Timing of/taking supplements

[Niao]

Hi

I already take quite a few supplements ie vits/minerals etc.

Take magnesium, calcium, multi Bs, Omega 3, D3 etc.

I've only just been more aware of the timing of taking them, when alerted to possible iron level issues with RA. As I'm also vegan, I have tried to separate certain ones like magnesium, calcium etc. From iron rich meals. Tried also to give up caffeine, certainly around mealtimes, all to maximise absorption.

This made me look into possible affects on the new meds I'm taking now, MTX and prednisolone . Pretty sure everything I take is ok and aware of the affects of meds on calcium/magnesium levels. Have also stopped taking my multi Bs on the MTX day, due to folates.

Just wondered if I am missing anything or if anyone had any ideas/pointers on good things/times to take? Also, I do take zinc and Vit C, and I know there are conflicting views on these, being immune stimulating?

Thank you!

This is such a helpful, informative group!

[allanah]

I was told by my rheumy be careful as hes trying to lower my immune system, not stimulate it ! Hes got a point I suppose!

[Niao in reply to allanah]

That's why I was not sure but my consultant said it was ok. It is so hard to decide what's right , there are so many conflicting opinions out there.

I know it seems counter productive, if one's trying to suppress the immune system, but just how far we need to suppress it in order to get results for RD is not as clear, or more importantly, which parts of the immune response are we trying to suppress, if that makes sense? For instance, we do not want/need to effects that Methotrexate has on folates. Hence are given folic acid, which cancer patients would not be.

[allanah in reply to Niao]

Agreed I didnt pursue it further but many on here will know , good luck x

[allanah in reply to Niao]

You could maybe ask for blood levels , I know there are private( expensive) companies that will tell you of your vitamin levels, then sell you them! But your levels might be fine. I get mine done for a different illness and they are always ok just with balanced diet? It's a hard one .

[Niao in reply to allanah]

Thank you. I'm not a great fan of supplements but do take magnesium religiously to both help my many ailments but also mainly because it can be seriously depleted when taking certain meds that I have to take. Same for calcium but I'm not as comfortable taking high amounts if this. Being vegan, and for others reasons, I try to ensure B12 and other levels. Oh and D is because I rarely get outside, so to be safe.

[allanah in reply to Niao]

Sounds sensible to me , but the rheumy SHOULD know!

[MJSlide1958 in reply to allanah]

Hi, Does this mean that you should not take Vit D3 on the same day as MTX?? Confused!

[Niao in reply to MJSlide1958]

Sorry again for any confusion caused.As far as I know taking Vit D on the day you take your MTX should be alright. It is just anthing containing folic acid or folates that I'm pretty sure should be avoided in most cases.

[Lolabridge]

My consultant was keen that I should ask for his/nurse’s advice before taking any supplements.

[Niao in reply to Lolabridge]

Mine wasn't interested at all , said yes to all I questioned, and the nurse hadn't a clue.Hadn't even heard of some of the things I was asking about.

[springcross]

Hi Niao. Only that if you take Vit D3 (or possibly D2 for that matter but I'm not sure of that one) you probably should be taking K2 also - I got the below info from the betteryou.com web site. I take it with D3 seperately but you can get them combined. Also, allanah has a point. x

Vitamin D3 and vitamin K2 ensure that calcium is absorbed easily and reaches the bone mass, while preventing arterial calcification. Helping to keep your heart and bones healthy. Separately, K2 regulates normal blood clotting, whilst D3 supports a healthy immune system and supports muscle function.

[allanah in reply to springcross]

That conflicts. My nurses said dont take vitamin D on my drugs? 😂 I am on anticoagulant etc ...

[springcross in reply to allanah]

I've been taking D3 for a few years now - I have osteoporosis but that's not the only reason I take it. My rheumy actually asked me if I take it when I was first diagnosed with RA when we were discussing the osteoporosis and I was under the impression that if I hadn't told him I already took it, he would have advised me to do so. I am on MTX but maybe it's different with biologics (is that what you're on) ?

[Niao in reply to springcross]

Yes, that was actually the one thing my Rheumatologist did take an interest in and encourage!

[allanah in reply to springcross]

Amazing isnt it!!!

