How to Take Supplements
Our Q & A with Dr. Sam Russo will show you how to get the most out of your supplements
We all want to get the maximum benefit from our supplements. To help you do just that, we compiled the questions you’ve asked most frequently and harnessed the knowledge of Sam Russo, ND, LAc, Better Nutrition research editor and director of Vermont Naturopathic Clinic in Winooski, Vermont. Here are his answers:
1 — Which nutrients/supplements should I always take with food? Which should I take between meals?
Food should be a balanced meal that includes protein, carbohydrates, and fat to stimulate optimum acid secretion in the stomach, which enables better absorption. For example, if you eat only fruit and cereal with nonfat milk for breakfast, add some peanut butter or other protein and fat when taking the following: vitamins; minerals; oils such as fish and flax; fatty acids such as alpha lipoic acid; fatty derivatives such as plant sterols and stanols (used to lower cholesterol), and cetyl myristoleate (used to ease joint pain).
Popular supplements that should be taken 30 minutes before or two hours after a meal include the following:
- Amino acids: Although all protein contains amino acids, which are broken down during digestion, individual amino acid supplements—when taken with food—will compete with protein for absorption. Common ones include lysine for herpes; tryptophan for better sleep; cysteine to thin mucus; N-acetylcysteine (NAC), a special form of cysteine to boost internal antioxidant production and neutralize toxins; arginine to support growth hormone production and blood-pressure regulation; and branched-chain amino acids (BCAAs) for building muscles.
- Herbal medicines: Bitter herbs to improve digestion should be taken with water 10 to 15 minutes before a meal. Other botanicals should usually be taken further away from meal times, as fiber in food can impair their absorption. When taking a formula, if the majority of the ingredients are botanicals, take between meals. But if vitamins and minerals predominate, take with food.
- Enzymes: Timing depends on the desired benefit. To aid digestion, take enzymes at the beginning of a meal. However, systemic enzymes to treat a condition or organ, such as bromelain to reduce pain and inflammation, should be taken between meals.
2 — Which supplements are better absorbed with fat?
The fat soluble nutrients: vitamins A, D, E, K; ascorbyl palmitate, a fat-soluble form of vitamin C; and other fats and fatty derivatives (see the question above for examples). The tocopheryl acetate form of vitamin E, however, is water soluble. CoQ10 comes in fat-soluble forms, such as Q-Sorb in softgels, and as water-soluble powder in capsules, such as Q-Gel (hydrosoluble).
3 — Is it necessary to occasionally take a vacation from your supplement routine?
There is no good evidence either way; however, some experts recommend cycling some nutrient or botanical regimens, particularly when targeting the immune system or the endocrine system. For example, you might take echinacea for one week out of each month to boost production of white blood cells that fight infection, as these cells live for about three weeks. [ my rematk—-not true ,likely!!]
4 — Are there any nutrients that should always be combined? For example, I’ve heard that iron is better absorbed with vitamin C.
There are many ways in which nutrients influence the absorption of each other. Minerals in general are better absorbed with vitamin C or acidic foods, such as cooked tomatoes, citrus, or vinegars. This is especially true in older people, as stomach-acid production decreases with age and in anyone who takes antacids.
The chart below shows how some popular nutrients affect each other when combined. This is usually not a problem when taking high-potency multivitamin and mineral supplements, as higher doses compensate. However, if you take additional individual nutrients, it makes sense to time for optimum benefits.
These are some important points to keep in mind:
- Calcium and magnesium can compete for absorption with one another in doses higher than 250 mg. When taking larger amounts, take each mineral at a different time or split doses of combinations into smaller amounts (not more than 250 mg).
- Fiber supplements should be taken at a separate time from all other nutrients and herbs, as these can bind with the fiber and be excreted.
