“People are increasingly concerned about their health – they consult doctors or pharmacists about medication use, and if necessary, strengthen their bodies with vitamin and mineral supplements. However, not all patients pay attention to the additional information provided by specialists about medication use, and some do not pay attention to it at all. Nevertheless, it should be kept in mind that some medications interact with everyday food or drinks, and some dietary supplements and medicines are better not taken together; the time of day when the medications are taken is also important,” says the pharmacist.
The first mistake – taking medicines with coffee, juice, or milk
The pharmacist says that the liquid with which we take medicine can have a significant impact on its effect in the body. Some drinks can alter the absorption of the medicine, its concentration in the blood, or even trigger unwanted reactions.
“Grapefruit juice is probably the most well-known example – it inhibits the enzyme that breaks down many drugs, so the amount of medicine in the blood can increase several times. This is especially dangerous for those taking cardiovascular drugs, cholesterol-lowering medications, or some antidepressants. However, grapefruits are not the only ones – orange and apple juices can have a similar effect, which may reduce the absorption of some medicines,” explains E. Zykienė.
Coffee and green tea can also have a negative effect. The caffeine and tannins they contain can disrupt the absorption of iron supplements, and when these drinks are taken with some medicines, nervous system stimulation may increase, anxiety may rise, or heart rhythm disturbances may occur. Milk and other calcium-containing products can inhibit the absorption of antibiotics, thyroid hormones, and some osteoporosis medications.
“Medicines should be taken with a glass of plain water. If you want to drink coffee or juice, wait at least an hour after taking the medicine. This is a small change that can have a big impact on the effectiveness of the medicine or dietary supplement,” advises the pharmacist.
The second mistake – improper timing of medication
The recommendations on medicine packages such as “before meals,” “during meals,” or “after meals” are not random; they indicate how food affects the absorption and effectiveness of a particular medicine. However, many people ignore these instructions or simply do not notice them.
“Some medicines must be taken on an empty stomach because food can significantly reduce their absorption. For example, thyroid hormone preparations are recommended to be taken at least 30 minutes before breakfast, and certain osteoporosis medicines even 60 minutes before a meal, during which time you should not sit down or lie down. If these recommendations are not followed, the medicine may simply not work as it should,” says the “Camelia” pharmacist.
Some medicines must be taken on an empty stomach because food can significantly reduce their absorption.
Other medicines, on the contrary, should be taken with food. Nonsteroidal anti-inflammatory drugs, whose active ingredients are ibuprofen or diclofenac, can irritate the stomach lining and eventually cause ulcers if taken on an empty stomach, so it is better to take them with at least a small amount of food. Some vitamins, especially fat-soluble A, D, E, and K, are better absorbed when taken with fat-containing foods such as avocados, nuts, seeds, olive oil, or fatty fish.
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“For example, magnesium supplements are useful to take in the evening because they can calm the nervous system and help relax. Vitamins that affect energy and can reduce fatigue, such as vitamin C or B vitamins, should be taken during the day and not on an empty stomach. Vitamin C, if taken on an empty stomach, can increase the likelihood of reflux. If you are unsure when to take medicine or vitamins, it is better to ask a doctor or pharmacist,” she says.
For example, magnesium supplements are useful to take in the evening because they can calm the nervous system and help relax.
The third mistake – incorrect combination of medicines and dietary supplements
A common habit is to take all medicines and dietary supplements together in the morning so as not to think about them all day. However, this approach can increase the likelihood of unwanted interactions because some substances compete for absorption or enhance each other’s effects.
“One of the most common examples is calcium and iron supplements. When taken together, calcium blocks iron absorption, and the iron supplement becomes almost useless. The same applies to calcium and thyroid medicines, as well as calcium and some antibiotics. I would recommend leaving at least a two-hour gap between taking these preparations,” explains E. Zykienė.
People taking blood-thinning medicines should be especially cautious. Omega-3 fatty acids, garlic supplements, ginkgo biloba extract – all these supplements can also affect blood thinning, so taking them together with medicines may increase the risk of bleeding. St. John’s wort, sometimes used to improve mood, is one of the most dangerous herbs in terms of interactions; it can weaken or significantly strengthen the effects of contraceptives, antidepressants, heart medicines, and many other drugs.
The fourth mistake – miscalculating daily doses
Many people take several different dietary supplements at the same time without realizing that they may contain the same active substances. A multivitamin complex, separate vitamin D supplements, a complex for skin and hair, a preparation for the immune system: upon examining the ingredients, it often turns out that the same substances are taken in double or even triple the recommended daily dose.
“This most often happens with vitamin D, zinc, vitamin B6, and iron. People think that excess vitamins will simply be eliminated from the body, but this may only be true for water-soluble vitamins. Fat-soluble vitamins – A, D, E, and K – accumulate in the body and can cause poisoning,” warns E. Zykienė.
The pharmacist recommends reading the ingredients of all products already being taken and calculating how much of the same substance you consume per day before starting new dietary supplements. If in doubt, just bring the supplements you have to the pharmacy – pharmacists will help assess whether the doses are safe and whether the preparations are compatible with each other.
