When considering building a supplement routine, the first question that often comes to mind is which nutritional supplements can be taken together. Commercially available nutritional supplements can contain various nutrients, including vitamins, minerals, amino acids, and botanicals. You might have heard about the synergistic relationship between certain nutrients that can enhance their health-promoting benefits. However, there are risks associated with mixing certain nutrients because of potential contraindications, adverse side effects, and interactions with other supplements or medications.
Here’s what you should know about which supplements can be taken together to promote various health functions and overall well-being. Use the links below to jump ahead to a topic of interest.
Nutrient Synergy: The Basis of Co-Supplementation
| Nutrient synergy is the dynamic interaction between different nutrients in the body, where their combined effect is more beneficial than their individual contributions. |
The concept of co-supplementation is to achieve nutrient synergy — when the combined benefits of two or more nutrients have a more significant physiological impact on the body than when each nutrient is consumed individually. Nutrition science traditionally focuses on isolating single nutrients to study their effects. For example, the Dietary Reference Intakes (DRIs) you see on product labels provide guidelines to prevent a nutrient deficiency or an excessive intake, but they are not designed to assess the potential synergistic effects of consuming nutrients together. Nevertheless, it is recognized that nutrients interact in complex ways, and their combined intake can have important additive effects.
For example, human trials demonstrate that combining the various B vitamins (vitamin B12, folate, and vitamin B6) helps lower homocysteine levels, which promotes optimal brain and cardiovascular functions.1 Similarly, co-supplementation of Coenzyme Q10 (CoQ10) and vitamin E has been shown to lower low-density lipoprotein (LDL) cholesterol2.
There is growing evidence that certain nutrients are more effective when consumed together than when consumed alone. Understanding the underlying mechanisms of nutrient synergy can develop dietary strategies to support various health functions.
What Supplements Can Be Taken Together?
A nutrient-rich, balanced diet should ideally provide all the nutrients a person needs. However, the reason for taking nutritional supplements is to fill the nutrient gaps in your diet. Multi-vitamin/multi-mineral supplements are among the most commonly used supplements to address the body’s nutrient needs. Additionally, botanical ingredients, such as curcumin, CoQ10, and berberine, have gained popularity as supplements.
The following table highlights some supplements that can be taken together to achieve their beneficial effects.
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What Supplements Can Be Taken Together: An Overview |
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| Vitamin C and Iron: Iron supports the production of red blood cells and is a component of hemoglobin, which carries oxygen from the lungs to the rest of the body. Iron is also involved in enzymatic reactions that produce cellular energy. Vitamin C, as an antioxidant, enhances iron absorption from plant-based food sources and supplements.3 | |
| Vitamin D and Calcium: Vitamin D maintains calcium homeostasis for optimal skeletal health. It is also recognized for extraskeletal functions, such as immune function. A minimum 25(OH)D (vitamin D3) level of 32 ng/mL is necessary for achieving optimal intestinal absorption of calcium.4 | |
| Vitamin D and Magnesium: Magnesium must be present for the body to metabolize vitamin D. But taking too large doses of vitamin D can induce severe magnesium depletion. Co-supplementation of vitamin D and magnesium is more effective in enhancing serum 25(OH)D concentrations.5 | |
| Vitamin D and Probiotics: There is emerging evidence that combined supplementation of vitamin D and probiotics benefits the gut microbiota. Co-supplementation with vitamin D and probiotics has been found to enhance metabolic parameters, including insulin sensitivity and antioxidative capacity.6 | |
| Vitamin B12, Folate, and Vitamin B6: Co-supplementation of these three B vitamins has been found to lower homocysteine levels and slow the progression of brain matter loss.7 | |
| Vitamin D3 and Vitamin K2: Calcium supplementation, especially at higher doses, may lead to vascular calcification and increase cardiovascular risk. Co-supplementation of vitamin D3 and vitamin K has been found to facilitate proper deposition of calcium in bones and teeth instead of arteries.8 | |
| Omega 3 fatty acids and Alpha Lipoic Acid: A clinical trial has shown that taking an omega 3 fatty acid and alpha lipoic acid together promotes brain functions and slows down cognitive and functional decline.8 | |
| Curcumin and Quercetin: The antioxidant effects of curcumin and quercetin in combination, have been found to promote wound healing by stimulating the migration of fibroblasts to the wound site.9 | |
| Quercetin and Magnesium: The free radical scavenging activity of quercetin increases after its complexation with magnesium (Mg(+2)) cation.10 | |
| Glutathione and CoQ10: Glutathione is the body’s master antioxidant. Combined with CoQ10, it can enhance antioxidant capacity to address oxidative stress | |
Supplements You Should Avoid Taking With Medications
A significant concern about consuming nutritional supplements together is the potential interactions between supplements and other ingested substances, such as other nutritional supplements, conventional foods, and prescription medications. The following are some possible interactions between supplement ingredients, medications, and other nutrients.11
- Direct chemical-chemical interactions: The formation of chemical-chemical complexes can modify the action of one or both compounds. Such interactions typically result after ingesting both compounds in a relatively short time.
