Dear Pharmacist: How to take dietary supplements and medications

Although it is best to get our nutrients from healthy foods and drinks, dietary supplements can fill a nutritional gap. However, it can be confusing to know when to take certain nutrients, especially minerals that can bind or chelate, with many medications. It can also be difficult to time your supplements around meals and medications.

Supplements (the high quality ones that really work) will act on your body exactly like a drug, and the timing affects effectiveness. Before embarking on any supplement regimen, I suggest that you ask a holistic minded doctor what is right for you with consideration of your allergies, liver, kidney function and even genetic mutations.

By learning everything you can about vitamins and minerals, you can make better dosage decisions. There are times when I need to discharge 50 percent of a capsule to get a lower dose. Other times, I will take more than is usually recommended. We are all very unique.

Today, I will teach you more about synchronizing your medications and supplements so you can optimize the effect and minimize the risk. Taking some medications too late in the day can make your eyes open at 3 a.m.! Interactions with minerals can defeat the purpose of taking medications.

Since there are thousands of medications and supplements, obviously I can not cover them all, but I will hit the big categories.

Medications, supplements best taken in the morning:

  • Thyroid medication
  • Modafinil (Provigil)
  • Stimulants (Ritalin, Concerta, Adderall)
  • Diuretics (including Lasix, HCTZ, dandelion, berberine, neem, green tea)
  • Medications for osteoporosis (including Boniva, Fosamax)
  • Best taken with food:
  • Mineral supplements (iodine, magnesium, calcium, iron)
  • Vitamins A, D, E or K (fat-soluble vitamins)
  • Antifungals
  • CoQ10

Better taken in the afternoon, or at bedtime:

  • Diphenhydramine
  • Aspirin
  • Magnesium
  • Ashwagandha
  • Skullcap
  • Muscle relaxants
  • Statin Cholesterol Reducers
  • ACE inhibitors (such as enalapril)
  • ARB class of blood pressure pills (such as candesartan)

DO NOT combine:

  • Vitamin K or ginkgo with anticoagulants
  • Folate with methotrexate or phenytoin
  • Minerals or dairy products with minocycline or doxycycline
  • Grapefruit / Statin Foods / Supplements
  • Chocolate with Nardil
  • Licorice extract with digoxin or HCTZ
  • HCTZ with vitamin D (too much calcium)
  • 5-HTP or St. John’s wort with any antidepressant

Over the years, I have used my list of vitamins to help me remember when and how to take supplements. I think I could help you. You can download my form for free on my website and fill in the blanks with your supplements. This cheat sheet can help you stay on track.