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Does it matter at what time I take my medications and supplements?

Strictly speaking, yes. Have you ever heard of chronotherapy? It’s a fancy word with a lot of meaning and studies behind it. Researchers at the University of Pennsylvania tried to understand the link between our circadian cycle or internal clock and the effect of medications on our bodies (1). While taking medication at any time is better than not taking it at all, the researchers found that there are certain times of the day that have a much greater impact on our health, because they are synchronized to various aspects of the circadian rhythm. Let's find out why.

What does the research show?

We know that, in addition to determining our adaptation to sunlight and preparing us for wakefulness or rest, the circadian cycle also interferes with hormonal processes, blood pressure, body temperature, and more. Researchers observed that an intake of medicine synchronized with the dynamics and natural rhythms of the organism can have better results and fewer side effects. (1)

The recommended times to take medications are:

  • In the morning for bones.

  • In the evening for muscles.

  • In the afternoon for the heart and lungs.

  • 4 to 6 hours before the time you usually experience the most intense discomfort when it comes to the joints, to best feel the medications effects. If you have intense pain during the night, take your non-steroidal anti-inflammatory drug(s) or NSAIDs, commonly used to reduce pain due to inflammation, at dinnertime (and always with food). The same when it comes to other arthritis medications like low-dose steroids, since taking them at night decreases the production of cytokines, helping avoid severe pain in the morning.

  • Before going to bed for cholesterol, the liver, and the kidneys. With statins, although the National Institutes of Health (NIH) – dependent on the CDC – point out that based on the type and dose, some can be taken at night while others at any time (2), the consensus is to take them at night. This is because the liver produces the greatest amount of cholesterol after midnight. (3)

  • Also before going to bed with respect to hypertension, because blood pressure is usually higher during the day and lower at night. The recommendation is that it is more effective to take the medicine before bedtime, especially for people who do not show a nocturnal drop. This decreases the risk of a heart attack, stroke, and kidney problems. (4)

What about supplements?

While most studies focus on chemical drugs, the circadian rhythm would also apply to supplements, such as natural statins, minerals, and antioxidants. They all work differently, so let’s look at a few:

  • Magnesium is recommended to be consumed during the day before 6pm because the production of an acid that is needed for the absorption of minerals in the digestive system decreases after that time. Take it with a meal to avoid diarrhea, and before 6pm even if the purpose of taking it is to help you sleep better.

  • Omega 3 fatty acids are recommended to be taken with a meal.

  • Glucosamine, on the other hand, is recommended to be taken at breakfast.

  • Zinc can be taken in the morning along with vitamins B12 and C

  • Other vitamins and multivitamins can be taken on an empty stomach, or with breakfast, for better absorption and assimilation.

  • Statins like monacolin K, found in red yeast rice, should be taken at night and, ideally, together with CoQ10. This is because statins can cause pain and muscle weakness after they decrease the CoQ10 enzyme in the body. It is typically taken in the morning to help provide energy but consider taking it before bed with your statin treatment.

ALWAYS consult with your doctor for your specific needs and the best way to use your medications or supplements. This helps ensure appropriate interaction and effectiveness. Ask, be informed, and trust your inner compass.

Let's be healthier together.

Your Santo Remedio Team

References

1.Ron C. Anafi, Lauren J. Francey, John B. Hogenesch, and Junhyong Kim. CYCLOPS reveals human transcriptional rhythms in health and disease. Research article. PNAS May 16, 2017 114 (20) 5312-5317; first published April 24, 2017; https://doi.org/10.1073/pnas.1619320114 Edited by Joseph S. Takahashi, Howard Hughes Medical Institute, University of Texas Southwestern Medical Center, Dallas, TX, and approved March 20, 2017 (received for review November 23, 2016)
https://www.pnas.org/content/114/20/5312.short
 
2.Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. How to take statins. Editorial team.Medline Plus, Medical Encyclopedia,
https://medlineplus.gov/ency/patientinstructions/000748.htm
 
3.Alan Wallace, David Chinn,Greg Rubin. Taking simvastatin in the morning compared with in the evening: randomised controlled trial. BMJ. 2003 Oct 4; 327(7418): 788. 
doi: 10.1136/bmj.327.7418.788. PMCID: PMC214096, PMID: 14525878
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC214096/
 
4.Ramón C Hermida Juan J CrespoManuel Domínguez-SardiñaAlfonso OteroAna MoyáMaría T RíosElvira SineiroMaría C CastiñeiraPedro A CallejasLorenzo PousaJosé L SalgadoCarmen DuránJuan J SánchezJosé R FernándezArtemio MojónDiana E AyalaHygia Project Investigators. Controlled Clinical Trial Eur Heart J. 2020 Dec 21;41(48):4565-4576. doi: 10.1093/eurheartj/ehz754. PMID: 31641769 DOI: 10.1093/eurheartj/ehz754 
https://pubmed.ncbi.nlm.nih.gov/31641769/

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