- Pharmacodynamic interactions: These interactions change the response to either the nutritional supplement’s ingredient or the chemical present in a drug or food, such as an additive or coloring agent, even when there is no change in the plasma concentration of either compound.
- Pharmacokinetic interactions: In these interactions, one substance affects the absorption, distribution, metabolism, or excretion of another substance, resulting in altered levels of one of the substances or its metabolites.
The following are various nutrients, when taken in supplement form, that can affect the efficacy of prescription medications.
- Calcium, magnesium, and zinc: When taken as supplements, these nutrients can impact the efficacy of the antibiotic tetracycline.12
- Potassium: It can cause interactions with anti-hypertensive drugs, including angiotensin II receptor blockers.13
- Calcium and Vitamin D: These nutrients when taken as supplements can interact with thiazides (prescribed as diuretics to address high blood pressure), causing hypercalcemia and metabolic alkalosis.
- Vitamin K, ginkgo biloba, and CoQ10: When taken as supplements, these nutrients can reduce the efficacy of the blood thinner medication warfarin in preventing blood from clotting.
- Antioxidant supplements: Vitamins C and E can reduce the efficacy of some types of cancer chemotherapy.
- St. John’s Wort: This botanical supplement can increase the breakdown of several medications, adversely impacting their efficacy.
- Goldenseal: The compound berberine in goldenseal can interact with blood thinners, such as warfarin.
Consulting With Your Doctor Before Taking Supplements Together
Most patients do not disclose their supplement usage to their doctors. However, it is critical to consult with your healthcare provider to learn about the potential benefits and side effects of supplements before including them in your diet. Before taking two or more nutritional supplements together or taking them with prescription medications, you should:
- Make sure you discuss the supplement dosages with your doctor.
- Consult before taking any additional supplements beyond a standard prenatal supplement if you are pregnant or breastfeeding.
- Consult before planning surgery, because some nutritional supplements can interact with the medications that are prescribed before, after, or during surgery.
Selecting Advanced Supplement Formulations Based on Their Efficacy and Safety
Efficacy of Supplement Formulations
The efficacy of a nutritional supplement depends on how well its nutrients are absorbed and how the formulation enhances their bioavailability. Certain nutrients, such as glutathione and curcumin, are considered to be difficult-to-absorb molecules. Therefore, nanodelivery of such nutrients through carriers, such as cyclodextrins, has been found to enhance both their absorption and bioavailability, thereby tapping their health-promoting benefits.
Tesseract’s Supplements Formulated with Multiple Proven Nutrients
Tesseract Medical Research has formulated a wide range of nutritional supplements with multiple proven nutrients that promote various health functions. Tesseract’s proprietary CyLoc® – DexKey® nutrient delivery nanotechnology enables the delivery of active nutrient molecules through the gastrointestinal tract — one palatable molecule at a time. CyLoc® technology encases each molecule and creates nano-sized particles, thereby protecting them from breaking down during transit through the stomach. DexKey® technology accompanies each CyLoc® molecule and releases it at the desired point in the intestinal tract for maximum absorption and effectiveness.
The unprecedented optimal absorption of nutrient molecules in the gastrointestinal tract enables micro-dosing, which means using a lesser amount of the active ingredients in supplement formulations than previously required.
