lab status
Why this gate exists: Iron is excluded when a recent lab puts the user in the high band — high ferritin (with or without inflammation context) takes iron off the table.
Engine field: lab_ferritin_status = high
| Supplement | Action | Evidence |
|---|---|---|
| Iron | Excluded | Tier A |
SSRIs and other serotonergic agents
Why this gate exists: Risk of serotonin syndrome with serotonergic botanicals (5-HTP, SAM-e, St John's wort, saffron, rhodiola).
Engine field: ssri_or_serotonergic_use = yes | not_sure
| Supplement | Action | Evidence |
|---|---|---|
| 5-HTP | Excluded | Tier C |
| L-Tryptophan | Excluded | Tier C |
| Melatonin | Clinician review | Tier B |
| Rhodiola Rosea | Clinician review | Tier D |
| Saffron Extract | Excluded | Tier C |
| SAM-e | Excluded | Tier C |
| Vitex (Chasteberry) | Excluded | Tier C |
Thyroid disorder
Why this gate exists: Iodine, ashwagandha, soy isoflavones and a few others can alter thyroid function or interfere with levothyroxine.
Engine field: thyroid_disorder = yes | not_sure
| Supplement | Action | Evidence |
|---|---|---|
| Acetyl-L-Carnitine (ALCAR) | Clinician review | Tier C |
| Alpha-Lipoic Acid | Clinician review | Tier B |
| Ashwagandha | Excluded | Tier D |
| Iodine | Excluded | Tier B |
| L-Tyrosine | Excluded | Tier C |
| Maca | Excluded | Tier C |
Pregnancy or breastfeeding
Why this gate exists: Many botanicals lack reproductive-safety data; high-dose fat-soluble vitamins are teratogenic. Clinician-led prenatal care takes precedence.
Engine field: pregnant_or_breastfeeding = yes | not_sure
| Supplement | Action | Evidence |
|---|---|---|
| 5-HTP | Excluded | Tier C |
| Ashwagandha | Excluded | Tier D |
| Berberine | Excluded | Tier B |
| Black Cohosh | Excluded | Tier D |
| DIM (Diindolylmethane) | Excluded | Tier D |
| Eleuthero (Siberian Ginseng) | Excluded | Tier D |
| Fenugreek | Excluded | Tier C |
| Gymnema Sylvestre | Excluded | Tier D |
| Holy Basil (Tulsi) | Excluded | Tier D |
| Kava | Excluded | Tier D |
| Melatonin | Excluded | Tier B |
| Panax Ginseng (Korean / Asian) | Excluded | Tier C |
| Passionflower | Excluded | Tier D |
| Rhodiola Rosea | Excluded | Tier D |
| Saffron Extract | Excluded | Tier C |
| Schisandra Chinensis | Excluded | Tier D |
| Soy Isoflavones | Excluded | Tier C |
| Spirulina | Excluded | Tier C |
| Tongkat Ali (Eurycoma longifolia) | Excluded | Tier C |
| Valerian | Excluded | Tier D |
| Vitamin A / Beta-Carotene | Excluded | Tier C |
| Vitex (Chasteberry) | Excluded | Tier C |
Kidney disease history
Why this gate exists: Creatine, high-dose vitamin C, magnesium loading, and several botanicals are routed to clinician review when renal function is uncertain.
Engine field: kidney_history = yes | not_sure
| Supplement | Action | Evidence |
|---|---|---|
| Creatine Monohydrate | Clinician review | Tier A |
| Electrolytes (Na/K/Mg) | Clinician review | Tier B |
| Iron | Clinician review | Tier A |
| Magnesium | Clinician review | Tier B |
| Sodium Bicarbonate | Excluded | Tier B |
| Vitamin D3 | Clinician review | Tier B |
Liver disease history
Why this gate exists: Several botanicals (kava, green-tea extract, comfrey, some adaptogens) carry hepatotoxicity signals; high-dose niacin and fat-soluble vitamins are flagged.
