When to take supplements... so confused.

[Jules13]

So I'm more baffled than ever when to take supplements because of other pills I'm taking. Here we go...

Before breakfast: Thyroxine, omeprazole and folic acid.

With breakfast: diclofenic & paracetamol, sulphasalazine, omega 3 fish oil, MSM, glucosamine and turmeric.

Evening meal: hydrochloroquine, sulphasalazine, calcium, vitamin D, MSM.

Bed time with plain yogurt: diclofenic and paracetamol.

I was told I needed the calcium and vitamin d because of the omeprazole. But I had to take it 8 hours later because of absorption. I have to take the omeprazole because of the diclofenic.

Now it's suggested I need B12, iron and magnesium.

So... is anyone clued up on supplements and when they should be taken in regards to other medications. I'm exhausted.

[Nettac]

Probably best to ask rheumatologist. Early diagnosis,, mine told me not to take anything before all results were back (apart from the b vitamins).

[nomoreheels]

Definitely ask your Rheumy, you've been told not to take your calcium & Vitamin D at the same time as omeprazole, I can (though I take Adcal-D3 a combined chewable form). I take both with my other morning meds so in case you have any other absorption problems he'll know which can be taken with your morning meds & which shouldn't be. Always best to be on the safe side, even with supplements.

[ITYFIALMCTT]

As per the others, it's good to discuss this with your pharmacist/rheumatologist/endocrinologist but something that stood out for me as worth a discussion for you is taking the levothyroxine and PPI/omeprazole together (irrespective of that, levo. is usually taken alone): pharmacytimes.com/publicati...

There's a tremendous amount of individual variation in this. E.g., some people (depending on dosage) find that vitamin D at night disrupts their sleep (very much a sunshine vitamin for them that is better taken in the morning).

ETA: are you a member of Thyroid UK on HU? It's probably true of other forums but some of the members/admins there are very knowledgeable about timing supplements with thyroid hormones and would respond if you posted a question about your timing of medication, levoythyroxine, and supplements as this comes up on a regular basis.

healthunlocked.com/thyroiduk

[Jules13 in reply to ITYFIALMCTT]

Bloody hell. I've been taking thyroxine for over 28 years. No one has ever said it reacts with anything. Thanks though. Will check it out. Another thing to worry about.

[Jules13 in reply to ITYFIALMCTT]

I also have blood tests for my thyroid every 6 months and nothing has ever been flagged.

[ITYFIALMCTT in reply to Jules13]

The people on Thyroid UK find it more straightforward to make useful suggestions if they have the results of your blood work (thyroid-related, plus any vitamins and minerals and make sure to include the ranges). However, even while you're waiting to obtain the print out of your most recent blood work (if you don't have the results to hand via the online record access), if you ask for assistance with your medication, hormone, and supplement schedule, they'll be able to guide you. Jules13

[Jules13 in reply to ITYFIALMCTT]

Thanks.

[Strayleaves]

Hi Jules ,

I agree with the other helpful comments.

Anywhere I have ever worked , we always have given thyroxine , early in am , and usually on its own.

Folic acid should be given with food , usually taken with meals.

If you go onto iron supplement, always take it with vitamin c (even a little orange juice) ( and it can be a little constipating as well).

Always take voltaren with food ....

As far as I'm aware , you should always take your calcium tablet , prior to bed at night. ( through the night , is usually when your body's blood calcium levels drop and that is when it comes "out of the bones", to assist in keeping normalised blood calcium levels ....!!!

Apologies for not explaining very well ......not sure if it's methotrexate brain , fibromyalgia fog , or dementia settling in .... 😳😳😳 😞😞😔😟

Karen x

[Jules13 in reply to Strayleaves]

Oh crap. So I've been taking the folic acid on an empty stomach with my thyroxine and omeprazole! So thats not right is it? I should take the thyroxine on its own half an hour before eating. Then all the others with food? I thought the omeprazole stopped absorption of supplements which is why I took it first thing. Now even more confused.

[Jules13 in reply to Strayleaves]

Karen you seem very knowledgable about all this... so can I just review and see if you think this sounds right:

30-60 mins before breakfast = thyroxine

With breakfast = Sulphasalazine, Diclofenic (voltaren), Paracetamol, Iron (& Vit C), Magnesium, Folic Acid, MSM, Omega 3 fish oil, Glucosamine

Mid morning = Omeprazole

With evening meal: Sulphasalazine, Hydroxychloroquine, Diclofenic, Paracetamol, MSM, Glucosamine

Before Bed: Calcium, Vitamin D

My God, my head hurts. J x

[Mellisa1066]

Always been told by lots of hospital pharmacists never take any important drugs 2hrs before or 2hrs after taking stomach meds (esomeprazole , omeprazole etc) as these stop drug being absorbed in this time period.

[Jules13 in reply to Mellisa1066]

when do I take omeprazole then? If I can't take it with food, then do I take it around 11am? Two hours after breakfast and 2 hours before lunch? Would that work?

[ITYFIALMCTT in reply to Jules13]

Unless you've been instructed otherwise, you can take omeprazole with food: beta.nhs.uk/medicines/omepr...

It might come down to a matter of preference and when you prefer to take your vitamin/mineral supplements.

[Jules13 in reply to ITYFIALMCTT]

That's what I thought too. God I am getting so confused with everything. I will check it all wth my GP today x

[ITYFIALMCTT in reply to Jules13]

As long as you're attending your GP, if you've had any recent blood test results that are suitable for sharing with Thyroid UK, that might be a good time to ask the receptionist for a print out (assuming you don't have online access).

[Mellisa1066 in reply to Jules13]

Sorry jules13 I meant certain important drugs because of absorption like auto immune meds etc!

Im lupus , sjogrens, arthritis and thyroid so I do have to play around with 23 drugs a day and 4 weekly bio infusions i have to take 40mg esomeprazole in morning and 40mg at night as well as the others, so it is a bit of literally taking drugs every few hrs all day untill 11pm ,then ones that have to be at night .

I will take then take my night time stomach drugs before sleep 2hrs later.

Alot of my drugs state on the prescription box do not take with stomach medication 2hrs before or after ( but that is my drugs ) . I used to not worry about this until I was told by health professionals certain drugs will not be absorbed if taken with stomach drugs.

Most drugs will state on the box with PRESCRIPTION if they are not to take 2 hrs before or after stomach medications' (if they are affected by stomach medication)

I'm not 100% on supplements I dont take them.

So as advised check with your health professional.

Good luck anyway

[Jules13 in reply to Mellisa1066]

Yup I'm on 24 a day. No thyroid too. X

[Mellisa1066 in reply to Jules13]

Hope you get all sorted

[Lucy11]

Magnesium is best taken at night as it is sometimes used for insomnia. It relaxes the muscles and helps regulate metabolic processes like sugar metabolism.

I assume you tested low for it as we can usually get all the magnesium we need to replenish it from the food we eat. There are many different forms of magnesium so if it was suggested by your doctor it might be good to see which one he recommends for you.

[AgedCrone]

Unless your doctors tell you are lacking anything you shouldn't need supplements.,

A good healthy diet is all most people need.speak to your rheumy nurse, I'm sure she will know if you need anything!

You migh be spending a fortune unnecessarily!

[Jules13 in reply to AgedCrone]

Well I just had an update on all that which is rather interesting. See my new post.