How to Get the Most Benefits From Your Daily Prescriptions
Balancing multiple prescription medications and supplements can feel like a full-time job
It's becoming routine now: another doctor's appointment, another new prescription medication. The choices made in your twenties and thirties are now mingling with the genetic inheritance from your family. As a result, physical, psychological and emotional symptoms are cropping up daily.
You have made a plan with your medical doctor and specialists, or you are reaching out and working with a naturopathic provider or utilizing both avenues to find your optimal health. Balancing multiple prescription medications and supplements feels like a full-time job.
How do you figure out when to take which prescription? Are a prescription and a drug the same thing? And what about taking other drugs, like over-the-counter things? Do some medications cancel out others? And should you take dietary supplements? It's overwhelming.
Let's get some answers. We chatted with Natalie Kravchenko, Pharm D, and Dr. Austin Lake, a board-certified Functional Medicine Doctor and owner of Theophilus Health, to gain some perspective on these questions.
Medications vs. Supplements
So what is medication? Typically, "a substance intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease." These can be prescriptions from a doctor or over-the-counter (OTC).
Kravchenko says, "Prescription medications are reviewed by Food and Drug Administration (FDA) by using animal and human studies to look at how the drug behaves in the body in different patient populations."
In addition, Kravchenko adds, "You can purchase OTC medications without a prescription. The FDA also evaluates these; they are deemed safe for the general population if used as instructed on the label."
A dietary supplement is a manufactured product intended to increase the availability of nutrients derived from food sources. The term supplements also include any herbal remedies and vitamins. Supplements are often more preventive options than treatment.
Lake states, "The purpose of taking medications or supplements is to support overall health and wellbeing and address underlying imbalances or deficiencies that may contribute to health issues."
Timing of Medications and Supplements
Now that we better understand medications and supplements, let's talk about when to take them for the most benefit. Kravchenko tells us that absorption is not necessarily about a specific time but more about the conditions in the stomach, like the pH level. Some work better on an empty stomach, and some are better with food or specific foods.
The purpose of taking medications or supplements is to support overall health and wellbeing.
For example, Lake explains that fat-soluble vitamins such as A, D, E and K and minerals like calcium and magnesium absorb better when taken with fatty food. But on the other hand, some foods do counteract a medication's intended purpose. To name a few situations: Vitamin K interferes with blood thinners, and grapefruit juice interacts with many common meds.
In both of these situations, you should altogether avoid the combinations. Other combinations are ok if you separate them by several hours. For example, iron competes with the absorption of calcium and thyroid replacement medications. However, if taken 3-4 hours apart, these can provide the expected benefit.
In other cases, medications are recommended at a particular time to maximize their effectiveness and minimize the side effects. For instance, diuretics increase the amount of urine you make. So taking it early in the day reduces the number of times you must go to the bathroom at night.
Kravchenko also gives several examples of similar situations:
"Statins work by blocking the enzyme that creates cholesterol, reducing the amount of cholesterol your liver makes. This enzyme is most active at night — so some short-acting cholesterol medications, like simvastatin or lovastatin, are best to take at bedtime."
"Corticosteroids work best if taken in the morning because such a dosing schedule mimics the natural increase in the production of cortisol by the body. Additionally, taking corticosteroids before bed may interfere with sleep."
"Antacids are most effective if taken immediately after or during a meal because stomach acid production usually occurs as food enters the stomach. Certain antibiotics and HIV medicines also fall under this category. Diabetes medications, such as glipizide and glimepiride, should be taken around mealtimes to reduce blood sugar levels after eating."
"Some medications must be taken on an empty stomach because food and some drinks can affect how these medicines work by reducing their absorption, making them less effective. For example, dairy products like milk, cheese and yogurt may decrease the absorption and effectiveness of doxycycline and fluoroquinolone antibiotics."
What To Know About Interactions
- Omega-3 Fatty Acids and Statins: Omega-3 fatty acids can help reduce triglycerides and inflammation, which can benefit people taking statins to lower cholesterol levels.
- Coenzyme Q10 and Statins: Statins can deplete the body's stores of coenzyme Q10, vital for energy production and heart health. Taking a coenzyme Q10 supplement can help replenish these stores and may reduce the risk of muscle pain and weakness associated with statin use.
- Zinc and Vitamin C: These two supplements work together to support healthy immune function, and taking them together may be beneficial for reducing the duration and severity of the common cold.
- Vitamin D and Calcium: Vitamin D helps the body absorb and utilize calcium, making these two supplements beneficial for maintaining bone health.
- Probiotics and Antibiotics: Antibiotics can disrupt the balance of healthy gut bacteria, but taking probiotics can help restore this balance and reduce the risk of gastrointestinal side effects.
- Magnesium and Vitamin B6: These two supplements support healthy neurotransmitter function and can help improve mood and reduce anxiety.
- NSAIDs and Glucosamine/Chondroitin: Nonsteroidal anti-inflammatory drugs (NSAIDs) can interfere with the absorption of glucosamine and chondroitin supplements, commonly used to support joint health. Taking these supplements at least two hours before or after NSAIDs can help minimize this potential interaction.
- Calcium and Thyroid Hormone Replacement: Calcium can interfere with the absorption of thyroid hormone replacement medications, so avoiding taking these two together is essential. Taking calcium supplements at least four hours before or after thyroid hormone replacement medications is best.
- Blood thinners and Vitamin K: Vitamin K interferes with the effectiveness of blood thinners, so it's important to avoid supplements or foods with high amounts (leafy greens) while taking these medications.
- St. John's Wort and Antidepressants: St. John's Wort can increase the risk of serotonin syndrome when taken with certain antidepressant medications, so it's important to avoid taking these two together.
- Iron and Calcium: Calcium can interfere with iron absorption, so it's best to avoid taking iron supplements with calcium-rich foods or supplements.
Resources for You
One of the best resources available is your local pharmacist. By filling all your prescriptions at the same pharmacy, your local pharmacist can help educate you on your exact medication profile based on your medical diagnoses, lifestyle and goals.
Be proactive and have a written list of all the medications, supplements, herbal remedies and vitamins you take daily.
They are also well-versed in many dietary supplements and how they interact with prescription medications. Bringing the bottle of your chosen supplements to your pharmacist can help them understand the ingredients and give you the best guidance.
Be proactive and have a written list of all the medications, supplements, herbal remedies and vitamins you take daily. A chart or pill box will help keep you organized and on track. Visual reminders on cupboards or countertops help support the concept at the top of your thoughts.
Set reminders or alerts on your phone to take your pills at the designated times. Quality conversations about tolerating the medications will help you reach optimal health.
Another great resource is the National Institute on Aging. In addition, you will find great resources such as worksheets on what to ask your doctor during appointments and additional advice on medications and supplements.
A final thought from Lake: "Ultimately, the decision to use prescribed medications, OTC supplements, or both should be made in consultation with a health care provider, who can provide guidance based on an individual's unique health status and needs."
"A functional medicine approach can help to support overall health and reduce the risk of side effects or interactions by addressing underlying imbalances and deficiencies through targeted interventions, whether that involves prescribed medications, OTC supplements or a combination of both."