Safe Supplement Combinations

September 6, 2017
Leigh Erin Connealy, M.D.

A lot of people write in with questions about how and when to take their supplements, if they should worry about their supplements interacting with their medications, and what vitamins cannot be taken together.

There are plenty of concerns when it comes to interactions between drugs and certain drug/supplement combos. But the good news is that most supplements are perfectly safe to take together, with little concern about harmful interactions.

With that said, the biggest potential “problem” with taking all your supplements in one fell swoop is decreased absorption.

Improving Absorption

There are some key nutrients you should consider taking apart from one another. This is especially true with minerals, which often compete with each other for absorption. Here are some of the biggest concerns:

Iron: Supplemental iron should be taken apart from calcium, zinc, and vitamin E, all three of which interfere with iron’s absorption. Ideally, take your iron supplement on an empty stomach a few hours apart from other minerals. To enhance iron absorption, take with vitamin C.

Calcium: A lot of bone-building products contain calcium along with other minerals like magnesium. You may wonder should calcium and magnesium be taken together or separately. But magnesium and calcium compete for absorption, especially when taken in doses higher than 250 mg. Zinc is another mineral you should avoid using at the same time as calcium. If you take extra calcium to support your bones, get a supplement that does not include other nutrients except for vitamin D, which greatly improves calcium’s absorption into the bones. Keep in mind, magnesium is still extremely important for bone and heart health. Just be sure to take your magnesium and calcium a few hours apart. Fat also helps improve the absorption of calcium and vitamin D. So, try taking calcium with a meal. And if you drink milk, opt for full fat, not skim or low-fat.

Zinc: Speaking of zinc, taking high doses (50 mg or more) for long periods of time (10 weeks or longer) can affect copper absorption. Also, as noted above, zinc should not be taken with iron or calcium either.

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Usually, you’ll find all of these minerals together in multivitamins. But, multis typically contain dosages up to the recommended daily allowance (RDA), and RDAs are notoriously low. Absorption issues only tend to crop up with higher dosages of minerals, so if you’re taking additional calcium, iron, or zinc above and beyond what’s in your multi, be sure to consume them several hours before or after taking your multi for optimal absorption.

Finally, if you take a fiber supplement, do so at a completely separate time from all of your other vitamins, minerals, and herbs, as they can bind with the fiber and end up getting excreted rather than absorbed.

Supplement “Interactions”

As I mentioned, harmful interactions between supplements are pretty uncommon. But some combinations can amplify effects.

For example, if you take melatonin (the “sleep hormone”) with other herbs known for their sedative properties (such as St. John’s wort), you could experience more of a tranquilizing effect than you possibly intended.

You also want to be careful not to use omega-3 supplements, a known blood thinner, with other supplements that can slow clotting, such as Ginkgo biloba.

Before taking any herbal/supplement combinations, it’s important that you understand how those products work in your body. This can help prevent potential issues. If you have any questions or concerns about supplements and how they may interact in your body, be sure to discuss them with a doctor or pharmacist.

Overall, though, you should feel confident that taking vitamins, minerals, and other nutrients can do a lot of good and little-to-no harm to your body.

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