About one-third of all American adults take a multivitamin regularly, making this an incredibly common supplement. But while multivitamins are generally viewed as safe, they still have the potential to make you sick. “Multivitamins are classified as dietary supplements, which means that they are not heavily regulated by the United States Food and Drug Administration (FDA),” says Dr. Kelly Johnson-Arbor, MD, a toxicologist at MedStar Health. “The ingredients and potency of vitamins, minerals and trace elements can vary among multivitamin brands, and in some cases, multivitamins may provide excessively high amounts of nutrients that may cause signs and symptoms of vitamin toxicity, interact with other medications and may even increase the risk of developing certain diseases.”That’s why it’s important to tell your healthcare provider if you’re taking a multivitamin, she says. They can also be a bad mix with certain prescription drugs, making them extra important to flag if you’re on a medication, says Dr. Jamie Alan, Ph.D., an associate professor of pharmacology and toxicology at Michigan State University. If you’re one of the millions of American adults who take a multivitamin, it’s fair to have questions. Here’s what doctors want you to know. ?SIGN UP for Parade’s health newsletter with expert-approved tips, healthy eats, exercises, news & more to help you stay healthy & feel your best self?
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First, it's important to always tell your healthcare provider that you’re on a multivitamin. “There can be potential drug interactions with prescription medications and we also want to make sure that you aren’t taking too much of a certain vitamin,” says Christina Inteso, Pharm.D., a clinical pharmacist at Corewell Health. “In particular, taking too much vitamin A, D, E or K can be harmful.”
These are the biggest concerns with medications that may interact with a multivitamin.
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Blood thinners like warfarin prevent blood clots by changing how your body uses vitamin K, Inteso points out. “Vitamin K, which can be in a multivitamin, helps regulate blood clotting,” she says. “If you suddenly start or stop something with vitamin K or take it inconsistently, it can interfere with how warfarin works.”
2. Bisphosphonates
“Multivitamins with calcium, magnesium or iron can interfere with bisphosphonate absorption,” Alan says. These medications need to be taken on an empty stomach for that reason, Inteso adds. “My recommendation is to take your bisphosphonate first thing in the morning—remember to sit up for 30 minutes after you take it—and then take your multivitamin later in the day, at least one to two hours after you have taken the bisphosphonate,” Dr. Alan explains. “If you are taking an IV or injectable bisphosphonate, this does not apply.”Related: Never Combine These 2 Supplements Without Checking With Your Doctor First, Experts Warn
Antibiotics like tetracycline and fluoroquinolone can interact with some of the vitamins and minerals that tend to show up in multivitamins, Dr. Johnson-Arbor says. “Medications belonging to both of these classes of antibiotics can bind tightly to elements like iron, calcium, zinc and magnesium, forming compounds that are poorly absorbed by the human body,” she notes. “The formation of these largely insoluble complexes reduces the amount of antibiotics that are delivered through the bloodstream to the rest of the body, reducing the overall effectiveness of the antibiotics.”
4. Levothyroxine
Multivitamins that contain calcium or iron can interact with tablets of the thyroid medication levothyroxine, Dr. Johnson-Arbor says. “Taking levothyroxine along with chromium-containing supplements may also reduce the effectiveness of levothyroxine." She recommends spacing your supplement out from your medication by two to four hours.
5. Retinoids
Retinoids like Accutane are derivatives of vitamin A, and taking a multivitamin that contains the nutrient could cause health issues, Alan says, explaining, “A patient can get too much vitamin A, which can lead to toxicity."
Related: In High Doses, Cardiologists Say This Heart-Healthy Supplement May Be Doing More Harm Than Good
What To Do if You Take a Multivitamin
There are a few things to consider. First, talk to your healthcare provider about any supplements you’re taking. “Because different vitamins and minerals may interact with medications in various ways, there is no uniform recommendation for how to safely take multivitamins with all prescription or over-the-counter medications,” Dr. Johnson-Arbor says. So, it’s important to have that conversation.
If you’re starting a new prescription medication and you take a multivitamin, Dr. Johnson-Arbor recommends reading the included insert to see if there are any potential interactions.
“Many times spacing them out will work but not always,” Dr. Alan explains. “I would recommend that you double-check with your healthcare provider for more specifics on your individual case.”
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Sources:
Kelly Johnson-Arbor, M.D., a toxicologist at MedStar HealthJamie Alan, Ph.D., an associate professor of pharmacology and toxicology at Michigan State UniversityChristina Inteso, Pharm.D., a clinical pharmacist at Corewell HealthMultivitamin/mineral supplements, National Institutes of HealthHence then, the article about 5 medications you should never ever mix with your multivitamins without talking to your doctor was published today ( ) and is available on Parade ( Saudi Arabia ) The editorial team at PressBee has edited and verified it, and it may have been modified, fully republished, or quoted. You can read and follow the updates of this news or article from its original source.
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