Supplement protocols

Most supplement value comes from how supplements are taken, not just which ones are taken. Timing, separation, food context, and which supplements are continued or stopped at key moments (surgery, pregnancy, medication changes) often matter more than dose differences within reasonable ranges. The 5 entries in this section cover practical protocol questions: building a personalised daily schedule, when to separate supplements that compete for absorption, how to handle fat-soluble vitamins together vs separately, what to stop pre-surgery, and what tier of supplementation actually delivers clinical benefit.

Most supplement decisions are made one product at a time, but the practical evidence shows that the most consequential decisions are about how supplements are sequenced, separated, and combined across a day and across life events. A correctly-dosed iron supplement loses much of its benefit if taken with the morning coffee or alongside calcium. Vitamin D absorption from a 1,000 IU capsule rises by roughly a third when taken with a fat-containing meal compared with no fat (Dawson-Hughes 2015, J Acad Nutr Diet 115(2):225-30). Levothyroxine separation from minerals by less than 4 hours can reduce TSH stability by enough to require dose adjustment.

The dominant practical separations in UK supplementation are between iron and calcium (4 hours), iron and coffee/tea/dairy polyphenols (1 hour minimum), levothyroxine and any mineral supplement (4 hours), and zinc above 25 mg/day with sustained copper exposure. Most other interactions can be managed by simply taking supplements with a meal that contains modest fat. Fat-soluble vitamins (A, D, E, K) share an absorption pathway, can be taken together with fat at typical supplemental doses, and only show meaningful intra-vitamin competition at very high single-vitamin doses.

Surgery is the other inflection point that most supplement users are not walked through. SPAQI 2021 (Cummings et al, Mayo Clin Proc 96(5):1342-1355) is the authoritative recent guidance and changed practice in two directions: fish oil and omega-3 should be continued through surgery, because prior bleeding concerns have not been borne out in prospective studies, while ginkgo biloba, high-dose vitamin E, and several herbal preparations should be stopped 1-2 weeks pre-op.

The recreational-vs-optimised framing matters too. The gap between a basic supplement protocol and a research-grounded one is smaller than supplement marketing implies. Tier 1 fundamentals (protein 1.6-2.2 g/kg/day, sleep 7-9 hours, energy availability matched to load, sodium-containing hydration) close most of the gap. Tier 2 (creatine 3-5 g/day, caffeine 3-6 mg/kg pre-key sessions) closes most of the rest. Tier 3 (omega-3 1-3 g/day, beta-alanine, tart cherry, deficiency correction for vitamin D, iron, B12) is refinement, not foundation.

This is a summary of published research, not personal health advice. Discuss any health or supplement decisions with a qualified healthcare professional, particularly during ongoing care, pregnancy, or with chronic conditions.