Taking Your Supplements and Medications Correctly
We are constantly fielding questions after patients leave their appointments regarding how to take their supplements, hormones, and medications correctly and how to remember them. As hard as we try to explain and write things down clearly on the Optimal Health Plan that you take home with you, many of you still aren’t sure. If you are at our practice to experience optimal health, taking your supplements at the correct dose and time is imperative! Here’s a review of how to take some of our most common supplements and prescriptions, and how to remember them!
Common Hormones and Supplements and How To Take Them
(1) Sublingual Medications: Pregnenolone, DHEA, Oxytocin, Melatonin, Estradiol Rapid Dissolve Tablets, HCG and Progesterone are some of the most commonly prescribed hormones we use for adrenal health, sleep, low testosterone, and PMS/menopause. Sublingual medications are placed under the tongue and held for 1-3 minutes! It takes a full 60 seconds for 90% of the medication to be absorbed! HCG is an a high proof alcohol base and may be absorbed more quickly; however, you must still hold it a full 60 seconds to be sure! After dropping the medication under the tongue you may swish your tongue around gently to increase absorption, wait the 1-3 minutes, then swallow.
(2) All Thyroid Medications: Cytomel, Nature-Throid, Synthroid, and Armour ALL must be take on a completely empty stomach to be absorbed. For those of you on once a day dosing, take your thyroid medication first thing in the morning upon rising. Keep it on your bedside table so that it is the first thing you do even before getting out of bed! Do not eat or drink anything for 20-30 minutes after taking your thyroid medication other than water. Nature-Throid should be chewed to improve absorption. If you eat food or drink something besides water, your thyroid medication will get bound up with the minerals in your food, and you will not absorb it! For those patients on twice a day dosing of cytomel/liothyronine, be sure your afternoon dose is also taken on a completely empty stomach at least an hour after lunch, preferable 2 hours.
(3) Essential Fatty Acids/Oily Supplements: Krill oil, Omega-3’s, CoQ10/ Ubiquinol, Vitamin D, Vitamin E, and Evening Primrose Oil all require fat to be absorbed correctly. Therefore, it is recommended that you take these supplements with a meal that has fat in it!. If you do not do this, these expensive and very important supplements will not be absorbed. If you are taking our liquid Vitamin D, that particular supplement is already bound in olive oil for absorption and you may take it alone any time. If you are taking another Vitamin D supplement in capsule form, take it with a fatty meal.
(4) Water Soluble Vitamins and Minerals: Iodorol, Iron, Chromium, Zinc, Selenium, Magnesium, Vitamins B, and C are examples of water soluble vitamins and minerals we frequently prescribe. These are easily absorbed anytime with just a glass of water and may often be taken with or without food. If you are prone to nausea you may want to take them with a meal.
(5) Glutathione, Probiotics, Herbal GI preparations and GI Cleanse Supplements: These are all best taken on an empty stomach unless we direct you otherwise. When we say “empty stomach” we mean 30 minutes before eating or at least an hour after a meal. Glutathione is one of the few supplements that may be taken with your thyroid medication first thing in the morning.
(6) Progesterone, Estradiol, Bi-Est, or Estriol Topi-Click Cream: Your progesterone or estrogen cream is best rubbed into the skin using pressure on your forearms or directly to your face (where it will prevent wrinkles). It is optimal to apply your cream right out of the shower so it is easily absorbed or right before bed. Do not use other lotions or creams for at least 20 minutes on the area you place your estrogen cream because this will reduce absorption. It is also a good idea to rotate sites so that you do not get “dermal fatigue” in any one area. Dermal fatigue is when your skin stops absorbing a hormone. Rotate sites and rub in the skin multiple times using pressure each application for best absorption.
(7) Testosterone Creams and Gels for Men: Testosterone is applied differently depending on your gender. For men, Testosterone gels and creams are best placed on the area of the neck below the hairline to the clavicles, on the forehead, or on the sides of your torso. Testosterone cream must also be rubbed in well to be absorbed, do not use other creams or lotions within 20 minutes of application, and wash your hands after application! You may inadvertently touch a partner or a child, and they may grow hair where it is accidentally applied!
