Vitamin Pairing

Some things just seem to go together naturally. Peas and carrots. Meat and potatoes. Cookies and milk. Sweet and sour. Other things do not mix well. Oil and water. Mayonnaise and cinnamon. Pickles and vanilla pudding. Tuna and chocolate sauce. You get the idea.

It turns out that our body is designed for some substances to be paired, and others
to receive separate entrance tickets. Today we’re learning about vitamin pairing.

Vitamins That Go Together

Some vitamins, when paired together, enhance the way that each of them works.
They work better as a team than they do as solo players.
  • Vitamin D and calcium. Calcium is absorbed primarily in the small intestine and contributes to bone-strengthening. When there are just small amounts of calcium present, then vitamin D helps the calcium get absorbed. D also helps the absorption of phosphorus (important to keeping bones strong and healthy) and magnesium.
  • Sodium and potassium. About 90% of our sodium comes from salt. Our bodies need sodium and chloride, but in excess sodium can interfere with the natural ability of blood vessels to relax and expand. This results in blood pressure increase and an increased risk of a stroke or heart attack. Potassium helps out by encouraging the kidneys to excrete sodium.

  • Vitamin B12 and folate. B12 and folate go together like an old married couple. They are from different families (different sides of the animal-plant divide) and work closely together. B12 occurs naturally in meat, eggs and milk. Folate comes from leafy green vegetables, beans and legumes. Folate depends on B12 to be absorbed, stored and metabolized. Vitamin B12 and folate work together to support cell division and replication. They also metabolize homocysteine an amino acid) together. Deficiency in either one, or both, may cause macrocytic anemia, a form of anemia that results in enlarged red blood cells. B12 deficiencies cause neurological problems, ranging from mild tingling sensations to memory loss and anemia.
  • Zinc and copper. Copper and zinc, found in small amounts in many foods, compete for absorption sites in the small intestine. If there’s a lot of zinc around, copper tends to lose out and a copper deficiency may develop. If someone is taking AREDS pills to combat macular degeneration, 80 mg of zinc in the pills is enough to cause a copper deficiency. Denture cream can also lead to a copper deficiency.
  • Niacin and tryptophan. Niacin is a B vitamin which can lower “bad” LDL cholesterol and increase “good” HDL cholesterol in large doses. Tryptophan is one of nine amino acids that we need to build protein. Tryptophan is a supplier of niacin, courtesy of some rather complicated metabolism. One way to avoid niacin shortfalls is to eat foods that contain a lot of tryptophan, such as chicken and turkey.
A well-balanced diet should supply you with these nutrients in proper amounts, especially if taken with a multivitamin. The cautions arise when a person has some other medical condition (like high blood pressure) for which they are taking medication, or is a strict vegetarian.

Talk to y our doctor about your vitamin intake, as well as your medications during your annual checkup.
Vitamins That Don’t Play Well Together

You have probably been prescribed a medication that cautioned “take on an empty stomach” or “don’t take on an empty stomach.” Both statements can be correct because of the way nutrients are absorbed by the body and how they interact with each other.


Absorption decreases for these nutrients when combined with other substances
  • B12. Decreased absorption with vitamin C doses greater than 500mg
  • B6. Decreased absorption with zinc, oral contraceptives, coffee, and tobacco
  • Calcium. Decreased absorption of calcium with large doses of magnesium, zinc, and phosphate
  • Folic acid. Decreased absorption with zinc
  • Iron. Decreased absorption of iron with high doses of zinc or copper, coffee, tea, and soy
  • Magnesium. Decreased absorption with large doses of calcium and phosphate
  • Vitamin C. Decreased absorption with pectin, iron, zinc, and aspirin


Other supplements have negative interactions with other supplements, nutrients or medications
  • Calcium. Calcium can reduce the absorption of many medications, including osteoporosis drugs known as bisphosphonates; antibiotics in the tetracycline and quinolone families (like Cipro); and levothyroxine, which treats hypothyroidism.
  • Fiber supplements. These should be taken at a separate time from all other nutrients and herbs, as the nutrients can bind with the fiber and be excreted.
  • Fish oil. Taking fish oil with blood pressure-lowering drugs can increase the effects of these drugs and may lower blood pressure too much. Birth control pills may interfere with the triglyceride-lowering effects of fish oils.
  • Polyphenols. If you’re taking B1 for diabetic neuropathy or chemotherapy side effects, don’t eat polyphenols (grape seed, pine bark, green tea extract) because they decrease absorption of the B vitamin. Separate polyphenols and B1 by at least two hours.
  • Vitamin D. Vitamin D might decrease the effectiveness of the cholesterol-lowering drug atorvastatin (Lipitor). High doses of D combined with diuretic medication may result in too much calcium in the body, which can cause kidney problems.

As you can see, vitamins do different things and interact in different ways. Make sure you tell your physician of any vitamin supplements you are taking, so potential negative interactions can be avoided.


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