- Extra Vitamin B1, taken for diabetic neuropathy, chemotherapy side effects, or other conditions, should not be taken with polyphenols (such as grape seed, pine bark, and green tea extract) because these decrease absorption of the B vitamin. Separate polyphenols and B1 by at least two hours.
when combined with
when combined with
|Iron||Vitamin C, protein from animal foods, and amino acid supplements||High doses of zinc or copper, coffee, tea, and soy|
|Calcium||Vitamin D (does not need to be taken at the same time), lactose (naturally present in milk and other dairy products), protein, and vitamin C||Large doses of magnesium, zinc, and phosphate|
|Magnesium||Vitamin D (does not need to be taken at the same time)||Large doses of calcium and phosphate|
|Folic acid||Vitamin C||Zinc|
|B6||Zinc, oral contraceptives, coffee, and tobacco|
|B12||Vitamin C doses greater than 500 mg|
|Vitamin C||Pectin, iron, zinc, and aspirin|
5 — Is it better to refrigerate probiotics, fish oils, and flaxseed oil? What is the general rule of thumb for refrigerating supplements?
In general or when in doubt, oils and probiotics should be refrigerated. For other supplements, a good rule of thumb is to keep them at room temperature (72°F) or below, in a dark place. Probiotics that specify “shelf-stable” or “no refrigeration required” can safely be refrigerated or kept in a cool, dark place.
6 — Why do many single-nutrient supplements have tiny amounts of another nutrient in the formula, such as calcium or vitamin C?
Reasons vary. Nutrients may be added to help absorption, as with vitamin C, and some may be helpful in other ways. For example, lecithin blends water- and fat-soluble nutrients. In other cases, additional nutrients may be incidental.
7 — Should I keep the little silica pack in my supplement bottle or throw it away? What does it do?
Keep it! The silica pack keeps the inside of the bottle dry so that your supplements don’t break down as quickly. I also use those packs in my supplement pill box—great for traveling.
8 — When using powdered supplements, does it matter if I add the powder to warm or hot liquid?
In general, powder is safe to mix with liquid below 120°F (warm, not hot) if it’s consumed relatively quickly. But prolonged exposure to high temperatures breaks down most water-soluble vitamins. Fat-soluble vitamins are more tolerant, and minerals are virtually indestructible. With undenatured whey protein powder, liquid above 120°F will damage naturally occurring immunoglobins that benefit the immune system.
9 — I’ve heard that your body can absorb only a certain amount of vitamins at a time, and therefore, it’s better to stretch the dose out over the day (for example, take no more than 500 mg of vitamin C at a time). What are your thoughts?
This is true. Vitamin C and magnesium are good examples, as high doses cause loose stools, indicating you have surpassed the maximum your body can absorb. Take no more than 500 to 1,000 mg of vitamin C at one time. When taking either calcium or magnesium separately, limit each dose to 500 mg. (See question No. 1 about taking them together.)
Most water-soluble vitamins (eg., B-complex and C) and minerals do not stay in the blood stream for more than a few hours. So taking them throughout the day maximizes blood levels over a longer period.
10 — How much water should I take with my supplements and are there any that require even more water (like fiber)?
Generally, you just need enough liquid to swallow the supplement comfortably. Fiber requires more, usually at least 12 ounces per 15 grams, or 1 tablespoon. Otherwise, you can become constipated.
Contributing editor Vera Tweed has been writing about nutrition, fitness, and healthy living since 1997. As a journalist, she specializes in covering research and expert knowledge that empowers people to lead better lives. For more information, visit www.veratweed.com.
Updated June 14, 2014.
Most dietary supplements can be taken with or without foods, but sometimes taking them on an empty stomach causes heartburn or an upset stomach. If that happens, taking the supplements with food may alleviate the discomfort.
Foods and Absorption
Foods can change how you absorb certain nutrients — sometimes that’s good and sometimes that’s bad. Calcium carbonate supplements require stomach acid, so they’re best taken with meals. Another common form, called calcium citrate, doesn’t need the extra acid so it can be taken on an empty stomach.
Iron absorption can be increased when you consume vitamin C at the same time. You can take vitamin C supplements or eat foods or beverages that contain large amounts of vitamin C (like orange juice, peppers or strawberries).
Milk or tea can interfere with iron absorption. This isn’t a big deal if you’re taking a little iron to ensure adequate intake, but if you’re taking iron supplements to treat iron-deficiency anemia, you may need to be more careful. Follow the directions on the supplement package label or speak with your health care provider to make sure you’re getting enough iron.
Dietary supplements can also include herbs and other natural substances that may affect absorption. Always speak with your health care provider about the dietary supplements you’re taking, especially if you have any health conditions or if you’re taking any medications.
When to Take Supplements
Q: When should I take my supplements?
