Dietary supplements may not work well or cause unwanted side effects if taken incorrectly.
We asked Erin Shaughnessy, PharmD, MBA, BCPS, system associate vice president of acute care pharmacy at Rush University System for Health, about the supplements people most often take incorrectly.
*This interview has been edited and condensed for clarity.
Q: What are some common supplements that people often take incorrectly?Â
Shaughnessy: I would say the top five are iron, melatonin, magnesium, vitamin D, and fiber.
Those are the big ones that pharmacists can help patients take in a way that benefits them rather than causing side effects.
Iron can upset your stomach when you take it, so people try to take it with food. But when you take it with food, it actually decreases iron absorption, so it won’t have the intended effect.
Another confusing piece is that the amount of the element in the supplement isn’t necessarily the dose. When you pick up a supplement, and it says you’re getting a 325-milligram tablet, a pretty common iron dose, it’s actually only giving you 65 mg of iron. You should clarify with your healthcare provider or pharmacist how much elemental iron you’re supposed to be taking versus the total dose.
For melatonin, it is important to take it with your evening meal to allow it to help you wind down. Many people expect melatonin to work quickly. Melatonin mimics the circadian cycle, so you don’t want to take it right before bed, because if you’re trying to get to sleep, it’s probably not going to give you the sedative effect that you’re looking for.
Magnesium can change the pH in your stomach, which can affect how other things that you’re taking work. Take these two hours apart for the most benefit.
When taking vitamin D, you also need calcium to get the effect you want. You don’t have to take it at the same time, but you need to have adequate calcium in your body.
Fiber supplements need a significant amount of water to do their job, so focus on hydration. If you don’t drink enough water, you might have some undesirable side effects like bloating, flatulence, and cramping. It can actually cause more blockage than what you’re trying to resolve.
Q: How can consumers make sure they’re taking supplements correctly and safely?
Shaugnessy: Read the warnings on medication and supplement labels. Anyone who’s on an anticoagulant, anything that thins your blood or prevents you from having a blood clot, should talk with a pharmacist or healthcare provider first to double-check which supplements interact with those types of medications.
When you pick up a supplement, you can talk to the pharmacist or pharmacy intern for guidance. It helps to have someone break it down for you and make a schedule of when to take things during the day.
While supplements are available over the counter, it is still important to never take more than is recommended on the label. Also, the active ingredient in the supplement isn’t the only thing in there. If you have allergies, check the nutrition labels on the bottles for any known allergens.
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