Take With Food -- Or Maybe Not 
​(September 26, 2017)

Have you ever wondered about why you are supposed to take some supplements with food, and some on an empty stomach? Oh, you haven’t? Well. … Then, have you ever even thought about it? No? … Ok. Do you care? … Well, you SHOULD. 

Why does it matter? Because if you don’t take a supplement properly, you may receive little or no benefit from taking it. So you end up wasting your money. Also, if you get something that would help you if you took it properly, and you take it incorrectly -- then you still have your problem when you could be well. That's even worse.

When it first occurred to me to write something on this, I took out every bottle I had in my supplement stash and read all the “how to take” instructions. And do you know, half of them just said, “take with food”. The other half of them said to "take as directed". As who directed?

That's stupid at best, and criminal at worst. There are rules to taking supplements, perfectly good rules, and why someone would go to the trouble of manufacturing a decent product and then not tell people how to use it is beyond me. If I buy a clematis or something at Kroger’s, it’s got instructions for where and how to plant it. Those instructions might be wrong, but at the least the grower pretends to care, which at a certain point apparently is all that you can expect from a vendor. 

However, I actually DO care. You’re spending good money on stuff you think might help you. I want to help you with this. So. This is what you should do:

You go to ConsumerLab or a similarly-reliable website (NOT the one that’s trying to sell you the supplements), and  

1) Make sure there’s some evidence that the thing you’re buying is actually going to help you. Then you

2) Decide what dosage you need, depending on what you are taking it for. The dosage for vitamin D, for example, varies enormously depending on the reason you’re taking it AND on your existing blood levels of vitamin D. 

3) Do not buy a brand that hasn’t been tested (by ConsumerLab or by some other third-party testing service). Otherwise you may not be getting what you are paying for. That is always bad news. Which brings us to the subject of today's newsletter,

4) Taking the stuff properly. 

Take your multivitamin/minerals with food. You CAN take them on an empty stomach, if you must. They will still work. But your stomach, or colon, might object in some dramatic way. So, as a rule, take them with food. That is good not just from a comfort viewpoint, but also because with food present your stomach knows to secrete stomach acid and digestive enzymes, which help in breaking the pills down into something your body can absorb. . 

I think everyone should take a multivitamin a few times a week. The majority of Americans have nutrient deficiencies of one kind or another, and in light of that a multi is about as cheap health insurance as you can get. 

If you are taking a mineral or vitamin all by its lonesome, you need to be familiar with its personal idiosyncrasies. Individual nutrients are an entirely different ball game than a multi.

Take vitamin D again, which is a popular one these days. It’s best taken daily in smaller amounts rather than less frequently in larger doses – it is more effective and less likely to cause problems that way. It should be taken not just with food, but with the largest meal of the day, the one that contains the most fat (since vitamin D is a fat-soluble vitamin). And if you are supplementing any of the other fat soluble vitamins (A, K, E) they should be taken several hours apart, since the fat-soluble vitamins compete with each other for absorption. See what I mean?

If you are taking a large amount of a mineral (like iron, calcium, magnesium or zinc), take it at a different time also. The minerals compete with each other for absorption just like the fat-soluble vitamins do, so a big dose of one can crowd the others out. Minerals should also be taken with food, to help with their digestion and so as not to disturb a possibly delicate tummy. 

Don’t worry about that competing-for-absorption thing with multivitamin/minerals. The doses they contain aren’t large enough to muck each other up. 

Probiotics are a free-for-all right now. With very few, very specific exceptions, no one really knows yet which probiotic strains to take or how exactly to take them. If you are taking them for a particular purpose (rather than just for general health), I would find out how they were taken in the studies that demonstrated their effectiveness.

Failing specific information, I subscribe to taking them with just a little bit of food. It seems to me that it you take a probiotic on an empty stomach, the stomach acid will kill them. But if you take it with a lot of food, the little critters could just get carried along with the food and broken down in digestion. Am I right? Hell if I know. But that’s how I take mine – with a big spoonful of good yogurt a half hour before eating, and they seem to be doing what I want them to.

Herbs should be taken APART from food. There are exceptions to this. Turmeric/curcumin has to be taken with a fatty meal, for example. Or if you are taking an herb specifically to help with some aspect of digestion, you might take it during or after eating. So, again, you need to look up whatever it is that you plan on taking. 

But as a rule, if you take herbs with food your body will assume that they ARE food and break them down accordingly. They won’t have the medicinal action they would have if you took them on an empty stomach. Or that’s what they taught me in school, anyway, and I couldn’t find anything to the contrary. Again, this makes sense to me, and in the absence of evidence to the contrary, I say go with it. Don't argue with 2,000 years of tradition unless you’ve got a good reason, I always say.

"Apart from food", by the way, means at least a half an hour before or two hours after a meal.

Amino acids should be taken on an empty stomach, preferably first thing in the morning, at least a half an hour before eating. I see from perusing the internet that it’s mostly your body-building types that are taking amino acids these days, and they are paying a lot of money for buckets of them for muscle bulking purposes. You know what a large quantity of an amino acid mixture is called? PROTEIN. Better to eat hamburger and drink milk and not waste money on big jars of what is essentially pre-digested cheese. Sheesh.

However, back in the stone age (also known as the 1980s), we took isolated amino acids, and we had medicinal uses in mind for them. (Amino acids compete with each other for absorption, and we don't completely know which ones mess up which yet -- so take them alone.) The idea was that taking a bunch of a single amino acid that was used as a precursor to something in the body you wanted more of (like serotonin) would basically push that metabolic pathway and result in more of the end product. If you are doing this, make sure you take those amino acids first thing in the morning on an empty stomach and wait at least a half an hour before eating anything. 

In the end, do your research and read your labels, and you’ll be way ahead of the game. ‘Nuff said.

--dr. diane holmes
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