Many people take supplements to improve their health or prevent disease. In the United States, supplements are not regulated by the Food and Drug Administration. This means they do not come with strict instructions to follow or warnings about interactions like prescription medications.
So, you have to pay attention to which supplements you are taking, when you take them, and how much you take.
Vitamin combinations to avoid
Vitamin C with vitamin B-12
Vitamin C is an essential antioxidant for immune system health. Vitamin B-12 helps maintain your nervous system and form red blood cells. Studies show that taking these two supplements at the same time may reduce the amount of vitamin B-12 that you receive. So, experts recommend taking these supplements at least two hours apart.
Vitamin A supplement with vitamin A-rich foods
Since vitamin A is a fat-soluble vitamin, any excess is stored in the body. So, you don’t need to take vitamin A every single day. Too much vitamin A can lead to weaker bones and more bone fractures as you age. It can also be harmful to unborn babies.
If you are pregnant or take a vitamin A supplement, avoid eating liver or liver paté. These foods are so high in vitamin A that even if you do not take a vitamin A supplement, you should only eat them once a week to avoid consuming too much.
Folic acid (vitamin B9) and vitamin B12
While both of these B vitamins are important, taking too much folic acid or folate can actually hide the symptoms of a vitamin B12 deficiency. So, speak to your doctor to verify your vitamin levels before adding these supplements to your regimen.
Vitamin E and vitamin K
It is well documented that vitamin E supplementation can lead to increased bleeding in some people. Some doctors prescribe a vitamin K supplement to help with blood clotting. Taking vitamin E at the same time can counteract the effects of vitamin K.
Both copper and zinc are important minerals. Most people get enough of these nutrients through their diet. Copper helps with brain development, nervous system health, and in making important tissues in the body. Zinc is an important mineral for healing.
Different minerals can compete for absorption in your digestive system when taken at the same time. So, if you take copper and zinc together, one usually has poor absorption. In the case of these two supplements, zinc wins. People who take a lot of zinc supplements may develop a copper deficiency.
One source of zinc supplementation is denture cream. If you use denture cream and experience neurological problems, you may have a copper deficiency.
Green tea and iron
On their own, both of these supplements offer a lot of benefits. Green tea has anti-inflammatory compounds that may help people with conditions like inflammatory bowel disease. Iron is important for making hemoglobin, a protein in your blood.
However, when taken together, the antioxidants from green tea bind to iron. This lessens the positive effects of consuming green tea.
Calcium with other minerals
Calcium is an important mineral for bone health. Taking a calcium supplement can affect how your body absorbs other minerals including zinc, magnesium, or iron. If you take any combination of these supplements, talk to your doctor about the best timing for maximum absorption of each mineral.
How long should I wait between different vitamins?
The time between vitamins depends on the type of vitamin you are taking. But one rule remains the same—the most important time to take a vitamin pill is a time you will remember day after day. One of the most important things is consistency.
When it comes to the fat-soluble type of vitamin (vitamins A, D, E, and K), it’s best to take these at mealtime. Eating fat as part of your meal will help transport these vitamins where your body needs them most. The mealtime rule also goes for multivitamins and prenatal preparations.
How long should I wait between different vitamins?
The time between vitamins depends on the type of vitamin you are taking. But one rule remains the same—the most important time to take a vitamin pill is a time you will remember day after day. One of the most important things is consistency.
When it comes to the fat-soluble type of vitamin (vitamins A, D, E, and K), it’s best to take these at mealtime. Eating fat as part of your meal will help transport these vitamins where your body needs them most. The mealtime rule also goes for multivitamins and prenatal preparations.
What are symptoms of bad combinations or taking too many vitamins?
Some vitamins can be dangerous if you take too many. There are water-soluble vitamins and fat-soluble vitamins. If you take too many water-soluble vitamins, the excess just gets flushed out in your pee. But taking too many fat-soluble vitamins means the excess is stored in your body’s cells, making it harder to flush out and get rid of. They can then build up to toxic levels.
Vitamin B6 can also be dangerous in excess. Taking too much of this vitamin can cause neurological symptoms. You may feel numbness or tingling in your extremities.
At the same time, some vitamins interact with medications in potentially harmful ways. Vitamin K, for example, can make blood thinners less effective.
What vitamin should I take in the morning and at night?
For mornings, go for B vitamins. These should ideally be taken at breakfast. The reason is that they can be energizing, and some people may feel a bit too energized taking these just before bed.
In the evenings, try vitamin E. Vitamin E has been shown to prevent memory impairment caused by chronic sleep deprivation. It may help you fall asleep, too.
Vitamin, supplement, and medication interactions
In addition to having interactions with other supplements, some prescriptions interact with supplements. If you regularly take any prescription medications, always talk to your doctor before adding any new supplements to your routine.
Blood thinners
Vitamin A and vitamin K can have negative interactions with blood thinners, so you should avoid taking both.
Some herbal remedies can also interact with the blood thinner warfarin (Coumadin) including:
Cranberry
Fish oil
Garlic
Gingko
Ginseng
St. John’s wort
Vitamin E
Milk thistle
Drugs to treat heart disease
High doses of vitamin D can interact poorly with drugs to lower cholesterol and blood pressure, as well as some other drugs used to treat heart disease.
St. John’s wort is an herbal supplement that has been used for hundreds of years to treat mental health issues. It has a potential interaction with several drugs that treat cardiovascular disease symptoms like high blood pressure or high cholesterol. If you take Digoxin, Verapimil, or any statin, check with your doctor to manage this combination.
Additionally, black cohosh, an herbal remedy for gynecological issues, can reduce how well statins work.
Psychiatric medications
You may have side effects when combining certain supplements with antidepressants and anti-anxiety medications.
Taking gingko with trazodone can lead to behavioral or emotional changes.
The combination of ginseng and monoamine oxidase inhibitors can cause manic symptoms.
St. John’s wort may cause drowsiness when combined with SSRIs.
St. John’s wort can also interfere with the absorption of benzodiazepines.
Milk thistle may affect how well you absorb diazepam (Valium).
Overall drug interactions
Two herbal supplements, St. John’s wort and Goldenseal, have such a high risk of interactions, that many experts recommend avoiding them entirely if you take any prescriptions.
Which vitamins are best paired and recommended to be taken together?
Some vitamins work best together because they are absorbed by the body more readily that way. Iron and vitamin C are one of these combos. Vitamin C helps your body absorb plant-based iron. Iron is found in meat, beans, and leafy green vegetables. Vitamin C is found in strawberries, potatoes, and citrus.
Folate and B12 is another such combination. Folate helps your body absorb B12. Both of these B-vitamins helps your body replicate cells. Deficiencies in either can cause extreme exhaustion.
General supplement safety
Only some supplements have been researched and proven effective. For other supplements, more research is needed to find out if they work. Whether or not they are effective, they are usually safe to take. Follow these tips to stay safe with supplements.
Do not use supplements to replace a balanced diet.
Ask your doctor how much of a supplement to take if you’re not sure. You may experience negative side effects after taking too large of a dose of certain supplements.
Always tell your doctor about all supplements you take before any surgery or procedure.
Use government or non-profit organization websites to research supplement claims.
Report any adverse supplement reactions to the FDA.