[allanah in reply to springcross]

😂😂🤔well yikes, all different, maybe it's my other drugs that would disallow mine , dont know ?

[Niao in reply to springcross]

Thank you. Yes I forgot to list K2 which I do also take just not as religiously as I maybe should.

[Dobcross1]

I take all the supplements you mention and more besides (biotin, collagen, lysine, wheatgrass, maca). I've never been asked or told my rheumatologist but I really think they've helped me- though I'm aware there are many and varied opinions on supplements. I don't take any of them on the day I take methotrexate though (thats the only RA med I take). I take most of them on an empty stomach first thing each morning - Omega 3 and magnesium later in the day. I think we all have to find what works for us as individuals 😊

[Niao in reply to Dobcross1]

You"'re right. I don't take most either on day of methotrexate.

[Niao in reply to Dobcross1]

You're right! I did use to take all mine together before I started worrying about absorption, now tend to take certain things apart. MTX and prednisolone are all I'm taking right now but have only just started so not sure what I'll end up on. Looks like you're taking some good things there.

[MJSlide1958 in reply to Dobcross1]

Hi, Is it so that MTX can work on its own for severe RA? Does it have to be a high dose 15mg weekly or higher? Thanks

[Niao in reply to MJSlide1958]

Sorry if I have caused any confusion. As far as I know you should be

fine to take supplements if you wish on the methotrexate day apart from anything that contains folic acid or folates, such as a b multi.

My choice to try to limit taking others, at least right around the time I take the MTX is just a personal one and is because I don't want to interfere with the absorption of the MTX. I am not saying that it would interfere but erring on the side of caution.

I do sometimes take my Vit D, just later on in the day.

[MJSlide1958 in reply to Niao]

Thanks x

[Gilliancheche]

Oh heck! I am vegetarian and take the B, Calcium and D daily. My rheumatologist knows I am taking the calcium and B , the extra D was prescribed due to recent melanoma and they knew I was on MTX when prescribed. Am hoping no probs with this combo. I might call and ask my advice line to see if I should not take on MTX day. So hard to get a full picture from any one

[Niao in reply to Gilliancheche]

I think it would just, if anything, be the B ,if it is a multi contains folic acid, you may be better to avoid on that day. I do take my D on the day. I just don't take calcium, really as it sometimes gives me stomach ache which the MTX does too.

[Gilliancheche]

Ok thanks, will check with my nurse advice line x

[Durrell]

Hi I’m a little late on this but I see a nutritionist with the blessing of my Rheumy. I take several sups throughout the day, I don’t take any on mtx day. But the advise from nutritionist was take the magnesium citrate at bedtime with a good glass of water, this has helped me immensely, so they are beside my bed now, may or may not be helpful. Like you say there’s lots of for & against but I can say now Ive got over the fear of taking sups & seeked professional advice I’m feeling heaps better than with just meds alone.. I hope you find your own way through this mine field!! 🤞👍🎄

[Niao in reply to Durrell]

Thank you! And yes, I also take my magnesium citrate on its own before bed. It is the one supplement that I feel the surest of in terms of actually having a positive affect. Have also tried magnesium pycolate with, I think, good results, and have found the magnesium sprays/ gels to help with sleep. It's great you're getting such benefits from sups.

[Durrell in reply to Niao]

Yes the sprays are really handy as you don’t always want to have long soaks in the bath with Epsom salt (that’s if you can manage getting in & out!).. we’ll keep up the good work I think we are following a sensible path for our condition & feeling the benefits 👍🙌🏻

[Niao in reply to Durrell]

Agreed! Unfortunately got rid of the bath years ago as I couldn't get in or out! Do miss the long soaks.

[Durrell in reply to Niao]

Just like me, bath out wet room in. Though I was also advised still soak feet in bowl of warm Epsom salts approx 20 mins can have a very beneficial effect too!! So I’m giving that a go, I do sleep well after. Like nomoreheels if you can, food is the best source but it can difficult to fit it all in & keep on top of it..