Safety of Supplement Formulations
When considering which supplements can be taken together, remember that not all supplements marketed as ‘natural’ are safe. Even when a supplement contains plant-derived compounds, it is essential to know how the ingredients have been formulated to ensure their safety. If a formulation does not contain the right amount of ingredients, then it can cause adverse side effects.
The U.S. Food and Drug Administration has established Good Manufacturing Practices (GMPs) that manufacturers should follow to ensure the purity, strength, and composition of their nutritional supplements. At Tesseract Medical Research, we are committed to GMPs. We utilize the most appropriate and scientifically advanced analytical techniques and a well-designed quality control system to develop the finest-quality nutritional supplements.
The power of Tesseract supplements lies in enhancing palatability, maximizing solubility, absorption and bioavailability, and micro-dosing multiple nutrients in a single, highly effective capsule. Shop products on our website and learn more about how they support your health and wellness.*
1,7VITATOPS Trial Study Group. The VITATOPS (Vitamins to Prevent Stroke) Trial: rationale and design of an international, large, simple, randomised trial of homocysteine-lowering multivitamin therapy in patients with recent transient ischaemic attack or stroke.” Cerebrovascular Diseases (Basel, Switzerland) vol. 13,2 (2002):120-126. doi:10.1159/000047761
2Izadi A, et al. Independent and additive effects of coenzyme Q10 and vitamin E on cardiometabolic outcomes and visceral adiposity in women with polycystic ovary syndrome. Archives of Medical Research vol. 50,2 (2019):1-10. doi:10.1016/j.arcmed.2019.04.004
3Lynch SR, Cook JD. Interaction of vitamin C and iron. Annals of the New York Academy of Sciences vol. 355 (1980):32-44. doi:10.1111/j.1749-6632.1980.tb21325.x
4Khazai N, et al. Calcium and vitamin D: skeletal and extraskeletal health. Current Rheumatology Reports vol. 10,2 (2008):110-117. doi:10.1007/s11926-008-0020-y
5Cheung MM, et al. The effect of combined magnesium and vitamin D supplementation on vitamin D status, systemic inflammation, and blood pressure: A randomized double-blinded controlled trial. Nutrition (Burbank, Los Angeles County, Calif.) vol. 99-100 (2022):111674. doi:10.1016/j.nut.2022.111674
6Abboud M, et al. The health effects of vitamin D and probiotic co-supplementation: A systematic review of randomized controlled trials. Nutrients vol. 13,1 111. 30 Dec. 2020, doi:10.3390/nu13010111
7Aaseth, Jan O et al. “The Importance of Vitamin K and the Combination of Vitamins K and D for Calcium Metabolism and Bone Health: A Review.” Nutrients vol. 16,15 2420. 25 Jul. 2024, doi:10.3390/nu16152420
8Shinto L, et al. A randomized placebo-controlled pilot trial of omega-3 fatty acids and alpha lipoic acid in Alzheimer’s disease. Journal of Alzheimer’s Disease vol. 38,1 (2014):111-120. doi:10.3233/JAD-130722
9Chittasupho C, et al. Effects of quercetin and curcumin combination on antibacterial, antioxidant, in vitro wound healing and migration of human dermal fibroblast cells.” International Journal of Molecular Cciences vol. 23,1 142. 23 Dec. 2021, doi:10.3390/ijms23010142
10Ghosh N, et al. Synthesis, characterization and study of antioxidant activity of quercetin-magnesium complex. Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy vol. 151 (2015):807-813. doi:10.1016/j.saa.2015.07.050
11National Academies Press (US). Interactions. Dietary Supplements – NCBI Bookshelf, 2005, www.ncbi.nlm.nih.gov/books/NBK216072.
12Bushra R, et al. Food-drug interactions. Oman Medical Journal vol. 26,2 (2011):77-83. doi:10.5001/omj.2011.21
13Sica D A. Antihypertensive therapy and its effects on potassium homeostasis. Journal of Clinical Hypertension (Greenwich, Conn.) vol. 8,1 (2006):67-73. doi:10.1111/j.1524-6175.2006.05139.x
