Supplement stacking is combining multiple supplements to achieve a specific health or lifestyle goal. It’s often promoted by wellness influencers on social media, but it’s not a medical term.
Some people stack supplements alongside their prescribed treatment to better manage a chronic health condition, including Crohn’s disease or UC. But they may also take multiple supplements for reasons that aren’t related to their gastrointestinal (GI) health — like improved athletic performance, better sleep, stress management, or stronger focus.
But no matter the reason you’re taking them, when you have IBD, supplement stacking can be problematic.
“The main problem with piling on multiple products at once is that it becomes hard to know which one is helping, which might be causing side effects, and which could interact with IBD medications,” says Vikas Taneja, MD, a gastroenterologist at Hackensack Meridian Health’s Jersey Shore University Medical Center in Neptune City, New Jersey. “The risk of a bad interaction rises with each additional product,” he says.
Even though they may be naturally derived, certain supplements can trigger or worsen GI symptoms that you may already be dealing with due to IBD, like cramping, bloating, gas, nausea, diarrhea, or constipation. Common culprits include iron, vitamin C, magnesium, fiber supplements, and those that contain sugar alcohols, to name a few.
Stacking supplements can also create confusion. “If someone starts four products in the same week and then feels worse, nobody can tell which one is responsible, or whether it is the supplements at all,” says Ekta Gupta, MBBS, a gastroenterologist with the University of Maryland Medical System in Baltimore.
It may only take one of these supplements to irritate an IBD gut. And the odds of adverse effects may go up if you’re taking multiple products, because you could unknowingly be getting super high doses of certain vitamins or herbs without realizing it.
“A multivitamin, an immunity blend, and a wellness powder can each contain the same vitamins and minerals, and those doses add up quickly,” Dr. Gupta says.
Some supplements may also affect the way that your IBD medications are absorbed, metabolized, or eliminated from the body. But because research on any specific supplement and medication combination is limited, it’s hard to say how your IBD treatment might be impacted. And taking several supplements at once only muddles the picture further, says Dr. Rao.
Supplement stacking could impact your liver health, too. Because the liver is responsible for processing the supplements and medications you take, excessive doses of some supplements could lead to liver injury. That’s especially concerning for people with IBD, who already face a higher risk for certain liver complications.