A: Many of my patients have questions about when to take their supplements. Unless otherwise directed, take your supplements in divided doses with a glass of water at meal time. Doing this will help—
- Prevent nausea. This side effect is sometimes experienced when taking supplements, especially potent multivitamins, on an empty stomach.
- Improve absorption. Hydrochloric acid is required for optimal absorption of calcium, B12, and other nutrients, and the consumption of fat improves the uptake of fat-soluble nutrients such as vitamins D, E, A and K.
- Maintain consistent nutrient levels in your body. Because water-soluble nutrients are lost in the urine, they need to be replenished regularly—which is why I suggest dividing your supplements into two or three doses and taking them several hours apart.
When Not to Take Supplements with Meals
- Amino acids. When you take L-glutamine, L-arginine, L-carnitine, N-acetylcysteine, SAMe and 5-HTP along with a meal containing protein, they have to compete for absorption with the amino acids in the protein. Avoid this by taking them on an empty stomach instead.
- Enzymes. Digestive enzymes should be taken shortly before or during meals. However, if you’re using an enzyme like bromelain to relieve pain and inflammation, take it between meals. Otherwise, it will go to work breaking down food and you’ll get no anti-inflammatory benefits.
- Probiotics. Take probiotics on an empty stomach to ensure that they aren’t destroyed by hydrochloric acid as they pass through your upper GI tract.
An empty stomach is defined as a half-hour before eating or two hours after eating.
Another consideration for when to take supplements has to do with drug-supplement interactions. Calcium, for example, can inhibit the absorption of antibiotics, and fiber supplements may interfere with the efficacy of some drugs. If you are on medication, wait a few hours before taking your supplements, just to be on the safe side.
More Advice From Dr. Whitaker
Taking Vitamins With Food Vs. Without Food
Last Updated: Apr 09, 2014 | By Jessica Bruso Some vitamins are best absorbed with food. Photo Credit Creatas Images/Creatas/Getty Images
Although it may not seem like a big deal, how you take your vitamins could make a difference in how well they are absorbed and how you feel after you take them. Learning which vitamins you should take with food and which you can take apart from meals can help you get the most benefits from your vitamin supplements. Check with your doctor before taking vitamin supplements to make sure they are safe for you, as they can interact with certain medications.
The vitamins that are most important to take with food are the fat-soluble vitamins — A, D, E and K. These vitamins can only be absorbed in the presence of fat and are then stored in your fat cells until they are needed. It doesn’t need to be much fat, as long as a small amount is present in the meal.
Water-soluble vitamins don’t need fat for absorption, just water, so you don’t need to take them with meals. [my remark: for example B complex ] You can if you want to, but it isn’t necessary. Keep in mind that any extra water-soluble vitamins you take above and beyond your body’s daily needs will just be excreted in your urine because these vitamins aren’t stored in the body. Routinely taking your supplements every morning at breakfast can make it easier to remember to take them each day.
Because multivitamins contain a mix of fat-soluble and water-soluble vitamins, you’ll be able to get more benefits from them if you take them with a meal, notes registered dietitian Tanya Zuckerbrot in an April 2014 article published on FoxNews.com. You may want to avoid taking your multivitamin with dairy products, however, because these supplements often contain minerals that aren’t well absorbed in the presence of calcium.
Know Your Supplements: Top Dos and Don’ts
Do you start your day off with a mini “handful” of vitamins, minerals, and various other herbal supplements? If so you’re not alone; more than half of U.S. adults use dietary supplements,1 with the most popular being fish oil, multivitamins, vitamin D, vitamin E, vitamin C, calcium and B-complex vitamins.
If you have any of these, or others, in your kitchen cabinet, you certainly want to be sure you’re using them correctly, not only to protect your health but also to protect your “investment.” Americans spend an estimated $25 billion a year on natural products including dietary supplements, but if you’re not careful you could end up flushing the benefits right down the toilet (quite literally!).
This is because certain supplements do better when kept in the fridge. Others need to be taken with food or are most effective in combination with other supplements. Others can even be harmful if taken with certain medications. Knowing what to do, and what not to do, when it comes to storing, combining and using your supplements will ensure you stay safe and get the most health bang for your buck.
