How to Take Supplements

Q:I hear a lot of different things about which supplements to take, and when and how to take them. What do I really need to know?

-Nora C., San Francisco

Supplements are different than over-the-counter medicines because medicine is given to change the physiologic workings of the body (suppress cough, decrease mucus, dampen inflammation), whereas supplements are typically given to enhance the normal functioning of the body, or to promote the optimal expression of body and mind. Here are the four basic types of supplements, with information on how to take them.

1. Food-like supplements, including vitamins, minerals, and botanicals. In general, it’s best to take these supplements with meals, which allows the entire digestive system to work on breaking them down, enhancing their effectiveness, and reducing chances of a sour stomach.

Look for a multivitamin/mineral product that doesn’t have a lot of unpronounceable words in the “inactive ingredient” list. And test it out. If your supplement doesn’t dissolve completely within 2 hours of being placed in a glass of vinegar, it won’t break down in your stomach like it should.

Unless you’re a strict vegan or vegetarian, or have an iron deficiency, you probably don’t need iron supplements. But if you do, iron uptake can be improved by taking it with vitamin C. This vitamin comes in many forms, but I prefer a non-GMO source such as organic corn, tapioca , or acerola cherry. (Many vitamin C products are, unfortunately, derived from GMO corn.)

Herbal medicines are, on the whole, extremely safe. There are a few herbs that can pose problems if taken at high doses, but they aren’t widely available. A few other herbs also come with limited cautions. For instance, St. John’s wort (Hypericum perfoliatum) can cause a rash in people who live in northern climates and visit very sunny places. Called “solar urticaria,” this condition goes away if you stop taking the herb for 2-3 days, and it doesn’t cause residual problems.

Ginkgo is reputed to be a blood thinner and may enhance blood-thinning effects if you take it with pharmaceutical blood thinners (Plavix, Coumadin, aspirin), but it won’t cause you to bleed out in surgery.

Licorice (Glycyrrhiza glabra) supposedly puts people at risk for high blood pressure due to its diuretic-and thus potentially potassium-wasting-effects. But I have never seen this actually happen. Licorice is a potent adrenal support medicine, an antiviral, and an effective restorative herb for the lower esophageal sphincter, which is almost always the problem in cases of heartburn.

2. Probiotics. Antibiotics wreak havoc on our gut flora, which includes H. pylori in the stomach (a balanced amount is normal); Lactobacillus acidophilus at the top of the small intestine; and Bifidobacteria in the colon. It’s generally a good idea to take a broad-spectrum probiotic product for a month after taking antibiotics. And take probiotics right before eating a meal, which helps the friendly bacteria make its way to the intestines before stomach acid can compromise its viability.

I also recommend trying a variety of probiotic brands. The science of probiotics is highly complex, and scientists have yet to understand which bugs are best for you as an individual. So it doesn’t hurt to find out which ones make you feel better, improve your digestion, brighten your skin, etc.

3. Enzymes. Most common enzymes are named after the substance they digest. Amylase digests amyl (starch), and protease digests protein. If you have digestive difficulties (constipation, gas, bloating, or abnormal stools), digestive enzymes, taken with meals, can help.

Enzymes also help with immunity. Your immune system’s white blood cells contain enzymes called lysosomes, which “lyse” (break open) when they reach an area of infection or injury. These enzymes “digest” viruses, bacteria, or irritated tissue so that the debris can be expelled from the body.

High-potency proteases (protein-digesting enzymes), taken without food, are my favorite remedy for most any type of “itis,” including tendinitis, laryngitis, and adhesive capsulitis (bum shoulder). I often recommend a 10-day course of 1,000 mg of bromelain (a strong protein-digesting enzyme derived from pineapple), twice per day-first thing in the morning (½ hour before breakfast) and last thing at night (at least 2 hours after dinner).

In short, just remember: if you need digestive help, take enzymes with food. If you need tissue repair or immune support, take enzymes without food.

4. Homeopathic remedies. The true study of homeopathy is a lifelong pursuit that requires a deep understanding of the “strange, rare, and peculiar” aspects of each patient. However, the tiny white pellets that are available at health food stores can be extremely helpful for the “spot treatment” of various common conditions. A few to try: Sarsaparilla for bladder infections; Ignatia for menses-related “blues”; Belladonna for flushing and right-sided headaches; Lycopodium for excessive gas; and Arnica for garden-variety bumps and bruises.

Homeopathic medicines are extremely fragile. Take them with water only. Afterwards, wait at least 15 minutes before eating and drinking, or using perfumes, hair products, toothpaste, or herbs. Avoid mentholated substances (e.g., Tiger Balm, Vicks VapoRub)-the menthol can be highly disruptive, and will “antidote” a homeopathic remedy, causing symptoms to re-emerge.

Emily A. Kane, ND, LAc, has a private naturopathic practice in Juneau, Alaska, where she lives with her husband and daughter. She is the author of two books on health, including Managing Menopause Naturally. Visit her online at dremilykane.com.