Vitamin D and Calcium, Fish Oil and More — Eat This Not That

Millions of people take vitamins daily to help maintain overall health, but not all will have a positive effect if taken at the wrong time of day, according to experts. “When people don’t take vitamins the proper way, they don’t see improvement,” family medicine doctor Rodolfo Perez-Gallardo, MD told Cleveland Clinic. “Your body can’t fully absorb vitamins unless you know the best time to take them.”

However, not everyone agrees. “There is little research to suggest the timing of supplement consumption for optimum benefits,” Dr. Jagdish Khubchandani, MBBS, Ph.D., a professor of public health at New Mexico State University tells us. “The bigger question is whether a supplement is needed or recommended? Are there any natural sources of vitamins, minerals, and nutrients that you can take? And, above all, do supplements really work? The US dietary supplement market has crossed $100 billion per year and is expected to grow further, but most supplements have not been shown to have beneficial health effects.”

Dr. Khubchandani continues, “Also, for the vast majority of people, the timing of supplement consumption may not matter, but one has to look at their health/disease conditions, medication/supplement interactions, diet related restrictions, and ensure that the recommended supplements are taken at the same time every day.” Eat This, Not That! Health spoke with experts who share what to know about supplements before taking them and why time of day matters with certain ones. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

Smiling woman taking a pill.
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Kelly Johnson-Arbor, MD, FACEP, FUHM, FACMT Medical Toxicologist and Co-Medical Director at the National Capital Poison Center tells us, “Dietary supplements are not classified as drugs by the United States Food and Drug Administration. This means that they are not as heavily regulated as prescription or over-the-counter drugs, and are not required to have proof of safety or effectiveness because of this, supplements may contain different ingredients or doses of ingredients than are listed on the package label, and they may not be effective in treating the conditions they claim to manage.

As always, people should contact Poison Control if they have any unexpected or unwanted symptoms after use of dietary supplements. There are two ways to contact Poison Control in the United States: online atwww.poison.org or by phone at 1-800-222-1222. Both options are free, confidential, and available 24 hours a day.”

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Dr. Suzanne Soliman, PharmD, BCMAS & Founder of Pharmacist Moms GroupChief Health Officer, ACMA, NJ Board of Health Member says, “Supplements are necessary especially when you are not eating an appropriate diet. Many of us are constantly on the go and therefore eating diets high in processed foods and aren’t getting the nutrients we need from food.In these cases supplements are necessary.The most important thing to know about supplements before taking them is that they are not regulated closely and brand quality does matter.

Generally speaking, the lower less expensive brands may not contain what is listed on their label. If you are taking a supplement, it is very important to inform your physician or other healthcare providers as they can potentially interact with prescription medications or even lab testing. Some supplements may also be contraindicated in those with certain chronic conditions.”

Smiling young lady looking at her vitamins
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There’s eight nutrient groups in B vitamins and each one has a vital role in energy and maintaining cell health. There’s many reasons why someone can be deficient in B vitamins like certain health conditions such as Crohn’s disease, which can prevent the body from absorbing the vitamins, older people, pregnancy or diet. Deficiency symptoms can range anywhere from fatigue, change in mood, anemia, a swollen, inflamed tongue, cognitive difficulties, weakness, balance problems and strange sensations, numbness, or tingling in the hands, legs, or feet.

According to dr. Soliman, “B vitamins are typically taken in the morning. This includes vitamin B12 and vitamin B6. Vitamin B6 can interfere with sleep and can impact dreams if taken in the evening. Vitamin Bs play a role in energy production and stimulate the brain. They would probably impact sleep and provide an energizing effect if taking them at night. I recommend the morning only for them.”

Dr. Khubchandani explains, “Vitamins of B type are involved with sugar and energy metabolism and are water soluble. They can be taken in the evening, but the best time is morning as one needs strong metabolic function and energy throughout the day that can be aided by consuming Vitamin B in the morning.A diet rich in vitamin B is key for brain functions as well (eg, reduced stress, improved cognition) with deficiency being associated with higher levels of neural inflammation and oxidative stress. So, the best time for a multivitamin pill high on B-type vitamins can be consumed with breakfast for higher benefits.”

