Why your daily vitamin supplements might not be working – and how to fix it

Dr Sudhir Kumar, Consultant Neurologist at Apollo Hospitals, Hyderabad, says timing, combinations, and even meal choices matter.

Synopsis: Vitamin supplements are growing in popularity across India, but many people still don’t know how to take them safely and effectively. This simple guide covers the best times to take them, what to eat with them, and what to avoid.

An increasing number of Indians are turning to vitamin supplements. However, according to healthcare professionals, many people remain unaware of how, when, and with what to take them in order to gain maximum benefit.

Dr Sudhir Kumar, Consultant Neurologist at Apollo Hospitals, Hyderabad, told South First that simply popping a pill is not enough – timing, combinations, and even meal choices matter.

Here is Dr Kumar’s guide to using supplements correctly.

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Vitamin D

Who should take it:

Individuals with low sun exposure, dark skin, obesity, elderly people, those with osteoporosis, or people with malabsorption disorders. Also recommended for those with clinically low blood levels of vitamin D.

When to take it:

Morning or afternoon. It has been linked to improved sleep patterns when taken earlier in the day. Avoid late evening doses if you are sensitive to its effects.

How to take it:

With food, especially meals containing fat, for better absorption.

Can be taken with:

• Calcium
• Magnesium (if needed)
• Vitamin K2 (often recommended together for bone health)

Avoid taking with:

High doses of iron, as it can interfere with absorption.

Remember:

Get blood tests to determine the correct dosage. Excessive intake may cause toxicity, particularly hypercalcemia.

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Calcium

Who should take it:

Those at risk of or diagnosed with osteoporosis, menopausal women, individuals with low dietary calcium intake, or people with vitamin D deficiency.

When to take it:

Split the dosage if it exceeds 500 mg/day, as smaller amounts are absorbed better. Recommended regimen is 500 mg in the morning and 500 mg at night.

How to take it:

• Calcium carbonate: with food
• Calcium citrate: with or without food

Can be taken with:

• Vitamin D (aids absorption)

Avoid taking with:

• Iron, zinc, or magnesium at the same time
• High-oxalate foods such as spinach

Remember:

Excess calcium may lead to kidney stones. Monitor total intake from both food and supplements.

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Iron

Who should take it:

People with iron-deficiency anemia, those with heavy menstrual bleeding, pregnant women, or individuals with malabsorption disorders.

When to take it:

Preferably on an empty stomach – one hour before or two hours after meals. However, if it causes stomach discomfort, it can be taken with food  – preferably low-fiber and non-dairy.

How to take it:

Best taken without food, but can be taken with vitamin C to boost absorption.

Can be taken with:

• Vitamin C

Avoid taking with:

• Calcium, magnesium, zinc
• Milk, tea, or coffee

Remember:

Take in the morning if possible. It may cause constipation or dark stools. Use only under medical guidance to prevent iron overload.

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Vitamin B12 (Cobalamin)

Who should take it:

Vegetarians and vegans, elderly individuals, those with pernicious anemia, people on metformin or proton pump inhibitors (PPIs), and those with neuropathy.

When to take it:

Any time of the day, though morning or afternoon is preferable. Avoid taking it late in the evening, as it may have a mild stimulating effect.

How to take it:

Can be taken with or without food.

Can be taken with:

• Most vitamins, including folate, vitamin C, and vitamin D

Avoid taking with:

No major food or supplement interactions. However, it may compete with vitamin C if both are taken in very high doses.

Remember:

Sublingual (under-the-tongue) or injectable forms may offer better absorption for some individuals.

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Vitamin C

Who should take it:

People with low intake of fruits and vegetables, smokers, those under chronic stress, or individuals on iron supplements.

When to take it:

Best taken in the morning or early afternoon.

How to take it:

With meals, to reduce stomach irritation.

Can be taken with:

• Iron (enhances absorption)
• B12, vitamin D, and calcium (some synergistic effects)

Avoid taking with:

Very high doses of vitamin C (1,000 mg or more) may interfere with vitamin B12 absorption if taken together.

Remember:

Doses above 2,000 mg/day may cause kidney stones or diarrhea.

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Magnesium

Who should take it:

Individuals with muscle cramps, migraines, constipation, stress, insomnia, or inadequate dietary magnesium.

When to take it:

In the evening or at bedtime, due to its calming effect that may aid sleep.

How to take it:

With food, to prevent gastrointestinal discomfort or diarrhea.

Can be taken with:

• Vitamin D (supports bone health)
• B vitamins

Avoid taking with:

Iron, calcium, or zinc at the same time. Space them out by a few hours.

Remember:

Magnesium glycinate or citrate forms are generally better tolerated. Excessive intake can cause diarrhea.

(Edited by Dese Gowda)