Question:
What order should I take my medication/vitamins/supplements?

I am 22 months PO, down 252 lbs and a few lbs below goal. I find myself taking more supplements due to some low levels and could use some advice on what I can and cannot take together in order to get the best absorption. I've had to add the iron and zinc in the past few months and know that there can be issues with what I take them with. I take the following daily: <p>Prescription Meds: Celexa, Provigil and Ritalin. The first two are taken before breakfast and need to stay that way. The Ritalin is used to supplement the Provigil throughout the day to keep me awake. I have a very severe daytime sleep disorder. So far I have never noticed any interactions with these meds and anything else I take. <p>OTC - Calcium Citrate w/vitamin D, 300mg ea - 1 pill 4 times a day; Ferrous Gluconate 1 pill 3 times a day; Zinc 50mg once a day; Chewable Multi-Vitamin 1 pill 2 times a day; 1000mg sublingual B-12 every 2-3 days; 500mg Vitamin C 1 pill a day. I also take 50,000 units of prescription Vitamin D once a month. I am slightly low in calcium, vitamin D, zinc and iron. My iron had gotten into the normal range after the iron infusions I had in Sept but have dropped again since my PS 4 weeks ago. My B-12 floats up and down but usually is in the normal range. My protein is always slightly low 5.6-5.9, even though I eat a lot of protein. I'm not really worried about that number as it's very close to the min 6.0. <p>I would appreciate it if anyone can give me the order and times that I should ideally take these things. Thanks in advance for your help! Chris    — zoedogcbr (posted on December 8, 2004)

December 8, 2004
You should always take Iron.. The best is fumurate. Or if your already anemic - by the 'extra' duty one from Vitalady. Dont take your IRON at the same time as your Calcium Citrate. You might also want to do your multi with Iron for an 'extra' boost. Is your chewable an 'adult' chewable? I take a multi with iron, one B12 and iron in the AM and before bed. I do my citrate spaced out during the day.
   — star .

December 8, 2004
H. Collins - Thank you for the reply. My feeling and my doctors, is that if I do not need the extra iron then do not take it. I am watched very closely with labs every 3 months so there is no chance for it to get way out of order. I am low again, due to the blood loss from PS. My multi-vitamin is a children's and the reason is, is because they taste better and I take so many HUGE pills that I prefer to stay with the chewables. If one compares an adult (not specialized) multi vitamin with a children's multi-vitamin they will find that one pill of each is EXACTLY the same dosage of everything. A child takes 1/2 pill up to age 3 or 4 and then a whole one, which is the same as an adult. Trust me I have compared them extremely closely. I take the Centrum Rugrats but have also taken Centrun adult chewable in the past. I do not think taking a multi-vitamin with additional iron will help as the iron is sulfate, which we do not absorb. I have significant constipation issues with the iron so I do not wish to take them long term. I told my internist I want to try and get my level up, over the next three months, with the iron pills but that if it isn't successful I will agree to have the iron infusions again. They cost $1000 per treatment and I got a treatment each day for 4 days in a row, for a total of $4000. Granted insurance covered it, but yikes that is a ton of money if there is a cheaper way to get there. If not, then I will go that route.
   — zoedogcbr

December 8, 2004
Clarification: I take Ferrous Fumarate, not Ferrous Gluconate. Chris
   — zoedogcbr

December 8, 2004
Those irons are ok, but since they're giving you constipation, you might want to try the carbonyl. It tends to be the gentlest of the gang, cheap, easy to take and very well absorbed. You can chew if you want. Iron is always taken with C, and I never take mine with anything else. IF the protein is low, where is the albumin? You may need to add 1 protein shake a day and see if that makes any substantial diff. For example, if you kept eating protein foods as you are, but start your day with 30g whey + water and you count went to 6.3 within 30 days, you'd be onto something.
   — vitalady