- Multivitamins can intervene with the absorption and metabolism of sure medicines.
- Blood thinners, thyroid medicines and diuretics are simply among the medication that don’t combine nicely with multivitamins.
- Take to your pharmacist or well being care supplier about any medicines you’re taking which will work together with a multivitamin.
About one-third of U.S. adults take a day by day multivitamin, usually to fill dietary gaps or as a type of “insurance.” While most multivitamins are protected for wholesome adults, combining them with sure medicines can change how your physique absorbs both the complement or the drug itself. That’s as a result of nutritional vitamins and minerals share the identical absorption pathways, compete for enzymes and might alter how rapidly medicines are metabolized. As a consequence, drug-nutrient interactions might change how your remedy works.
If you usually take prescription or over-the-counter medicines, it’s value reviewing whether or not your multivitamin may affect their results. Below, specialists spotlight widespread medication that deserve further consideration and clarify how you can time your doses to keep away from interactions.
Thyroid Medications (Levothyroxine)
Thyroid remedy (levothyroxine) is likely one of the commonest prescriptions affected by multivitamins. Calcium and iron can bind to levothyroxine within the digestive tract, forming complexes that block absorption and make the drug much less efficient.
To keep away from this, take levothyroxine very first thing within the morning on an empty abdomen with water, explains Serena Pratt, M.S., RD. Then wait not less than 4 hours earlier than taking any complement containing calcium, iron or magnesium to make sure that the remedy is correctly absorbed.
Blood Thinners (Warfarin)
Warfarin is a medicine used to stop blood clots by blocking vitamin Ok, a nutrient your physique wants for regular clotting. Because many multivitamins include small quantities of vitamin Ok, all of a sudden beginning or stopping one can intervene with warfarin’s results.
People taking warfarin don’t should keep away from multivitamins fully, however consistency is vital. Pratt explains that fluctuating vitamin Ok consumption could make warfarin much less efficient or improve bleeding danger. Easy bruising, uncommon bleeding or new leg swelling might sign a clotting change, particularly if vitamin Ok consumption from dietary supplements has shifted, she provides.
Antibiotics (Tetracyclines and Fluoroquinolones)
Some antibiotics, similar to doxycycline or ciprofloxacin, can bind to minerals present in multivitamins—together with magnesium, calcium, iron and zinc—which may lower the antibiotic’s effectiveness.,, If taken concurrently a multivitamin, the antibiotic might not attain therapeutic ranges, explains Erica Park, M.D., M.B.A., FAAPMR.
To keep away from this, separate your antibiotic and multivitamin doses by not less than two hours. If you’re prescribed a number of day by day antibiotic doses, your pharmacist may help you create a schedule that minimizes overlap.
Osteoporosis Medications (Bisphosphonates)
Bisphosphonates, similar to alendronate (Fosamax), are extremely delicate to absorption interference. They should be taken on an empty abdomen with plain water, and even small quantities of calcium, iron or different minerals from a multivitamin can scale back their effectiveness.,
“[These medications] work best when taken alone [with] no food, no coffee and definitely no supplements at the same time,” explains Park. It’s typically really useful to attend not less than two hours earlier than taking a multivitamin after taking a bisphosphate.
Diuretics
Diuretics, usually used for blood strain, have an effect on how your kidneys deal with essential electrolytes like calcium, magnesium and potassium. Taking a multivitamin that additionally comprises these minerals might alter their absorption and metabolism.,
Thiazide diuretics have a tendency to extend calcium retention by lowering the quantity excreted via urine, whereas loop diuretics can result in important losses of magnesium, potassium and calcium.,
When taken with thiazide diuretics, excessive calcium consumption from dietary supplements or multivitamins might increase blood calcium, which in uncommon instances could cause nausea, confusion or irregular heartbeat, says Park. For anybody on diuretics, well being care suppliers usually suggest checking electrolyte ranges with a lab take a look at earlier than including dietary supplements to keep away from potential interactions.
Antacids and Proton Pump Inhibitors (PPIs)
Long-term use of acid-reducing medicines—like proton pump inhibitors (PPIs) similar to omeprazole, or some antacids—can scale back the absorption of sure vitamins, together with vitamin B12, magnesium and iron. Stomach acid helps launch these vitamins from meals and dietary supplements, so decreasing acidity might impair absorption over time. Because PPIs regularly suppress abdomen acid, it’s finest to debate along with your well being care supplier alternate methods, similar to sublingual vitamin B12, injections or nutrient formulations that don’t depend on abdomen acid for absorption. For antacids, Pratt recommends taking your multivitamin at a distinct time.
Our Expert Take
Experts agree that multivitamins will be helpful—however they’re meant to enhance, not substitute, a balanced weight loss plan. “[Multivitamins] supplement nutrients that may be lacking in the diet, not to replace real food,” says Pratt. A multivitamin may help fill dietary gaps, however personalization is vital, provides Park.
The most secure method is to give attention to nutrient-rich meals like fruits, greens, complete grains, legumes, wholesome fat and lean proteins, and use dietary supplements solely when indicated by your well being care supplier. If you’re taking prescription medicines, bringing your complement record to each appointment may help your well being care workforce display screen for attainable interactions.
