Many patients when they initially visit our office are confused about how they should take supplements that they have self prescribed. Should they be taken with meals, away from food, before bed, in divided doses? First, we assess the supplements a new patient is already taking to determine whether there are harmful combinations, toxic doses of certain components, ineffective forms of nutrients, poor manufacturing practices and if any of the products are contraindicated with current prescription or pharmaceutical medications and health conditions. We would advise any person taking supplements to consult a nutritionally minded health care provider, like a licensed naturopathic physician, to evaluate your supplementation program.

Once you have a sound, safe and effective supplement program, consideration must be made as to whether the product should be taken with food. A number of generalizations can be made. Vitamins, minerals and essential fatty acids should be taken with meals in divided doses to enhance absorption, while botanical medicines (herbs) are usually advised to be taken away from food. There are some minerals that are better absorbed on an empty stomach like iron and calcium. “Away from food” actually means either 30 minutes before a meal or about two hours following a meal. Amino acids are usually best administered on an empty stomach, but with a small amount of carbohydrate like fruit or fruit juice, which can facilitate absorption across the blood brain barrier. If nausea or other symptoms of indigestion occur, then these supplements can be taken with food. Other accessory food factors like coenzyme Q10 and alpha lipoic acid are best taken with meals, especially a meal with some healthy fat. Digestive enzymes to enhance digestion should be taken at the start of meals and dose may be adjusted accordingly with portion sizes. Conversely, enzymes, like bromelain, prescribed to reduce inflammation should be taken on an empty stomach. There is some controversy over whether probiotics should be taken with or without food. It seems “with food” may be the most sensible approach because yogurt is a food source of these beneficial bacteria. Studies have shown benefit from yogurt consumption in the treatment of conditions like vaginal candidiasis. Some experts say taken on an empty stomach right before bed.

Depending on what a particular product is prescribed to treat or enhance bodily functions, may affect the time of day the supplement should be taken. For example, botanical medicines like Valeriana officinalis and Passiflora incarnata, recommended to improve sleep quality should be taken about an hour before bed. While herbs prescribed to enhance thyroid function would be best taken upon rising as is recommended with pharmaceutical thyroid medication. As well, combinations of calcium and magnesium can be taken before bed to promote muscle relaxation. A naturopathic physician, or like minded primary health care provider, will give you these instructions when prescribing these supplements. Your supplement program will be most effective if you follow these simple guidelines.