(8) Vaginal Testosterone, Estriol, or DHEA: Vaginal hormonal creams should be applied directly to the mucous membrane tissue of your labia or rubbed directly into your vaginal walls. Vaginal creams are very effective for localized absorption. If you are using Testosterone Cream, wash your hands after applying the cream to avoid inadvertent transfer of the testosterone to other skin areas where you may grow hair!
(9) Subcutaneous Injectable HCG, Testosterone, B12, and MIC with Carnitine: All of these medications require a subcutaneous injection either in the soft part of your abdomen or the buttocks. For men with testosterone injections, depending on your labs, we may instruct you to inject it into a specific site. Follow the instructions we give you as to whether your injection is everyday, twice a week, or three times a week.
Remembering to Take Your Supplements
This is the next question patients ask us, “How am I supposed to remember all of this?” It may take a little bit of time to get used to, but when many of our successful patients start feeling better, they even ask us what else they can take to improve their health. Obviously, if you do not remember your medications or supplements, you will notice no change in how you feel. That’s not why you came here!
So, here are a few of our favorite strategies for remembering your supplements!
1) EZY Dose Pill Pouches: These are Ziploc tiny sized disposable (or reusable!) plastic pouches that you can put your necessary pills in for all your dosing while you are at work or traveling. Here is a link to buy them on amazon. com:
You can easily label them with a Sharpie if you desire; for example, you may want to write an L for lunch or an A for afternoon. Fill your pouch with your necessary supplements, Ziploc and throw them in your purse or pocket! We recommend reusing them until they wear out to give the environment a break!
2) The Bedside Table: Too many thyroid patients forget their thyroid medication if it is not there right on their bedside table. Go to bed with a glass of water near by and your medication handy. This way you are sure not to forget. Melatonin sprays and sublingual drops may also be very conveniently taken as you roll into bed if they are at the bedside!
3) Kitchen Counter Organizer: Crate and Barrel has some very attractive, sophisticated storage baskets that actually will look good at the end of your kitchen counter or in your pantry and they are perfect to house your supplements! This makes taking them easy: you finish up dinner and as you walk out of the kitchen, your supplements are staring at you as you march by. I like these because they look pretty, but you don’t actually see the supplements until you are walking right by them. I am extremely appreciative of my storage container in my kitchen! Some of them come with covers if you desire. Or you can put them on a pantry shelf and pull the organizer out once a day and fill your EZY Pouches! As an example only, here is a bamboo and jute storage box from Crate and Barrel:
Many stores offer attractive looking containers for counter top or pantry. Shop for yours today!
4) The Refrigerator Front and Center! It is recommended that you store oil supplements like krill oil, vitamin E, D or CoQ10/ubiquinol in a cool environment so the oils do not get deranged. Putting your oil supplements on the top shelf of your fridge front and center makes taking them easy. As you open up the fridge after eating breakfast or dinner, there they are, staring at you! “You just ate that fatty meal, take me!” they will say to you as you put leftovers away.
5) The Bathroom Toothpaste Place: Wherever it is that you keep your toothpaste out of view is a great place to put your hormones and injectables! Most people brush their teeth morning and night. After brushing my teeth before bed, I am confronted with my hormones when I put the toothpaste away. In the morning, same thing happens…except this time it’s my B-12 winking at me! Maybe it will be testosterone injections for you. The “toothpaste place” is a great place to remember your daily hormones.
We are grateful that you put your trust in us as part of your health care team. Taking your supplements after your appointments is critical to your success! We hope this supplement review and storage ideas will help you take yours correctly. And be sure to let us know if you have any special secrets for remembering yours that we haven’t mentioned! If you would like to order any refills, please click HERE to log into your account with our practice. From here you can make a follow up appointment or call 415 383 9903.
Also, as a reminder, all supplements that our shipped out of our office have FREE SHIPPING. Log into the store and take a look at all the items that you can get without any shipping charges!
Cheers to your health!
Written by Marya Grosse, FNP
Nurse Practitioner at Morgan Camp, MD & Associates