Engine field: liver_history = yes | not_sure
| Supplement | Action | Evidence |
|---|---|---|
| Ashwagandha | Excluded | Tier D |
| Black Cohosh | Excluded | Tier D |
| Cinnamon (Ceylon) | Excluded | Tier C |
| Curcumin (Turmeric Extract) | Excluded | Tier B |
| Iron | Clinician review | Tier A |
| Kava | Excluded | Tier D |
| Niacin (Vitamin B3) | Excluded | Tier B |
| Red Yeast Rice | Excluded | Tier B |
| Reishi | Excluded | Tier D |
| Valerian | Excluded | Tier D |
| Vitamin A / Beta-Carotene | Excluded | Tier C |
Autoimmune condition
Why this gate exists: Immune-stimulating botanicals (echinacea, certain mushrooms) and some adaptogens can worsen autoimmune flares.
Engine field: autoimmune_condition = yes | not_sure
| Supplement | Action | Evidence |
|---|---|---|
| Ashwagandha | Excluded | Tier D |
| Lactobacillus rhamnosus GG (LGG) | Clinician review | Tier B |
| Probiotic | Clinician review | Tier C |
| Reishi | Clinician review | Tier D |
| Saccharomyces boulardii | Clinician review | Tier B |
| Spirulina | Excluded | Tier C |
Kidney stone history
Why this gate exists: High-dose vitamin C and calcium loading can increase oxalate burden.
Engine field: kidney_stones = yes
| Supplement | Action | Evidence |
|---|---|---|
| Calcium | Clinician review | Tier B |
| Vitamin C | Clinician review | Tier B |
Glucose-lowering medications
Why this gate exists: Berberine, cinnamon, gymnema, and similar can compound hypoglycaemia risk.
Engine field: glucose_lowering_med = yes
| Supplement | Action | Evidence |
|---|---|---|
| Alpha-Lipoic Acid | Clinician review | Tier B |
| Berberine | Clinician review | Tier B |
| Chromium Picolinate | Clinician review | Tier C |
| Cinnamon (Ceylon) | Clinician review | Tier C |
| Fenugreek | Clinician review | Tier C |
| Gymnema Sylvestre | Clinician review | Tier D |
| Myo-Inositol | Clinician review | Tier B |
| Niacin (Vitamin B3) | Clinician review | Tier B |
Statin therapy
Why this gate exists: Red yeast rice duplicates statin mechanism; some botanicals affect CYP3A4 statin metabolism.
Engine field: statin_use = yes
| Supplement | Action | Evidence |
|---|---|---|
| Red Yeast Rice | Excluded | Tier B |
Current or recently-quit smoker (derived signal)
Why this gate exists: Beta-carotene supplementation increases lung-cancer mortality in current and recently-quit smokers (CARET / ATBC). The engine derives this signal from the smoking question; it overrides the supplement.
Engine field: derived_smoking_risk = current | former_recent
| Supplement | Action | Evidence |
|---|---|---|
| Vitamin A / Beta-Carotene | Excluded | Tier C |
Fish or shellfish allergy
Why this gate exists: Fish-oil omega-3 products and glucosamine derived from shellfish are excluded.
Engine field: known_allergies = allergy_fish | allergy_shellfish
| Supplement | Action | Evidence |
|---|---|---|
| Krill Oil | Excluded | Tier C |
| Omega-3 EPA/DHA | Excluded | Tier B |
Soy allergy
Why this gate exists: Soy isoflavones, lecithin, and several encapsulation excipients can carry soy protein traces.
Engine field: known_allergies = allergy_soy
| Supplement | Action | Evidence |
|---|---|---|
| Soy Isoflavones | Excluded | Tier C |
Full medication-by-medication interaction screening is a clinician’s job, not an algorithm’s. The matrix above covers the drug classes and conditions the engine asks about — not every prescription a person might be on. Whenever you report any prescription medication, the engine sets an unlisted_medications risk flag so the printable plan and the clinician export both prompt for a pharmacist or clinician review of the full list.