Top Tips for Being a Savvy Supplement User
Fat-based supplements, like omega-3 fats (fish oil), generally do better stored in the fridge. The cold temperature helps protect the fragile fat molecules from rancidity. Certain probiotics should also be stored in the refrigerator to help preserve the number of live bacteria (if your probiotic does not require refrigeration, it should say so on the label). All supplements should be stored in a cool, dry and dark place, particularly fat-soluble vitamins (like vitamins E, A and K), as they can be damaged by ultraviolet light and heat.
Take Fat-Soluble Supplements with Food
Certain vitamins cannot be absorbed by your body unless you eat them along with some fat. This includes vitamin A or retinol, vitamin D, vitamin K and vitamin E. Always take these supplements, as well as your multivitamin, with a meal that contains fat to ensure maximum absorption. Calcium carbonate is another example of a supplement to take with food, as your stomach acid during digestion will help its absorption.
Be Careful When Combining Supplements with Prescription Drugs
They can interact in ways you may not expect, and some of the interactions can be serious. For instance, supplements that can interfere with the blood-thinning medication warfarin (Coumadin) include:
- Dong quai
- Evening primrose oil
- Vitamin K
- St. John’s wort
Before you take any prescription drug, make sure to ask your doctor and pharmacist, and read the label yourself, to be sure supplements you’re taking will not cause an adverse event or otherwise impact its effects. Other important interactions to be aware of include:
- St. John’s wort may speed up the rate at which drugs such as antidepressants and birth control pills break down, impacting their effectiveness2
- Vitamins C and E and certain other antioxidants may reduce the effectiveness of certain types of chemotherapy
- Calcium may interact with antibiotics, bisphosphonates and blood pressure medications
- Certain oral diabetes drugs, aspirin, antacids and antibiotics can affect vitamin B6 metabolism
Combine Vitamins When Appropriate
Certain supplements are absorbed better when taken in combination. For instance, taking vitamin D along with calcium and magnesium can enhance the absorption of calcium, magnesium and other minerals. Taking calcium with vitamin D and magnesium may help your body absorb the calcium into the appropriate areas.
Similarly, vitamin C helps increase the absorption of iron.
Beware of Synthetic Versions
Certain supplements should be taken only in their natural form. For instance:
- In choosing a vitamin D supplement, for instance, look for vitamin D3, which is the same natural vitamin D your body makes when exposed to the sun. Vitamin D2, which is synthetic, may be less effective.
- Most vitamin E supplements contain a synthetic form called dl-alpha-tocopheryl, which is made from petrochemicals. Research suggests that natural vitamin E, d-alpha-tocopherol (or a natural vitamin E with mixed tocopherols and tocotrienols), is better absorbed and preferred by your body.
The mentality that “if a little is good a lot will be better” is dangerous when it comes to dietary supplements. Taking too much iron, for instance, could lead to liver problems and accumulation of fluid in your lungs. An excess of vitamin A can cause liver damage, while chronic overdosing on vitamin B6 may cause nerve damage in your arms and legs.
Follow Label Directions for Time of Day
Certain supplements require multiple daily doses, or work best when taken at a certain time of day. For instance, B vitamins should be taken in the morning for the best effectiveness and because they increase energy levels, which means taking them in the evening may interfere with your sleep. Magnesium, on the other hand, may support sound sleep so is best taken in the evening.
Know Your Supplements …
Before you add a new selection to your dietary supplement arsenal, do a little homework to find out the best way to take it. For instance, here’s a brief primer on calcium:
It’s best to take smaller doses of 500-600 mg at a time, as this will be absorbed most efficiently. If you need to take more than that, split the dose in half and take it twice a day. Iron should not be taken at the same time as calcium, as they compete for absorption. While calcium carbonate should be taken with food, calcium citrate is better absorbed on an empty stomach.3
Use Caution if You’re Pregnant, Nursing or Giving Supplements to a Child
Most dietary supplements have not been specifically tested in these groups, so be sure you are working with a knowledgeable health care provider before deciding which to take if you’re pregnant, nursing or giving supplements to a child.In many cases, supplements can be a smart and safe way to add nutritional oomph and a variety of health benefits to your lifestyle. In addition to the tips above, you can help get the most out of your dietary supplements by choosing only those that offer superior purity and reliability, from a brand you know and trust. The supplements you choose should go through a rigorous quality control process and offer guarantees of potency and purity to protect your health.
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