[nomoreheels in reply to Durrell]

We didn't fit a wet room due to constraints but I don't half appreciate the shower & tray we did decide on. We've put a bath in the en-suite upstairs as once we're fully finished (just carpets to sort now) we intend starting looking for somewhere else & didn't want to limit prospective buyers given it will be ready to walk into as far as biggest selling points go. I have actually been in the bath, that was finished before starting in the shower room. I lay down in it once, you can guess why it was only once! After that it was a wash down with my h rinsing the suds off with a measuring jug, 3 weeks of it. Boy was I happy when I eventually had a proper shower! Epsom Salts in a bowl of warm water, heavenly feet.

[Durrell in reply to nomoreheels]

Very sensible the bath is always a top selling point. Well sounds like you have a good plan, though your home sounds lovely fresh & cosy it will be sad to leave!!

[nomoreheels in reply to Durrell]

My h has itchy feet, & the garden's not as big as he'd like. Trouble was we'd to move quickly as one sale on our previous house fell through & the new buyer had a deadline to meet so this property wasn't our first choice. Anyway, we'll see what transpires.

[Durrell in reply to nomoreheels]

Well good luck with that, new year new start maybe 🤔

[Niao in reply to Durrell]

I will definitely try the Epsom foot soak, can't think why I haven't already! Thank you!

[Durrell in reply to Niao]

Great, I do soak my feet but it was the nutritionist who said it’s still extremely beneficial soaking in Epsom salts, enjoy 😊

[nomoreheels]

I think Durrell has given sound advice & would encourage you to follow suit & seek the expertise of a Nutritionist. Ordinarily I’d suggest trying to get the vitamins & minerals from the best source & save your money as quality supplements eat away at your pennies but being vegan I appreciate that's not always possible. There may even be others recommended which could be necessary or you're lacking that your research hasn't maybe covered. Also, it could be the timings of taking supplements & your meds are important, just as it is taking magnesium citrate an hour before a meal or a couple of hours after, with a glass of water.

Think about it. It could make all the difference to your well-being, not to say being as ok as you can be for helping yourself control the disease.

It would help to take a list of all your prescribed meds as it's likely they'll have access to contraindications. I wish you all the best Niao.

[Niao in reply to nomoreheels]

Thank you! I did post a reply yesterday but am not sure where it has gone? Yes, excellent advice, all round, from this group for which I'm very appreciative!

Nutritionist may be the way to go, have seen one but that was a long time ago and there is always something new to learn.

You're right in that vegan supplements tend to be more expensive but luckily I've managed to find some good ones at reasonable prices.

It's really not so much that I'm worried I'm deficient in something, or about my diet, but moreso , nutrition being an interest of mine, interested to hear what others are taking, and what they feel works for them. As I said, I previously hadn't given much thought to when I took my support but have recently paid a lot more attention to this and do believe it can help with absorption.

The main niggle I was having was the question of zinc and vit c but I tend to agree with Kikideelili on that.

[nomoreheels in reply to Niao]

Snap! Just had the same happen to me. I think you'd be wise to ask for advice from a Nutritionist. Also, if you haven't, a check for any deficiencies, I do believe it's important when you have some limitations in your diet, whichever they may be or if it's due to another medical issue.

You said you take calcium & Vitamin D3 but you didn’t mention Vitamin K, or specifically K2, unless it was one of the etcs?! It's necessary as calcium will otherwise make it's way to the kidneys & the coronary arteries, we need to limit calcium in both. Instead it helps the calcium find it's way to why we take it, to help strengthen our bones, ensure we have good bone density & help in avoiding fractures. This explains further inside-out-health.com/vitam... Just be sure you get a K2 suitable for vegans.

[Niao in reply to nomoreheels]

Thank you! Yes, more and more replies haven't registered!

Wise words and you're right about the K, I had been taking this but have let it slip recently, I musn't!

[Hidden]

I've been taking supplements for a year now I see a private functional gp. Rheumatologist and GPS are not qualified to advise on supplementation.I take lots of supplements vit c, D and zinc are all safe if you're immunosuppressed. You are topping up your levels not stimulating your immune system. My RA has been better not worse on these supplements.

I use Thriver for blood testing. Finger prick tests by post.

[Niao in reply to Hidden]

Thank you! It really was the issue of the vit C and zinc I couldn't make my mind up on and you have said what I had decided, yet kept questioning!