Lisa Richards, a nutritionist and author of the Candida Diet adds, “The water soluble B vitamins are a great addition to any supplement regimen, but should be relegated to the morning or daytime. B vitamins shouldn’t be taken in the evenings as they work in the body to convert food into energy. Therefore , taking them close to bedtime can disturb or inhibit sleep. They are also water soluble, which means they can be taken without food, or dietary fat, and be as easily absorbed.”

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Dr. Johnson-Arbor says, “Pre-workout supplements are popular among athletes and bodybuilders, and may have a beneficial effect on athletic performance and energy. Many pre-workout supplements contain caffeine or similar chemicals that can enhance energy production as well as wakefulness. Since caffeine is a stimulant drug, it’s not good to use these products in the evening as they may cause insomnia or interfere with overall sleep quality.”

Dr. Michael Hirt, a Board Certified Nutrition from Harvard University and Board Certified in Internal Medicine and is with The Center for Integrative Medicine in Tarzana California states, “Everybody knows not to take caffeine pills at night, but many are surprised to discover that their sleepless nights may be the result of hidden sources of caffeine in their evening supplement regimen.Planning to hit the gym after work?Have an important post-lunch meeting?Make sure to carefully read all of the ingredients in your pre-workout drink or your ‘attention-focus’ tabs You may be shocked to find that amidst the top line ingredients you expect may also be some caffeine-loaded herbal extracts that can make you feel amp’d for a midnight game of pickleball To avoid a night of restless sleep, look to avoid taking these ‘caffeinated’ herbs late in your day: matcha, guarana, cocoa, green tea, green coffee bean, and guayusa tea leaf.”

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According to dr. Khubchandani, “Vitamin D use has increased substantially in recent times due to the belief that it helps protect against COVID-19. There are only a couple of studies showing what times are best to take this vitamin. For example, some evidence suggests that our body may relate Vitamin D with sunlight and sleep.At night time, there is a natural increase in melatonin (which promotes sleep) and taking Vitamin D at night may disrupt sleep. But one has to take a good meal full of fat to help absorb Vitamin D, which is dinner for some people.

So, watch how your body reacts and your dietary habits and plan accordingly. Calcium and Vitamin D are intimately linked and are better absorbed together. also, calcium competes with magnesium for absorption in the stomach and magnesium promotes sleep and relaxation. So, for maximum benefit of magnesium, consume calcium and Vitamin D earlier in the day with heavy meals.”

woman taking fish oil
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Trista BestMPH, RD, LD says, “Fish oil supplements have risen in popularity over the last decade in the health and wellness world. Most anyone can benefit from integrating a fish oil supplement into their daily regimen. However, timing of this supplement is important to its efficacy and to avoid negative side effects.Because fish oil is high in fat, taking it prior to sleep can cause symptoms of acid reflux like indigestion and heartburn.Research shows that it is best absorbed when taken alongside a fat source, therefore, taking it in the morning with a breakfast or lunch that contains a healthy fat source would be ideal to prevent poor sleep due to reflux.”

While there’s many benefits to taking fish oil such as a lower risk of heart disease, lower blood pressure and lower cholesterol levels, there can be side effects. Mayo Clinic states, “Possible interactions include:

  • Anticoagulant and antiplatelet drugs, herbs and supplements. These types of drugs, herbs and supplements reduce blood clotting. It’s possible that taking fish oil supplements with them might increase the risk of bleeding.
  • Blood pressure drugs, herbs and supplements. Taking fish oil supplements might slightly lower blood pressure. Taking these supplements with blood pressure drugs might increase the effects on blood pressure.
  • Contraceptive drugs. Some contraceptive drugs might interfere with the effect fish oil typically has on triglycerides.
  • Orlistat (Xenical, Alli). Taking fish oil with this weight-loss drug might decrease absorption of fish oil fatty acids. Consider taking the supplement and drug two hours apart.
  • Vitamin E. Taking fish oil can reduce vitamin E levels.

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