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Do we need supplements? The most common response from experts is no: a nutrient-dense diet should provide all essential nutrients. Occasionally, however, we need a boost, especially for:
General ageing Common deficiencies are thiamine, vitamins C and A, and nicotinamide.
Eye health maintenance Key nutrients are vitamins C and E, zinc, lutein, zeaxanthin, astaxanthin, and omega-3 fatty acids.
Digestive conditions, e.g. inflammatory bowel disease A meta-analysis suggests deficiencies in prebiotics and probiotics, and omega-3 oils.
Weight-loss diets A lack of variety may mean less vitamin D, calcium, magnesium and healthy fats.
Gluten-free diets One in 10 people on a gluten-restricted diet has lower levels of vitamin A, iron, magnesium, calcium, zinc, and folate.
Low mood A reduced intake of whole grains leads to a lack of B vitamins, which benefit mental function.
Pregnancy Iron is critical to lessen maternal and infant mortality; folate to reduce neural tube defects.
Bone disorders Higher intakes of calcium and vitamin D reduce osteoporosis risk.
Statin use Taking coenzyme Q10 as ubiquinol reduces muscle pain, one of statins' side effects.
Hormone treatment Oral contraceptives and hormone replacement therapy both deplete the body of B vitamins; vitamin C; magnesium; and zinc.

How to take supplements

Some forms of vitamins and minerals are better absorbed than others. Generally, the best nutrients come from a professional clinic, and will cost a little more. Always read the label and discuss how to take them with your natural health practitioner. Some general rules apply: Never take supplements with alcohol, soft drinks, or tea and coffee, as these interfere with absorption and increase excretion of some minerals; they also destroy probiotics' effectiveness. Take iron on an empty stomach, in the morning, with vitamin C to enhance its entry into cells. Split vitamin C into several doses throughout the day to avoid gastric upset and provide a longer-lasting effect. B vitamins are best taken with breakfast, as technically they’re food and taken on an empty stomach may cause nausea. Have vitamins D, E and K with a fat (milk, nuts, yoghurt or avocado) for better absorption. Co-enzyme Q10 should also be taken with fat after breakfast or lunch, as it may impact sleep if taken later on. Always take zinc with food, as otherwise it can cause nausea, and at least four hours away from iron or calcium. Take fish oil with a meal to aid absorption; probiotics before food; and calcium and magnesium together before bed, as they assist sound sleep.

Contraindications

Some supplements interact with prescription drugs, so discuss with your doctor. For example:
Vitex agnus-castus (chaste tree) This herb is ineffective when taken with the Pill.
Ginkgo biloba This has a blood-thinning action.
Hypericum perforatum (St John’s wort) This should not be used with any prescription drug as it may render that drug ineffective.
Probiotics Expert advice is needed, especially with infants, the immune-compromised, or the elderly.
Panax ginseng This should only be prescribed by a qualified herbalist or naturopath. Never self-prescribe.
Vitamin C Large doses can cause loose bowel motions and gastric upsets.
Magnesium Large doses can cause loose bowel motions and cramps.
Zinc Large doses may cause a copper imbalance, which in turn may cause anxiety.
Iron Have levels checked before supplementing, as fatigue can mean a more serious condition

Teresa Mitchell-Paterson BHSc(CompSci) MHSc(HumNut) AdvDipNat is a member of the Australian Traditional Medicine Society. www.atms.com.au